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So... There's a miracle drug powerful enough to robustly lower people's all cause mortality, but since health insurance and life insurance are industries with v

So... There's a miracle drug powerful enough to robustly lower people's all cause mortality, but since health insurance and life insurance are industries with vastly different time preferences, this is not a good thing for the life insurers because people just keep getting off the magic longevity drug and screwing up their predictions. Because, admittedly, it kind of sucks in the moment to be on. And I'm guessing just based on my own experience paying for term life that the actual premia differences aren't actually enough in most cases for the life insurer to simply pay out of pocket themselves; the differences probably add up to a few hundred per year per customer, whereas a year's worth of a GLP-1 agonist probably costs a couple thousand (for now, in 2025, and probably dropping rapidly). Huh. Second order implementation details aside, this is an extremely fortunate turn of events for us.

ramoz 1y ago
Can you explain what sucks about being on the prescriptions?
- hiAndrewQuinn 1y ago
  I'm just reporting my cached knowledge of people saying they experienced some adverse side effects. Also injections are not fun, even though they are probably a lot less annoying than they look.
  - nwienert 1y ago
    In the 10 or so people I know who are on it, nearly all actually seem to enjoy it - reduced addictive tendencies/bad habits, appetite control, and reduced allergies seem to pretty well outweigh the minor side effects.
    - wormius 1y ago
      I was a heavy alcoholic, and the ability to quite drinking was... amazing. Now that I'm off, I just remind myself I never want to get back at that dark place, but I'm so very glad it made quitting just... happen. It's wild how easy it was. A little mental control in terms of "no, don't go to the liquor store" but it was habit more than physical addition at that point. This was with Rybelsus. Sober 4.5 years now. It was definitely not an intended side effect but I'm glad I was rx'd when I was. I was not in a good state.
      - nwienert 1y ago
        Crazy to hear all these stories. My wife’s friend was a pack a day smoker for a decade that had transitioned into a heavy vape smoker, normal weight but couldn’t get off vaping despite trying. She tried Tirz to see if it would help and after only about 3 months she quit entirely, now completely smoke free for two months.
    - AlphaAndOmega0 1y ago
      I'm on semaglutide for weight loss purposes, while having no other health issues relevant here. I don't think it's made any difference to any addictive tendencies or my bad habits (and with ADHD, those certainly exist). It certainly helps with the appetite of course. This is definitely anecdotal evidence, but it's wise to hold on longer for more data to come in before advocating for it on those grounds alone.
      - nwienert 1y ago
        Too many miraculous stories so far I’ve heard, numerous people close to me quitting lifelong addictions cold turkey within months of starting. I’ve never had an addictive personality but I also found I gave up a couple habits while on it. I wonder if ADHD specifically isn’t as prone to positive effects there.
    - wincy 1y ago
      I’m INVESTING more. I’ve paid off like $15,000 in debts this year. I swear it’s because of the Zepbound.
      - b3lvedere 1y ago
        Strange side effect, but maybe because you are happier? :)
        wincy 1y ago
        I’ve lost 80 pounds before GLP-1s were a thing and didn’t gain this superpower, and the last time I lost weight (about ten years ago) I went from front line desktop support to teaching myself to code and getting a job as a software engineer, so honestly maybe it’s just “not having sleep apnea”, then when I regained the weight it felt like I lost some IQ points. So you may be on to something. Also it seems to generally reduce inflammation. My heartburn I suffered from is completely gone but that’s because I just absolutely stuffed my face, I felt like I could never eat enough food.
  - ChadNauseam 1y ago
    A once-weekly subcutaneous injection is not a big deal for most people I think, outside of those who are very afraid of needles. It's a tiny needle and you don't even feel it. I've given injections to people who are afraid of needles, and they sometimes close their eyes in fear and are begging me to "just get it over with" without even realizing that I'm already done. Anyway, all this to say that outside of needle-phobic people I think the annoyance of the injections is probably not the reason people stop taking GLP-1 agonists.
