9 ms·

This study doesn't consider the very recent advent of weight loss medications that actually no-BS work, like semaglutide and tirzepatide. They're way too expens

This study doesn't consider the very recent advent of weight loss medications that actually no-BS work, like semaglutide and tirzepatide. They're way too expensive right now but that will absolutely change. I wouldn't be surprised if you could buy Flintstones vitamins with peptides included for your kids in 5 years. The health benefits of not being obese are simply extraordinary. And again I must stress, for those that haven't read up on these drugs, they REALLY work. Like statins for cholesterol. Nothing less than transformative. Honestly, I expect obesity to be nearly eradicated in wealthy countries in 10 years. It will be like malaria, a problem only in less privileged regions.

anovikov 3y ago
True. The field of weight loss was so full of bullshit for all the time since William Howard Taft invented it that people just can't believe this time is different - but that will change. Yes, it is an actual scientific fact that before semaglutide, only treatment for weight loss that could pass a clinical trial, was stomach surgery, plus a couple pills from 1980s that turned people into pathetic drug addicts and destroyed their health in several ways at once. So i understand why people are sceptical: WHOLE of this multibillion dollar industry that worldwide, employs millions of people, some of them intentional, criminal charlatans, as well as many more who are just delusional and believe their BS works, WHOLE of it was a scam. What's happening now is a true "creative destruction" as they are all going to lose their jobs, fast. Effects will be so profound i'm even afraid it can alone result in a recession and social strife: people lose their jobs, healthcare loses their incomes as people become healthier not being obese -> jobs are lost there too, plus those same people will now have a lot of energy and losing their incomes, will have enough vim to rebel. It can be a turbulent time when glp-1 agonists enter mass market!
- lytefm 3y ago
  > healthcare loses their incomes as people become healthier not being obese -> jobs are lost there too, plus those same people will now have a lot of energy and losing their incomes. In most developed countries, an effect like this would be desperately needed in order to prevent the health care systems from crumbling under the weight of few healthy, young people financing many old and sick people. Worst case would be Pharma companies making a bit less profit, stable or falling health insurance costs and health care professionals having enough time for their patients. Not exactly a disaster.
- operatingthetan 3y ago
  >couple pills from 1980s that turned people into pathetic drug addicts This tone seems... unnecessary.
- phil21 3y ago
  I agree with most of this take. Maybe not the whole healthcare crashing down thing, but the rest is spot-on after my personal experience and watching others. The effectiveness of this drug class cannot be overstated. In fact, I believe most are understating just how damn effective it is due to both personal/social shame, and not quite believing in something "too good to be true". The truth is if you have a modicum of ability to accomplish hard goals in life, but have had issues losing weight, you will find this drug to be too effective. I feel very confident in stating that for the selection of people the first statement is legitimately true for. It is absolutely nothing short of a magic pill for many people who fit this description. I can only describe the effects comparable to that of opioids or benzos. Literally hours later. For most folks the side effects are quite trivial. The lean muscle mass loss from what I can tell is entirely a red herring, and occurs in anyone not changing activity levels but losing 15-20% of their body weight due to severe calorie deficit over 3-6mo. No one I know who lost significant weight on these meds lost more lean mass than you would expect via napkin math. Increasing activity level 50% or so (not hard for most obese folks) counteracts much of this. Short of an unknown severe side effect for long-term use, or it definitely becoming ineffective over time, this will be a society changing drug on the level of antibiotics or painkillers. It does look like it's much like bariatric surgery - most will "bounce back" after discontinuing use. However, even if that is the case - just the ability for many to now put on 60lbs over the course of a decade and then take if off in 12mo is likely game changing in itself. I got interested in this drug class when my son was first diagnosed with type 1 diabetes - it just started coming up in news feeds ~5 years ago. I then became more interested as an investor the more I looked into it. If nothing else I firmly believe this will be the most profitable drug class ever invented.
flextheruler 3y ago
