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I don't think the medical bar for obesity is as high as you might think it is. A lot of people who you and I might regard as simply overweight if we saw them on

I don't think the medical bar for obesity is as high as you might think it is. A lot of people who you and I might regard as simply overweight if we saw them on the street are, in fact, obese according to the BMI criteria. Moreover these drugs are not going to get people an "optimal beach body"; they might at best help to get weight in the range where work can start on that. In fact for people at normal weight looking to improve their appearance these drugs would probably be counterproductive, for the reasons mentioned in the study. When the goal is to optimize for aesthetics a low body fat percentage is key. That requires a solid amount of muscle mass, and a drug regimen that catabolizes muscle is going to be counterproductive.

AdamH12113 3y ago
That is largely a sensible comment, but unfortunately none of what you're saying affects the actual demand for fad weight loss treatments. Look at the "alternative medicine" industry if you want to see how much demand there can be for products that literally have no effect on the body whatsoever. And there is certainly a very large demand for minor, purely cosmetic weight loss.
- aantix 3y ago
  Over 2/3's of the American population falls in the overweight/obese category. https://www.healthline.com/health/obesity-facts#statistics https://www.healthline.com/health/obesity-facts#statistics It's probable that the demand is overwhelmingly coming from that large cohort. Which wouldn't be "cosmetic" weight loss.
- projectazorian 3y ago
  If you have a normal BMI, no diabetes, and want Ozempic for aesthetic reasons you first have to find a willing prescriber - not easy although I'm sure there are shady online services out there. Then you have to pay for the drug out of pocket, that's a 5 figure sum annually. You can get a nutritionist, personal trainer, and meal prep for less in a lot of the country. Oh yeah and it also requires injections, a lot of people hate needles. As another poster pointed out, 2/3 of the country are overweight or obese. There's plenty of medically qualified patients around, no need to assume some epidemic of already-thin people taking Ozempic to try to get six-pack abs.
  - AdamH12113 3y ago
    > If you have a normal BMI, no diabetes, and want Ozempic for aesthetic reasons you first have to find a willing prescriber - not easy although I'm sure there are shady online services out there. You are wildly underestimating how many doctors are willing to prescribe medicines without a strong need. Have you heard of the opiod epidemic? > Then you have to pay for the drug out of pocket, that's a 5 figure sum annually. Unless you can convince your insurance company to pay for it -- say, with the help of a willing doctor. And even if you can't, there are a surprising number of people who will pay that kind of money for weight loss. > You can get a nutritionist, personal trainer, and meal prep for less in a lot of the country. You've been able to get those things for many years. They are not the same as an easy weight loss drug. > As another poster pointed out, 2/3 of the country are overweight or obese. The medical definition of "overweight" is quite broad, and clinically it's based on BMI, an extremely flawed measurement at an individual level. There are certainly plenty of people with a medical need for a weight loss drug! (I am one of them!) But there are also plenty of people who think they are ugly because they are 10-15 pounds over their "ideal" weight and have one little roll of belly fat. There is a strong tendency to medicalize this kind of problem. This is a pretty big part of American culture. Have you not encountered this before? What I'm arguing here is that when a drug is in limited supply the people with an immediate need for it (diabetics) ought to take precedence over people who are worried about potential future health problems somewhere down the line (younger, mildly obese people), and that people who are mainly worried about cosmetics ought to wait for wider availability. I don't think that's controversial?
    - projectazorian 3y ago
      > You are wildly underestimating how many doctors are willing to prescribe medicines without a strong need. Have you heard of the opiod epidemic? Opioids don't cost $10k+ a year out of pocket. > Unless you can convince your insurance company to pay for it -- say, with the help of a willing doctor. Even with "good insurance", it's quite difficult to get Ozempic covered for weight loss, even if you are obese - let alone normal weight or just overweight. Not speculating here, I know people who meet the criteria and have tried. > You've been able to get those things for many years. They are not the same as an easy weight loss drug Yes, and that's one of the many reasons why obesity rates are lower among the wealthy. I don't think that paying over $1k a month and getting weekly injections is especially "easy." > What I'm arguing here is that when a drug is in limited supply the people with an immediate need for it (diabetics) ought to take precedence over people who are worried about potential future health problems somewhere down the line (younger, mildly obese people), and that people who are mainly worried about cosmetics ought to wait for wider availability. I don't think that's controversial? What evidence do you have that this is not occurring? I see a lot of evidence that insurance companies are aggressively rationing Ozempic for non-diabetic patients - both in the news media and in my personal life. Many of those paying out of pocket for semaglutide are getting it from compounding pharmacies because they can't get access to the brand name drug, either due to cost or supply constraints.

