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It's not just obesity. Drugs like Ozempic will change the world
- sharpshadow 2y agoWe don’t know long-term effects yet. Interfering with hormones and their receptors can change the amount of the hormone the body produces and the sensitivity of the receptor. If it’s applied carefully then it shouldn’t be a problem though and the body would re-regulate later itself for the trade of many positive effects immediately.
- hatenberg 2y agoPeople keep saying that but we've had GLP-1's in active use on millions of people for decades in diabetes care.
- cyberax 2y agoLiraglutide has been in clinical use for two decades, with no real serious downsides.
- orionsbelt 2y agoGastropreisis may be a rare side effect, but is serious and appears to a be a real risk.
- cyberax 2y agoIt goes away after discontinuation. And apparently it mostly happens when people jump into too high doses straight away instead of titrating slowly.
- ajhurliman 2y agoGLP1s have been on the market for at least a decade, they’re pretty well studied at this point. Their sudden popularity is due to the FDA allowing it to be prescribed for obesity (instead of diabetes), not the discovery of a new drug.
- Karunamon 2y agoWait a sec. Something which provides such an unambiguous quality of life upgrade by addressing one of the biggest health problems in the country, is only now available because of regulations? Surely it's not that simple.
- ajhurliman 2y agoSeems wild right? Would you believe that there’s a male contraceptive that’s been actively used in other countries successfully for over a decade, is easily and painlessly reversible, and non-hormonal?
- stevenAthompson 2y agoIt took the FDA four years to pull Thalidomide from the market. Hell, it was OTC in the early days and often prescribed for morning sickness. They're more cautious now when it comes to pregnancy related drugs. As someone who was not born with flippers instead of hands, I'm pretty happy about that.
- cyberax 2y ago> It took the FDA four years to pull Thalidomide from the market. BZZT! Wrong. Thalidomide had _never_ been approved in the USA for the morning sickness, thanks to the FDA. The only pregnant people receiving it were getting experimental pre-approval samples (now illegal) and during the clinical trials. See, for example: https://www.reuters.com/article/fact-check/fda-did-not-approve-thalidomide-for-pregnant-women-in-1950s-or-1960s-idUSL1N2PY2F7/ https://www.reuters.com/article/fact-check/fda-did-not-appro...
- stevenAthompson 2y agoYou're correct, I was mistaken. Although my mistake may actually help to support my stance. It was used, and marketed, for morning sickness primarily in other countries (Germany in particular). It's an important distinction, because the US FDA actually stopped it's approval in the US. It seems that "only" about 20,000 American study participants were given the drug at that time. So more than half of the dead/deformed babies came from Germany. Had the German equivalent of the FDA prevented the drug from going to market many babies might not have been born with deformities. There are VERY good reasons to be slow in approving drugs that might impact a fetus.
- stevenAthompson 2y agoWe kind of do know the long term side effects. Exenatide has been in use since around since 2005. They can include pancreatitis and thyroid cancer in a small percentage of the population. Modern GLP-1 agonists exhibit essentially the same threat profile. EDIT - Just wanted to note that the cancer thing has only been seen in rats. Not humans. After 20 years we'd probably have seen it by now.
- A_D_E_P_T 2y agoThyroid cancer sounds more scary than it actually is. It's one of the weakest forms of cancer, and it's extremely easy to treat if caught early enough. Also, living without a thyroid is no big deal. Somebody very near and dear to me was diagnosed with thyroid cancer ten years ago, and now has no thyroid. She's hardly inconvenienced by it & hasn't even gained any weight since then. Just gotta remember to take those T4 tablets in the morning, is all. Point is: If you weigh in the balance [lives saved or QALY gained due to GLP agonist administration] vs. [lives lost or QALY lost due to thyroid cancer secondary to GLP agonist administration], it's not even going to be remotely close. "Lives saved" will probably win by an enormous margin, maybe a factor of twenty or so.
- ZYbCRq22HbJ2y7 2y agoIs it wise to minimize thyroid cancer or ablation just because you know someone who fared well afterwards?
