4 ms·

If you literally cannot stop yourself from being obese any other way, then Ozempic and similar may be a good choice. But the side effects are large. You can ne

If you literally cannot stop yourself from being obese any other way, then Ozempic and similar may be a good choice. But the side effects are large. You can never, ever stop taking it. We don't know what being on it for decades causes. There are anecdotes that it numbs you out emotionally. There are no shortcuts in life. There is always a tradeoff.

nwienert 2y ago
1) Side effects not much more than the most tame of drugs, like aspirin. This one, if it exists, is incredibly rare. 2) You can stop taking it, obviously. Just like any medicine, the effects will wear off, but there's no rebound effect or risky side effect from coming off. You simply return to your previous state. 3) There's more positive anecdotes than negative basically wherever you look. I have a friend who took it and while he lost 20% of weight, he plateau'd - I asked him if he was going to cycle off it and his answer was an emphatic no - I asked why, he said beyond the positive weight effects it: massively curbed his weed addiction, curbed his social media addiction, improved his sleep, and because his compulsive behaviors were down he was doing better at work, reading books for the first time in years, and going to therapy which had helped his dating life. No joke, I was floored at how ridiculous the answer sounded, especially as this was a pretty bro-y friend. Yet I've heard many anecdotes like this from others, one friend stopped a 15-year pack-a-day cigarette addiction they'd had since high school. 4) Some of the other positive trade-offs: reduces addictive behavior, heals heart/bones/brain, dramatically reduces inflammation and can fix inflammatory disorders, positive early studies for Alzheimer's and Parkinson's, etc. 5) There may be no completely free lunches, but there are nearly-free lunches all the time for people with ailments. If I have debilitating GERD, there are antacids that essentially save my life with only mild side-effects. If I have bad eyesight, glasses are a miracle cure. This is all over medicine. If I'm getting surgery, 100/100 people will choose the mild side-effects of anesthetics over the pain.
- AnthonBerg 2y ago
  The most interesting aspect of GLP-1 agonists is indeed the reduction of inflammation. All the effects on the mind like reduction of addiction, compulsions, craving have a direct basis in neuroimmunobiology. Neuroimmunopsychiatry. As I see it, it’s a productive and reasonably accurate view to look at things in the way that inflammation is suffering. Neuroinflammation and suffering being one and the same. In addiction, in craving, there is neuroinflammation. In getting the fix there is a reduction of inflammation. Neuroinflammation also makes us angry; it’s behavior-modifying from a social point of view too.
- matwood 2y ago
  Using glp1s for addiction treatment is in active study because of anecdotes like your friends. Hopefully there are some solid results soon.
bshepard 2y ago
Human civilization is built on the creation of shortcuts. Insulin is a shortcut for T1 diabetics to avoid death.
- monero-xmr 2y ago
  Perhaps a better phrasing would be, "There is no free lunch." If you prefer to take Ozempic rather than monitoring caloric intake and exercising, then there are consequences. But if the consequences are worth it, is up to the individual.
  - lnsru 2y ago
    I am the guy with an appointment with Ozempic prescribing doctor. I will seriously think about it twice. “Normal” starving does not have any very rare and very bad consequences. It’s just very very difficult.
  - beardedwizard 2y ago
    Someone reading this might assume its zero sum to you - as if people on Ozempic have not already been exercising and monitoring caloric intake without the associated weight loss/health results they desire - and have only chosen it because they don't want to try something else. I'm sure you aren't trying to come across as fat shaming, but the reality is of course not zero sum. Diet and exercise doesn't magically work for the entire population. Diet and exercise definitely worked for me but im not willing to be a sample size of 1 in the face of so many others with legitimate stories.
    - monero-xmr 2y ago
      Diet alone is 100% guaranteed to cause you to lose weight. It really is as easy as counting calories. It is a scientific fact. It is physically impossible to gain, or maintain weight, if you cut caloric intake sufficiently.
      - copperx 2y ago
deleted 2y ago
[deleted]
daedrdev 2y ago
Clinical trials started in 2008. Thats decades for something major to appear. There are minor things, but people can simply stop taking it. Given the weight lost causes years of healthy lifespan to be gained, it would take a monumental problem that would have been seen by now to make it not worth it for a lot of people who can't lose weight on their own.
