3 ms·

I wouldn't count the Ozempic chickens before they roost. So far it looks like it's a costly lifelong injectable drug with a lot of reported uncomfortable side e

I wouldn't count the Ozempic chickens before they roost. So far it looks like it's a costly lifelong injectable drug with a lot of reported uncomfortable side effects. That doesn't bode well for adherence at the population level.

mannyv 2y ago
Actually, it's also a miracle drug that can reduce inflammation and reduce the medication load of millions of people. From what I've seen anecdotally, Ozempic adherence is much higher than most other meds. And the side effects are minor compared to, say, being 200 lbs overweight.
- blackeyeblitzar 2y ago
  That depends. A lot of people experience significant GI issues. And it isn’t clear yet if those issues are reversible after stopping. It’s still best for people to naturally control their weight and diet. Is one better than the other - depends on how overweight and how severe the side effects. Right now I feel like there isn’t much focus and rigorous study of those side effects but over time I expect it will reduce the overall positives of the drug somewhat.
  - djur 2y ago
    "A lot of people experience significant GI issues. And it isn’t clear yet if those issues are reversible after stopping." I don't think there's any reasonable definition of "a lot" where this is true. A significant number of people experience GI issues. Most of them subside after a time. There is some evidence that a small number of people may experience more severe GI issues that don't go away after stopping. "It’s still best for people to naturally control their weight and diet." What is your evidence for this? Right now, it's looking like the "unnatural" GLP-1 agonists are racking up quite a score against "natural" methods like "willpower" and programmed diets. It's not a useful distinction, in any case. These medications cause reduced calorie consumption, and reduced calorie consumption causes weight loss naturally.
    - willcipriano 2y ago
      The only advantage I know of for the natural way is you can retain more muscle mass potentially[0], so your relative body composition is probably better than someone who lost 75 pounds with Ozempic (eg. Ozempic Face). [0]https://www.theatlantic.com/health/archive/2024/02/ozempics-muscle-loss-problem/677326/ https://www.theatlantic.com/health/archive/2024/02/ozempics-... [0-1] Especially if you: Try to consume about 1 gram of protein per day per gram of lean mass, lift weights, limit cardio intensity and duration (30 mins on stationary bike 3x a week worked for me)
      - deleted 2y ago
        [deleted]
      - hombre_fatal 2y ago
        In the first study (https://www.nejm.org/doi/pdf/10.1056/nejmoa2032183 https://www.nejm.org/doi/pdf/10.1056/nejmoa2032183), the semaglutide group lost less LBM than the control group. > the proportion of lean body mass relative to total body mass increased with semaglutide. In the second study (https://link.springer.com/article/10.1007/s13679-023-00534-z https://link.springer.com/article/10.1007/s13679-023-00534-z), in the STEP 1 trial, the semaglutide group lost less LBM (40%) than the placebo group (56%).
        deleted 2y ago
        [deleted]
        djur 2y ago
        Yeah, the lean mass loss effect associated with GLP-1 agonists is just the effect of rapid weight loss without lifestyle and dietary changes other than calorie restriction. There's nothing about Ozempic etc. that keeps you from eating more protein, working out more, and so on (in fact, it makes it easier to do those things in most cases). People are noticing "Ozempic face" because the people who are losing weight through calorie restriction via GLP-1 agonists previously would have just failed at dieting and kept the weight on.
- outworlder 2y ago
  Given that >80% of Americans have some form of metabolic dysfunction, it's not surprising that those drugs are having miraculous effects.
- max51 2y ago
  >And the side effects are minor compared to, say, being 200 lbs overweight. I was about the reply the same thing. Obesity is directly or indirectly a risk factor for almost every health problem imaginable. Even for a situation that looks completely unrelated like getting shot in the knee by a gun, the risk of dying during the surgery will be significantly higher if you are obese.
- wpm 2y ago
  People have a real hard time with harm reduction strategies and I don't really know why. Ego, sense of moral authority, bein just plain old mean? I heard all the same crap when vaping became big 10 years ago.
cameronh90 2y ago
Weekly injectable semaglutide is the first generation. Tirzepatide is already more effective and better tolerated for most people, and there is also semaglutide as a daily oral pill available as Rybelsus. Further generations of obesity drugs are already in human trials, and are showing even greater effects relative to the side effects (e.g. retatrutide and combination therapy with cagrilintide). Price is an issue, but with multiple pharma companies that have effective drugs, the prices have already come down quite a lot. My tirzepatide is running me less than £200/month now, and I'm saving at least that on groceries and eating out. Not even counting that it's effectively cured a few weight related medical conditions that were costing me more.
diebeforei485 2y ago
Diet and exercise are also costly, have uncomfortable side effects, and require lifelong adherence.