- A_D_E_P_T 2y agoPeople hear the word "cancer" and think "death sentence." (Or, at the very least, an extremely difficult ordeal.) It's a scary word. Yet thyroid cancer is generally a mild disease -- especially mild as cancer goes -- and almost invariably nonfatal if caught early enough. If GLP-1 inhibitors get people screened for thyroid cancers more frequently, or lead to improved treatments for thyroid cancer, they will almost certainly lead to a reduction in thyroid cancer deaths -- even if, as some surmise, they are responsible for an increase in thyroid cancer cases. Even without this effect, if you balance [QALY lost] versus [QALY gained] GLP-1 agonists should come out so far ahead that it's almost laughable. In any case, I believe it is wise to talk about these things openly and without fear.
- swatcoder 2y agoIt's okay. We go through this every 10 years or so, for at least the last 100 years. The market doesn't really have the patience to wait to see the aggregate or long-term effects of new "pop culture" drugs and formulations so we just charge ahead and then let another generation deal with whatever mess. When the pharmaceutical companies really luck out, the cleanup can even come through yet another such wonder drug.
- VoodooJuJu 2y agoOh you just done a heckin double badspeak. Not only are you not trusting my science, but you're slandering my big pharma. Big mistake. Thats a downvote.
- consteval 2y agoI don't know what category of comment this is but can we please make this go away
- Extropy_ 2y agoThis is exactly right. Let the market decide. If people want to use new experimental drugs, why not let them have at it. They oughta be responsible for their choices
- fragmede 2y agoOzempic was approved for medical use by the FDA in diabetics in 2017, seven years ago. Meaning it passed phase 1, 2, and 3 trials. So it's not exactly an experimental research out of China like a brand new fentanyl analogue.
- Extropy_ 2y agoYou're right. I'm not saying the chemical or using it in of itself is dangerous
- PNewling 2y ago
- welferkj 2y agoBut we know the long-term effects of obesity, alcoholism, and every other form of spiritual weakness this thing apparently allows people to escape. The long-term effects would have to be comically atrocious for it not to be worth it. Put ozempic in the water supply.
- PNewling 2y agoSo I agree with all of this, but will add we do know the long-term effects of obesity, diabetes and a host of the other things it is showing some potential signs of helping with. And because of the serious damage being done by those issues ([0] heart disease is the leading cause of death in the US), it just needs to be good enough to help resolve those issues without introduction anything too major as far as long term side-effects. This is all to say, because of the current state of health norms (at least in the US), it just has to not do too much damage long term and the pro's can still outweigh the con's of its use. [0] https://injuryfacts.nsc.org/all-injuries/deaths-by-demographics/all-leading-causes-of-death https://injuryfacts.nsc.org/all-injuries/deaths-by-demograph...
- wyre 2y ago>We don’t know long-term effects yet. Compared to the long-term effects of obesity, Alzheimers, and addiction? Everything treatable by Ozempic, et al. has immediate short-term effects, and long term effect that significantly effect longevity. The fearmongering around Ozempic not knowing the long-term effects would have to be is unnessicary. Yes, it sucks to have to be stuck taking a medication for the rest of your life, but would you rather be stuck with a delibitating disease and die 10 years early, or have to take a medication for the rest of your life?
- hagbard_c 2y ago> would you rather be stuck with a delibitating disease and die 10 years early, or have to take a medication for the rest of your life? I'd rather have a cure for that disease instead of lifelong medication. While not nearly as profitable it is far preferable over a lifelong dependency.
- notpushkin 2y agoIt also doesn't exist sometimes.
- salawat 2y agoIt won't exist if no one can look for it because they cdn't get the research funded, because cures are unprofitable.
- hagbard_c 2y agoNor do the therapeutic preparations, these are developed just like curative treatments are. There is far more profit to be had from therapeutic treatments in the absence of curative treatments so there is a perverse incentive to develop the former in lieu of the latter.