    - cjbgkagh 1y ago
      You don’t feel it most of the time, it’s actually random with the sparse placement of nerves. Maybe 1 in 5 still sting a bit.
    - loeg 1y ago
      > It's a tiny needle and you don't even feel it. I'll add that while it isn't a big deal, I definitely feel the needle; sometimes worse than others. (I'm using 8mm 30 gauge needles.)
      - swat535 1y ago
        You have to inject it correctly, it needs to be injected in the fat and with the right angle. If you have very little body fat, your glutes are probably a better place. Source: I take HCG and have to use injection 2x a week. 27G is my favorite.. https://medneedles.ca/products/1ml-27g-x-1-2-sol-care%E2%84%A2-tb-safety-syringe-with-fixed-needle-100-per-box https://medneedles.ca/products/1ml-27g-x-1-2-sol-care%E2%84%...
        cjbgkagh 1y ago
        It’s mostly random and some people do feel it more than others. It’s a rapidly absorbed peptide suspended in water, it could even be used with a transdermal patch, so it doesn’t matter that much where it gets in or how deep. Best to avoid painful areas though.
        loeg 1y ago
  - Spivak 1y ago
    Subcutaneous shots with insulin needles are basically painless. You don't even feel a prick, it's just a little pressure and then it slides in. When you get a shot at the doctor it's painful because they're intramuscular.
  - deleted 1y ago
    [deleted]
  - toomuchtodo 1y ago
    Once daily pills will very likely replace injections in the near future. Eli Lilly will soon release key data on its weight loss pill orforglipron - https://news.ycombinator.com/item?id=43465346 https://news.ycombinator.com/item?id=43465346 - March 2025 https://en.wikipedia.org/wiki/Orforglipron https://en.wikipedia.org/wiki/Orforglipron
    - tempestn 1y ago
      There's already Rybelsus. It's a bit more of a pain though as it needs to be taken on an empty stomach and you then need to wait 30-60 minutes before eating.
      - toomuchtodo 1y ago
        Looks like the benefit of orforglipron is you can take it whether you’ve eaten or not.
  - gedy 1y ago
    I've taken these and self injected, and it was surprising that I really felt nothing - no pain at all. I suppose because they recommend in stomach, and it's not in muscle, etc.
  - dooglius 1y ago
    There's an auto-injector mechanism, at least with my brand; you don't need to needle yourself
    - ahartmetz 1y ago
      Ah, auto-injectors, a curious piece of technology. I've always wondered how it is to actually use one since we had these in everyone's medkit in the German army, loaded with nerve agent antidotes. Just slam it on you leg and inject through the pants were the instructions... Kinda grisly, I guess it's less emotionally charged for a weight loss drug!
      - saratogacx 1y ago
        For drugs like these it isn't that different from a normal injection. The pen has about 4 doses in it so you twist it to set your dose. You attach a needle tip to the pen and give yourself a poke, press an inject button on the top and a spring loaded ratchet system pumps in the dose amount you set (making a wonderful ticking noise as it progresses). Pull out and toss the needle and put it back in the fridge for next week. I do manual injection which involves doing the full prep work. It takes about 3x as long to setup but is still only about a 3-5 minute process in total.
        ahartmetz 1y ago
        Thanks!
    - loeg 1y ago
      These tend to cost more than self-injecting. Maybe your insurance covers it and you don't care.
  - wincy 1y ago
    I had terrible side effects with Ozempic but have had minimal side effects with Zepbound that have disappeared over time. I just wake up on Thursdays and inject it first thing. The auto pen misfired the other day and I called Eli Lilly and they immediately emailed me a voucher for a free 4 pack of the shots. It’s also eliminated my sleep apnea (via the weight loss).
