6 ms·

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 eff

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.
        fragmede 2y ago
        the belief is that the ozempic is what's allows the giving up of alcohol
- mmcnl 2y ago
  But has it had long-term studies as a weight-loss drug instead of a diabetes treatment? The results might be different.
  - fragmede 2y ago
    it might be, but the question is if there's some long term bad effect, like it causes brain bleeds if you take it for 20 years or something. I don't think patients taking it for weight-loss instead of diabetes changes the underlying biological processes that happens as a result of taking the medication, so long term studies based on diabetes patients is useful information for non-diabetes patients.
scarmig 2y ago
There's always tradeoffs. Ozempic probably has some long term side effects, but are they worse than obesity? Probably not. (And an intervention based on ozempic is far more likely to cause lasting change than one based on a prescribed behavioral program.)
- deleted 2y ago
  [deleted]
- throwup238 2y ago
  > (And an intervention based on ozempic is far more likely to cause lasting change than one based on a prescribed behavioral program.) I was under the impression that for lasting change the behavioral program was pretty much required anyway, unless the patient wants to take Ozempic for the rest of their life. It helps someone go from obese to the point where they can exercise to maintain their health but they still have to eat healthy and exercise afterwards.
  - scarmig 2y ago
    Yes: for most obese people, to become not obese and stay so for the rest of their life, lifelong Ozempic is the only thing that works at scale. Behavioural interventions more or less don't work (on an individual level they occasionally do, but on a population level they don't).
    - throwup238 2y ago
      > for most obese people, to become not obese and stay so for the rest of their life, lifelong Ozempic is the only thing that works at scale. Ozempic hasn't been around long enough to make that conclusion. It hasn't been prescribed at scale. It hasn't even been around long enough for its patent to expire, which is significantly shorter than a human lifespan ("rest of their life"). You're just making stuff up.
whatthesmack 2y ago
GLP-1 agonists have been around for a while. They're just gaining popularity lately, it seems. The first one was approved in the US in 2005 (exenatide).
hackerlight 2y ago
The status quo (obesity) is extremely dangerous, so whatever potential danger you're thinking may exist would have to exceed that.
- TibbityFlanders 2y ago
  Unless that's a false dichotomy. Obesity can be treated in less harmful ways. Companies can be regulated into only including a safe amount of sugar in drinks and foods that arent considered sweets
  - Meekro 2y ago
    But when are those changes going to happen? Ozempic is available today.
- makeitdouble 2y ago
  > extremely dangerous I wish I could just quip a "citation needed", but we're at a point where the visceral hate for fat includes researchers spitting out feel good papers going with the flow, as funding is basically guaranteed. We don't have satanists, so this has become our day's moral panic IMHO: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885862/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885862/
  - xenospn 2y ago
    Are you suggesting obesity is not harmful?
    - makeitdouble 2y ago
      Obesity is correlated to potentially harmful issues. That's a difference that matters when people reverse the goals and the means, reducing obesity often doesn't equate to solving the related issues.
deleted 2y ago
[deleted]
fyt2024 2y ago
Yes. I am very worried about the long term effects of this. While I have no need for this drug, I worries me for the broad population. There are problems known already (cancer). I understand that it is a trade off if you are obese. A buddy of mine died with 43 bc a combination of obesity and COVID. Yes, it might be justified for high risk patients but currently it looks like it will become a life style drug like Viagra. And a drug that digs so deep into your metabolism and take it for life? Call me a sceptic.
- deleted 2y ago
  [deleted]
Buttons840 2y ago
Seems like a valid ethical consideration, no doubt. But remember some people are suffering very serious harms already. A new drug might have side effects, but are they worse than the physical and social harms of being addicted to alcohol? The ethical considerations are more difficult when it comes to someone who simply wants a little help. Consider the common case of someone mostly happy and successful, but is a little overweight and has been struggling off and on for decades to lose 20 pounds; almost all of us have been there, or will be. Do you give those people the drug? Do you allow them to choose for themselves, or should big organizations decide for us?
znpy 2y ago
> 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. It isn't that different from what happened with vapes and e-cigs, and they were even worse (nicotine-based, explicitly harmful).
- barney54 2y ago
  I’m not sure I understand your point. Vapes and e-cigs are less dangerous to your health than regular tobacco cigarettes.
glp1guide 2y ago
Hey don't worry, your fears are mostly unfounded -- GLP1 Receptor Agonists have been an effective treatment method for type 2 diabetes for a very long time. They're well studied, researched and trialed, at this point, and many side effects are known. I'm a bit biased of course (I do a lot of trying to keep up with the research and effects of GLP1 drugs), but I honestly don't think the weight loss scene has seen something so effective and safe for a very long time.
- makeitdouble 2y ago
  Isn't the worry that Ozempic is only "effective and save" as far as all the other weight loss drugs being utter predatory bullshit ? Last time I looked into it the "loss" is only happening while taking the medication and you get back to normal once you stop, regardless of how long you’ve been taking it. So if stabilizing at a thinner state is your goal, the drug would be mostly useless or you should be ready to take the rest of your life. Going only a tad too far, it feels like recomming meth for its energizing and diet effects, that's not something we want at wide scale.
  - pixl97 2y ago
    I mean come up with a pill that changes your eating habits and doesn't just repress them. Don't think anyone's got close to that yet. In the meantime overweight people are going to take what they can get.
    - glp1guide 2y ago
      > I mean come up with a pill that changes your eating habits and doesn't just repress them. Don't think anyone's got close to that yet. So GLP1 gene therapy (if it ever gets here) might be the most reasonable way to achieve this, and might be the safest we've ever seen so far outside of maybe brain control. > In the meantime overweight people are going to take what they can get. 100%. And AFAIK GLP1s are some of the safest we've seen so far, and much more effective than "eat less and move more" (as true as that may be).
    - makeitdouble 2y ago
a1445c8b 2y ago
> 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. Test in production. YOLO!
- thereisnospork 2y ago
  Considering it's not ethical (or legal) to spin up a test human what else are you going to do?
jstummbillig 2y ago
No, not at all. While I think we have a pretty fantastic drug approval process (that got a frustratingly bad rap for all the wrong reasons during covid), long term consequences will remain to be seen. It's just that these considerations run up against a very solid understanding of how much death is caused by being overweight and having high blood pressure. Right now, Ozempic does not have to be very good, to be most likely a lot better than the alternative.