- wyre 2y agoSo ozempic can save the lives of millions of people but it’s bad and not worth celebrating because it’s not a cure?
- notpushkin 2y agohttps://archive.is/tLaw3 https://archive.is/tLaw3
- Extropy_ 2y agoTo me at least, celebrating individuals using drugs that support an unhealthy lifestyle does not appear like a positive for society at large. I thought medicine was about aiding people to become healthy, not providing quick fixes to common problems. Why is this being celebrated? EDIT: I do not mean to say Ozempic is useless or dangerous, only that celebrating it as a solution to the problem of obesity is. It is certainly a tool that helps people. I don't think it should be relied on continously. People need to live healthy lives to be healthy. I am not perfect, no one is. Losing weight is hard.
- daedrdev 2y agoThis medicine literally aids people to become healthy. They will gain years of life from the lost weight. Their lifestyle changes to be healthier by eating less, which many are unable to do without help because the human body has millions of years of baked in evolution demanding we overeat if able
- Extropy_ 2y agoMy father has used ozempic. He hails it as a wonder drug, yet he does little to nothing to change his behaviours because he can rely on this crutch. I see that as concerning
- nemomarx 2y agoIs he not eating less? If it's reducing appetite that seems like the biggest change of behavior you'd want, right?
- Extropy_ 2y agoYou're suggesting that appetite is the cause of obesity. I don't agree with that notion. Repeatedly giving into your "appetite" will reinforce overeating
- daedrdev 2y agoI dont really think an ancedote is a good argument. We have studies showing many people eat less on ozempic and loose substantial amounts of weight, and its main effect is not even the weight loss but reducing heart problems and fixing blood sugar in diabetes patients
- EcommerceFlow 2y agoIf we can alter the chemical composition of peoples brains/guts to make them less hungry, how long until something similar exists to overcome anxiety? Public speaking fears? etc.
- stevesimmons 2y agoIt's called alcohol
- graeme 2y agoThe answer is Ozempic seems to do this already. My theory is that something goes haywire in the body and causes many issues. Obesity being the most visible of these but far from the only issue. GLP-1 agonists reverse this thing that went haywire and fix many issues https://www.medicalnewstoday.com/articles/weight-loss-drugs-help-lower-depression-and-anxiety-risk https://www.medicalnewstoday.com/articles/weight-loss-drugs-...
- willsmith72 2y agoOr... Non-obese people average better mental health than obese people. That article is all just correlation. Which cause is more likely?
- hughes 2y agoAs a thin and anxious person, I hope that's not the whole story.
- graeme 2y agoOzempic appears to fix some problems unrelated to obesity. It improves autoimmune conditions for example and opioid addiction.
- throwaway041207 2y agoThe improved mental health and decision making effects of this drug present well before people lose meaningful amounts of weight.
- Nashooo 2y agoIt's so weird to me that with a vaccine against COVID the populace was going all conspiracy theorist. Saying the longterm effects are unknown etc. But with these kind of drugs there are suddenly no issues.
- cnlwsu 2y agoThis has 10+ years with tons or people and studies over the side effects. Not to justify the the conspiracy theories, but it’s not apple to apples
- mynameishere 2y agoIf people were compelled to take Ozempic to keep their jobs, there would be "issues".
- tom_ 2y agoYou could be seeing two different sets of people, largely non overlapping.
- xk_id 2y agoOzempic and other research peptides are very popular in online biohacking communities. The same communities were against vaccines. This paradox has been pointed out quite often and it became a meme.
- Izkata 2y agoAre they against vaccines in general or just the mRNA ones? Because for the covid vaccines, what I saw was almost entirely anti-mRNA.
- xk_id 2y agoThe typical argument was that all the various types of covid vaccines had been fast tracked and safety data was insufficient; hence the irony.
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- rmellow 2y agoCeci n'est pas un submarine.
- siliconc0w 2y agoI wonder if all these other 'bonus' effects really just stem from the same root cause which is effectively food that is just really bad for us. So if you eat less poison, you get a lot healthier - not just slimmer.