- DrillShopper 1y ago
  Hi there - Mounjaro user here. I've been using it for about a year at this point. I feel sick for three days in a row after taking it. Even after several months on the same dose. I get horrible gut cramps, sour stomach, near constant nausea, and occasionally vomiting and diarrhea. I have to take my shot on Thursday night because I'll feel bad the next day and supremely sick the next two days. If I took it earlier or later in the week it would absolutely impact my ability to work during the work week. It has had amazing effects. I've lost about 60 lbs in the last year and my A1c is now around 6.2. It's a very effective drug, but it is brutal on my body. I'm not sure anything in the medication is causing the weight loss. It just makes me feel so sick that even if I'm hungry I don't feel like eating.
  - jstummbillig 1y ago
    I mean no offense, but you have a fairly substantiated body of evidence that something in the medication is causing the weight loss. The side effects do sound really shitty though.
    - dboreham 1y ago
      These medications don't work in the way many people think. The drug doesn't make you "lose weight" in the sense that it causes the body to excrete fat. Rather it interferes with the constants in the gut/brain signaling/programming system such that your brain doesn't want to eat as much. That in turn leads typically to weight loss.
      - aydyn 1y ago
        I dont think there is any confusion about that. How would "excreting fat" even work?
        Auracle 1y ago
        DNP makes you burn fat, so technically it’s possible. It’s also dangerous as hell.
    - 1y ago
- glp1guide 1y ago
  Tried to list them all here: https://glp1.guide/content/are-glp1-side-effects-all-the-same/ https://glp1.guide/content/are-glp1-side-effects-all-the-sam... It was a while ago, but IMO the list still plays
  - glp1guide 1y ago
    Oh also, the side-effect category is a good place to watch: https://glp1.guide/tag/category-side-effects/ https://glp1.guide/tag/category-side-effects/ https://glp1.guide/tag/category-risks/ https://glp1.guide/tag/category-risks/ I try to tag all the new news of negative side effects there
  - esperent 1y ago
    Which of these are issues that diabetic/pre-diabetic/obese people would be likely to suffer from anyway? And which of them are issues that people massively changing their diet and dropping weight, while also making lifestyle changes like exercising more (due to finding it easier after losing weight) would be likely to experience?
- wonderwonder 1y ago
  I cant think of anything. I take 18 shots a week, including the GLP-1 shot once a week. I don't even notice it. I even give my wife her shot. Gotten to the point where I don't have a lot of belly fat to inject into so I have to lean forward but that's really it. I've never had a side effect from GLP-1. No nausea, nothing. Only side effect is I now have the will power not to kill a pint of ice-cream after 6pm. Its been 100% a willpower increase for me vs a physical change. Started in January at 240lbs. 210.8lbs as of this morning. Every ab is defined. Stuff is great, no idea why anyone would want to come off. I can still eat whatever I want I just choose not to. For example, had burgers, fries and ice-cream for lunch on Saturday with the family and then just a protein shake for dinner. I also don't snore anymore. I used to snore terribly, my wife would wake me up at least once a night to tell me to roll over. Not at all now. Most importantly, even though I am on a ton of test and deca, my blood pressure is normal, and my cholesterol has actually gone down.
jiveturkey 1y ago
For a single person, perhaps fortunate. What about in aggregate? What if the math is so bad that your life insurer goes bankrupt?
- hiAndrewQuinn 1y ago
  ... I just switch life insurance providers? Seriously, that's just not that big of a deal. It takes like a few days at most for simple term life. Can't speak to the other policies, which I understand are mostly tax vehicles anyway, but it's not hard to simply get a new life insurance policy if your current one goes kaput.
  - FabHK 1y ago
    ... and the question was about the aggregate effect. What happens if all life insurers go bankrupt?
    - hiAndrewQuinn 1y ago
      Every single life insurer? All at once? Jeez.... I guess in that scenario I become a billionaire because it will be very easy to scoop up some VC money to snoop up some of those newly unemployed actuaries to monopolize the market at a profit margin an order of magnitude larger than any of my now non-existent competition, because this is a financial product and doesn't require months of building a factory or something to offer.
