10 ms·

I'd think it more likely that it'll be one of the next generation drugs, but I do agree with the premise that it will be really common. A few weeks ago I start

I'd think it more likely that it'll be one of the next generation drugs, but I do agree with the premise that it will be really common. A few weeks ago I started a low dose of tirzepatide (aka Mounjaro, aka Zepbound) and the side effects are interesting. The biggest negative, which just takes adjustment, is drastically lower stomach capacity. Used to be that two eggs and two pieces of toast was breakfast. Now I better skip at least one of those pieces of toast or I'm going to feel overfull and might get reflux as punishment. But there are some unexpected positives. Obviously I am eating less. I have to log food not to keep it in check, but to make sure I'm eating enough and with the right nutrients. There's another possible negative here -- you get a lot of hydration from food, so if you start eating less you should carefully monitor your fluid intake to allow for that. But I'm also more focused. Not nearly as distracted. I'm getting a lot of things done which I used to just procrastinate on until years had passed in some cases. Man, the garage is going to be clean and superbly organized in a few weeks. And my emotions are quieter. Not just the food noise, that was expected, but I feel more relaxed. That's not what I expected, and I'm pleasantly surprised. As an aside, what makes this all really noticeable is that it's a once-a-week injection, and the peaks and valleys are very obvious. Saturday is injection day, but Sunday is where it really becomes quite noticeable that I took it. Monday-Wednesday is cruising altitude and the effects are good but not over the top. Thursday I can feel it tapering, and today ... well, I'm looking forward to tomorrow's injection. I might switch to a twice-a-week split dose at some point to ease the peaks and valleys. Edit: Before someone asks, yes I have considered there may be long term effects. This is a risk, which I've decided I'm okay with at my age. Nobody gets to live forever anyway, and I was going to end up in an early grave via another route if I didn't do this. "Just eat less and exercise more" is trite. If it were that easy, we'd all be in fantastic shape. I do hope to taper off at some point if I can figure out an alternate strategy for staying lighter. Though I'll miss some of the positive side-effects.