Those drugs are not approved for use in children and require subcutaneous injections. It would probably take more than 10 years just to push it through children approval and it would fail because they are not at all side effect free especially on a growing body. I think you’re way too optimistic about drug efficacy. The studies I’ve seen on those drugs showed they were less effective then gastric bypass surgery and I’ve seen people who get that surgery and then still struggle to keep weight off. We need more government propaganda against obesity. We were able to reduce smoking with propaganda we can do the same with obesity. Problem is the majority is overweight or obese already and they’re sensitive about it. There’s even pro obesity people.
- anovikov 3y ago
  [flagged]
  - nindalf 3y ago
    Are you suggesting that race and weight are equally immutable? Or that man-made consequences (incarceration) is the same as automatic health consequences (heart problems)?
    - ceejayoz 3y ago
      > Are you suggesting that race and weight are equally immutable? Statistically, they're pretty close. https://www.ncbi.nlm.nih.gov/books/NBK221839/ https://www.ncbi.nlm.nih.gov/books/NBK221839/ "The percentage of individuals who lose weight and successfully maintain the loss has been estimated to be as small as 1 to 3 percent." Every intervention outside of bariatric surgery and maybe these new drugs (we still need to see how those patients are doing in a decade) is virtually guaranteed to fail.
      - anovikov 3y ago
        That's exactly my point. Nearly as immutable as race.
      - 3y ago
bamboozled 3y ago
How will it work, do you just take the pills and then just go on doing whatever you like? I have people in my family who take semaglutide, and they actually had to get off it because it ran out and people with diabetes actually needed it. I believe they gained weight again but they also have side effects from it so wouldn't it just be better to lose the weight without the pills, as usual?
- anovikov 3y ago
  Well, that's the point: you just don't discontinue it. Supply issues will be nailed soon.
  - bamboozled 3y ago
    Maybe you could just fix the actual problem which is eating shit and exercising? I get that in very rare cases this is hard but it is possble.
    - anovikov 3y ago
      This is simply not how obesity works. Yes initially it's the person's own fault but when it happens, it is self-reinforcing and sticky and can't really be countered by any (previously) known lifestyle or medical interventions short of yes, stomach surgery or a couple kinds of pills approved in 1980s that turned out to be too harmful to be used and were later retracted.
      - hendersoon 3y ago
        Nobody knows why some people are obese and some aren't. It may start with willpower and then reinforce metabolism, sure. Or maybe you caught a virus when you were two years old that disposed you to be fat for life. Or for whatever reason, a specific flora of gut bacteria grew in your belly. We just don't know yet.
hn_throwaway_99 3y ago
Doesn't ozempic have some pretty bad side effects in a significant portion of people? Remember hearing a news blurb where Amy Schumer said she stopped taking it due to side effects.
- Auracle 3y ago
  The main one is diarrhea/nausea. I took a few doses as someone who isn’t fat for other reasons and it wasn’t great the first two days after injection, but not terrible either. Everyone is different, of course.
Llamamoe 3y ago
It causes weight loss, sure, but it doesn't seem like it's actually healthy weight loss - it entails disproportionate loss of lean mass and unfavorable metabolic changes. https://twitter.com/raphaels7/status/1662021374276255746 https://twitter.com/raphaels7/status/1662021374276255746 There are also anecdotes of appetite bouncing back up above the baseline after discontinuation. It's very much so not a magic pill.
- anovikov 3y ago
  These are not anecdotes, that's a fact and clinical trial doesn't attempt to hide that: you are stuck on those injections for the rest of your days or half the weight returns in about 3 months and nearly all of it, in a year.
- hendersoon 3y ago
  It is absolutely magical, and I can say based on extensive blood work and a MRI that the changes were extraordinarily beneficial for me, personally. "Unhealthy weight loss" is a stupid phrase. When you're morbidly obese and lose a third of your body weight, your life expectancy changes dramatically. You do need to take it for the rest of your life. But, so what? If you have high blood pressure or cholesterol, you need to take an ACE inhibitor or statin the rest of your life too. These are chronic conditions. Obesity is too.
  - Llamamoe 3y ago
    Skeletal muscle is a very, very important organ, and there's way more to health risks of obesity than having too much fat tissue alone. Take PPAR-gamma agonists(Pioglitazone, Rosiglitazone, CBD): They cause weight gain but are one of the most effective diabetes treatments. Why? Because they generate healthy, insulin-sensitive subcutaneous fat and increase the insulin sensitivity of other cells in your body. Saying it doesn't matter how you lose the weight doesn't matter is plain ridiculous. Losing 1kg of visceral fat would be amazing, but 1kg of muscle? That's fucking bad for you. What I see is yet another expensive(profitable) way to manage symptoms while discouraging healthcare as a field from looking for or treating root causes. Not that it's doing much of that as it is.