      - ecb_penguin 1y ago
        If you think it's that simple, you have no idea what you're talking about. How many years experience do you have in the insurance industry that you're so confident to talk like this? > because this is a financial product and doesn't require months of building a factory or something to offer. How many financial instruments have you launched? If the answer is zero, you should refrain from any conversations on the topic because your opinion literally means nothing.
petesergeant 1y ago
> admittedly, it kind of sucks in the moment to be on I don’t think that’s a typical experience for most people, other than the price
- mattmanser 1y ago
  There's often side effects, including nausea, diarrhea, headaches, bloating, discomfort, etc. As far as I can tell from forums, it's not like 5% have the side effects, it's like 80-90%. But for the first time in decades, I felt full. I didn't want to finish a meal, it was too much. My body regulated my food intake in what felt like a natural way. I hadn't even realized my body had somehow lost that fundamental mechanism of appetite control. It made me realize I wasn't weak willed, something is different about my body than other people. But it comes with a price. The side effects I had were quite bad and so I stopped (though I now read that if I switch to a different brand, I might be ok). I often didn't want to leave the house due to a dicky tummy. It could come/go in waves. But often can last a whole week. Plus you've got to inject yourself every week. Often you can't drink as it makes you sick. Even when you're doing everything 'right' you can feel a bit off. If you do over-indulge (with food or drink) the side effects can sometimes be massively amplified and you feel terrible for days. So amazing in some ways, but it's not like taking a vitamin tablet. There are costs and making one slip up can result in suddenly feeling awful for a day or two. Perhaps I was just particularly prone to the side effects, but it seems to happen to a lot of people (I found Mumsnet threads about it useful, they are quite revealing as they seem to be fairly honest and willing to share their experiences)
  - loeg 1y ago
    I had more side effects ramping up the dose than after a while at the same dose. But they were all fairly mild. (I'm on 5mg/week of Tirzepatide; higher doses probably have more side effects.) > If you do over-indulge (with food or drink) the side effects can sometimes be massively amplified and you feel terrible for days. Never had anything like that.
  - DrillShopper 1y ago
    The one thing that helped blunt the side effects for me was cannabis. Just a few puffs at night on the three nights after my injection made a huge difference. I wouldn't recommend that to everyone, but it helped a lot for me.
linsomniac 1y ago
>There's a miracle drug powerful enough to robustly lower people's all cause mortality Did I misread the article, my TL;DR of the article is that GLP-1 reduce the indicators or mortality without modifying the actual mortality (because most users return to normal indicators within about 2 years).
- yumraj 1y ago
  > because most users return to normal indicators within about 2 years Because they stop taking GLP-1s after 1-2 years, not, it seems, because the meds stop working.
  - alistairSH 1y ago
    They do? I was under the impression people stopped taking them because they’re massively expensive. And weekly injections is a bit annoying (though should be less annoying than diabetes or death or whatever else).
    - saratogacx 1y ago
      There is a set of the population, and not a small one, that will quit the drug as soon as they hit the weight they feel is good enough. Even if they can afford it and are used to the shots they just feel that it is done and don't feel like they'll rebound (although most do) once off it.
- readthenotes1 1y ago
  "If we assume about 65% of people who start GLP-1 medications quit by the end of year one, that creates a big problem. When someone stops the medication, they'll usually regain the weight they lost, and in two years, most of those key health indicators (like BMI, blood pressure, blood sugar and cholesterol) bounce back to their starting point. " So in addition to the quitters returning back to normal after they got life insurance underwritten when they were healthy, we have the unknown of the longevity of people on the glp-1 drugs.
loeg 1y ago
They aren't even that awful in maintenance -- just expensive. The unpleasant part is when you're increasing the dose. After a while at the same dose, it's more or less unnoticeable IMO.
- gregw134 1y ago
  Unnoticable meaning doesn't have any effect at all, or just no bad side effects?
  - throwawaysleep 1y ago
    As in I cannot identify anything wrong with me most of the time while on them.
