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Eating less food and keeping your body from knowing it seems to be a big part of why it works. On GLP-1 agonists, you don’t get nearly the counterbalancing red
by didgeoridoo 2y ago
Eating less food and keeping your body from knowing it seems to be a big part of why it works.
On GLP-1 agonists, you don’t get nearly the counterbalancing reduction in energy expenditure you usually see with caloric restriction. Your body keeps happily releasing lipid stores, assuming they will be replenished, but they aren’t. Hunger hormones remain untriggered, cortisol stays low, and insulin keeps shuttling glucose into cells to be burned.
If you aren’t metabolically deranged, your body does this anyway. But many people have totally decompensated metabolically due to excess energy intake over time, and essentially cannot recover without some kind of treatment.
GLP-1 is just the beginning — future compounds will do a better job maintaining muscle mass, for example. But this is looking like an absolute miracle, and once patent protection ends (especially for oral formulations), we’re going to be living in a very different world health-wise.
- arijo 2y agoAssuming you're going to fix a extremely complex system like the human body by just taking a pill is what some people call the bias of Illusion of Control. https://en.wikipedia.org/wiki/Illusion_of_control https://en.wikipedia.org/wiki/Illusion_of_control
- didgeoridoo 2y agoYou’re going to have to be more specific, because I am sure you are not arguing against the concept of medicine.
- breck 2y ago[flagged]
- arijo 2y agoI argue that medicine still does not have enough accumulated knowledge about the complexity of the human body to be playing God with a single pill.
- kelseyfrog 2y agoYou may begin your argument now
- cyberax 2y agoThere is no god. So I argue that medicine is at least just as potent as nothing.
- okaram 2y agoMaybe ... maybe not. Modern medicine does have magic pills for many illnesses; for example, antibiotics are magical for many bacterial infections, many vaccines are almost magical too. OTOH, many pills will have undesired side-effects, and the body is in a complex dynamic equilibrium, so it may happen that blocking GLP-1 may have side effects. Eventually, we'll all die, but I'm optimistic that GLP-1 will lead to a better equilibrium. Preliminary evidence says it will. I'm not as confident as the author though :)
- emptiestplace 2y agoYou're right, but the way you're going about it isn't.
- kadoban 2y agoAny single pill? Or is your objection specific to this one? (That iirc is actually an injection, not a pill, but w/e)
- herval 2y agoYou don’t believe the medicine that billions of people take to treat diseases that would’ve otherwise demonstrably killed them is “accumulated knowledge” enough? From insulin to antibiotics, we have sufficient evidence that many types of medicine DO work. Nobody is “playing god” (whatever that means), it’s just reproducible and consistent data
- deleted 2y ago[deleted]
- kadoban 2y agoAre diabetics biased in this way when they take insulin? Or where is your cutoff? How many average person years does an intervention need to save before it meets your approval?
- akira2501 2y agoUntreated diabetics can die within a week. Are we facing the same sort of problem here?
- kadoban 2y agoNo, but same thing with different numbers. Like I asked, where's our cutoff? If obesity on average kills you a couple of decades earlier than otherwise, does treatment for that meet your approval?
- akira2501 2y ago> No, but same thing They're either the same or they're different. > Like I asked, where's our cutoff? Exigency of loss of life. > kills you a couple of decades earlier Staying obese into old age carries risks. There are multiple ways to manage that risk. None of it is as exigent as other conditions. > does treatment for that meet your approval? Universally? No.
- kadoban 2y ago>> Like I asked, where's our cutoff? > Exigency of loss of life. Cool. How about cancer treatment? Some of those you can live with for some months/years. We allowed to treat anyway when the outcomes are better? > Staying obese into old age carries risks. There are multiple ways to manage that risk. None of it is as exigent as other conditions. And why should this not be one of the ways to manage that risk? The biggest difference seems to be that it actually works, on average, unlike some other common treatments like telling people to eat less and exercise more.
- scheme271 2y agoPatent protection for the early versions has already ended. Teva is making generic versions of liraglutide and it's been available in the US for a few months. The other GLP-1 agonists will be protected for a few more years though.
- didgeoridoo 2y agoTrue but imagine the price and availability impact when the oral formulations go off-patent. The autoinjectors are inherently expensive to make and ship, and some people have a needle phobia. Oral daily seems like the endgame here.
- outworlder 2y ago> On GLP-1 agonists, you don’t get nearly the counterbalancing reduction in energy expenditure you usually see with caloric restriction And that's mostly related to how much you move. If the body needs to reduce energy expenditure, there isn't much it can cut that's non essential that will make a difference, other than activity and movement in general. So you feel like laying on the couch all day. I haven't tried GLP-1 myself, but reports seem to indicate that GLP-1 drugs make you feel _tired_, which is basically the same thing. So I am not sure the body is fooled that easily. > many people have totally decompensated metabolically Around 88% of americans have some level of metabolic dysfunction so that tracks. Numbers worldwide are trending up. > and essentially cannot recover without some kind of treatment. They can. Going back to a healthy food intake will fix anything that's not permanently damaged(and if it is permanently damaged, there isn't much medicine can do either). That can be sped up with other measures, such as fasting. I am a bit skeptical of trying to fix a problem that was mostly created by the food industry with medication. GLP-1 isn't without side effects. Cutting sugars and simple carbs in general has very similar effects and will decrease your hunger hormones as well. I think everybody should try that first before relying on medical interventions. Besides, carbs tend to make you retain a lot of liquid. Drastically cutting them usually improves fluid retention, people see changes pretty quickly in the scale, and that can motivate them to continue. Do that long enough and even eating habits will change and so will your palate. A soda becomes unbearable.
- pixl97 2y ago>but reports seem to indicate that GLP-1 drugs make you feel _tired_, I know a few people that take one of the name brands, and they really don't complain about this issue. What they do talk about is having more energy after dropping weight because they just don't feel compelled to eat much anymore. I'm not overweight myself, but I am a Type 1 diabetic from a young age. "Sugar noise" is not something that is easy to ignore. Especially in the case where you have excess insulin in your bloodstream but not active enough for your body to use it. Your body will scream at you to eat something sweet/carby. In people that are overweight this can be caused by insulin resistance. Until you experience it, it's really easy to say "People should try", but it's about as easy as telling someone to drop meth or heroin.
- stavros 2y ago> But this is looking like an absolute miracle What are you referring to here? The muscle-preserving medication? Are GLP-1s actively reducing your muscle mass, or is it the fact that people on them ate very little and didn't tend to exercise?
- schnebbau 2y agoLosing muscle mass is just what happens when you're in a calorie deficit. The same thing happens if you're in a calorie deficit without the aid of a GLP-1. Making sure each meal contains substantial protein will help negate this.
- didgeoridoo 2y agoRight, it’s not something specific to GLP-1 treatment, but there are myostatin and activin A modulators under investigation to specifically counteract muscle loss related to caloric deficit more generally.