11 ms·

Ozempic will disrupt big tobacco, candy companies, and alcohol brands

147 points by robertn702 2y ago

deleted 2y ago
[deleted]
lispisok 2y ago
I had the thought there are gonna be some people on these drugs who will still find a way to have bad diets that keeps them fat and unhealthy. Since they have less appetite instead of a sandwich and a milkshake they will skip to the milkshake only.
- akgoel 2y ago
  When I was on Ozempic, I just didn't want the milkshake. It rewires all reward centers.
  - someplaceguy 2y ago
    May I ask about your experience since leaving Ozempic compared to before you started taking it? I'm not considering taking Ozempic nor am I aware of anyone who has, so I'm curious.
    - nvahalik 2y ago
      I haven't taken it, but my wife has and since she's been off, while she is eating more, it mainly appears to be maintenance as she's not really losing nor gaining weight anymore. Food just doesn't seem to be as big of a deal. We can enjoy a nice steak going out it's not as much as a draw.
  - chpatrick 2y ago
    But it still doesn't sound like a sustainable lifetime solution. I think it makes great sense if you're badly out of shape, you fix it, and then you can maintain a healthy weight. But going on ozempic every few years sounds really bad.
    - kelseyfrog 2y ago
      "Sounds really bad" is orthogonal to "is really bad". There's a heuristic that goes, "Shortcuts will catch up to people eventually," but I'm ok with letting the evidence bear that out.
      - jart 2y ago
        Yeah that's the kind of folk wisdom that causes people with psychiatric conditions to stop taking their medications. It's very ignorant and harmful.
        chpatrick 2y ago
        I don't think that's a fair analogy. Psychiatric medications don't have a non-pharmacological alternative in many cases. You can't just consciously do something and not be depressed or schizophrenic any more. However, putting food in your mouth is a completely conscious decision. If people have problems with controlling that then I think that's what should be treated, instead of medicating your body to react to food differently. I think a future where we turn to drugs on an ongoing basis to compensate our unhealthy lifestyles is pretty dystopic. Again, if someone is obese and struggles to lose weight I think Ozempic sounds like a great way to get on the road to health. I just don't think you should take it for the rest of your life instead of changing your lifestyle.
        jart 2y ago
        What you call dystopia, I call paradise. Evolution didn't give us bodies that are adapted to life in modern technological society. The better technology gets, the more unnatural the world gets for our bodies. People who are unfit to live won't die, because technology breaks the evolutionary process. Since we know that technology is better, the only way we can keep having it and thrive is by using more technology to hack our bodies so they're adapted for existence in the modern world.
        chpatrick 2y ago
  - spirit557 2y ago
    You cant take these drugs forever afaik. Do they have permanent effects? It's just absurd to me the world has come to the point that we need these drugs in the first place but it makes total sense when you look at America for example. Awash in hyperpalatable processed "food" and corrupt food guidelines, a medical industry that "manages" chronic metabolic preventable disease but never cures it when probably 99% of cases could be reversed naturally. Big pharma and big food play their roles. Just insanity.
    - PierceJoy 2y ago
      On the contrary, most weight loss doctors consider these drugs to be like statins. You take them for the rest of your life. The number of people who maintain healthy habits after stopping them is shockingly low.
      - JumpCrisscross 2y ago
        > number of people who maintain healthy habits after stopping them is shockingly low Source?
        PierceJoy 2y ago
        https://pubmed.ncbi.nlm.nih.gov/35441470/ https://pubmed.ncbi.nlm.nih.gov/35441470/
    - JumpCrisscross 2y ago
      > absurd to me the world has come to the point that we need these drugs in the first place GLP-1 looks increasingly like a miracle drug. We see problems of addiction and obesity skyrocketing across the developing world. It’s not cost free, but it’s a hell of a lot better than the majority of America, China and India becoming potatoes. When vitamins were discovered, there was similar moralising about there being no free lunch. With the benefit of hindsight those concerns were misfounded. Perhaps Ozempic has terrible side effects that haven’t been noticed since 2005. Given that timeline, however, we can confidently say someone obese taking the drug is better off with it. > never cures it I have friends who took it, lost weight and then stopped. The rebound was real but nowhere close to what they lost. (The lifestyle changes also mostly stuck.) For all practical purposes, their fatness was cured. > when probably 99% of cases could be reversed naturally Scientifically unfounded.
  - odiroot 2y ago
    If they invent something like this but for procrastination, they'd get a Nobel prize.
    - fooker 2y ago
      Adderall is used pretty effectively for this.
    - galangalalgol 2y ago
      It is called dexamphetamine. Or more more commonly these days, lysdexamphetamine.
    - aleksiy123 2y ago
      Adderall and Vyvanse?
      - dpig_ 2y ago
        Anecdotally, those don't cure procrastination. They mostly cure issues with consistency and throughput once the task has begun. Starting the task is still the same hill to climb as it was before.
    - someplaceguy 2y ago
      Oh God, imagine the self-, peer, and top-down pressure to take that, both for students and working adults.
      - MadnessASAP 2y ago
        No need to imagine, there's a reason Adderall, Vyvanse, and just about any amphetamine are banned in Japan.
  - sniggers 2y ago
    For me, it's just less hunger and being full faster. I still want the milkshake, just a smaller one and less often.
- notyourwork 2y ago
  It’s not about either or but portion control and limiting caloric intake. Also with alcohol it’s reduced consumption.
kylebenzle 2y ago
[flagged]
- Vecr 2y ago
  The original proposed mechanism was probably wrong, these drugs probably make you change your diet. Or at least eat less, obviously you have to be concerned with nutrition.
- choilive 2y ago