  - loeg 1y ago
    Just in terms of bad side effects. Hunger was still suppressed. (Might be worse on the higher doses, I'm not on a very high dose.)
    - PeterStuer 1y ago
      Why would that be a 'bad' side effect? Isn't that the whole point of the medication?
      - coldtea 1y ago
        Parent is not saying hunger supression is a bad side effect, they just clarify that the difference in noticabeality talked about a few comments up refers to the bad ones - but the good one's remain the same.
  - craz8 1y ago
    I have 2 measurable ones on Zepbound. My lowest sleeping heart rate is now at least 10 beats higher than before starting (it comes down during the week to about 10 over) The night after taking the injection my sleep is crap, and the heart rate is 5+ higher again I have lost 20lbs since mid March with no real effort, and we’re about to do some blood tests for specific cholesterol numbers, which was one of the reasons to try this out.
zer00eyz 1y ago
> And I'm guessing just based on my own experience paying for term life that the actual premia differences aren't actually enough in most cases for the life insurer to simply pay out of pocket themselves; the differences probably add up to a few hundred per year per customer, whereas a year's worth of a GLP-1 agonist probably costs a couple thousand (for now, in 2025, and probably dropping rapidly). I wonder why life insurance isnt funding more research into things like metformin, where we have amazing long standing data but haven't done the real research. See: https://www.afar.org/tame-trial https://www.afar.org/tame-trial
- loeg 1y ago
  Because metformin is super unpleasant.
blackqueeriroh 1y ago
[flagged]
- AlphaAndOmega0 1y ago
  I would appreciate citations. I'm a doctor on GLP-1s,who had previously convinced my mother to commence the same. In her case, it was driven clearly by failure of other methods to control her obesity and worsening liver fibrosis, on top of pre-existing diabetes. On my end, no such issues at present, but I consider it safe enough that it's a first-choice approach to robust weight loss, and I personally use it in conjunction with diet and exercise. "Relatively high levels of significant side effects" is a vague and unhelpful claim: High compared to what? What counts as a significant side effect here? What actually are the side effects in question? Are those side effects permanent and irreversible? Can they be avoided by adjusting the dose? Dozens of such considerations come into play. No drug I'm aware of is perfectly safe, and I know many drugs indeed. To the best of my knowledge, the combined risk of taking semaglutide utterly pales in comparison to the clear and present harms of obesity. The only clear downside is cost, and while I'm lucky enough to to have access to cheaper sources, they're not even that expensive when you consider the QOL and health benefits.
  - friendzis 1y ago
    https://pubmed.ncbi.nlm.nih.gov/38629387/ https://pubmed.ncbi.nlm.nih.gov/38629387/ > Conclusion: Semaglutide displays potential for weight loss primarily through fat mass reduction. However, concerns arise from notable reductions in lean mass, especially in trials with a larger number of patients. That's a significant long-term damage to health, quite possibly permanent for 40+ patients.
    - Daishiman 1y ago
      That has nothing to do with GLP-1 agonists and everything to do with the fact that rapid weight loss without exercise and sufficient protein intake leads to substantial lean mass reduction. It's still better unless you were woefully weak, in which case a doctor should have prescribed adequate nutrition and physical activity.
exabrial 1y ago
I think this is pretty far off the cusp and seems like a bit of reddit logic "health insurance is scam, internet said so". Health insurance is one of the rare services where incentives between consumer and business are well aligned. The vast majority of people are healthy. Healthcare is expensive in the US because the uninsured population continues to rise out of "they're not making me pay for it": There are entire tranches (in the US) also don't buy insurance and use the ER and abuse EMTALA for their primary care (most of this is actually unintentional in my opinion, it's less educated populations in the US who are repeatedly taken advantage of and left to ride on government, which is extremely eye-wateringly bad at spending money). Personal experience here working in an ER. The real pathway in the US to success is getting those populations onto private health insurance. Obama tried a heavy handed "health insurance mandate" that hilariously somehow passed the supreme court, but was so laughable mis-aligned with American ideals even Biden wouldn't enforce it. What is apparent though is these populations are completely willing to pay bills like their cell service, gasoline, car payments, etc before investing in the most important thing (their health). This gives me hope there is a way forward by riding these perceived essential services somehow. I'm not really sure what the answer is here, but there is at least opportunity for some creative solutions. I also think the disagreement here between red vs blue isn't the outcome: both want people to be healthy. Red doesn't want single payer, whereas blue does. Red ignores the fact these systems don't exist, blue ignores the fact that no other country in the world has the diversity of America and there are not functional examples.
