3 ms·

We 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

We 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 ago
People keep saying that but we've had GLP-1's in active use on millions of people for decades in diabetes care.
cyberax 2y ago
Liraglutide has been in clinical use for two decades, with no real serious downsides.
- orionsbelt 2y ago
  Gastropreisis may be a rare side effect, but is serious and appears to a be a real risk.
  - cyberax 2y ago
    It goes away after discontinuation. And apparently it mostly happens when people jump into too high doses straight away instead of titrating slowly.
ajhurliman 2y ago
GLP1s 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 ago
  Wait 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 ago
    Seems 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 ago
      It 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 ago
        You'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.
- cyberax 2y ago
  > 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. That's not true. I started on liraglutide, which is a previous-gen GLP-1 agonist. It was approved for that purpose in early 2010-s. It worked, but it required daily injections due to its short half-life. It also was unpleasant, as you could feel its effects wax and wane throughout the day. Ozempic was approved for diabetes in 2018, but became available in sufficient quantities for that purpose in 2019. Doctors started prescribing it off-label for weight loss in 2020 (that's when I also got switched to it), and it was approved by the FDA for weight-loss in mid-2021. So while we could have moved faster, it's not like there were decades of time lost.
stevenAthompson 2y ago
We 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 ago
  Thyroid 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 ago
    Is it wise to minimize thyroid cancer or ablation just because you know someone who fared well afterwards?
    - A_D_E_P_T 2y ago
      People 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 ago
It'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 ago
  Oh 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 ago
    I don't know what category of comment this is but can we please make this go away
- Extropy_ 2y ago
  This 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 ago
    Ozempic 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 ago
      You're right. I'm not saying the chemical or using it in of itself is dangerous
- PNewling 2y ago
welferkj 2y ago
But 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 ago
So 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 ago
    It also doesn't exist sometimes.
    - salawat 2y ago
      It 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 ago
      Nor 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 ago
    So ozempic can save the lives of millions of people but it’s bad and not worth celebrating because it’s not a cure?

hatenberg 2y ago

People keep saying that but we've had GLP-1's in active use on millions of people for decades in diabetes care.

cyberax 2y ago

Liraglutide has been in clinical use for two decades, with no real serious downsides.

orionsbelt 2y ago
Gastropreisis may be a rare side effect, but is serious and appears to a be a real risk.
- cyberax 2y ago
  It goes away after discontinuation. And apparently it mostly happens when people jump into too high doses straight away instead of titrating slowly.

ajhurliman 2y ago

GLP1s 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 ago
Wait 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 ago
  Seems 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 ago
    It 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 ago
        You'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.
cyberax 2y ago
> 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. That's not true. I started on liraglutide, which is a previous-gen GLP-1 agonist. It was approved for that purpose in early 2010-s. It worked, but it required daily injections due to its short half-life. It also was unpleasant, as you could feel its effects wax and wane throughout the day. Ozempic was approved for diabetes in 2018, but became available in sufficient quantities for that purpose in 2019. Doctors started prescribing it off-label for weight loss in 2020 (that's when I also got switched to it), and it was approved by the FDA for weight-loss in mid-2021. So while we could have moved faster, it's not like there were decades of time lost.

stevenAthompson 2y ago

We 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 ago
Thyroid 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 ago
  Is it wise to minimize thyroid cancer or ablation just because you know someone who fared well afterwards?
  - A_D_E_P_T 2y ago
    People 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 ago

It'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 ago
Oh 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 ago
  I don't know what category of comment this is but can we please make this go away
Extropy_ 2y ago
This 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 ago
  Ozempic 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 ago
    You're right. I'm not saying the chemical or using it in of itself is dangerous
PNewling 2y ago

welferkj 2y ago

But 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 ago

So 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 ago
  It also doesn't exist sometimes.
  - salawat 2y ago
    It 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 ago
    Nor 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 ago
  So ozempic can save the lives of millions of people but it’s bad and not worth celebrating because it’s not a cure?