3 ms·

> This is not the case with Ozempic. If you take it to lose weight then cessation will cause rapid weight gain. You'll be stuck with it for the rest of your lif

by borski 2y ago

> This is not the case with Ozempic. If you take it to lose weight then cessation will cause rapid weight gain. You'll be stuck with it for the rest of your life, for something that can [again] usually be permanently solved with other forms of treatment. This is not true. If you stop taking GLP-1 meds, you will revert back to whatever it was you were like prior to taking them, unless you have made significant lifestyle changes. So: you take a GLP-1 med, change nothing, lose a bunch of weight, get off it, and still eat McDonald’s every day? Yeah, you’ll gain it back. But if you exercise regularly (specifically strength training) and adjust your diet, which is what every single doctor worth their salt will tell you you must do, then you can get off of it over time or go to a much lower dose. These drugs are not and should not be prescribed to people who are simply “temporarily overweight.” It is not like magically getting off the GLP-1 meds makes you ravenous; it’s all about whether or not you’ve changed anything while on it.

calmoo 2y ago
But isn't one of the effects of GLP-1 is that it literally makes you not crave junk food? It doesn't just metabolize food more, or however that works, it also changes your dietary behaviours.
- borski 2y ago
  Not in the way you're implying. I should mention that I'm in a clinical trial for CagriSema (and it's a head-to-head efficacy trial against tirzepatide, so not blind, with no placebo, but randomized), so I am speaking from experience. It works in a few ways, but the vast majority of the benefit is just from delayed gastric emptying (food sticks around in you longer) which makes you feel fuller, and it helps remove hunger in general. If you're not careful, you'll find yourself simply not eating, so you have to be careful - that's a lot of why it leads to nausea. People don't eat, don't hydrate, and they get sick. Turns out that happens with or without the drug; not eating and not drinking will make you nauseous. If you have a bag of french fries, you will find yourself sick because you overdid it. It doesn't make them taste any less good. You just learn about portion control somewhat through force, because when you screw it up you feel ill. The other thing it does is remove the "food noise" so many of us simply exist with. I didn't know this was a thing, but it is - I grew up very impoverished, and we didn't always have food. I am also genetically predisposed to retaining more weight than necessary. Looking back now, I was constantly seeking a next snack or a next meal, almost before I finished my previous one, subconsciously. My days were split, in my head, into mealtimes and the times between mealtimes, which were usually snacking time. But between the habit, the ADHD, and the predisposition to always be thinking about it, it was an impossible habit to break. I didn't realize this until talking to my wife, who doesn't have this problem. She also didn't used to think every food tasted incredible. Just some. Meanwhile, there was almost nothing I ate that didn't taste fantastic, in my brain. That has also adjusted to be more "normal," but historically whenever my mom has stopped, that adjustment didn't revert. It would appear to have been stable, as it helps your brain and body simply figure out it isn't starving all the time. It's kind of hard to explain, so I hope that made sense.
  - calmoo 2y ago
    Thanks for sharing your experience, very interesting!
zamalek 2y ago
I agree with your sentiment in general. The problem is how people are actually using it, especially the rich. We shouldn't prescribe antidepressants for life so easily, but we do. We shouldn't feed livestock antibiotics, but we do. We shouldn't solve an eating/sedentary disorder with Ozempic, but we do.
- borski 2y ago
  What is the alternative? Sure, I agree people misuse medications sometimes. So should we not help people curb their obesity and/or T2D because some folks misuse it? Of course not. People misuse Sudafed and use it to make meth, or drink Robitussin to get high. I would be very upset if I lost access to those medications when I was sick, simply because we decided to make rules about the exception. :)
  - zamalek 2y ago
    I'm really not sure what the alternative is.
orwin 2y ago
My uncle and his wife were on GPL-1 (not Ozempic) from 2019 to 2022,stopped, took a bit of their belly back but are clearly not obese anymore, even if still overweight. Without discernable change in their behavior (they might cook a bit more)
- borski 2y ago
  That's great! But I guarantee you there is a discernible change in behavior to them.

by borski 2y ago

calmoo 2y ago

But isn't one of the effects of GLP-1 is that it literally makes you not crave junk food? It doesn't just metabolize food more, or however that works, it also changes your dietary behaviours.

borski 2y ago
Not in the way you're implying. I should mention that I'm in a clinical trial for CagriSema (and it's a head-to-head efficacy trial against tirzepatide, so not blind, with no placebo, but randomized), so I am speaking from experience. It works in a few ways, but the vast majority of the benefit is just from delayed gastric emptying (food sticks around in you longer) which makes you feel fuller, and it helps remove hunger in general. If you're not careful, you'll find yourself simply not eating, so you have to be careful - that's a lot of why it leads to nausea. People don't eat, don't hydrate, and they get sick. Turns out that happens with or without the drug; not eating and not drinking will make you nauseous. If you have a bag of french fries, you will find yourself sick because you overdid it. It doesn't make them taste any less good. You just learn about portion control somewhat through force, because when you screw it up you feel ill. The other thing it does is remove the "food noise" so many of us simply exist with. I didn't know this was a thing, but it is - I grew up very impoverished, and we didn't always have food. I am also genetically predisposed to retaining more weight than necessary. Looking back now, I was constantly seeking a next snack or a next meal, almost before I finished my previous one, subconsciously. My days were split, in my head, into mealtimes and the times between mealtimes, which were usually snacking time. But between the habit, the ADHD, and the predisposition to always be thinking about it, it was an impossible habit to break. I didn't realize this until talking to my wife, who doesn't have this problem. She also didn't used to think every food tasted incredible. Just some. Meanwhile, there was almost nothing I ate that didn't taste fantastic, in my brain. That has also adjusted to be more "normal," but historically whenever my mom has stopped, that adjustment didn't revert. It would appear to have been stable, as it helps your brain and body simply figure out it isn't starving all the time. It's kind of hard to explain, so I hope that made sense.
- calmoo 2y ago
  Thanks for sharing your experience, very interesting!

zamalek 2y ago

I agree with your sentiment in general. The problem is how people are actually using it, especially the rich. We shouldn't prescribe antidepressants for life so easily, but we do. We shouldn't feed livestock antibiotics, but we do. We shouldn't solve an eating/sedentary disorder with Ozempic, but we do.

borski 2y ago
What is the alternative? Sure, I agree people misuse medications sometimes. So should we not help people curb their obesity and/or T2D because some folks misuse it? Of course not. People misuse Sudafed and use it to make meth, or drink Robitussin to get high. I would be very upset if I lost access to those medications when I was sick, simply because we decided to make rules about the exception. :)
- zamalek 2y ago
  I'm really not sure what the alternative is.

orwin 2y ago

My uncle and his wife were on GPL-1 (not Ozempic) from 2019 to 2022,stopped, took a bit of their belly back but are clearly not obese anymore, even if still overweight. Without discernable change in their behavior (they might cook a bit more)

borski 2y ago
That's great! But I guarantee you there is a discernible change in behavior to them.