mannyv 2y ago

Actually, it's also a miracle drug that can reduce inflammation and reduce the medication load of millions of people. From what I've seen anecdotally, Ozempic adherence is much higher than most other meds. And the side effects are minor compared to, say, being 200 lbs overweight.

blackeyeblitzar 2y ago
That depends. A lot of people experience significant GI issues. And it isn’t clear yet if those issues are reversible after stopping. It’s still best for people to naturally control their weight and diet. Is one better than the other - depends on how overweight and how severe the side effects. Right now I feel like there isn’t much focus and rigorous study of those side effects but over time I expect it will reduce the overall positives of the drug somewhat.
- djur 2y ago
  "A lot of people experience significant GI issues. And it isn’t clear yet if those issues are reversible after stopping." I don't think there's any reasonable definition of "a lot" where this is true. A significant number of people experience GI issues. Most of them subside after a time. There is some evidence that a small number of people may experience more severe GI issues that don't go away after stopping. "It’s still best for people to naturally control their weight and diet." What is your evidence for this? Right now, it's looking like the "unnatural" GLP-1 agonists are racking up quite a score against "natural" methods like "willpower" and programmed diets. It's not a useful distinction, in any case. These medications cause reduced calorie consumption, and reduced calorie consumption causes weight loss naturally.
  - willcipriano 2y ago
    The only advantage I know of for the natural way is you can retain more muscle mass potentially[0], so your relative body composition is probably better than someone who lost 75 pounds with Ozempic (eg. Ozempic Face). [0]https://www.theatlantic.com/health/archive/2024/02/ozempics-muscle-loss-problem/677326/ https://www.theatlantic.com/health/archive/2024/02/ozempics-... [0-1] Especially if you: Try to consume about 1 gram of protein per day per gram of lean mass, lift weights, limit cardio intensity and duration (30 mins on stationary bike 3x a week worked for me)
    - deleted 2y ago
      [deleted]
    - hombre_fatal 2y ago
      In the first study (https://www.nejm.org/doi/pdf/10.1056/nejmoa2032183 https://www.nejm.org/doi/pdf/10.1056/nejmoa2032183), the semaglutide group lost less LBM than the control group. > the proportion of lean body mass relative to total body mass increased with semaglutide. In the second study (https://link.springer.com/article/10.1007/s13679-023-00534-z https://link.springer.com/article/10.1007/s13679-023-00534-z), in the STEP 1 trial, the semaglutide group lost less LBM (40%) than the placebo group (56%).
      - deleted 2y ago
        [deleted]
      - djur 2y ago
        Yeah, the lean mass loss effect associated with GLP-1 agonists is just the effect of rapid weight loss without lifestyle and dietary changes other than calorie restriction. There's nothing about Ozempic etc. that keeps you from eating more protein, working out more, and so on (in fact, it makes it easier to do those things in most cases). People are noticing "Ozempic face" because the people who are losing weight through calorie restriction via GLP-1 agonists previously would have just failed at dieting and kept the weight on.
outworlder 2y ago
Given that >80% of Americans have some form of metabolic dysfunction, it's not surprising that those drugs are having miraculous effects.
max51 2y ago
>And the side effects are minor compared to, say, being 200 lbs overweight. I was about the reply the same thing. Obesity is directly or indirectly a risk factor for almost every health problem imaginable. Even for a situation that looks completely unrelated like getting shot in the knee by a gun, the risk of dying during the surgery will be significantly higher if you are obese.
wpm 2y ago
People have a real hard time with harm reduction strategies and I don't really know why. Ego, sense of moral authority, bein just plain old mean? I heard all the same crap when vaping became big 10 years ago.

cameronh90 2y ago

Weekly injectable semaglutide is the first generation. Tirzepatide is already more effective and better tolerated for most people, and there is also semaglutide as a daily oral pill available as Rybelsus. Further generations of obesity drugs are already in human trials, and are showing even greater effects relative to the side effects (e.g. retatrutide and combination therapy with cagrilintide). Price is an issue, but with multiple pharma companies that have effective drugs, the prices have already come down quite a lot. My tirzepatide is running me less than £200/month now, and I'm saving at least that on groceries and eating out. Not even counting that it's effectively cured a few weight related medical conditions that were costing me more.

diebeforei485 2y ago

Diet and exercise are also costly, have uncomfortable side effects, and require lifelong adherence.