14 ms·

FDA Approves Lilly's Zepbound (Tirzepatide) for Chronic Weight Management

50 points by openair18 3y ago

jfengel 3y ago
I see that it's another GLP-1 agonist, like Ozempic/Wegovy. Are there any particular advantages, or is it just a me-too drug?
- nexus7556 3y ago
  This is also known as Mounjaro when prescribed for diabetes. Its also a GIP agonist in addition to GLP-1.
- xnx 3y ago
  "Semaglutide simulates a single hormone in the body, while tirzepatide [active ingredient in Zepbound] mimics two, which experts say may be why it’s often more effective at triggering weight loss." From: https://www.nytimes.com/2023/11/08/well/zepbound-mounjaro-weight-loss.html https://www.nytimes.com/2023/11/08/well/zepbound-mounjaro-we...
- DrBenCarson 3y ago
  It is a double agonist, the second being GIP. Retatrutide, still in trials, is an even more efficacious triple agonist,
- aantix 3y ago
  It's a GIP agonist as well. The weight loss number surpass that of semaglutide alone. https://www.nejm.org/doi/full/10.1056/nejmoa2107519 https://www.nejm.org/doi/full/10.1056/nejmoa2107519
DrBenCarson 3y ago
Can't wait for the day semaglutide and tirzepatide are available as generics
- jfengel 3y ago
  As I understand it, as the patents begin to expire, they suddenly discover that the old formulation has serious side effects that make it too dangerous to keep making. And oh, by the way, we also happen to be introducing a very very very slightly different molecule that qualifies for a brand new patent. No side effects this time, we promise, and see you in 20 years.
  - lotsofpulp 3y ago
    > they suddenly discover that the old formulation has serious side effects that make it too dangerous to keep making. Who is they? > And oh, by the way, we also happen to be introducing a very very very slightly different molecule that qualifies for a brand new patent Presuming “we” is the companies that own the current patent, what does this have to do with the older molecule’s patent that is expiring?
    - chimeracoder 3y ago
      > Presuming “we” is the companies that own the current patent, what does this have to do with the older molecule’s patent that is expiring? "Evergreening" is a very common practice among pharmaceutical companies. In its purest form, it looks like this: * About 10 years after a drug has been approved, they will seek approval for a replacement version which is very similar, but different enough to qualify for a different patent. * Then they have a few years to get everyone onto the new drug, claiming that the new one is safer, or more effective, or (in some cases) that the original one is horribly dangerous or has abuse potential which is somehow solved with the new drug[0]. * Around 15 years after the first drug was first approved, once enough people are on the second drug, they'll withdraw the first one from the market entirely, forcing everyone still using the first drug to switch to the second. * Then, when the patent for the first drug expires (year 17), there's "no market" for it, because nobody is currently prescribed that drug, so no manufacturers will bother producing any generic versions of it. Rinse and repeat. [0] Heroin™ was one of the first examples of this: it was developed and marketed by Bayer as a "less addictive" version of morphine.
clumsysmurf 3y ago
This appears to be a GIP and GLP-1 agonist. Recently I read there might be some severe side effects with this class of med in diabetic and non-diabetic patients: https://medicalxpress.com/news/2023-10-links-popular-weight-loss-drugs-stomach.html https://medicalxpress.com/news/2023-10-links-popular-weight-... But its still pretty exciting.
- aantix 3y ago
  N=1 I've lost 60+lbs with Mounjaro and never experienced any of the side effects listed. I lost cravings for alcohol, sugars. I was tired once jumping from 2.5->5, but we also have four kids, so.. These are my most recent blood work numbers. My A1C was 4.7 https://imgur.com/a/Wwwbhon https://imgur.com/a/Wwwbhon
  - nexus7556 3y ago
    +1 I'm at 55 lbs lost since July 1. No side effects at all.
    - nwienert 3y ago
      Lost 35 (I didn't start too high so this was all I needed), and actually side effects almost entirely positive. Stopped all smoking, better quality sleep, less immune system issues.
- dsr_ 3y ago
  AIUI, filtered through my doctor: the gastroparesis occurs when you stop eating. You stop eating because you're no longer hungry. Remember to eat, and you don't get gastroparesis.
  - derefr 3y ago
    You don't have to eat anything particularly "hearty" / filling, though. Popcorn would do. Or cucumber. Just a bit of mass to keep things going.
- 3y ago
xnx 3y ago
This is definitely a historic moment in US public health. Today we look at photos and marvel at how prevalent smoking was 50 years ago (in restaurants, in hospitals, in airplanes, etc.). 40 years from now people will look at photos from the last decade and be in disbelief at how widespread obesity was.
- nathanyz 3y ago