pessimizer 2y ago
> You can never, ever stop taking it. You can't stop taking it without gaining the weight back (unless the lifestyle change sticks), but everybody stops taking it in the medium term. The side effects are horrible and stack up over time. We'll start seeing the miserable condition of very long-term users (or maybe, hopefully, their bodies will reach an equilibrium!), and we will be able to use the sacrifice of their health in order to understand how better to counteract the long-term side effects, or to get hints on how to design the next class of miracle weight loss drugs. I'm never going to take them. There are better ways to lose weight, with no side effects, and they slowly and stably got me from a 28 BMI to a 22 BMI. I will push the people I love towards those rather than to a set of powerful, expensive drugs with wild side effects that somebody invented a week ago. But I am not hostile to the concept in any way. > There are no shortcuts in life. There is always a tradeoff. There are an enormous number of shortcuts in life. This is just the Law of Averages as Protestant superstition stated as a pithy self-help maxim. Taking shortcuts rather than going the long way is almost the definition of intelligence. If you see a bunch of points laid out in a rectangle, you can count them one by one, or you can count the ones on the sides and multiply. There's no tradeoff.
- cthalupa 2y ago
  > You can't stop taking it without gaining the weight back (unless the lifestyle change sticks), but everybody stops taking it in the medium term. The side effects are horrible and stack up over time. Some people experience significant side effects. Many people do not. Tirzepatide seems to induce even fewer side effects in general than semaglutide. > We'll start seeing the miserable condition of very long-term users (or maybe, hopefully, their bodies will reach an equilibrium!), and we will be able to use the sacrifice of their health in order to understand how better to counteract the long-term side effects, or to get hints on how to design the next class of miracle weight loss drugs. I'm active on several GLP-1 related forums. On those, people near-universally report side effects lessening over time, from those that have significant side effects to begin with. The next generation of drugs is arriving now. Eli Lilly is finishing up their initial phase 3 trials for retatrutide at EOY, and in a matter of months I've seen it reduce my ALT levels from edging towards an indication of NAFLD to right in the middle of optimal. Preliminary results from the trials in general seem very positive, so I imagine FDA approval will come later '25/early '26, though the glucagon receptor activity does seem to increase resting heart rate in many people (including myself, though tirzepatide did as well, to a lesser degree.) > I'm never going to take them. There are better ways to lose weight, with no side effects, and they slowly and stably got me from a 28 BMI to a 22 BMI. I will push the people I love towards those rather than to a set of powerful, expensive drugs with wild side effects I would agree if you have success in losing weight with other methods, there's not a strong reason to go on the GLP-1s. We do have some evidence that they have other positive health benefits even without the weight loss, but there are some side effects, yes, and we of course do not strongly know what happens if you take these for decades on end. On the other hand, we know that improving diet and increasing exercise are basically all net positives, outside the minimal injury risk that comes with exercise. I do think you are overstating the side effects, though. There seems to be some small risk of sight issues, though I would like more data here - we know that diabetes is significant risk factor for eye disease, and I'm curious how well these results will be replicated in general, and how well they translate to non-diabetics taking them purely for weight loss. We've also seen thyroid cancer in rodent studies, and while so far no human studies have found an increase, I wouldn't be surprised if there is some risk increase for humans. > somebody invented a week ago. We're actually about two decades in on the GLP-1 class of drugs being in-use by humans, but obviously semaglutide and tirzepatide have really ratcheted up adoption.
Spooky23 2y ago
That’s not true. It’s like anything else, it’s about you. I was on it for 18 months, it allowed me to lose weight and change my habits in a way that has persisted. I lost 90 pounds, and gained back 15, which I attribute to an injury that stopped me from running. I’m back in action now and down 5. I cannot stress how transformative this drug was for me, at a time of my life that was particularly difficult.