anovikov 3y ago

True. The field of weight loss was so full of bullshit for all the time since William Howard Taft invented it that people just can't believe this time is different - but that will change. Yes, it is an actual scientific fact that before semaglutide, only treatment for weight loss that could pass a clinical trial, was stomach surgery, plus a couple pills from 1980s that turned people into pathetic drug addicts and destroyed their health in several ways at once. So i understand why people are sceptical: WHOLE of this multibillion dollar industry that worldwide, employs millions of people, some of them intentional, criminal charlatans, as well as many more who are just delusional and believe their BS works, WHOLE of it was a scam. What's happening now is a true "creative destruction" as they are all going to lose their jobs, fast. Effects will be so profound i'm even afraid it can alone result in a recession and social strife: people lose their jobs, healthcare loses their incomes as people become healthier not being obese -> jobs are lost there too, plus those same people will now have a lot of energy and losing their incomes, will have enough vim to rebel. It can be a turbulent time when glp-1 agonists enter mass market!

lytefm 3y ago
> healthcare loses their incomes as people become healthier not being obese -> jobs are lost there too, plus those same people will now have a lot of energy and losing their incomes. In most developed countries, an effect like this would be desperately needed in order to prevent the health care systems from crumbling under the weight of few healthy, young people financing many old and sick people. Worst case would be Pharma companies making a bit less profit, stable or falling health insurance costs and health care professionals having enough time for their patients. Not exactly a disaster.
operatingthetan 3y ago
>couple pills from 1980s that turned people into pathetic drug addicts This tone seems... unnecessary.
phil21 3y ago
I agree with most of this take. Maybe not the whole healthcare crashing down thing, but the rest is spot-on after my personal experience and watching others. The effectiveness of this drug class cannot be overstated. In fact, I believe most are understating just how damn effective it is due to both personal/social shame, and not quite believing in something "too good to be true". The truth is if you have a modicum of ability to accomplish hard goals in life, but have had issues losing weight, you will find this drug to be too effective. I feel very confident in stating that for the selection of people the first statement is legitimately true for. It is absolutely nothing short of a magic pill for many people who fit this description. I can only describe the effects comparable to that of opioids or benzos. Literally hours later. For most folks the side effects are quite trivial. The lean muscle mass loss from what I can tell is entirely a red herring, and occurs in anyone not changing activity levels but losing 15-20% of their body weight due to severe calorie deficit over 3-6mo. No one I know who lost significant weight on these meds lost more lean mass than you would expect via napkin math. Increasing activity level 50% or so (not hard for most obese folks) counteracts much of this. Short of an unknown severe side effect for long-term use, or it definitely becoming ineffective over time, this will be a society changing drug on the level of antibiotics or painkillers. It does look like it's much like bariatric surgery - most will "bounce back" after discontinuing use. However, even if that is the case - just the ability for many to now put on 60lbs over the course of a decade and then take if off in 12mo is likely game changing in itself. I got interested in this drug class when my son was first diagnosed with type 1 diabetes - it just started coming up in news feeds ~5 years ago. I then became more interested as an investor the more I looked into it. If nothing else I firmly believe this will be the most profitable drug class ever invented.

flextheruler 3y ago

Those drugs are not approved for use in children and require subcutaneous injections. It would probably take more than 10 years just to push it through children approval and it would fail because they are not at all side effect free especially on a growing body. I think you’re way too optimistic about drug efficacy. The studies I’ve seen on those drugs showed they were less effective then gastric bypass surgery and I’ve seen people who get that surgery and then still struggle to keep weight off. We need more government propaganda against obesity. We were able to reduce smoking with propaganda we can do the same with obesity. Problem is the majority is overweight or obese already and they’re sensitive about it. There’s even pro obesity people.