  This cannot be understated. Obesity is being changed from a willpower problem to a chronic disease that is treatable. The follow-on effects of this are huge.
  - candiddevmike 3y ago
    What are the side effects? There's never a free lunch with biological systems...
    - belltaco 3y ago
      Free lunches are part of the problem that led us here in the first place.
      - qwertox 3y ago
        It was sugar.
        Obscurity4340 3y ago
        More glucose == more brain power /s
    - nathanyz 3y ago
      It slows down gastric emptying as one of the primary ways it helps people feel full longer, so there a slew of possible GI side effects (nausea, constipation, diarrhea). In general they are manageable due to being able to adjust dosages to where patients still lose significant weight and minimize the impact of those side effects.
belltaco 3y ago
This is the same chemical compound that's Mounjaro that was approved for T2D, relabeled for weight loss.
ng12 3y ago
> Research now shows that the body may respond to a calorie-deficit diet by increasing hunger and reducing feelings of fullness Dieting makes you hungry, truly revolutionary research.
- n8cpdx 3y ago
  It seems obvious but the “just eat less” crowd needs to hear it. Ever try working on a tricky coding project while starving? Take a math test when all you can think about is finding something, anything, to eat? Losing significant amounts of weight the natural way isn’t so much a test of willpower as a test of how well you can function under a constant sense of hunger (or, how good you are at tricking your way out of it). Bonus tip: when you are so hungry you can’t sleep and don’t want to drink a bunch of water right before bed, sugar-free jell-o has only 10 calories and can silence the feeling long enough to fall asleep.
  - dearsaturn 3y ago
    To fight off hunger while dieting, you eat lower calorie density, fiber-rich vegetables and unsaturated fats. Potatoes, avocados, legumes, there are a lot of options. They just don't fulfill the same psychological need that less healthy food does.
    - bb88 3y ago
      If it's a psychological issue, then couldn't it also be a chemical imbalance?
  - poopchute 3y ago
    There are quite a few veggies that are low calorie, filling, and are tasty enough to snack on without dip. The ones I eat when I just want to feel full without a bunch of calories are carrots (45 cal/100g), cucumbers (14 cal/100g), sugar snap peas ( 42 cal/100g), and yellow bell pepper (27 cal/100g).
    - chownie 3y ago
belltaco 3y ago
Lilly's also working on retatrutide, that has 3 targets in addition to the two that this drug targets. https://www.reuters.com/business/healthcare-pharmaceuticals/lilly-experimental-triple-g-obesity-drug-leads-242-weight-loss-trial-nejm-2023-06-26/ https://www.reuters.com/business/healthcare-pharmaceuticals/...
- Obscurity4340 3y ago
  What is the gold standard currently? Like phentermine or diethylpropion? Or is it actually Ozempic?
  - aantix 3y ago
    Of FDA approved medications for weight loss, tirzepatide would be the current gold standard. https://www.nejm.org/doi/full/10.1056/nejmoa2107519 https://www.nejm.org/doi/full/10.1056/nejmoa2107519 I think retatrutide might be the current leader for weight loss from clinical trials. If I remember correctly, you lost the same amount of weight on retatrutide vs tirzepatide, but over a shorter time span.
    - Obscurity4340 3y ago
      You're saying this NEW medication is already currently the gold standard? What was it prior?
      - quux 3y ago
        The active ingredient, tirzepatide, isn't what's new here. It was patented in 2016 and has been on the market for treating type 2 diabetes since 2021. What's new is that tirzepatide is now FDA approved for treatment of obesity, which will make it possible for insurance to cover it without a type 2 diabetes diagnosis.
        bb88 3y ago
        It should also be noted that during those original studies significant weight loss was observed, which is why doctor's were prescribing tirzepatide off-label. Also just like Ozempic/Wegovy, Mounjaro is still indicated for type 2 diabetes. Zepbound will be the weight loss drug.
gen220 3y ago
Has anybody here taken this category of drug, lost significant weight, and kept it off after dropping the drug? I've seen great success stories, but I'm kind of nervous of the long-term effects of taking a drug like this for your whole lifetime (i.e. what's implied by the "chronic" in "chronic weight management"). It seems like it might be a great off-ramp from obesity to a body weight where the risk of injury in exercise is greatly diminished and the degree of enjoyment in exercise goes way up. If you could go off the drug and then use exercise to maintain the caloric deficit (instead of under-eating, as the drug induces you to do), that sounds like it would be kind of miraculous.
- xnx 3y ago
  > exercise to maintain the caloric deficit Exercise is great for dozens of reasons, but weight loss is probably at the bottom of the list (if it's on the list at all). The asymmetry between the ease of consuming calories and the effort of exhaling calories during exercise is too great.