  What is the moral issue? How is it evil?
- akgoel 2y ago
  Everyone already knows that diet and exercise are "the" solution to obesity, and yet it keeps getting worse.
  - Apocryphon 2y ago
    Microplastics? Pesticides? Antibiotics in the feed?
  - fnordpiglet 2y ago
    If diet and exercise as an intervention were subjected to approval as a medical treatment they would never be approved. As a medical intervention they are rarely effective and when they are the effects are almost always temporary and relapse is worse than the original state. It’s about as effective as teaching abstinence to treat alcoholism or opioid addiction - but abstinence isn’t an option for food addiction.
entropicgravity 2y ago
And casinos apparently.
vasco 2y ago
> A policy of cost-restriction and access guarantees would bring massive public health benefits. Ah yes price controls, the best way to keep something inaccessible to everyone except those with personal connections.
- cmdli 2y ago
  For many (most?) drugs, the actual cost to produce the drug is usually far less than the selling price as it is an enforced monopoly. Given that monopoly, price restrictions don't actually restrict supply as the single supplier will still try to sell as much as they can to make as much as they can.
  - nickff 2y ago
    It probably wouldn’t have much of an impact on the sales or marketing of this product, but it’d definitely have significant impacts on drug manufacturers’ future plans (by reducing expected ROI & discouraging the development of ‘marginal drugs’).
    - Eisenstein 2y ago
      Would it? Drug manufacturers don't really do as much 'R&D' as we assume, they buy biotech companies that have already discovered drugs. Also, why would a company stop wanting to make money? 'We are only going to make $5billion instead of $15 billion, let's not bother with that one.'
      - hackerlight 2y ago
        > 'We are only going to make $5billion instead of $15 billion, let's not bother with that one.' Well, yes. If there's a 10% chance of success, these differences matter. Decision making happens at the margin.
        Eisenstein 2y ago
        How would they know how much one drug would make vs the other while in the research phase?
Xenoamorphous 2y ago
I'm not very familiar with the approval process for new drugs, but as far as I know it involves some initial step where the safety is assessed, and then the effectiveness. But I don't think either of those are actually long term processes (like, longer than 5 years). So it scares me a bit when something like Ozepmic pops up and tons of people jump on it, without knowing the long term effects that might appear. I read the other day there's an entire subreddit devoted to Ozempic side effects, and those are only short term ones (maybe those being discussed there were already discovered during the trials, I don't know to be honest). Are my fears unfounded and just the result of my lack of knowledge around the approval process and/or the inner workings of drugs?
- tyre 2y ago
  Semaglutide has been on the market since 2017 and clinical trials commenced in 2008. So we have a fair amount of data on longer-term users. It wasn't being used for general obesity until recently.
  - onionisafruit 2y ago
    My doctor has been prescribing it for obesity for about five years.
    - bamboozled 2y ago
      Doesn’t work for everyone. I have relatives on it. Still big. The best improvement they made was giving up alcohol.
      - fragmede 2y ago
        Giving up alcohol is huge though
        bamboozled 2y ago
        Yeah, I just meant that they've done both, Ozempic and Alcohol, it was a noticable change after giving up the alcohol, awesome weight loss, the Ozempic hasn't changed a lot.
rglullis 2y ago
[flagged]
jakub_g 2y ago
Re: "mounting concern" about the profits of processed food & tobacco companies, here you are also the 2018 classic of the genre: > Goldman Sachs asks in biotech research report: ‘Is curing patients a sustainable business model?’ https://www.cnbc.com/2018/04/11/goldman-asks-is-curing-patients-a-sustainable-business-model.html https://www.cnbc.com/2018/04/11/goldman-asks-is-curing-patie...
- Ygg2 2y ago
  Can't wait for 2034 Goldman Sachs report: "Can we sell cocaine to toddlers?", "Can we re-lead the water? People are too smart anyway"
  - mrtesthah 2y ago
    It wouldn’t be the first time! https://www.bbc.co.uk/bbcthree/article/966b1bdd-69ff-4de0-9c39-d9276eba706b https://www.bbc.co.uk/bbcthree/article/966b1bdd-69ff-4de0-9c...
- deleted 2y ago
  [deleted]
- umeshunni 2y ago
  The actual report (not linked to by CNBC of course) says The potential to deliver “one shot cures” is one of the most attractive aspects of gene therapy, genetically-engineered cell therapy and gene editing. However, such treatments offer a very different outlook with regard to recurring revenue versus chronic therapies, particularly in certain diseases where it is possible to cure a large proportion of the prevalent patient pool (or at least prevent an additional dose from being required for an extended period). While this proposition carries tremendous value for patients and society, it could represent a challenge for genome medicine developers looking for sustained cash flow. GILD is a case in point, where the success of its hepatitis C franchise has gradually exhausted the available pool of treatable patients. We highlight several potential solutions for these genome medicine companies to sustain an attractive profile. Solution 1: Address large markets: Hemophilia is a $9-10bn WW market (hemophilia A, B), growing at ~6-7% annually. We estimate that the hemophilia A market currently represents ~$6.5bn, while hemophilia B is ~$1.2bn. Solution 2: Address disorders with high incidence: Spinal muscular atrophy (SMA) affects the cells (neurons) in the spinal cord, impacting the ability to walk, eat, or breathe. It is the leading genetic cause of death in infants. SMA affects ~1 in 11k babies, and 1 in 50 individuals in the US is a genetic carrier. Cancer is also a sustainable market given the patient population is almost entirely incident driven. Solution 3: Constant innovation and portfolio expansion: There are hundreds of inherited retinal diseases (genetics forms of blindness). Once a gene therapy is approved for a genetic eye disease, the validated platform could be used to quickly develop many more eye-based gene therapies. Pace of innovation will also play a role as future programs can offset the declining revenue trajectory of prior assets.