AdamH12113 3y ago

That is largely a sensible comment, but unfortunately none of what you're saying affects the actual demand for fad weight loss treatments. Look at the "alternative medicine" industry if you want to see how much demand there can be for products that literally have no effect on the body whatsoever. And there is certainly a very large demand for minor, purely cosmetic weight loss.

aantix 3y ago
Over 2/3's of the American population falls in the overweight/obese category. https://www.healthline.com/health/obesity-facts#statistics https://www.healthline.com/health/obesity-facts#statistics It's probable that the demand is overwhelmingly coming from that large cohort. Which wouldn't be "cosmetic" weight loss.
projectazorian 3y ago
If you have a normal BMI, no diabetes, and want Ozempic for aesthetic reasons you first have to find a willing prescriber - not easy although I'm sure there are shady online services out there. Then you have to pay for the drug out of pocket, that's a 5 figure sum annually. You can get a nutritionist, personal trainer, and meal prep for less in a lot of the country. Oh yeah and it also requires injections, a lot of people hate needles. As another poster pointed out, 2/3 of the country are overweight or obese. There's plenty of medically qualified patients around, no need to assume some epidemic of already-thin people taking Ozempic to try to get six-pack abs.
- AdamH12113 3y ago
  > If you have a normal BMI, no diabetes, and want Ozempic for aesthetic reasons you first have to find a willing prescriber - not easy although I'm sure there are shady online services out there. You are wildly underestimating how many doctors are willing to prescribe medicines without a strong need. Have you heard of the opiod epidemic? > Then you have to pay for the drug out of pocket, that's a 5 figure sum annually. Unless you can convince your insurance company to pay for it -- say, with the help of a willing doctor. And even if you can't, there are a surprising number of people who will pay that kind of money for weight loss. > You can get a nutritionist, personal trainer, and meal prep for less in a lot of the country. You've been able to get those things for many years. They are not the same as an easy weight loss drug. > As another poster pointed out, 2/3 of the country are overweight or obese. The medical definition of "overweight" is quite broad, and clinically it's based on BMI, an extremely flawed measurement at an individual level. There are certainly plenty of people with a medical need for a weight loss drug! (I am one of them!) But there are also plenty of people who think they are ugly because they are 10-15 pounds over their "ideal" weight and have one little roll of belly fat. There is a strong tendency to medicalize this kind of problem. This is a pretty big part of American culture. Have you not encountered this before? What I'm arguing here is that when a drug is in limited supply the people with an immediate need for it (diabetics) ought to take precedence over people who are worried about potential future health problems somewhere down the line (younger, mildly obese people), and that people who are mainly worried about cosmetics ought to wait for wider availability. I don't think that's controversial?
  - projectazorian 3y ago
    > You are wildly underestimating how many doctors are willing to prescribe medicines without a strong need. Have you heard of the opiod epidemic? Opioids don't cost $10k+ a year out of pocket. > Unless you can convince your insurance company to pay for it -- say, with the help of a willing doctor. Even with "good insurance", it's quite difficult to get Ozempic covered for weight loss, even if you are obese - let alone normal weight or just overweight. Not speculating here, I know people who meet the criteria and have tried. > You've been able to get those things for many years. They are not the same as an easy weight loss drug Yes, and that's one of the many reasons why obesity rates are lower among the wealthy. I don't think that paying over $1k a month and getting weekly injections is especially "easy." > What I'm arguing here is that when a drug is in limited supply the people with an immediate need for it (diabetics) ought to take precedence over people who are worried about potential future health problems somewhere down the line (younger, mildly obese people), and that people who are mainly worried about cosmetics ought to wait for wider availability. I don't think that's controversial? What evidence do you have that this is not occurring? I see a lot of evidence that insurance companies are aggressively rationing Ozempic for non-diabetic patients - both in the news media and in my personal life. Many of those paying out of pocket for semaglutide are getting it from compounding pharmacies because they can't get access to the brand name drug, either due to cost or supply constraints.