- nexus7556 3y ago
  There are lots of success stories on the Mounjaro subreddit.
- petesergeant 3y ago
  > a great off-ramp from obesity I, and many many other overweight people, have successfully lost a lot of weight in the past. There's no off-ramp when you look at the data, you always gain it back. Mounjaro is no different from any other way of losing weight in that respect, except it doesn't rely on willpower, so you can keep taking it, and keep the weight off.
molsongolden 3y ago
With these drugs, is there any mechanism at work beyond "patients have a lower appetite and eat less food"? I've only read a few papers and articles but what I've seen is that all of the hormone triggering leads to 1) decreased appetite 2) slowed gastric emptying which also decreases appetite. Patients lose weight due to eating less but usually regain the weight when stopping the drug since they then go back to their normal level of eating. --- Are these drugs fixing/replacing a system failure where people don't feel satiated normally? Can the same effect be replicated by eating a higher fiber and higher fat diet with more whole foods to feel full longer and slow gastric emptying?
- aantix 3y ago
  - Tirzepatide may activate brown fat, which might be a metabolic advantage. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9396640/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9396640/ - Another study - there was a 16% weight loss for those that received semaglutide/diet/exercise/counseling versus a loss of 5% for placebo those that received diet/exercise/counseling without semaglutide. But they didn't control for calories, so it may just be proving that dietary adherence with the medication is better than without. https://pubmed.ncbi.nlm.nih.gov/33625476/ https://pubmed.ncbi.nlm.nih.gov/33625476/ https://classic.clinicaltrials.gov/ct2/show/NCT03611582 https://classic.clinicaltrials.gov/ct2/show/NCT03611582
- quux 3y ago
  GLP-1 affects a lot of systems beyond just appetite and gastric emptying. For instance it acts in the pancreas to promote insulin secretion. GLP-1 receptors are also found in a lot of other tissues, including heart, tongue, adipose, muscles, bones, kidneys, liver and lungs. The effects of GLP-1 in these tissues are an area of intense research.
- Shekelphile 3y ago
  > Are these drugs fixing/replacing a system failure where people don't feel satiated normally? > Can the same effect be replicated by eating a higher fiber and higher fat diet with more whole foods to feel full longer and slow gastric emptying? I think it simply takes a long time for your body to adjust back to where it should be after a period of extended binging and these drugs make it happen much faster. The only time I consistently lost weight in my life was when I lived in a food desert and had no car and not much money, so I was forced to only buy the cheapest vegetables and meats (usually chicken) and make what I could out of that and make it last for the week. Even then it took more than 6 months before I felt normal eating that way. Of course, it's extremely easy to fall off the wagon when your body works this way too. Even a day can wipe out weeks of gains and you can always 'relapse' even after months of doing the right thing, and end up stagnating or completely reversing any progress you've made. In a way it seems that food is the most addictive drug of all. You can easily quit alcohol, cigarettes, hard drugs with a couple weeks of willpower (and I have multiple times). You can't ever stop eating food if you want to be around to experience life.
cowboyscott 3y ago
While personally I'd like to see a reduction in obesity rates by focusing on causes (e.g., "sugar taxes" and the like), it's hard to deny the positive impact of these drugs. Obesity is such a destructive epidemic in my country (US) that I see an argument for providing these drugs either for free or at substantially reduced costs via government subsidy. Despite vaccine skepticism, free COVID vaccinations might be a model worth following. If the public sector doesn't help, I imagine that insurance companies are doing what they can to put downward price pressure on these drugs. If I can pay x now to avoid 10x in payout costs to medical providers for obesity complications (while keeping rates the same), I'm going to take that trade (subject to actuarial data and discount rates).
- nathanyz 3y ago
  While I agree on your points of the benefits, the one place who is not advocating for them is insurance. People switch insurance frequently, so there is no benefit to help this year what causes a significant disease to their customer in 10 years as that benefit will likely acrue to some other insurance company. The insurance companies basically think 1 year at a time for drug coverage and only care about keeping you alive for that 1 year at the cheapest possible price. Long term care and planning is something medicare/medicaid may better be able to utilize in their economic model to justify coverage.

