7 ms·
We’re nearing the utopic phase for this drug (if we aren’t already there) Mindful that this also lowers muscle mass (can weight train and eat enough protein to
by spacephysics 2y ago
We’re nearing the utopic phase for this drug (if we aren’t already there)
Mindful that this also lowers muscle mass (can weight train and eat enough protein to compensate slightly)
AND less easily mitigated lowers bone mass, weakens tendons, and weakens ligaments.
It’s a great option if the patient is diabetic and their current lifestyle/condition has worse outcomes than the side effects listed, but we’re hearing from celebrities like this is a vitamin D pill
- xcskier56 2y agoYeah, I'm with you. It seems like there are some almost miraculous results from this class of drugs, but I'm very concerned what's going to rear it's head 5, 10, 15 years down the line
- rasz 2y ago>miraculous results All the results are from lowering BMI, being fat is just this unhealthy.
- ssijak 2y agoIt looks like it lowers addictions of all kinds which are not BMI related
- throwup238 2y agoI don't envy anyone tasked with calculating the risk/reward benefit of this drug versus obesity and friends. These drugs aren't a free lunch and from my understanding can't be stopped without dramatic lifestyle changes or most of the weight comes right back. 20+ years of losing bone density and connective tissue mass is going to be catastrophic in old age for people who have to stay on it long term but really so is the obesity, diabetes, and heart disease. It's a tough moral quandary.
- inquirerGeneral 2y ago[dead]
- akira2501 2y agoIt seems like the most corrupt time with the government almost entirely asleep at the regulatory switch. Perhaps that's just a coincidence that so many "miraculous" results seem to exist.
- robertonoa 2y ago[flagged]
- JumpCrisscross 2y ago> more severe unknown incidents like thyroid and pancreatic cancer Alcoholism, diabetes and obesity don't give you long enough to get these cancers. Even if we had evidence GLP-1 agonists massively increased the risk of these cancers, which we don't, despite them having been studied and prescribed for decades [1][2], the tradeoff makes sense for much of the population. [1] https://en.wikipedia.org/wiki/GLP-1_receptor_agonist#Approved https://en.wikipedia.org/wiki/GLP-1_receptor_agonist#Approve... [2] https://en.wikipedia.org/wiki/Exenatide https://en.wikipedia.org/wiki/Exenatide
- EA-3167 2y agoPeople also talk about the cost, but that cost will come down, and besides the cost to society from alcoholism and obesity are absolutely staggering.
- JamesBarney 2y agoThis really depends how you calculate cost to society. Everyone dies, and the healthiest people die the slowest. So when you look at the cost of the alternatives the difference looks much smaller or non-existant. If the alternative of getting a heart attack at 57 is retiring at 67, collecting social security for 20 years, getting Alzheimers at 73 and spending 10 years in a Medicare funded memory care facility, obesity and alcoholism don't look as expensive.
- JumpCrisscross 2y ago> really depends how you calculate cost to society Age doesn't cost society, morbidity does [1]. A society of long-lived healthy people is richer than one of the short-lived obese. [1] https://pubmed.ncbi.nlm.nih.gov/37117804/ https://pubmed.ncbi.nlm.nih.gov/37117804/
- 2y ago
- Analemma_ 2y agoObesity has a whole galaxy of side effects an absurdly strong correlation with a large increase in all-cause mortality. From a cost-benefit standpoint, ozempic would be an obvious win even if the side effects were much worse than they actually are.
- robertonoa 2y agoCan you perform cost benefit analysis in the long term on a drug that has only been used in the short term?
- Analemma_ 2y agoYou know that GLP-1s aren't new, right? There are diabetics who have been on them continuously for decades; it's only the realization that they can treat obesity which is new. If there were common and severe side-effects from continuous long-term use, they'd already have shown up in diabetic patients.
- Rastonbury 2y agoWhat is better about the newer ones that there is so much hype? Or did it take 30 years to realise the other positive effects of these?
- deleted 2y ago[deleted]
- ewoodrich 2y agoA few things: 1. Weekly vs daily administration, liraglutide and exenatide had to be injected daily which made the drug less attractive for patients and doctors vs metformin which is well known and a cheap pill. 2. Greater magnitude of effect. Liraglutide had less impact at prescribed dosage for both lowering A1C and weight loss so in combo with (1) made it less attractive than semaglutide. 3. Magnitude of weight loss from (2) now so significant it easily beats all previously approved weight loss drugs with few side effects. So entire GLP-1 agonist class of drugs reexamined as direct weight loss treatments vs just a modest but very welcome side effect of diabetes treatment. And once weekly administration meant it would have much better patient compliance than a daily injection.