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.
      - fragmede 2y ago
        the belief is that the ozempic is what's allows the giving up of alcohol
mmcnl 2y ago
But has it had long-term studies as a weight-loss drug instead of a diabetes treatment? The results might be different.
- fragmede 2y ago
  it might be, but the question is if there's some long term bad effect, like it causes brain bleeds if you take it for 20 years or something. I don't think patients taking it for weight-loss instead of diabetes changes the underlying biological processes that happens as a result of taking the medication, so long term studies based on diabetes patients is useful information for non-diabetes patients.

scarmig 2y ago

There's always tradeoffs. Ozempic probably has some long term side effects, but are they worse than obesity? Probably not. (And an intervention based on ozempic is far more likely to cause lasting change than one based on a prescribed behavioral program.)

deleted 2y ago
[deleted]
throwup238 2y ago
> (And an intervention based on ozempic is far more likely to cause lasting change than one based on a prescribed behavioral program.) I was under the impression that for lasting change the behavioral program was pretty much required anyway, unless the patient wants to take Ozempic for the rest of their life. It helps someone go from obese to the point where they can exercise to maintain their health but they still have to eat healthy and exercise afterwards.
- scarmig 2y ago
  Yes: for most obese people, to become not obese and stay so for the rest of their life, lifelong Ozempic is the only thing that works at scale. Behavioural interventions more or less don't work (on an individual level they occasionally do, but on a population level they don't).
  - throwup238 2y ago
    > for most obese people, to become not obese and stay so for the rest of their life, lifelong Ozempic is the only thing that works at scale. Ozempic hasn't been around long enough to make that conclusion. It hasn't been prescribed at scale. It hasn't even been around long enough for its patent to expire, which is significantly shorter than a human lifespan ("rest of their life"). You're just making stuff up.

whatthesmack 2y ago

GLP-1 agonists have been around for a while. They're just gaining popularity lately, it seems. The first one was approved in the US in 2005 (exenatide).

hackerlight 2y ago

The status quo (obesity) is extremely dangerous, so whatever potential danger you're thinking may exist would have to exceed that.