50 points by openair18 3y ago

I see that it's another GLP-1 agonist, like Ozempic/Wegovy. Are there any particular advantages, or is it just a me-too drug?

nexus7556 3y ago
This is also known as Mounjaro when prescribed for diabetes. Its also a GIP agonist in addition to GLP-1.
xnx 3y ago
"Semaglutide simulates a single hormone in the body, while tirzepatide [active ingredient in Zepbound] mimics two, which experts say may be why it’s often more effective at triggering weight loss." From: https://www.nytimes.com/2023/11/08/well/zepbound-mounjaro-weight-loss.html https://www.nytimes.com/2023/11/08/well/zepbound-mounjaro-we...
DrBenCarson 3y ago
It is a double agonist, the second being GIP. Retatrutide, still in trials, is an even more efficacious triple agonist,
aantix 3y ago
It's a GIP agonist as well. The weight loss number surpass that of semaglutide alone. https://www.nejm.org/doi/full/10.1056/nejmoa2107519 https://www.nejm.org/doi/full/10.1056/nejmoa2107519

DrBenCarson 3y ago

Can't wait for the day semaglutide and tirzepatide are available as generics

jfengel 3y ago
As I understand it, as the patents begin to expire, they suddenly discover that the old formulation has serious side effects that make it too dangerous to keep making. And oh, by the way, we also happen to be introducing a very very very slightly different molecule that qualifies for a brand new patent. No side effects this time, we promise, and see you in 20 years.
- lotsofpulp 3y ago
  > they suddenly discover that the old formulation has serious side effects that make it too dangerous to keep making. Who is they? > And oh, by the way, we also happen to be introducing a very very very slightly different molecule that qualifies for a brand new patent Presuming “we” is the companies that own the current patent, what does this have to do with the older molecule’s patent that is expiring?
  - chimeracoder 3y ago
    > Presuming “we” is the companies that own the current patent, what does this have to do with the older molecule’s patent that is expiring? "Evergreening" is a very common practice among pharmaceutical companies. In its purest form, it looks like this: * About 10 years after a drug has been approved, they will seek approval for a replacement version which is very similar, but different enough to qualify for a different patent. * Then they have a few years to get everyone onto the new drug, claiming that the new one is safer, or more effective, or (in some cases) that the original one is horribly dangerous or has abuse potential which is somehow solved with the new drug[0]. * Around 15 years after the first drug was first approved, once enough people are on the second drug, they'll withdraw the first one from the market entirely, forcing everyone still using the first drug to switch to the second. * Then, when the patent for the first drug expires (year 17), there's "no market" for it, because nobody is currently prescribed that drug, so no manufacturers will bother producing any generic versions of it. Rinse and repeat. [0] Heroin™ was one of the first examples of this: it was developed and marketed by Bayer as a "less addictive" version of morphine.

clumsysmurf 3y ago

This appears to be a GIP and GLP-1 agonist. Recently I read there might be some severe side effects with this class of med in diabetic and non-diabetic patients: https://medicalxpress.com/news/2023-10-links-popular-weight-loss-drugs-stomach.html https://medicalxpress.com/news/2023-10-links-popular-weight-... But its still pretty exciting.

aantix 3y ago
N=1 I've lost 60+lbs with Mounjaro and never experienced any of the side effects listed. I lost cravings for alcohol, sugars. I was tired once jumping from 2.5->5, but we also have four kids, so.. These are my most recent blood work numbers. My A1C was 4.7 https://imgur.com/a/Wwwbhon https://imgur.com/a/Wwwbhon
- nexus7556 3y ago
  +1 I'm at 55 lbs lost since July 1. No side effects at all.
  - nwienert 3y ago
    Lost 35 (I didn't start too high so this was all I needed), and actually side effects almost entirely positive. Stopped all smoking, better quality sleep, less immune system issues.
dsr_ 3y ago
AIUI, filtered through my doctor: the gastroparesis occurs when you stop eating. You stop eating because you're no longer hungry. Remember to eat, and you don't get gastroparesis.
- derefr 3y ago
  You don't have to eat anything particularly "hearty" / filling, though. Popcorn would do. Or cucumber. Just a bit of mass to keep things going.
3y ago

xnx 3y ago

This is definitely a historic moment in US public health. Today we look at photos and marvel at how prevalent smoking was 50 years ago (in restaurants, in hospitals, in airplanes, etc.). 40 years from now people will look at photos from the last decade and be in disbelief at how widespread obesity was.