raziel2701 2y ago
Ozempic costs $1000/month (in the US) but $5/month to manufacture [0]. I think if this drug and others are to have a significant anti-consumption effect on other companies it needs to be vastly more accessible, which first requires more accessible healthcare in the US, which is unlikely to happen. Also it's an injection, which raises the barrier. If drugs like these become orally administered and over-the-counter, then yeah, I'd be more confident that it could have a positive effect. But currently, it looks like a drug that few can access/afford in the US. [0] https://www.sanders.senate.gov/press-releases/news-sanders-statement-on-outrageous-cost-of-ozempic/ https://www.sanders.senate.gov/press-releases/news-sanders-s...
- pain_perdu 2y ago
  Rybelsus is an oral version of semaglutide which has good efficacy.
- 01100011 2y ago
  Plenty of ongoing research into orally active analogs and cheaper variants. Give it a year or two.
- jakub_g 2y ago
  In worst case, Ozempic patents expire in 2031, which is not that far.
  - kgwgk 2y ago
    The worst case is worse than that: in addition to composition of matter patents there are dosage patents that can be invoked. https://www.fiercepharma.com/pharma/novo-nordisk-patent-semaglutide-invalid-viatris-request-uspto-will-review https://www.fiercepharma.com/pharma/novo-nordisk-patent-sema...
    - voisin 2y ago
      I am not familiar with pharma patents. Are you saying, for example, a 300ml dose could have a patent with different expiry than a 400ml dose? I could see patenting mechanism of delivery, like injections versus oral, but not the example above.
jrflowers 2y ago
I like that four out of the six posts on the Curing Addiction substack blog are about ozempic
01100011 2y ago
These effects started being priced in last year. Citrini on Twitter called a lot of this out in advance and made a bunch of money on long/short plays. Might be some room left to run, but be careful shorting potato chip companies and fast food because you think you found a secret.
slfnflctd 2y ago
If these drugs turn out to be significantly more effective for a wide range of addictions than past approaches, that would indeed be a major societal shift. I wouldn't try any of them right now, but if my insurance covered one for treating alcoholism at some point I'd give it a shot. If it actually worked it would likely significantly improve not only my life experience, but also my productivity and thereby the lives of others I have an impact on. It's a nice thought.
- trogdor 2y ago
  Have you considered naltrexone?
  - slfnflctd 2y ago
    I appreciate the thoughtful suggestion. I have not actually tried it, but I've read many accounts from other alcoholics trying to quit who have done so (among a couple dozen other approaches), and came to the conclusion that it's not for me right now. If I did give it a chance I would probably have to go with an implant, which I would only do under extreme circumstances. What it boils down to is that on some level, I often feel death would be preferable to not being able to experience the 'reward' my brain has been long conditioned to expect from my next drink. If there was a lasting way to shift that to something healthier it would be miraculous. Simply taking it away would just drive me to despair. Having attempted suicide in the past, I do everything I can to avoid that situation again, and unfortunately drinking became a big part of this effort.
    - hollerith 2y ago
      In a Youtube video {Leveraging Dopamine, 2023}, neuroscientist Andrew Huberman defines addiction as "a progressive narrowing of the things that bring us pleasure". I worry that framing the goal as, "a lasting way to shift that to something healthier", will prime you to switch from one addiction to another. I would prefer for you to frame it as diversifying the sources of pleasure in your life and becoming able to take pleasure (and consequent to take interest) in practical things that you currently experience as tedious obstacles that must be endured so that you can get your next drink.
dougb5 2y ago
"It’s pretty amazing that a reporter can write with a straight face that people eating less Doritos and Oreos is a ‘mounting concern’!" This is a really bad-faith interpretation of what the reporter said. The "mounting concern" is linked to a CNBC video. It's obvious in context that it's the investors in processed food companies who are concerned, not the reporter herself.
pelorat 2y ago
[flagged]
- burtness 2y ago
  Buddy, I have some bad news about tobacco and alcohol...
- rexpop 2y ago
  Alcohol is a central nervous system depressant, so it can slow down vital functions leading to loss of consciousness and respiratory depression. Nicotine is highly addictive and can lead to immediate withdrawal symptoms if usage is abruptly stopped. Short-term side effects include nausea, dizziness, and headaches. Smoking tobacco can also cause respiratory irritation. Long-term use can lead to serious health issues, including various forms of cancer and cardiovascular diseases. Sugar can contribute to metabolic issues such as insulin resistance, which has immediate effects on metabolism and can lead to long-term health problems like type 2 diabetes. All three substances—tobacco, sugar, and alcohol—have well-documented immediate effects on the body that can range from desirable (e.g., feeling relaxed or euphoric) to harmful (e.g., intoxication, poisoning, or overdose). But let's focus on sugar for a minute. Research suggests that sugar intake alters composition and function of gut bacteria, which can have a whole host of knock-on effects. Fructose, additionally, drives inflammatory responses throughout the body which stresses all your organ systems. Chronic inflammation promotes heart disease, diabetes, arthritis... you name it. Sugar has links to changes in brain function, increasing risk of depression (this might be due to inflammation[0]) and may contribute to a greater likelihood of developing neurodegenerative diseases like Alzheimer's. Sugar also raises triglyceride levels, and low-density lipoprotein (LDL) cholesterol profiles. Dietary sugars lead to higher de novo lipogenesis (DNL), increasing risk of cardiovascular disease. An increase in DNL can lead to an overproduction of triglyceride-rich very low-density lipoprotein (VLDL) particles, which are eventually converted into LDL particles in a process known as "adipose tissue remodeling". The phrase "adipose tissue" should strike fear into your heart, as this is the unsexy "fat" tissue that can lead to stigma and discrimination, negative judgments from others, joint stress, musculoskeletal disorders, and increased risk of injury. So there's a mountain of evidence that you're wrong about Tobacco, sugar and alcohol.