jeffbee 2y ago
> Man, the garage is going to be clean and superbly organized in a few weeks.' Manic behaviors also associated with older, popular diet drugs like meth.
- cyberax 2y ago
  It's not the manic behavior, but the opposite. GLP-1 agonists appear to reduce the impulsive behavior.
  - abeppu 2y ago
    Does anyone have references on any explanation, or even partial explanation, on why this might be the case? The published stuff I can find seems to be at the level of anecdata, scarcely better than "I know a guy who..." - What people talk about on social media: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10669484/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10669484/ - Some people made large "reckless" life choices: https://academic.oup.com/qjmed/advance-article-abstract/doi/10.1093/qjmed/hcae095/7665706 https://academic.oup.com/qjmed/advance-article-abstract/doi/...
    - deleted 2y ago
      [deleted]
    - cyberax 2y ago
      > Does anyone have references on any explanation, or even partial explanation, on why this might be the case? Not yet. The effect appears to be real, but it's too soon to tell: https://www.science.org/content/blog-post/ozempic-and-other-glp-1-drugs-more-people-realize https://www.science.org/content/blog-post/ozempic-and-other-... From my own anecdata, unnecessary impulsive eating probably reinforces the impulsive behavior. You start associating impulsive behavior with a reward. GLP-1 not only removes that, but adds a slight negative reinforcement. Impulsive eating no longer brings reward, but makes you feel over-full. This can then down-regulates the pathways that lead to increased impulsive behavior.
      - rootusrootus 2y ago
        Great description, thanks! I won't sugarcoat my problems. I knew I wasn't hungry when I'd eat sometimes. I knew it would keep me overweight. I knew it wouldn't even feel great afterwards. And yet, more often than not I did it. And beat myself up over it every time. Very demoralizing, even without help from moralizing folks on the internet. On tirzepatide the impulse is just gone. I feel like I can take it or leave it, and since the consequences of eating unnecessarily are quickly negative, I just don't do it.
copperx 2y ago
It would be interesting to compare the anxiolytic effects of the drug versus the cancer anxiety caused by being on the drug. The cancer anxiety could be reduced by frequent testing. e.g., having a thyroid ultrasound every 6 months, or a yearly abdominal MRI, just to make sure cancer is not brewing.
- arcticbull 2y ago
  There's no evidence that GLP-1s cause cancer in any meaningful amount, but obesity definitely does. Either way the only cancer they found any correlation to was thyroid which is one of the most treatable -- over 99% survival rates.
  - copperx 2y ago
    While thyroid cancer is highly treatable, the type of thyroid cancer that GLP-1 drugs cause is the rare and untreatable variety.
    - arcticbull 2y ago
      There's no causative relationship. There is a correlation in some studies. This is not the same thing. Beyond that, some studies have found a very weak association and some have found no association at all. To say with this corpus of evidence they cause anything is very premature. This 2024 study showed no increase in risk over 3.9 years. https://www.bmj.com/content/385/bmj-2023-078225 https://www.bmj.com/content/385/bmj-2023-078225
      - cyberax 2y ago
        > There's no causative relationship. To be fair, GLP-1 drugs cause dose-dependent increase in thyroid cancer in mice. But mice are not humans.
- gcr 2y ago
  Is cancer anxiety a common response? I haven't seen any mention of cancer on r/zepbound
arcticbull 2y ago
> "Just eat less and exercise more" is trite. If it were that easy, we'd all be in fantastic shape. Studies show it just doesn't work. There was a massive (18,000,000 people) cohort analysis published in 2023 that showed the likelihood of someone losing 5% of their body weight in any given year was 1 in 11 and the likelihood of going from severely obese to normal weight is 1 in 1667. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407685/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407685/ [edit] not to mention for those 1 in 11, the average weight regain over 5 years is 80%. https://www.sciencedirect.com/science/article/pii/S0002916523063748 https://www.sciencedirect.com/science/article/pii/S000291652...
- oldpersonintx 2y ago
  [dead]
- pfdietz 2y ago
  I've lost 27 pounds since May (12%). Eliminating most carbs and doing lots of walking. I think being on metformin helped.
  - jeffbee 2y ago
    > and doing lots of walking If you just teleport a fat guy from Bentonville to Manhattan and give him a Metrocard he will lose a pound a week. The people who say nobody can lose weight, it's too hard, cannot explain why there are macroscale populations with lower obesity.
    - arcticbull 2y ago
      Surely you have a study to support this? Or are we just speculating. The problem with this particular area is that it's not intuitive, and relying on "common sense" guidance is why everyone got fat in the first place.
      - randomdata 2y ago
        Does it matter? This is a discussion forum, not a scientific journal. If you have something more informative to add, just do it.
nullc 2y ago
Glad you're having a good time, but the broad ranging psychological effects are concerning.
- noch 2y ago
  > but the broad ranging psychological effects are concerning. Fwiw, to me the symptoms he and others have described don't seem very different from those of long fasting. And I would definitely prefer those symptoms to the ones I had due to obesity which ranged from extreme fatigue, heart-pain, muscle spasms, depressive shame, restlessness and so forth.
- firesteelrain 2y ago
  What kinds? I have been taking tirz for 7 weeks and walking 5 miles a day + exercise. My depression is gone and I have lost 30 lbs. I am loving life.
noch 2y ago
> Saturday is injection day, but Sunday is where it really becomes quite noticeable that I took it. Monday-Wednesday is cruising altitude and the effects are good but not over the top. Thursday I can feel it tapering, and today ... well, I'm looking forward to tomorrow's injection. I might switch to a twice-a-week split dose at some point to ease the peaks and valleys. Perhaps coincidentally, this is similar to my experience with week long fasts: After 48 hours I feel like a precision missile cruising towards my target until about 5-6 days later. But I will use a suitable GLP-1 based drug, because, man, fasting feels unbearably brutal for me after 6 days: profuse sweat, increased heart rate, brief but intense panic attacks, an insane level of sad (but not depressed) introspection, a hairpin trigger temper. I become a ridiculous mess. There's got to be a better way! Thanks for sharing your experience and insight!
- whatshisface 2y ago
  You could have food allergies that take a couple days to clear up.
pixl97 2y ago
>I might switch to a twice-a-week split dose at some point to ease the peaks and valleys. If you're willing to shoot up more often it moderates the effects better.
- rootusrootus 2y ago
  I definitely am. That first shot took a solid 30 seconds and three false starts before I could jab it in, but it turns out to be a great big nothingburger once you do it. Can barely even feel it, nothing like the intramuscular shots like flu/etc. I could do this shot as often as necessary without batting an eye.
- spondylosaurus 2y ago
  Might have to float this by my tirz-taking partner, especially if it helps with side effects. They always feel a little icky the day immediately after a dose.
nixosbestos 2y ago
These are the same effects I got from doing OMAD and going gluten free. If I fuck up and eat processed food, the "food brain" comes back, and I start chasing dopamine like a fiend. I'm a fan of these tools helping people get this insight, because otherwise people just accept that cloud as their normal.
iLoveOncall 2y ago
> The biggest negative, which just takes adjustment, is drastically lower stomach capacity. Used to be that two eggs and two pieces of toast was breakfast. Now I better skip at least one of those pieces of toast or I'm going to feel overfull and might get reflux as punishment. If you want to be successful long term in your weight loss, especially after stopping the drug, you should really invest in changing your mindset. This is a massive positive, not at all a negative. You got fat because you ate too much. If you don't understand what are normal portions now, you'll go back to your starting weight as soon as the drug isn't having effects anymore. This is a lifestyle change that you MUST embrace to be successful long term.