anovikov 3y ago
[flagged]
- nindalf 3y ago
  Are you suggesting that race and weight are equally immutable? Or that man-made consequences (incarceration) is the same as automatic health consequences (heart problems)?
  - ceejayoz 3y ago
    > Are you suggesting that race and weight are equally immutable? Statistically, they're pretty close. https://www.ncbi.nlm.nih.gov/books/NBK221839/ https://www.ncbi.nlm.nih.gov/books/NBK221839/ "The percentage of individuals who lose weight and successfully maintain the loss has been estimated to be as small as 1 to 3 percent." Every intervention outside of bariatric surgery and maybe these new drugs (we still need to see how those patients are doing in a decade) is virtually guaranteed to fail.
    - anovikov 3y ago
      That's exactly my point. Nearly as immutable as race.
    - 3y ago

bamboozled 3y ago

How will it work, do you just take the pills and then just go on doing whatever you like? I have people in my family who take semaglutide, and they actually had to get off it because it ran out and people with diabetes actually needed it. I believe they gained weight again but they also have side effects from it so wouldn't it just be better to lose the weight without the pills, as usual?

anovikov 3y ago
Well, that's the point: you just don't discontinue it. Supply issues will be nailed soon.
- bamboozled 3y ago
  Maybe you could just fix the actual problem which is eating shit and exercising? I get that in very rare cases this is hard but it is possble.
  - anovikov 3y ago
    This is simply not how obesity works. Yes initially it's the person's own fault but when it happens, it is self-reinforcing and sticky and can't really be countered by any (previously) known lifestyle or medical interventions short of yes, stomach surgery or a couple kinds of pills approved in 1980s that turned out to be too harmful to be used and were later retracted.
    - hendersoon 3y ago
      Nobody knows why some people are obese and some aren't. It may start with willpower and then reinforce metabolism, sure. Or maybe you caught a virus when you were two years old that disposed you to be fat for life. Or for whatever reason, a specific flora of gut bacteria grew in your belly. We just don't know yet.

hn_throwaway_99 3y ago

Doesn't ozempic have some pretty bad side effects in a significant portion of people? Remember hearing a news blurb where Amy Schumer said she stopped taking it due to side effects.

Auracle 3y ago
The main one is diarrhea/nausea. I took a few doses as someone who isn’t fat for other reasons and it wasn’t great the first two days after injection, but not terrible either. Everyone is different, of course.

Llamamoe 3y ago

It causes weight loss, sure, but it doesn't seem like it's actually healthy weight loss - it entails disproportionate loss of lean mass and unfavorable metabolic changes. https://twitter.com/raphaels7/status/1662021374276255746 https://twitter.com/raphaels7/status/1662021374276255746 There are also anecdotes of appetite bouncing back up above the baseline after discontinuation. It's very much so not a magic pill.

anovikov 3y ago
These are not anecdotes, that's a fact and clinical trial doesn't attempt to hide that: you are stuck on those injections for the rest of your days or half the weight returns in about 3 months and nearly all of it, in a year.
hendersoon 3y ago
It is absolutely magical, and I can say based on extensive blood work and a MRI that the changes were extraordinarily beneficial for me, personally. "Unhealthy weight loss" is a stupid phrase. When you're morbidly obese and lose a third of your body weight, your life expectancy changes dramatically. You do need to take it for the rest of your life. But, so what? If you have high blood pressure or cholesterol, you need to take an ACE inhibitor or statin the rest of your life too. These are chronic conditions. Obesity is too.
- Llamamoe 3y ago
  Skeletal muscle is a very, very important organ, and there's way more to health risks of obesity than having too much fat tissue alone. Take PPAR-gamma agonists(Pioglitazone, Rosiglitazone, CBD): They cause weight gain but are one of the most effective diabetes treatments. Why? Because they generate healthy, insulin-sensitive subcutaneous fat and increase the insulin sensitivity of other cells in your body. Saying it doesn't matter how you lose the weight doesn't matter is plain ridiculous. Losing 1kg of visceral fat would be amazing, but 1kg of muscle? That's fucking bad for you. What I see is yet another expensive(profitable) way to manage symptoms while discouraging healthcare as a field from looking for or treating root causes. Not that it's doing much of that as it is.