neither_color 2y ago
Many years ago as a teen I worked seasonally at a big blue/yellow electronics store that sells TVs, computers, appliances....and candy at the register. Curious, I asked my manager about it. "Oh yeah, someone comes in here to buy a $10 HDMI cable, and impulse buys a $2 candy bar at checkout. Instant 20% more sales. Gas stations, pharmacies, they all do it."
- wffurr 2y ago
  It ought to be illegal. Ideally I could choose to shop somewhere that didn’t do that, but like your boss said, they all do it. It makes shopping with small children hellish.
  - coremoff 2y ago
    the UK is supposed to have made it illegal to have unhealthy stuff etc. near checkouts and illegal to include them in certain promos (e.g. buy-one-get-one-free) - I thought it had passed into law years ago, but when I had a quick look it isn't even due to take effected until 2025 and until then everyone is ignoring it anyway.
- sandspar 2y ago
  Imagine if you could sell cigarettes by the stick at the register. $1 for a cigarette.
cactusplant7374 2y ago
When I took Ozempic I had these side effects: * Low libido and erectile dysfunction * Constipation, diarrhea, and extreme bloating (burping all night long) * Often difficulty sleeping. Waking up a lot. Very restless. We need a drug that doesn't slow digestion but decreases hunger and increases satiety.
- glp1guide 2y ago
  These are some interesting side effects -- I'm not sure I've seen low libido very commonly -- have you noticed any other reports/disclosures of that sort of side effect? Note that GLP1 RAs do decrease hunger, and their effects are very much also psychological. It's not simply a digestion slowing pharmacological effect.
  - cactusplant7374 2y ago
    > have you noticed any other reports/disclosures of that sort of side effect? There are a few articles in the news. Nothing substantial yet.
- abruzzi 2y ago
  > We need a drug that doesn't slow digestion but decreases hunger and increases satiety. This is exactly what it does for me. The only side effect I have is a little bit of occasional acid reflux.
tonetheman 2y ago
[dead]
glp1guide 2y ago
People like Scott Galloway have been saying this for a while, and he's completely right. The research isn't all there quite yet for stopping addiction, but the research definitely points to GLP1's effectiveness at reducing food cravings, appetite (and anecdotally "food noise") for people taking it. If you're looking for a quick primer on what the term "GLP1 Agonist" even means: https://glp1.guide/content/what-are-glp1-agonists/ https://glp1.guide/content/what-are-glp1-agonists/ This will absolutely have a huge effect on companies that sell ingestable... "luxuries"/addictive substances -- the only thing holding back the deluge of change is the accessibility/pricing of the drugs. It also seems like the next phase of this is gene therapy: https://glp1.guide/content/a-glimpse-of-the-future-glp1-gene-therapy https://glp1.guide/content/a-glimpse-of-the-future-glp1-gene...
globular-toast 2y ago
We could also clamp down on addictive shit like Doritos and Oreos like we did with tobacco. Unbelievable that people will need to take a drug to escape the treachery of junk food companies everywhere you turn.
- rexpop 2y ago
  To achieve similar controls over sugar (and specifically fructose) as those put in place by eg the Cigarette Labeling and Advertising Act[0] (which mandated Surgeon General's warnings on cigarette packaging), the Public Health Cigarette Smoking Act of 1970[1], and the Family Smoking Prevention and Tobacco Control Act of 2009[2], we might need to first see lawsuits similar to those against tobacco companies. Litigation played a major role in shifting public opinion and policy, eg the 1998 Tobacco Master Settlement Agreement[3]. 0. https://en.wikipedia.org/wiki/Cigarette_Labeling_and_Advertising_Act https://en.wikipedia.org/wiki/Cigarette_Labeling_and_Adverti... 1. https://en.wikipedia.org/wiki/Public_Health_Cigarette_Smoking_Act https://en.wikipedia.org/wiki/Public_Health_Cigarette_Smokin... 2. https://en.wikipedia.org/wiki/Family_Smoking_Prevention_and_Tobacco_Control_Act https://en.wikipedia.org/wiki/Family_Smoking_Prevention_and_... 3. https://en.wikipedia.org/wiki/Tobacco_Master_Settlement_Agreement https://en.wikipedia.org/wiki/Tobacco_Master_Settlement_Agre...
- bobmcnamara 2y ago
  Increasing and sustaining corn syrup consumption has been a key republican party strategy to win over rural farmers and agribusiness since the 70s. I just don't see them changing.
comova 2y ago
hi! this is my substack post and new policy org. thanks to whoever posted this. hope you will subscribe! we are looking for folks with MDs and PhDs or other experience in the field or in EA type writing to join the project. the thesis is that the addiction crisis is solvable if we put sufficient resources into new medication development, including GLP-1 for addiction and powerful non opiate painkillers like the Vertex drug that will be approved early next year. addiction is the number 1 cause of DALYs in the united states if you include opiates, stimulants, alcohol, and cigarettes. the right policies can get new treatments to people rapidly without massive public costs and without disrupting incentives. but we're currently on track for at least another decade of massive damage if we don't change things. join the effort!
redder23 2y ago
[dead]
mensetmanusman 2y ago
Take-for-life drugs with random paralysis as side effects that cost $12k per year might not be affordable by governments when half of society is obese.
syndicatedjelly 2y ago
In March 2023, Novo Nordisk was suspended from the ABPI for a period of two years, for engaging in misleading marketing practices that amounted to "bribing health professionals with inducement to prescribe".[59] This is only the eighth time in the last 40 years that ABPI sanctioned a member organization. https://en.m.wikipedia.org/wiki/Novo_Nordisk https://en.m.wikipedia.org/wiki/Novo_Nordisk
black_13 2y ago
[dead]