jeffbee 2y ago

> Man, the garage is going to be clean and superbly organized in a few weeks.' Manic behaviors also associated with older, popular diet drugs like meth.

cyberax 2y ago
It's not the manic behavior, but the opposite. GLP-1 agonists appear to reduce the impulsive behavior.
- abeppu 2y ago
  Does anyone have references on any explanation, or even partial explanation, on why this might be the case? The published stuff I can find seems to be at the level of anecdata, scarcely better than "I know a guy who..." - What people talk about on social media: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10669484/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10669484/ - Some people made large "reckless" life choices: https://academic.oup.com/qjmed/advance-article-abstract/doi/10.1093/qjmed/hcae095/7665706 https://academic.oup.com/qjmed/advance-article-abstract/doi/...
  - deleted 2y ago
    [deleted]
  - cyberax 2y ago
    > Does anyone have references on any explanation, or even partial explanation, on why this might be the case? Not yet. The effect appears to be real, but it's too soon to tell: https://www.science.org/content/blog-post/ozempic-and-other-glp-1-drugs-more-people-realize https://www.science.org/content/blog-post/ozempic-and-other-... From my own anecdata, unnecessary impulsive eating probably reinforces the impulsive behavior. You start associating impulsive behavior with a reward. GLP-1 not only removes that, but adds a slight negative reinforcement. Impulsive eating no longer brings reward, but makes you feel over-full. This can then down-regulates the pathways that lead to increased impulsive behavior.
    - rootusrootus 2y ago
      Great description, thanks! I won't sugarcoat my problems. I knew I wasn't hungry when I'd eat sometimes. I knew it would keep me overweight. I knew it wouldn't even feel great afterwards. And yet, more often than not I did it. And beat myself up over it every time. Very demoralizing, even without help from moralizing folks on the internet. On tirzepatide the impulse is just gone. I feel like I can take it or leave it, and since the consequences of eating unnecessarily are quickly negative, I just don't do it.

copperx 2y ago

It would be interesting to compare the anxiolytic effects of the drug versus the cancer anxiety caused by being on the drug. The cancer anxiety could be reduced by frequent testing. e.g., having a thyroid ultrasound every 6 months, or a yearly abdominal MRI, just to make sure cancer is not brewing.

arcticbull 2y ago
There's no evidence that GLP-1s cause cancer in any meaningful amount, but obesity definitely does. Either way the only cancer they found any correlation to was thyroid which is one of the most treatable -- over 99% survival rates.
- copperx 2y ago
  While thyroid cancer is highly treatable, the type of thyroid cancer that GLP-1 drugs cause is the rare and untreatable variety.
  - arcticbull 2y ago
    There's no causative relationship. There is a correlation in some studies. This is not the same thing. Beyond that, some studies have found a very weak association and some have found no association at all. To say with this corpus of evidence they cause anything is very premature. This 2024 study showed no increase in risk over 3.9 years. https://www.bmj.com/content/385/bmj-2023-078225 https://www.bmj.com/content/385/bmj-2023-078225
    - cyberax 2y ago
      > There's no causative relationship. To be fair, GLP-1 drugs cause dose-dependent increase in thyroid cancer in mice. But mice are not humans.
gcr 2y ago
Is cancer anxiety a common response? I haven't seen any mention of cancer on r/zepbound

arcticbull 2y ago

> "Just eat less and exercise more" is trite. If it were that easy, we'd all be in fantastic shape. Studies show it just doesn't work. There was a massive (18,000,000 people) cohort analysis published in 2023 that showed the likelihood of someone losing 5% of their body weight in any given year was 1 in 11 and the likelihood of going from severely obese to normal weight is 1 in 1667. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407685/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407685/ [edit] not to mention for those 1 in 11, the average weight regain over 5 years is 80%. https://www.sciencedirect.com/science/article/pii/S0002916523063748 https://www.sciencedirect.com/science/article/pii/S000291652...