TibbityFlanders 2y ago
Unless that's a false dichotomy. Obesity can be treated in less harmful ways. Companies can be regulated into only including a safe amount of sugar in drinks and foods that arent considered sweets
- Meekro 2y ago
  But when are those changes going to happen? Ozempic is available today.
makeitdouble 2y ago
> extremely dangerous I wish I could just quip a "citation needed", but we're at a point where the visceral hate for fat includes researchers spitting out feel good papers going with the flow, as funding is basically guaranteed. We don't have satanists, so this has become our day's moral panic IMHO: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885862/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885862/
- xenospn 2y ago
  Are you suggesting obesity is not harmful?
  - makeitdouble 2y ago
    Obesity is correlated to potentially harmful issues. That's a difference that matters when people reverse the goals and the means, reducing obesity often doesn't equate to solving the related issues.

deleted 2y ago

[deleted]

fyt2024 2y ago

Yes. I am very worried about the long term effects of this. While I have no need for this drug, I worries me for the broad population. There are problems known already (cancer). I understand that it is a trade off if you are obese. A buddy of mine died with 43 bc a combination of obesity and COVID. Yes, it might be justified for high risk patients but currently it looks like it will become a life style drug like Viagra. And a drug that digs so deep into your metabolism and take it for life? Call me a sceptic.

deleted 2y ago
[deleted]

Buttons840 2y ago

Seems like a valid ethical consideration, no doubt. But remember some people are suffering very serious harms already. A new drug might have side effects, but are they worse than the physical and social harms of being addicted to alcohol? The ethical considerations are more difficult when it comes to someone who simply wants a little help. Consider the common case of someone mostly happy and successful, but is a little overweight and has been struggling off and on for decades to lose 20 pounds; almost all of us have been there, or will be. Do you give those people the drug? Do you allow them to choose for themselves, or should big organizations decide for us?

znpy 2y ago

> 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. It isn't that different from what happened with vapes and e-cigs, and they were even worse (nicotine-based, explicitly harmful).

barney54 2y ago
I’m not sure I understand your point. Vapes and e-cigs are less dangerous to your health than regular tobacco cigarettes.

glp1guide 2y ago

Hey don't worry, your fears are mostly unfounded -- GLP1 Receptor Agonists have been an effective treatment method for type 2 diabetes for a very long time. They're well studied, researched and trialed, at this point, and many side effects are known. I'm a bit biased of course (I do a lot of trying to keep up with the research and effects of GLP1 drugs), but I honestly don't think the weight loss scene has seen something so effective and safe for a very long time.

makeitdouble 2y ago
Isn't the worry that Ozempic is only "effective and save" as far as all the other weight loss drugs being utter predatory bullshit ? Last time I looked into it the "loss" is only happening while taking the medication and you get back to normal once you stop, regardless of how long you’ve been taking it. So if stabilizing at a thinner state is your goal, the drug would be mostly useless or you should be ready to take the rest of your life. Going only a tad too far, it feels like recomming meth for its energizing and diet effects, that's not something we want at wide scale.
- pixl97 2y ago
  I mean come up with a pill that changes your eating habits and doesn't just repress them. Don't think anyone's got close to that yet. In the meantime overweight people are going to take what they can get.
  - glp1guide 2y ago
    > I mean come up with a pill that changes your eating habits and doesn't just repress them. Don't think anyone's got close to that yet. So GLP1 gene therapy (if it ever gets here) might be the most reasonable way to achieve this, and might be the safest we've ever seen so far outside of maybe brain control. > In the meantime overweight people are going to take what they can get. 100%. And AFAIK GLP1s are some of the safest we've seen so far, and much more effective than "eat less and move more" (as true as that may be).
  - makeitdouble 2y ago

a1445c8b 2y ago

> 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. Test in production. YOLO!

thereisnospork 2y ago
Considering it's not ethical (or legal) to spin up a test human what else are you going to do?

jstummbillig 2y ago

No, not at all. While I think we have a pretty fantastic drug approval process (that got a frustratingly bad rap for all the wrong reasons during covid), long term consequences will remain to be seen. It's just that these considerations run up against a very solid understanding of how much death is caused by being overweight and having high blood pressure. Right now, Ozempic does not have to be very good, to be most likely a lot better than the alternative.