147 points by robertn702 2y ago

deleted 2y ago

[deleted]

I had the thought there are gonna be some people on these drugs who will still find a way to have bad diets that keeps them fat and unhealthy. Since they have less appetite instead of a sandwich and a milkshake they will skip to the milkshake only.

akgoel 2y ago
When I was on Ozempic, I just didn't want the milkshake. It rewires all reward centers.
- someplaceguy 2y ago
  May I ask about your experience since leaving Ozempic compared to before you started taking it? I'm not considering taking Ozempic nor am I aware of anyone who has, so I'm curious.
  - nvahalik 2y ago
    I haven't taken it, but my wife has and since she's been off, while she is eating more, it mainly appears to be maintenance as she's not really losing nor gaining weight anymore. Food just doesn't seem to be as big of a deal. We can enjoy a nice steak going out it's not as much as a draw.
- chpatrick 2y ago
  But it still doesn't sound like a sustainable lifetime solution. I think it makes great sense if you're badly out of shape, you fix it, and then you can maintain a healthy weight. But going on ozempic every few years sounds really bad.
  - kelseyfrog 2y ago
    "Sounds really bad" is orthogonal to "is really bad". There's a heuristic that goes, "Shortcuts will catch up to people eventually," but I'm ok with letting the evidence bear that out.
    - jart 2y ago
      Yeah that's the kind of folk wisdom that causes people with psychiatric conditions to stop taking their medications. It's very ignorant and harmful.
      - chpatrick 2y ago
        I don't think that's a fair analogy. Psychiatric medications don't have a non-pharmacological alternative in many cases. You can't just consciously do something and not be depressed or schizophrenic any more. However, putting food in your mouth is a completely conscious decision. If people have problems with controlling that then I think that's what should be treated, instead of medicating your body to react to food differently. I think a future where we turn to drugs on an ongoing basis to compensate our unhealthy lifestyles is pretty dystopic. Again, if someone is obese and struggles to lose weight I think Ozempic sounds like a great way to get on the road to health. I just don't think you should take it for the rest of your life instead of changing your lifestyle.
        jart 2y ago
        What you call dystopia, I call paradise. Evolution didn't give us bodies that are adapted to life in modern technological society. The better technology gets, the more unnatural the world gets for our bodies. People who are unfit to live won't die, because technology breaks the evolutionary process. Since we know that technology is better, the only way we can keep having it and thrive is by using more technology to hack our bodies so they're adapted for existence in the modern world.
        chpatrick 2y ago
- spirit557 2y ago
  You cant take these drugs forever afaik. Do they have permanent effects? It's just absurd to me the world has come to the point that we need these drugs in the first place but it makes total sense when you look at America for example. Awash in hyperpalatable processed "food" and corrupt food guidelines, a medical industry that "manages" chronic metabolic preventable disease but never cures it when probably 99% of cases could be reversed naturally. Big pharma and big food play their roles. Just insanity.
  - PierceJoy 2y ago
    On the contrary, most weight loss doctors consider these drugs to be like statins. You take them for the rest of your life. The number of people who maintain healthy habits after stopping them is shockingly low.
    - JumpCrisscross 2y ago
      > number of people who maintain healthy habits after stopping them is shockingly low Source?
      - PierceJoy 2y ago
        https://pubmed.ncbi.nlm.nih.gov/35441470/ https://pubmed.ncbi.nlm.nih.gov/35441470/
  - JumpCrisscross 2y ago
    > absurd to me the world has come to the point that we need these drugs in the first place GLP-1 looks increasingly like a miracle drug. We see problems of addiction and obesity skyrocketing across the developing world. It’s not cost free, but it’s a hell of a lot better than the majority of America, China and India becoming potatoes. When vitamins were discovered, there was similar moralising about there being no free lunch. With the benefit of hindsight those concerns were misfounded. Perhaps Ozempic has terrible side effects that haven’t been noticed since 2005. Given that timeline, however, we can confidently say someone obese taking the drug is better off with it. > never cures it I have friends who took it, lost weight and then stopped. The rebound was real but nowhere close to what they lost. (The lifestyle changes also mostly stuck.) For all practical purposes, their fatness was cured. > when probably 99% of cases could be reversed naturally Scientifically unfounded.
- odiroot 2y ago
  If they invent something like this but for procrastination, they'd get a Nobel prize.
  - fooker 2y ago
    Adderall is used pretty effectively for this.
  - galangalalgol 2y ago
    It is called dexamphetamine. Or more more commonly these days, lysdexamphetamine.
  - aleksiy123 2y ago
    Adderall and Vyvanse?
    - dpig_ 2y ago
      Anecdotally, those don't cure procrastination. They mostly cure issues with consistency and throughput once the task has begun. Starting the task is still the same hill to climb as it was before.
  - someplaceguy 2y ago
    Oh God, imagine the self-, peer, and top-down pressure to take that, both for students and working adults.
    - MadnessASAP 2y ago
      No need to imagine, there's a reason Adderall, Vyvanse, and just about any amphetamine are banned in Japan.
- sniggers 2y ago
  For me, it's just less hunger and being full faster. I still want the milkshake, just a smaller one and less often.
notyourwork 2y ago
It’s not about either or but portion control and limiting caloric intake. Also with alcohol it’s reduced consumption.

kylebenzle 2y ago

[flagged]