oldpersonintx 2y ago
[dead]
pfdietz 2y ago
I've lost 27 pounds since May (12%). Eliminating most carbs and doing lots of walking. I think being on metformin helped.
- jeffbee 2y ago
  > and doing lots of walking If you just teleport a fat guy from Bentonville to Manhattan and give him a Metrocard he will lose a pound a week. The people who say nobody can lose weight, it's too hard, cannot explain why there are macroscale populations with lower obesity.
  - arcticbull 2y ago
    Surely you have a study to support this? Or are we just speculating. The problem with this particular area is that it's not intuitive, and relying on "common sense" guidance is why everyone got fat in the first place.
    - randomdata 2y ago
      Does it matter? This is a discussion forum, not a scientific journal. If you have something more informative to add, just do it.

nullc 2y ago

Glad you're having a good time, but the broad ranging psychological effects are concerning.

noch 2y ago
> but the broad ranging psychological effects are concerning. Fwiw, to me the symptoms he and others have described don't seem very different from those of long fasting. And I would definitely prefer those symptoms to the ones I had due to obesity which ranged from extreme fatigue, heart-pain, muscle spasms, depressive shame, restlessness and so forth.
firesteelrain 2y ago
What kinds? I have been taking tirz for 7 weeks and walking 5 miles a day + exercise. My depression is gone and I have lost 30 lbs. I am loving life.

noch 2y ago

> Saturday is injection day, but Sunday is where it really becomes quite noticeable that I took it. Monday-Wednesday is cruising altitude and the effects are good but not over the top. Thursday I can feel it tapering, and today ... well, I'm looking forward to tomorrow's injection. I might switch to a twice-a-week split dose at some point to ease the peaks and valleys. Perhaps coincidentally, this is similar to my experience with week long fasts: After 48 hours I feel like a precision missile cruising towards my target until about 5-6 days later. But I will use a suitable GLP-1 based drug, because, man, fasting feels unbearably brutal for me after 6 days: profuse sweat, increased heart rate, brief but intense panic attacks, an insane level of sad (but not depressed) introspection, a hairpin trigger temper. I become a ridiculous mess. There's got to be a better way! Thanks for sharing your experience and insight!

whatshisface 2y ago
You could have food allergies that take a couple days to clear up.

pixl97 2y ago

>I might switch to a twice-a-week split dose at some point to ease the peaks and valleys. If you're willing to shoot up more often it moderates the effects better.

rootusrootus 2y ago
I definitely am. That first shot took a solid 30 seconds and three false starts before I could jab it in, but it turns out to be a great big nothingburger once you do it. Can barely even feel it, nothing like the intramuscular shots like flu/etc. I could do this shot as often as necessary without batting an eye.
spondylosaurus 2y ago
Might have to float this by my tirz-taking partner, especially if it helps with side effects. They always feel a little icky the day immediately after a dose.

nixosbestos 2y ago

These are the same effects I got from doing OMAD and going gluten free. If I fuck up and eat processed food, the "food brain" comes back, and I start chasing dopamine like a fiend. I'm a fan of these tools helping people get this insight, because otherwise people just accept that cloud as their normal.

iLoveOncall 2y ago

> The biggest negative, which just takes adjustment, is drastically lower stomach capacity. Used to be that two eggs and two pieces of toast was breakfast. Now I better skip at least one of those pieces of toast or I'm going to feel overfull and might get reflux as punishment. If you want to be successful long term in your weight loss, especially after stopping the drug, you should really invest in changing your mindset. This is a massive positive, not at all a negative. You got fat because you ate too much. If you don't understand what are normal portions now, you'll go back to your starting weight as soon as the drug isn't having effects anymore. This is a lifestyle change that you MUST embrace to be successful long term.