nathanyz 3y ago
This cannot be understated. Obesity is being changed from a willpower problem to a chronic disease that is treatable. The follow-on effects of this are huge.
- candiddevmike 3y ago
  What are the side effects? There's never a free lunch with biological systems...
  - belltaco 3y ago
    Free lunches are part of the problem that led us here in the first place.
    - qwertox 3y ago
      It was sugar.
      - Obscurity4340 3y ago
        More glucose == more brain power /s
  - nathanyz 3y ago
    It slows down gastric emptying as one of the primary ways it helps people feel full longer, so there a slew of possible GI side effects (nausea, constipation, diarrhea). In general they are manageable due to being able to adjust dosages to where patients still lose significant weight and minimize the impact of those side effects.

belltaco 3y ago

This is the same chemical compound that's Mounjaro that was approved for T2D, relabeled for weight loss.

ng12 3y ago

> Research now shows that the body may respond to a calorie-deficit diet by increasing hunger and reducing feelings of fullness Dieting makes you hungry, truly revolutionary research.

n8cpdx 3y ago
It seems obvious but the “just eat less” crowd needs to hear it. Ever try working on a tricky coding project while starving? Take a math test when all you can think about is finding something, anything, to eat? Losing significant amounts of weight the natural way isn’t so much a test of willpower as a test of how well you can function under a constant sense of hunger (or, how good you are at tricking your way out of it). Bonus tip: when you are so hungry you can’t sleep and don’t want to drink a bunch of water right before bed, sugar-free jell-o has only 10 calories and can silence the feeling long enough to fall asleep.
- dearsaturn 3y ago
  To fight off hunger while dieting, you eat lower calorie density, fiber-rich vegetables and unsaturated fats. Potatoes, avocados, legumes, there are a lot of options. They just don't fulfill the same psychological need that less healthy food does.
  - bb88 3y ago
    If it's a psychological issue, then couldn't it also be a chemical imbalance?
- poopchute 3y ago
  There are quite a few veggies that are low calorie, filling, and are tasty enough to snack on without dip. The ones I eat when I just want to feel full without a bunch of calories are carrots (45 cal/100g), cucumbers (14 cal/100g), sugar snap peas ( 42 cal/100g), and yellow bell pepper (27 cal/100g).
  - chownie 3y ago

belltaco 3y ago

Lilly's also working on retatrutide, that has 3 targets in addition to the two that this drug targets. https://www.reuters.com/business/healthcare-pharmaceuticals/lilly-experimental-triple-g-obesity-drug-leads-242-weight-loss-trial-nejm-2023-06-26/ https://www.reuters.com/business/healthcare-pharmaceuticals/...

Obscurity4340 3y ago
What is the gold standard currently? Like phentermine or diethylpropion? Or is it actually Ozempic?
- aantix 3y ago
  Of FDA approved medications for weight loss, tirzepatide would be the current gold standard. https://www.nejm.org/doi/full/10.1056/nejmoa2107519 https://www.nejm.org/doi/full/10.1056/nejmoa2107519 I think retatrutide might be the current leader for weight loss from clinical trials. If I remember correctly, you lost the same amount of weight on retatrutide vs tirzepatide, but over a shorter time span.
  - Obscurity4340 3y ago
    You're saying this NEW medication is already currently the gold standard? What was it prior?
    - quux 3y ago
      The active ingredient, tirzepatide, isn't what's new here. It was patented in 2016 and has been on the market for treating type 2 diabetes since 2021. What's new is that tirzepatide is now FDA approved for treatment of obesity, which will make it possible for insurance to cover it without a type 2 diabetes diagnosis.
      - bb88 3y ago
        It should also be noted that during those original studies significant weight loss was observed, which is why doctor's were prescribing tirzepatide off-label. Also just like Ozempic/Wegovy, Mounjaro is still indicated for type 2 diabetes. Zepbound will be the weight loss drug.

gen220 3y ago

Has anybody here taken this category of drug, lost significant weight, and kept it off after dropping the drug? I've seen great success stories, but I'm kind of nervous of the long-term effects of taking a drug like this for your whole lifetime (i.e. what's implied by the "chronic" in "chronic weight management"). It seems like it might be a great off-ramp from obesity to a body weight where the risk of injury in exercise is greatly diminished and the degree of enjoyment in exercise goes way up. If you could go off the drug and then use exercise to maintain the caloric deficit (instead of under-eating, as the drug induces you to do), that sounds like it would be kind of miraculous.