Vecr 2y ago
The original proposed mechanism was probably wrong, these drugs probably make you change your diet. Or at least eat less, obviously you have to be concerned with nutrition.
choilive 2y ago
What is the moral issue? How is it evil?
akgoel 2y ago
Everyone already knows that diet and exercise are "the" solution to obesity, and yet it keeps getting worse.
- Apocryphon 2y ago
  Microplastics? Pesticides? Antibiotics in the feed?
- fnordpiglet 2y ago
  If diet and exercise as an intervention were subjected to approval as a medical treatment they would never be approved. As a medical intervention they are rarely effective and when they are the effects are almost always temporary and relapse is worse than the original state. It’s about as effective as teaching abstinence to treat alcoholism or opioid addiction - but abstinence isn’t an option for food addiction.

entropicgravity 2y ago

And casinos apparently.

vasco 2y ago

> A policy of cost-restriction and access guarantees would bring massive public health benefits. Ah yes price controls, the best way to keep something inaccessible to everyone except those with personal connections.

cmdli 2y ago
For many (most?) drugs, the actual cost to produce the drug is usually far less than the selling price as it is an enforced monopoly. Given that monopoly, price restrictions don't actually restrict supply as the single supplier will still try to sell as much as they can to make as much as they can.
- nickff 2y ago
  It probably wouldn’t have much of an impact on the sales or marketing of this product, but it’d definitely have significant impacts on drug manufacturers’ future plans (by reducing expected ROI & discouraging the development of ‘marginal drugs’).
  - Eisenstein 2y ago
    Would it? Drug manufacturers don't really do as much 'R&D' as we assume, they buy biotech companies that have already discovered drugs. Also, why would a company stop wanting to make money? 'We are only going to make $5billion instead of $15 billion, let's not bother with that one.'
    - hackerlight 2y ago
      > 'We are only going to make $5billion instead of $15 billion, let's not bother with that one.' Well, yes. If there's a 10% chance of success, these differences matter. Decision making happens at the margin.
      - Eisenstein 2y ago
        How would they know how much one drug would make vs the other while in the research phase?

Xenoamorphous 2y ago

I'm not very familiar with the approval process for new drugs, but as far as I know it involves some initial step where the safety is assessed, and then the effectiveness. But I don't think either of those are actually long term processes (like, longer than 5 years). So it scares me a bit when something like Ozepmic pops up and tons of people jump on it, without knowing the long term effects that might appear. I read the other day there's an entire subreddit devoted to Ozempic side effects, and those are only short term ones (maybe those being discussed there were already discovered during the trials, I don't know to be honest). Are my fears unfounded and just the result of my lack of knowledge around the approval process and/or the inner workings of drugs?

tyre 2y ago
Semaglutide has been on the market since 2017 and clinical trials commenced in 2008. So we have a fair amount of data on longer-term users. It wasn't being used for general obesity until recently.
- onionisafruit 2y ago
  My doctor has been prescribing it for obesity for about five years.
  - bamboozled 2y ago
    Doesn’t work for everyone. I have relatives on it. Still big. The best improvement they made was giving up alcohol.
    - fragmede 2y ago
      Giving up alcohol is huge though
      - bamboozled 2y ago
        Yeah, I just meant that they've done both, Ozempic and Alcohol, it was a noticable change after giving up the alcohol, awesome weight loss, the Ozempic hasn't changed a lot.

rglullis 2y ago

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jakub_g 2y ago

Re: "mounting concern" about the profits of processed food & tobacco companies, here you are also the 2018 classic of the genre: > Goldman Sachs asks in biotech research report: ‘Is curing patients a sustainable business model?’ https://www.cnbc.com/2018/04/11/goldman-asks-is-curing-patients-a-sustainable-business-model.html https://www.cnbc.com/2018/04/11/goldman-asks-is-curing-patie...

Ygg2 2y ago
Can't wait for 2034 Goldman Sachs report: "Can we sell cocaine to toddlers?", "Can we re-lead the water? People are too smart anyway"
- mrtesthah 2y ago
  It wouldn’t be the first time! https://www.bbc.co.uk/bbcthree/article/966b1bdd-69ff-4de0-9c39-d9276eba706b https://www.bbc.co.uk/bbcthree/article/966b1bdd-69ff-4de0-9c...
deleted 2y ago
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umeshunni 2y ago
The actual report (not linked to by CNBC of course) says The potential to deliver “one shot cures” is one of the most attractive aspects of gene therapy, genetically-engineered cell therapy and gene editing. However, such treatments offer a very different outlook with regard to recurring revenue versus chronic therapies, particularly in certain diseases where it is possible to cure a large proportion of the prevalent patient pool (or at least prevent an additional dose from being required for an extended period). While this proposition carries tremendous value for patients and society, it could represent a challenge for genome medicine developers looking for sustained cash flow. GILD is a case in point, where the success of its hepatitis C franchise has gradually exhausted the available pool of treatable patients. We highlight several potential solutions for these genome medicine companies to sustain an attractive profile. Solution 1: Address large markets: Hemophilia is a $9-10bn WW market (hemophilia A, B), growing at ~6-7% annually. We estimate that the hemophilia A market currently represents ~$6.5bn, while hemophilia B is ~$1.2bn. Solution 2: Address disorders with high incidence: Spinal muscular atrophy (SMA) affects the cells (neurons) in the spinal cord, impacting the ability to walk, eat, or breathe. It is the leading genetic cause of death in infants. SMA affects ~1 in 11k babies, and 1 in 50 individuals in the US is a genetic carrier. Cancer is also a sustainable market given the patient population is almost entirely incident driven. Solution 3: Constant innovation and portfolio expansion: There are hundreds of inherited retinal diseases (genetics forms of blindness). Once a gene therapy is approved for a genetic eye disease, the validated platform could be used to quickly develop many more eye-based gene therapies. Pace of innovation will also play a role as future programs can offset the declining revenue trajectory of prior assets.