- multjoy 1y ago
  Universal healthcare is a human right.
  - eru 1y ago
    Food is even more of a human right, but in most places around the world most people buy their own food. Especially the better run places. (Food assistance is usually coupled with means testing.)
  - exabrial 1y ago
    Really? I have the right to demand the services of another person?
imtringued 1y ago
It's not different time preferences. According to time preference theory the insurers have perfect information about the future so they would have taken the change in lifespan induced by GLP-1 into account before it was even invented. The assumption that mistakes are impossible is one of the core foundations of neoclassical economics. In time preference theory the bias towards the present or future is a moral issue that you get beaten over with to enact a just world fallacy. In liquidity preference theory insurers do not have perfect information so they must make a tradeoff between collecting information and acting on the information they already have. There will be a bias towards the present and the past, because more information is available about the past and present than the future. What's being "discounted" is uncertainty, not time. Hence there is also a general bias towards stability and conservatism (sticking with existing decisions, even if they are bound to become obsolete). Now let's apply this to the article: The insurers don't know if you can stick with your weight loss, so they will conservatively deny coverage until they are certain that they know your health/risk profile. According to time preference theory this would never happen since the insurer already knows whether you will succeed at weightloss or not.
- eru 1y ago
  > The assumption that mistakes are impossible is one of the core foundations of neoclassical economics. [citation needed]
PeterStuer 1y ago
Pharmaceuticals generally do not drop in price while they are under patent. They will lobby like crazy to get on the approved 3rd party payment schemes though as that makes it "affordable" to more as then everybody pays regardless of wether you use or not. And a treatement that you have to continue forever or fall back? Pure gold! Insurers certaily don't mind you living longer. More payments, less payouts. They just need to update their predictive models or coverage policies to safeguard their margins. The 'problem' is transitory.
- tonyhart7 1y ago
  I think this is US only problem
- fhdkweig 1y ago
  > Insurers certaily don't mind you living longer. More payments, less payouts. There are times when this is a problem, but even then it isn't the insurance companies that are complaining. There was a big "problem" during the beginning of the AIDS epidemic. For reasons I don't quite understand, the holder of the policy (the insured) can sell their policy to a random third party. The seller sells because they need immediate cash for end of life hospice treatment. The buyer buys because they know this person is about to die and they are going to get a cash payout of more than they paid for. This was a guaranteed payout because there was no treatment. This was a rare example of an investment with zero risk and high return. If you got the virus, you were going to be dead in a few months. This is a win-win for both the deceased and the new buyer, and it is neutral for the life insurance company because either way they have to pay the same amount to someone at the time of death. The arrival of AZT cocktails threw a monkey wrench into the whole plan because suddenly a guaranteed death is no longer guaranteed and it leads to an ethical quandary because the "investor" doesn't get a return for their "investment" unless that person dies, and now they are literally wishing death on someone. (see also: There is no such thing as a risk free investment.) https://www.theatlantic.com/health/archive/2018/10/viatical-settlements-aids-gay-men/572044/ https://www.theatlantic.com/health/archive/2018/10/viatical-... "The Gay Men Who Have Lived for Years With Someone Waiting on Their Death"
downrightmike 1y ago
Insurance companies need to go after processed food companies if they don't like it, not their customers

ramoz 1y ago

Can you explain what sucks about being on the prescriptions?