nwienert 2y ago

1) Side effects not much more than the most tame of drugs, like aspirin. This one, if it exists, is incredibly rare. 2) You can stop taking it, obviously. Just like any medicine, the effects will wear off, but there's no rebound effect or risky side effect from coming off. You simply return to your previous state. 3) There's more positive anecdotes than negative basically wherever you look. I have a friend who took it and while he lost 20% of weight, he plateau'd - I asked him if he was going to cycle off it and his answer was an emphatic no - I asked why, he said beyond the positive weight effects it: massively curbed his weed addiction, curbed his social media addiction, improved his sleep, and because his compulsive behaviors were down he was doing better at work, reading books for the first time in years, and going to therapy which had helped his dating life. No joke, I was floored at how ridiculous the answer sounded, especially as this was a pretty bro-y friend. Yet I've heard many anecdotes like this from others, one friend stopped a 15-year pack-a-day cigarette addiction they'd had since high school. 4) Some of the other positive trade-offs: reduces addictive behavior, heals heart/bones/brain, dramatically reduces inflammation and can fix inflammatory disorders, positive early studies for Alzheimer's and Parkinson's, etc. 5) There may be no completely free lunches, but there are nearly-free lunches all the time for people with ailments. If I have debilitating GERD, there are antacids that essentially save my life with only mild side-effects. If I have bad eyesight, glasses are a miracle cure. This is all over medicine. If I'm getting surgery, 100/100 people will choose the mild side-effects of anesthetics over the pain.

AnthonBerg 2y ago
The most interesting aspect of GLP-1 agonists is indeed the reduction of inflammation. All the effects on the mind like reduction of addiction, compulsions, craving have a direct basis in neuroimmunobiology. Neuroimmunopsychiatry. As I see it, it’s a productive and reasonably accurate view to look at things in the way that inflammation is suffering. Neuroinflammation and suffering being one and the same. In addiction, in craving, there is neuroinflammation. In getting the fix there is a reduction of inflammation. Neuroinflammation also makes us angry; it’s behavior-modifying from a social point of view too.
matwood 2y ago
Using glp1s for addiction treatment is in active study because of anecdotes like your friends. Hopefully there are some solid results soon.

bshepard 2y ago

Human civilization is built on the creation of shortcuts. Insulin is a shortcut for T1 diabetics to avoid death.

monero-xmr 2y ago
Perhaps a better phrasing would be, "There is no free lunch." If you prefer to take Ozempic rather than monitoring caloric intake and exercising, then there are consequences. But if the consequences are worth it, is up to the individual.
- lnsru 2y ago
  I am the guy with an appointment with Ozempic prescribing doctor. I will seriously think about it twice. “Normal” starving does not have any very rare and very bad consequences. It’s just very very difficult.
- beardedwizard 2y ago
  Someone reading this might assume its zero sum to you - as if people on Ozempic have not already been exercising and monitoring caloric intake without the associated weight loss/health results they desire - and have only chosen it because they don't want to try something else. I'm sure you aren't trying to come across as fat shaming, but the reality is of course not zero sum. Diet and exercise doesn't magically work for the entire population. Diet and exercise definitely worked for me but im not willing to be a sample size of 1 in the face of so many others with legitimate stories.
  - monero-xmr 2y ago
    Diet alone is 100% guaranteed to cause you to lose weight. It really is as easy as counting calories. It is a scientific fact. It is physically impossible to gain, or maintain weight, if you cut caloric intake sufficiently.
    - copperx 2y ago

deleted 2y ago

[deleted]

daedrdev 2y ago

Clinical trials started in 2008. Thats decades for something major to appear. There are minor things, but people can simply stop taking it. Given the weight lost causes years of healthy lifespan to be gained, it would take a monumental problem that would have been seen by now to make it not worth it for a lot of people who can't lose weight on their own.

