6 ms·

I saw a news article the other day that the obesity rate decreased instead of increased last year for the first time in well over a decade. I wonder how much G

I saw a news article the other day that the obesity rate decreased instead of increased last year for the first time in well over a decade. I wonder how much GLP-1s have to do with all of that, and how much more they'll do.

quaffapint 2y ago
I do wonder how much affect it has. At least in the US most insurance companies won't cover them (unless you already have diabetes, for example) and at over $1,000 a month I can't see how the people who could really benefit from this to lower the numbers can possibly afford it.
- malfist 2y ago
  From personal experience, it's ridiculously easy to get a compounded formulation from one of the telehealth suppliers, and it's cheap even though you can't submit it to insurance. I think I pay $200 and get two one month vials for it. It's been marvelous for me, I was just over the edge into overweight, so no one would prescribe it for me, even though I had a borderline pre-diabetes A1C, and reactive hypoglycemia runs in my family. My choices were gain another 10 pounds, or find a telehealth that wasn't bothered by not following the FDA rules so strictly. So that's what I did, I got a script from telahealth and now I'm smack dab in the middle of the healthy weight range (-24lb), haven't had a hypoglycemic incident since I started it, and as a bonus my IBS-D went away completely. I've reduced my dose to the point that I'm at the dose you start out on, and that has let me keep my weight constant without losing more or gaining more. Plan to stay this way for a year and then see about titrating it even more until I'm off of it. I also followed their instructions and only titrated up when I wasn't seeing weightloss, so I never hit the highest dose, and kept my weight loss to .75-1.5 lb/week. Perfectly sustainable. This has been miraculous, and something that multiple years of consistent dieting hasn't solved. And as a bonus, I can now do my strength training I love without feeling like I have to eat the house on the recovery day
  - aoanevdus 2y ago
    Random question about how those compounding pharmacies work. Can you order a higher dose and then just stretch it out by taking the minimum dose to save cost? Do they automatically bill you monthly or can you skip months?
    - malfist 2y ago
      That's kinda what I'm doing. They still send me enough for my max dose reached (1.5mg/wk), but I've titrated down (to 0.5mg/wk) since I'm at the weight I should be at, so I just use a vial for a month, and toss the remainder. They send me two vials at a time. The vials have a 6 month use by date, though evidence indicates semaglutide is stable for 1 year. I can log into the portal and tell it to skip a month, but since it's a push system, I don't get automatically billed. I actually have to do a checkin and the doc has to approve the refill. So if I have extra vials, I just skip that month's check in. There's some indication that you don't have to toss the vial after a month, the FDA set those limits assuming it was insulin that is used sometimes more than daily. 4 penetrations of the vial's membrane probably isn't enough to contaminate it, but I'd rather be on the safe side so I don't use the vial for more than a month at a time. My partner is a pharmacist, so that part of the influence for the safer approach.
    - daedrdev 2y ago
      I think which is usually they start you at a small dose, ramp you up in dosage, then ramp you down when its time to come off, that way you dont suddenly feel much hungrier when it goes away because you've slowly adjusted it.
  - sjsisjxjdjd 2y ago
    > something that multiple years of consistent dieting hasn't solved Did you continue to track calories while using the drug? As somebody who has successfully increased and decreased their body weight over the years (after initially being obese), if you’re able to diet consistently I don’t see why a drug is needed. My guess is whatever diet you were on was consistent for the weight you were at.
- jimbob45 2y ago
  Doesn't seem like it will matter. The core patent expires in 2026[0] and the rest expire in 2033. It seems like most will have access to at least some form of the drug affordably within the next five years. [0]https://www.reddie.co.uk/2024/08/30/the-year-of-ozempic-an-ip-take/ https://www.reddie.co.uk/2024/08/30/the-year-of-ozempic-an-i...
- danans 2y ago
  Ozempic is around $100/month in most western European countries, including the country of it's maker, Novo Nordisk. Sen. Bernie Sanders has been recently calling out this company for charging an order of magnitude more in the US, where it is priced like a cosmetic medical product.