xnx 3y ago
> exercise to maintain the caloric deficit Exercise is great for dozens of reasons, but weight loss is probably at the bottom of the list (if it's on the list at all). The asymmetry between the ease of consuming calories and the effort of exhaling calories during exercise is too great.
nexus7556 3y ago
There are lots of success stories on the Mounjaro subreddit.
petesergeant 3y ago
> a great off-ramp from obesity I, and many many other overweight people, have successfully lost a lot of weight in the past. There's no off-ramp when you look at the data, you always gain it back. Mounjaro is no different from any other way of losing weight in that respect, except it doesn't rely on willpower, so you can keep taking it, and keep the weight off.

molsongolden 3y ago

With these drugs, is there any mechanism at work beyond "patients have a lower appetite and eat less food"? I've only read a few papers and articles but what I've seen is that all of the hormone triggering leads to 1) decreased appetite 2) slowed gastric emptying which also decreases appetite. Patients lose weight due to eating less but usually regain the weight when stopping the drug since they then go back to their normal level of eating. --- Are these drugs fixing/replacing a system failure where people don't feel satiated normally? Can the same effect be replicated by eating a higher fiber and higher fat diet with more whole foods to feel full longer and slow gastric emptying?

aantix 3y ago
- Tirzepatide may activate brown fat, which might be a metabolic advantage. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9396640/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9396640/ - Another study - there was a 16% weight loss for those that received semaglutide/diet/exercise/counseling versus a loss of 5% for placebo those that received diet/exercise/counseling without semaglutide. But they didn't control for calories, so it may just be proving that dietary adherence with the medication is better than without. https://pubmed.ncbi.nlm.nih.gov/33625476/ https://pubmed.ncbi.nlm.nih.gov/33625476/ https://classic.clinicaltrials.gov/ct2/show/NCT03611582 https://classic.clinicaltrials.gov/ct2/show/NCT03611582
quux 3y ago
GLP-1 affects a lot of systems beyond just appetite and gastric emptying. For instance it acts in the pancreas to promote insulin secretion. GLP-1 receptors are also found in a lot of other tissues, including heart, tongue, adipose, muscles, bones, kidneys, liver and lungs. The effects of GLP-1 in these tissues are an area of intense research.
Shekelphile 3y ago
> Are these drugs fixing/replacing a system failure where people don't feel satiated normally? > Can the same effect be replicated by eating a higher fiber and higher fat diet with more whole foods to feel full longer and slow gastric emptying? I think it simply takes a long time for your body to adjust back to where it should be after a period of extended binging and these drugs make it happen much faster. The only time I consistently lost weight in my life was when I lived in a food desert and had no car and not much money, so I was forced to only buy the cheapest vegetables and meats (usually chicken) and make what I could out of that and make it last for the week. Even then it took more than 6 months before I felt normal eating that way. Of course, it's extremely easy to fall off the wagon when your body works this way too. Even a day can wipe out weeks of gains and you can always 'relapse' even after months of doing the right thing, and end up stagnating or completely reversing any progress you've made. In a way it seems that food is the most addictive drug of all. You can easily quit alcohol, cigarettes, hard drugs with a couple weeks of willpower (and I have multiple times). You can't ever stop eating food if you want to be around to experience life.

cowboyscott 3y ago

While personally I'd like to see a reduction in obesity rates by focusing on causes (e.g., "sugar taxes" and the like), it's hard to deny the positive impact of these drugs. Obesity is such a destructive epidemic in my country (US) that I see an argument for providing these drugs either for free or at substantially reduced costs via government subsidy. Despite vaccine skepticism, free COVID vaccinations might be a model worth following. If the public sector doesn't help, I imagine that insurance companies are doing what they can to put downward price pressure on these drugs. If I can pay x now to avoid 10x in payout costs to medical providers for obesity complications (while keeping rates the same), I'm going to take that trade (subject to actuarial data and discount rates).

nathanyz 3y ago
While I agree on your points of the benefits, the one place who is not advocating for them is insurance. People switch insurance frequently, so there is no benefit to help this year what causes a significant disease to their customer in 10 years as that benefit will likely acrue to some other insurance company. The insurance companies basically think 1 year at a time for drug coverage and only care about keeping you alive for that 1 year at the cheapest possible price. Long term care and planning is something medicare/medicaid may better be able to utilize in their economic model to justify coverage.