- justmarc 2y agoThis, and most likely a lot of this "research" will be debunked in due time (years, decades), and new, currently unknown side effects will come to light. How can some engineered drug be a solution to a life choice problem? Typical human behavior to look for easy "solutions" that don't actually solve anything, just delay or temporarily mitigate a problem.
- sodality2 2y agoIs your opposition to these drugs that you think the patients haven't somehow earned the right to be rid of their ailments, or that they have side-effects (thyroid problems, yo-yo problems for weight lost, etc)? The first one is a moral judgment, the second one is a claim that should be backed by evidence.
- tshaddox 2y agoWhy would engineering (of anything!) be a valid approach to some problems but not others? If I want to move cars across a body of water then engineering is a great approach. Why would it not also be a great approach if I want to change my eating habits?
- consteval 2y ago> life choice problem Not this simple. Choice isn't binary, it's incredibly complex. There're millions of individual little effects that go into each and every one of your choices. You actually have no idea how much influences you have over your "choices". In fact, almost everything you do in life is completely out of your control - you just do it, it's habit. Is brushing my teeth a choice? Certainly, I do it, but I also don't make that choice ever, it just happens. Why is it that some can drink every week and be fine, but some can't ever drink because they are alcoholics? Why is it that I am able to eat as much as I want, and I'm not fat? You could just be lucky enough that you do not have a propensity to overeat. Neither do I. But be humble, have some humility. You and I are privileged. I did nothing to earn this. I eat what I want, when I want. It's merely a coincidence the what and when happens to not harm me.
- kubectl_h 2y agoI can't read the article but I have kept up with the almost daily revelations about this class of drugs so I have an idea of what its about. I am truly hopeful for the kinds of society wide changes it promises to bring about. We seem to be rapidly approaching an inflection point, brought on by the compounding distributors such as Hims, that will need to be resolved: there are probably more people on the compounded version of this drug than most suspect and that number is growing by the tens of thousands every day. Meanwhile, Norvo Nordisk is trying to shut down this channel of distribution. That would be a bad idea and I think the FDA must be aware of that. This conflict between NN and the compounders needs to be resolved. Personally I think the promise of this drug makes it a moral issue and have little sympathy for NNs position here: they will need to capitulate on their control over it and accept some kind of suboptimal pricing agreement. The potential positive outcomes of this drug supersedes their sole claim to it IMO.
- r00fus 2y agoI mean there are many GLP-1 weight loss drugs, and only one of them is from NN.
- kubectl_h 2y agoYou are right. What I meant is sole claim to production of semaglutide. If they want to produce the injector version, which is considerably more expensive and more difficult to produce (and thus justifies their exorbitant pricing) as opposed to what the compounders are doing, then they are not acting in good faith here and are purposefully slow walking a product that is in incredible demand.
- songbird23 2y agoI tried Ozempic for three months, gradually increasing the dose monthly. Then, on the fourth month, I switched to Mounjaro and continued it for five months. It did help me lose weight, but the discomfort in my upper left abdomen turned into pain. It felt like the food I ate was still in my stomach, undigested, even four days later. I eventually stopped because I was worried it might have harmed my pancreas. A year later, I still occasionally experience the same abdominal pain. but doctor didn't didn't see pancreas issue. I It did help with my blood sugar management(diabetes) and weight though, but ill never do it again and stick to IF
- somethingold 2y ago[dead]
- wouterjanl 2y agoLiving without appetite. I get it can help some people with losing weight. But doesn’t it sound a tad sad too? Isn’t desire one of the most complex, beautiful emotions?
- ZYbCRq22HbJ2y7 2y agoYour picture of desire and the reality of addiction are very different things
- daedrdev 2y agoMany people do not want to eat how they do, the just cannot help themselves
- tshaddox 2y agoUnwanted desires are extremely uncomfortable.