pessimizer 2y ago

> You can never, ever stop taking it. You can't stop taking it without gaining the weight back (unless the lifestyle change sticks), but everybody stops taking it in the medium term. The side effects are horrible and stack up over time. We'll start seeing the miserable condition of very long-term users (or maybe, hopefully, their bodies will reach an equilibrium!), and we will be able to use the sacrifice of their health in order to understand how better to counteract the long-term side effects, or to get hints on how to design the next class of miracle weight loss drugs. I'm never going to take them. There are better ways to lose weight, with no side effects, and they slowly and stably got me from a 28 BMI to a 22 BMI. I will push the people I love towards those rather than to a set of powerful, expensive drugs with wild side effects that somebody invented a week ago. But I am not hostile to the concept in any way. > There are no shortcuts in life. There is always a tradeoff. There are an enormous number of shortcuts in life. This is just the Law of Averages as Protestant superstition stated as a pithy self-help maxim. Taking shortcuts rather than going the long way is almost the definition of intelligence. If you see a bunch of points laid out in a rectangle, you can count them one by one, or you can count the ones on the sides and multiply. There's no tradeoff.

cthalupa 2y ago
> You can't stop taking it without gaining the weight back (unless the lifestyle change sticks), but everybody stops taking it in the medium term. The side effects are horrible and stack up over time. Some people experience significant side effects. Many people do not. Tirzepatide seems to induce even fewer side effects in general than semaglutide. > We'll start seeing the miserable condition of very long-term users (or maybe, hopefully, their bodies will reach an equilibrium!), and we will be able to use the sacrifice of their health in order to understand how better to counteract the long-term side effects, or to get hints on how to design the next class of miracle weight loss drugs. I'm active on several GLP-1 related forums. On those, people near-universally report side effects lessening over time, from those that have significant side effects to begin with. The next generation of drugs is arriving now. Eli Lilly is finishing up their initial phase 3 trials for retatrutide at EOY, and in a matter of months I've seen it reduce my ALT levels from edging towards an indication of NAFLD to right in the middle of optimal. Preliminary results from the trials in general seem very positive, so I imagine FDA approval will come later '25/early '26, though the glucagon receptor activity does seem to increase resting heart rate in many people (including myself, though tirzepatide did as well, to a lesser degree.) > I'm never going to take them. There are better ways to lose weight, with no side effects, and they slowly and stably got me from a 28 BMI to a 22 BMI. I will push the people I love towards those rather than to a set of powerful, expensive drugs with wild side effects I would agree if you have success in losing weight with other methods, there's not a strong reason to go on the GLP-1s. We do have some evidence that they have other positive health benefits even without the weight loss, but there are some side effects, yes, and we of course do not strongly know what happens if you take these for decades on end. On the other hand, we know that improving diet and increasing exercise are basically all net positives, outside the minimal injury risk that comes with exercise. I do think you are overstating the side effects, though. There seems to be some small risk of sight issues, though I would like more data here - we know that diabetes is significant risk factor for eye disease, and I'm curious how well these results will be replicated in general, and how well they translate to non-diabetics taking them purely for weight loss. We've also seen thyroid cancer in rodent studies, and while so far no human studies have found an increase, I wouldn't be surprised if there is some risk increase for humans. > somebody invented a week ago. We're actually about two decades in on the GLP-1 class of drugs being in-use by humans, but obviously semaglutide and tirzepatide have really ratcheted up adoption.

Spooky23 2y ago

That’s not true. It’s like anything else, it’s about you. I was on it for 18 months, it allowed me to lose weight and change my habits in a way that has persisted. I lost 90 pounds, and gained back 15, which I attribute to an injury that stopped me from running. I’m back in action now and down 5. I cannot stress how transformative this drug was for me, at a time of my life that was particularly difficult.