raziel2701 2y ago

Ozempic costs $1000/month (in the US) but $5/month to manufacture [0]. I think if this drug and others are to have a significant anti-consumption effect on other companies it needs to be vastly more accessible, which first requires more accessible healthcare in the US, which is unlikely to happen. Also it's an injection, which raises the barrier. If drugs like these become orally administered and over-the-counter, then yeah, I'd be more confident that it could have a positive effect. But currently, it looks like a drug that few can access/afford in the US. [0] https://www.sanders.senate.gov/press-releases/news-sanders-statement-on-outrageous-cost-of-ozempic/ https://www.sanders.senate.gov/press-releases/news-sanders-s...

pain_perdu 2y ago
Rybelsus is an oral version of semaglutide which has good efficacy.
01100011 2y ago
Plenty of ongoing research into orally active analogs and cheaper variants. Give it a year or two.
jakub_g 2y ago
In worst case, Ozempic patents expire in 2031, which is not that far.
- kgwgk 2y ago
  The worst case is worse than that: in addition to composition of matter patents there are dosage patents that can be invoked. https://www.fiercepharma.com/pharma/novo-nordisk-patent-semaglutide-invalid-viatris-request-uspto-will-review https://www.fiercepharma.com/pharma/novo-nordisk-patent-sema...
  - voisin 2y ago
    I am not familiar with pharma patents. Are you saying, for example, a 300ml dose could have a patent with different expiry than a 400ml dose? I could see patenting mechanism of delivery, like injections versus oral, but not the example above.

jrflowers 2y ago

I like that four out of the six posts on the Curing Addiction substack blog are about ozempic

01100011 2y ago

These effects started being priced in last year. Citrini on Twitter called a lot of this out in advance and made a bunch of money on long/short plays. Might be some room left to run, but be careful shorting potato chip companies and fast food because you think you found a secret.

slfnflctd 2y ago

If these drugs turn out to be significantly more effective for a wide range of addictions than past approaches, that would indeed be a major societal shift. I wouldn't try any of them right now, but if my insurance covered one for treating alcoholism at some point I'd give it a shot. If it actually worked it would likely significantly improve not only my life experience, but also my productivity and thereby the lives of others I have an impact on. It's a nice thought.

trogdor 2y ago
Have you considered naltrexone?
- slfnflctd 2y ago
  I appreciate the thoughtful suggestion. I have not actually tried it, but I've read many accounts from other alcoholics trying to quit who have done so (among a couple dozen other approaches), and came to the conclusion that it's not for me right now. If I did give it a chance I would probably have to go with an implant, which I would only do under extreme circumstances. What it boils down to is that on some level, I often feel death would be preferable to not being able to experience the 'reward' my brain has been long conditioned to expect from my next drink. If there was a lasting way to shift that to something healthier it would be miraculous. Simply taking it away would just drive me to despair. Having attempted suicide in the past, I do everything I can to avoid that situation again, and unfortunately drinking became a big part of this effort.
  - hollerith 2y ago
    In a Youtube video {Leveraging Dopamine, 2023}, neuroscientist Andrew Huberman defines addiction as "a progressive narrowing of the things that bring us pleasure". I worry that framing the goal as, "a lasting way to shift that to something healthier", will prime you to switch from one addiction to another. I would prefer for you to frame it as diversifying the sources of pleasure in your life and becoming able to take pleasure (and consequent to take interest) in practical things that you currently experience as tedious obstacles that must be endured so that you can get your next drink.

dougb5 2y ago

"It’s pretty amazing that a reporter can write with a straight face that people eating less Doritos and Oreos is a ‘mounting concern’!" This is a really bad-faith interpretation of what the reporter said. The "mounting concern" is linked to a CNBC video. It's obvious in context that it's the investors in processed food companies who are concerned, not the reporter herself.

pelorat 2y ago

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burtness 2y ago
Buddy, I have some bad news about tobacco and alcohol...
rexpop 2y ago
Alcohol is a central nervous system depressant, so it can slow down vital functions leading to loss of consciousness and respiratory depression. Nicotine is highly addictive and can lead to immediate withdrawal symptoms if usage is abruptly stopped. Short-term side effects include nausea, dizziness, and headaches. Smoking tobacco can also cause respiratory irritation. Long-term use can lead to serious health issues, including various forms of cancer and cardiovascular diseases. Sugar can contribute to metabolic issues such as insulin resistance, which has immediate effects on metabolism and can lead to long-term health problems like type 2 diabetes. All three substances—tobacco, sugar, and alcohol—have well-documented immediate effects on the body that can range from desirable (e.g., feeling relaxed or euphoric) to harmful (e.g., intoxication, poisoning, or overdose). But let's focus on sugar for a minute. Research suggests that sugar intake alters composition and function of gut bacteria, which can have a whole host of knock-on effects. Fructose, additionally, drives inflammatory responses throughout the body which stresses all your organ systems. Chronic inflammation promotes heart disease, diabetes, arthritis... you name it. Sugar has links to changes in brain function, increasing risk of depression (this might be due to inflammation[0]) and may contribute to a greater likelihood of developing neurodegenerative diseases like Alzheimer's. Sugar also raises triglyceride levels, and low-density lipoprotein (LDL) cholesterol profiles. Dietary sugars lead to higher de novo lipogenesis (DNL), increasing risk of cardiovascular disease. An increase in DNL can lead to an overproduction of triglyceride-rich very low-density lipoprotein (VLDL) particles, which are eventually converted into LDL particles in a process known as "adipose tissue remodeling". The phrase "adipose tissue" should strike fear into your heart, as this is the unsexy "fat" tissue that can lead to stigma and discrimination, negative judgments from others, joint stress, musculoskeletal disorders, and increased risk of injury. So there's a mountain of evidence that you're wrong about Tobacco, sugar and alcohol.