- ryandrake 2y agoI don't suffer from an uncontrollable appetite, but for those who do, I would imagine that compulsive-anything is undesirable and eliminating it is an unambiguously positive miracle. If a drug can cure an out-of-control appetite, can it cure chemical addictions? Compulsive gambling? None of these are beautiful emotions.
- fragmede 2y agoFunny you should say that. There's mounting anecdotal evidence that GL-1's curb addiction more generally, including the two you mentioned, SUD/chemical and gambling. There are currently trials underway to try and prove that scientifically. https://news.unchealthcare.org/2023/12/use-of-glp-1-receptor-agonists-to-treat-substance-and-alcohol-use-disorders-is-promising-but-premature/ https://news.unchealthcare.org/2023/12/use-of-glp-1-receptor...
- consteval 2y agoYes but when your brain is broken and the desire a liiiiitle too strong it becomes bad. I smoked. The desire to have a cig was debilitating. And I didn't want it, I never wanted it. But the sheer desire would bring me to my knees.
- f38zf5vdt 2y agoThe current narrative of Ozembic reminds me a lot of the 1930s narrative around amphetamine. [1] The mood booster wonder drug was used extensively in the military and civilian population, from soldier to politician. Indications included weight loss, depressed mood, alcoholism [2], and fatigue. > Another early pharmacologic approach to alcoholism treatment used psychostimulants to create a feeling of well-being and obviate the euphoric effects of alcohol. Bloomberg (1939) administered amphetamine to 21 alcoholic patients, who became more alert and energetic and reported no desire to drink (see also Bowman and Jellinek, 1941). Reifenstein and Davidoff (1940) found that amphetamine was of benefit in cases of acute alcohol intoxication and recommended it to treat depression in institutionalized alcoholics (see also Bowman and Jellinek, 1941). Of course, I'm interested, but I will let medical science do the damage first before I elect to dive in. [1] https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2007.110593 https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2007.... [2] https://pmc.ncbi.nlm.nih.gov/articles/PMC4453501/ https://pmc.ncbi.nlm.nih.gov/articles/PMC4453501/
- bdz 2y agoI'm on Saxenda for 3 months now (basically Gen 1 of the same GLP-1 drug, Ozempic being the Gen 2, both made by Novo Nordisk). The hunger suppression is real and what's intersting that this is the first time I've felt that I'm "not in control of my thoughts". Of course it's my own decision to take the drug is not about that. But I'm not hungry anymore, I don't binge eat anymore, and I generally don't enjoy food as before. Like even if I have my favorite foods it's just an OK experience. It's like I'm eating because I know I need energy to live but otherwise it's totally gone as the "main focus" from my daily life (which was my main eating disorder)
- bitshiftfaced 2y ago> what's intersting that this is the first time I've felt that I'm "not in control of my thoughts". What do you mean?
- firecall 2y agoI also recently started taking Saxenda, and I’ll give my take on what they mean: I found it remarkable that almost immediately after taking the drug it began to work. And by work I mean that it removed any thoughts I had about eating. What you feel like eating isn’t a thought or conversation with yourself that you have any more. It’s a rather strange feeling, but also one you don’t notice as it’s an absence of something that you don’t even miss once it’s gone! LOL - seeing as this is HN, I’ll make a joke and go as far to say that these drugs are a productivity unlock hack! Why waste time eating when you could be building the next unicorn!
- joquarky 2y agoIt's one of the first things that people typically discover when meditating.
- valval 2y agoYou perfectly summarise my relationship with food, although I’ve never taken any appetite suppressants. I spent my early adulthood competing in bodybuilding, and ever since I can’t really treat food as entertainment. I cherish every meal I have and everything tastes amazing to me, since I only eat to hunger. Food can’t get better to me than the stuff I eat every day, so I don’t go out or spend money on fancy food. I just eat what keeps me healthy. I’m not sure if it’s a good or bad thing that people are now able to join this camp without destroying their relationship with food through questionable activities.
- z3ncyberpunk 2y agoYeah, change the world for the worse.