- JumpCrisscross 2y ago> We’re nearing the utopic phase for this drug (if we aren’t already there) GLP-1 increasingly looks like a vitamin. It is "essential to [humans] in small quantities for proper metabolic function" [1]. But what our body produces gets eliminated in minutes [2]. Not everyone needs supplementation and too much can be harmful. But a deficit results in ultimately-fatal chronic conditions. [1] https://en.wikipedia.org/wiki/Vitamin https://en.wikipedia.org/wiki/Vitamin [2] https://en.wikipedia.org/wiki/Glucagon-like_peptide-1 https://en.wikipedia.org/wiki/Glucagon-like_peptide-1
- malfist 2y agoGood thing they're not GLP-1. They're GLP-1 agonists. At least in semaglutide's case their half-life is 1 week
- JumpCrisscross 2y ago> Good thing they're not GLP-1. They're GLP-1 agonists Sure, which is why I say looks like, not may be. If calcitrol were eliminated like GLP-1, a drug that activated the VDR would be beneficial to those with a deficiency [1]. [1] https://en.wikipedia.org/wiki/Vitamin_D_receptor https://en.wikipedia.org/wiki/Vitamin_D_receptor
- suzzer99 2y ago> Mindful that this also lowers muscle mass (can weight train and eat enough protein to compensate slightly) > AND less easily mitigated lowers bone mass, weakens tendons, and weakens ligaments. Does it do these things any more than losing the same amount of weight by other means in a similar time frame?
- diydsp 2y agoIIUC, it depends how the patient would lose that weight. Afaict, these drugs work by lowering appetite overall and making people poop out lots of food before it's fully digested. If the patient macros are still bad, the same proportions as before the drug, they'll have deficiencies such as protein, fiber, electrolytes, vitamins (esp fat-soluble ones), etc. But hopefully it's just for short term. (star) So to get back to your question, one could lose the weight in the best possible way by correcting their diet, eating less, doing HIIT, fasting, good supplements like creatine, stress reduction through breath work and meditation, and resistance training and end up in a very strong position. Please anyone correct me on this. (star) Anecdote about my friend: He went on Metformin for a few years, had lots of diarrhea, and lost about 30 pounds and is skinnier than me. At this point, he could really really get into a strong health position having had that shortcut. His eating habits even got a little better from wearing a glucose monitor. He's sick of the diarrhea which really keeps him from wanting to be out of the house for long, and is slowly looking for some intriguing physical activities. So I think these drugs can help people.
- mise_en_place 2y agoIt only lowers muscle mass and bone density because your body only secretes the bare minimum amount of insulin needed to maintain while on it. Put another way, you want insulin sensitivity when you cut, but you want insulin resistance when you bulk. If you know what you're doing it can greatly increase your strength and lean body mass. I took compounded semaglutide for one week, cut about 15 lbs, then bulked 45+ lbs over the next few months.
- stavros 2y agoHow do you increase your lean body mass while on it?
- mise_en_place 2y agoBryan Johnson protocol - testosterone and weight training.
- stavros 2y agoOof, testosterone comes with a ton of downsides (your body will stop making its own). We are really careful about people who start on testosterone replacement therapy, as it's a lifelong thing.
- mise_en_place 2y agoWhat’s interesting is that Bryan himself claimed to have stopped TRT and was able to restore his levels to baseline levels. I have clinical hypogonadism so I was probably going to need lifelong TRT anyway. My LH and FSH were normal but testosterone and estradiol were both low. It was a sudden drop too.
- nyokodo 2y ago> Mindful that this also lowers muscle mass (can weight train and eat enough protein to compensate slightly) AND less easily mitigated lowers bone mass, weakens tendons, and weakens ligaments. These are the common effects of weight-loss and they and other risks are why you should be under the care of a specialist in obesity and/or diabetes, a nutritionist, and a trainer.
- r00fus 2y agoYou need lots of muscle mass to be overweight. Losing weight means losing the muscle “scaffolding” also. Until I see proof that these drugs result in dramatically more muscle mass loss, I’m going to assume the argument is FUD.