quaffapint 2y ago

I do wonder how much affect it has. At least in the US most insurance companies won't cover them (unless you already have diabetes, for example) and at over $1,000 a month I can't see how the people who could really benefit from this to lower the numbers can possibly afford it.

malfist 2y ago
From personal experience, it's ridiculously easy to get a compounded formulation from one of the telehealth suppliers, and it's cheap even though you can't submit it to insurance. I think I pay $200 and get two one month vials for it. It's been marvelous for me, I was just over the edge into overweight, so no one would prescribe it for me, even though I had a borderline pre-diabetes A1C, and reactive hypoglycemia runs in my family. My choices were gain another 10 pounds, or find a telehealth that wasn't bothered by not following the FDA rules so strictly. So that's what I did, I got a script from telahealth and now I'm smack dab in the middle of the healthy weight range (-24lb), haven't had a hypoglycemic incident since I started it, and as a bonus my IBS-D went away completely. I've reduced my dose to the point that I'm at the dose you start out on, and that has let me keep my weight constant without losing more or gaining more. Plan to stay this way for a year and then see about titrating it even more until I'm off of it. I also followed their instructions and only titrated up when I wasn't seeing weightloss, so I never hit the highest dose, and kept my weight loss to .75-1.5 lb/week. Perfectly sustainable. This has been miraculous, and something that multiple years of consistent dieting hasn't solved. And as a bonus, I can now do my strength training I love without feeling like I have to eat the house on the recovery day
- aoanevdus 2y ago
  Random question about how those compounding pharmacies work. Can you order a higher dose and then just stretch it out by taking the minimum dose to save cost? Do they automatically bill you monthly or can you skip months?
  - malfist 2y ago
    That's kinda what I'm doing. They still send me enough for my max dose reached (1.5mg/wk), but I've titrated down (to 0.5mg/wk) since I'm at the weight I should be at, so I just use a vial for a month, and toss the remainder. They send me two vials at a time. The vials have a 6 month use by date, though evidence indicates semaglutide is stable for 1 year. I can log into the portal and tell it to skip a month, but since it's a push system, I don't get automatically billed. I actually have to do a checkin and the doc has to approve the refill. So if I have extra vials, I just skip that month's check in. There's some indication that you don't have to toss the vial after a month, the FDA set those limits assuming it was insulin that is used sometimes more than daily. 4 penetrations of the vial's membrane probably isn't enough to contaminate it, but I'd rather be on the safe side so I don't use the vial for more than a month at a time. My partner is a pharmacist, so that part of the influence for the safer approach.
  - daedrdev 2y ago
    I think which is usually they start you at a small dose, ramp you up in dosage, then ramp you down when its time to come off, that way you dont suddenly feel much hungrier when it goes away because you've slowly adjusted it.
- sjsisjxjdjd 2y ago
  > something that multiple years of consistent dieting hasn't solved Did you continue to track calories while using the drug? As somebody who has successfully increased and decreased their body weight over the years (after initially being obese), if you’re able to diet consistently I don’t see why a drug is needed. My guess is whatever diet you were on was consistent for the weight you were at.
jimbob45 2y ago
Doesn't seem like it will matter. The core patent expires in 2026[0] and the rest expire in 2033. It seems like most will have access to at least some form of the drug affordably within the next five years. [0]https://www.reddie.co.uk/2024/08/30/the-year-of-ozempic-an-ip-take/ https://www.reddie.co.uk/2024/08/30/the-year-of-ozempic-an-i...
danans 2y ago
Ozempic is around $100/month in most western European countries, including the country of it's maker, Novo Nordisk. Sen. Bernie Sanders has been recently calling out this company for charging an order of magnitude more in the US, where it is priced like a cosmetic medical product.