neither_color 2y ago

Many years ago as a teen I worked seasonally at a big blue/yellow electronics store that sells TVs, computers, appliances....and candy at the register. Curious, I asked my manager about it. "Oh yeah, someone comes in here to buy a $10 HDMI cable, and impulse buys a $2 candy bar at checkout. Instant 20% more sales. Gas stations, pharmacies, they all do it."

wffurr 2y ago
It ought to be illegal. Ideally I could choose to shop somewhere that didn’t do that, but like your boss said, they all do it. It makes shopping with small children hellish.
- coremoff 2y ago
  the UK is supposed to have made it illegal to have unhealthy stuff etc. near checkouts and illegal to include them in certain promos (e.g. buy-one-get-one-free) - I thought it had passed into law years ago, but when I had a quick look it isn't even due to take effected until 2025 and until then everyone is ignoring it anyway.
sandspar 2y ago
Imagine if you could sell cigarettes by the stick at the register. $1 for a cigarette.

cactusplant7374 2y ago

When I took Ozempic I had these side effects: * Low libido and erectile dysfunction * Constipation, diarrhea, and extreme bloating (burping all night long) * Often difficulty sleeping. Waking up a lot. Very restless. We need a drug that doesn't slow digestion but decreases hunger and increases satiety.

glp1guide 2y ago
These are some interesting side effects -- I'm not sure I've seen low libido very commonly -- have you noticed any other reports/disclosures of that sort of side effect? Note that GLP1 RAs do decrease hunger, and their effects are very much also psychological. It's not simply a digestion slowing pharmacological effect.
- cactusplant7374 2y ago
  > have you noticed any other reports/disclosures of that sort of side effect? There are a few articles in the news. Nothing substantial yet.
abruzzi 2y ago
> We need a drug that doesn't slow digestion but decreases hunger and increases satiety. This is exactly what it does for me. The only side effect I have is a little bit of occasional acid reflux.

tonetheman 2y ago

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glp1guide 2y ago

People like Scott Galloway have been saying this for a while, and he's completely right. The research isn't all there quite yet for stopping addiction, but the research definitely points to GLP1's effectiveness at reducing food cravings, appetite (and anecdotally "food noise") for people taking it. If you're looking for a quick primer on what the term "GLP1 Agonist" even means: https://glp1.guide/content/what-are-glp1-agonists/ https://glp1.guide/content/what-are-glp1-agonists/ This will absolutely have a huge effect on companies that sell ingestable... "luxuries"/addictive substances -- the only thing holding back the deluge of change is the accessibility/pricing of the drugs. It also seems like the next phase of this is gene therapy: https://glp1.guide/content/a-glimpse-of-the-future-glp1-gene-therapy https://glp1.guide/content/a-glimpse-of-the-future-glp1-gene...

globular-toast 2y ago

We could also clamp down on addictive shit like Doritos and Oreos like we did with tobacco. Unbelievable that people will need to take a drug to escape the treachery of junk food companies everywhere you turn.

rexpop 2y ago
To achieve similar controls over sugar (and specifically fructose) as those put in place by eg the Cigarette Labeling and Advertising Act[0] (which mandated Surgeon General's warnings on cigarette packaging), the Public Health Cigarette Smoking Act of 1970[1], and the Family Smoking Prevention and Tobacco Control Act of 2009[2], we might need to first see lawsuits similar to those against tobacco companies. Litigation played a major role in shifting public opinion and policy, eg the 1998 Tobacco Master Settlement Agreement[3]. 0. https://en.wikipedia.org/wiki/Cigarette_Labeling_and_Advertising_Act https://en.wikipedia.org/wiki/Cigarette_Labeling_and_Adverti... 1. https://en.wikipedia.org/wiki/Public_Health_Cigarette_Smoking_Act https://en.wikipedia.org/wiki/Public_Health_Cigarette_Smokin... 2. https://en.wikipedia.org/wiki/Family_Smoking_Prevention_and_Tobacco_Control_Act https://en.wikipedia.org/wiki/Family_Smoking_Prevention_and_... 3. https://en.wikipedia.org/wiki/Tobacco_Master_Settlement_Agreement https://en.wikipedia.org/wiki/Tobacco_Master_Settlement_Agre...
bobmcnamara 2y ago
Increasing and sustaining corn syrup consumption has been a key republican party strategy to win over rural farmers and agribusiness since the 70s. I just don't see them changing.

comova 2y ago

hi! this is my substack post and new policy org. thanks to whoever posted this. hope you will subscribe! we are looking for folks with MDs and PhDs or other experience in the field or in EA type writing to join the project. the thesis is that the addiction crisis is solvable if we put sufficient resources into new medication development, including GLP-1 for addiction and powerful non opiate painkillers like the Vertex drug that will be approved early next year. addiction is the number 1 cause of DALYs in the united states if you include opiates, stimulants, alcohol, and cigarettes. the right policies can get new treatments to people rapidly without massive public costs and without disrupting incentives. but we're currently on track for at least another decade of massive damage if we don't change things. join the effort!

redder23 2y ago

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mensetmanusman 2y ago

Take-for-life drugs with random paralysis as side effects that cost $12k per year might not be affordable by governments when half of society is obese.

syndicatedjelly 2y ago

In March 2023, Novo Nordisk was suspended from the ABPI for a period of two years, for engaging in misleading marketing practices that amounted to "bribing health professionals with inducement to prescribe".[59] This is only the eighth time in the last 40 years that ABPI sanctioned a member organization. https://en.m.wikipedia.org/wiki/Novo_Nordisk https://en.m.wikipedia.org/wiki/Novo_Nordisk

black_13 2y ago

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