hiAndrewQuinn 1y ago
I'm just reporting my cached knowledge of people saying they experienced some adverse side effects. Also injections are not fun, even though they are probably a lot less annoying than they look.
- nwienert 1y ago
  In the 10 or so people I know who are on it, nearly all actually seem to enjoy it - reduced addictive tendencies/bad habits, appetite control, and reduced allergies seem to pretty well outweigh the minor side effects.
  - wormius 1y ago
    I was a heavy alcoholic, and the ability to quite drinking was... amazing. Now that I'm off, I just remind myself I never want to get back at that dark place, but I'm so very glad it made quitting just... happen. It's wild how easy it was. A little mental control in terms of "no, don't go to the liquor store" but it was habit more than physical addition at that point. This was with Rybelsus. Sober 4.5 years now. It was definitely not an intended side effect but I'm glad I was rx'd when I was. I was not in a good state.
    - nwienert 1y ago
      Crazy to hear all these stories. My wife’s friend was a pack a day smoker for a decade that had transitioned into a heavy vape smoker, normal weight but couldn’t get off vaping despite trying. She tried Tirz to see if it would help and after only about 3 months she quit entirely, now completely smoke free for two months.
  - AlphaAndOmega0 1y ago
    I'm on semaglutide for weight loss purposes, while having no other health issues relevant here. I don't think it's made any difference to any addictive tendencies or my bad habits (and with ADHD, those certainly exist). It certainly helps with the appetite of course. This is definitely anecdotal evidence, but it's wise to hold on longer for more data to come in before advocating for it on those grounds alone.
    - nwienert 1y ago
      Too many miraculous stories so far I’ve heard, numerous people close to me quitting lifelong addictions cold turkey within months of starting. I’ve never had an addictive personality but I also found I gave up a couple habits while on it. I wonder if ADHD specifically isn’t as prone to positive effects there.
  - wincy 1y ago
    I’m INVESTING more. I’ve paid off like $15,000 in debts this year. I swear it’s because of the Zepbound.
    - b3lvedere 1y ago
      Strange side effect, but maybe because you are happier? :)
      - wincy 1y ago
        I’ve lost 80 pounds before GLP-1s were a thing and didn’t gain this superpower, and the last time I lost weight (about ten years ago) I went from front line desktop support to teaching myself to code and getting a job as a software engineer, so honestly maybe it’s just “not having sleep apnea”, then when I regained the weight it felt like I lost some IQ points. So you may be on to something. Also it seems to generally reduce inflammation. My heartburn I suffered from is completely gone but that’s because I just absolutely stuffed my face, I felt like I could never eat enough food.
- ChadNauseam 1y ago
  A once-weekly subcutaneous injection is not a big deal for most people I think, outside of those who are very afraid of needles. It's a tiny needle and you don't even feel it. I've given injections to people who are afraid of needles, and they sometimes close their eyes in fear and are begging me to "just get it over with" without even realizing that I'm already done. Anyway, all this to say that outside of needle-phobic people I think the annoyance of the injections is probably not the reason people stop taking GLP-1 agonists.
  - cjbgkagh 1y ago
    You don’t feel it most of the time, it’s actually random with the sparse placement of nerves. Maybe 1 in 5 still sting a bit.
  - loeg 1y ago
    > It's a tiny needle and you don't even feel it. I'll add that while it isn't a big deal, I definitely feel the needle; sometimes worse than others. (I'm using 8mm 30 gauge needles.)
    - swat535 1y ago
      You have to inject it correctly, it needs to be injected in the fat and with the right angle. If you have very little body fat, your glutes are probably a better place. Source: I take HCG and have to use injection 2x a week. 27G is my favorite.. https://medneedles.ca/products/1ml-27g-x-1-2-sol-care%E2%84%A2-tb-safety-syringe-with-fixed-needle-100-per-box https://medneedles.ca/products/1ml-27g-x-1-2-sol-care%E2%84%...
      - cjbgkagh 1y ago
        It’s mostly random and some people do feel it more than others. It’s a rapidly absorbed peptide suspended in water, it could even be used with a transdermal patch, so it doesn’t matter that much where it gets in or how deep. Best to avoid painful areas though.
      - loeg 1y ago
- Spivak 1y ago
  Subcutaneous shots with insulin needles are basically painless. You don't even feel a prick, it's just a little pressure and then it slides in. When you get a shot at the doctor it's painful because they're intramuscular.
- deleted 1y ago
  [deleted]
- toomuchtodo 1y ago
  Once daily pills will very likely replace injections in the near future. Eli Lilly will soon release key data on its weight loss pill orforglipron - https://news.ycombinator.com/item?id=43465346 https://news.ycombinator.com/item?id=43465346 - March 2025 https://en.wikipedia.org/wiki/Orforglipron https://en.wikipedia.org/wiki/Orforglipron
  - tempestn 1y ago
    There's already Rybelsus. It's a bit more of a pain though as it needs to be taken on an empty stomach and you then need to wait 30-60 minutes before eating.
    - toomuchtodo 1y ago
      Looks like the benefit of orforglipron is you can take it whether you’ve eaten or not.
- gedy 1y ago
  I've taken these and self injected, and it was surprising that I really felt nothing - no pain at all. I suppose because they recommend in stomach, and it's not in muscle, etc.
- dooglius 1y ago
  There's an auto-injector mechanism, at least with my brand; you don't need to needle yourself
  - ahartmetz 1y ago
    Ah, auto-injectors, a curious piece of technology. I've always wondered how it is to actually use one since we had these in everyone's medkit in the German army, loaded with nerve agent antidotes. Just slam it on you leg and inject through the pants were the instructions... Kinda grisly, I guess it's less emotionally charged for a weight loss drug!
    - saratogacx 1y ago
      For drugs like these it isn't that different from a normal injection. The pen has about 4 doses in it so you twist it to set your dose. You attach a needle tip to the pen and give yourself a poke, press an inject button on the top and a spring loaded ratchet system pumps in the dose amount you set (making a wonderful ticking noise as it progresses). Pull out and toss the needle and put it back in the fridge for next week. I do manual injection which involves doing the full prep work. It takes about 3x as long to setup but is still only about a 3-5 minute process in total.
      - ahartmetz 1y ago
        Thanks!
  - loeg 1y ago
    These tend to cost more than self-injecting. Maybe your insurance covers it and you don't care.
- wincy 1y ago
  I had terrible side effects with Ozempic but have had minimal side effects with Zepbound that have disappeared over time. I just wake up on Thursdays and inject it first thing. The auto pen misfired the other day and I called Eli Lilly and they immediately emailed me a voucher for a free 4 pack of the shots. It’s also eliminated my sleep apnea (via the weight loss).
DrillShopper 1y ago
Hi there - Mounjaro user here. I've been using it for about a year at this point. I feel sick for three days in a row after taking it. Even after several months on the same dose. I get horrible gut cramps, sour stomach, near constant nausea, and occasionally vomiting and diarrhea. I have to take my shot on Thursday night because I'll feel bad the next day and supremely sick the next two days. If I took it earlier or later in the week it would absolutely impact my ability to work during the work week. It has had amazing effects. I've lost about 60 lbs in the last year and my A1c is now around 6.2. It's a very effective drug, but it is brutal on my body. I'm not sure anything in the medication is causing the weight loss. It just makes me feel so sick that even if I'm hungry I don't feel like eating.
- jstummbillig 1y ago
  I mean no offense, but you have a fairly substantiated body of evidence that something in the medication is causing the weight loss. The side effects do sound really shitty though.
  - dboreham 1y ago
    These medications don't work in the way many people think. The drug doesn't make you "lose weight" in the sense that it causes the body to excrete fat. Rather it interferes with the constants in the gut/brain signaling/programming system such that your brain doesn't want to eat as much. That in turn leads typically to weight loss.
    - aydyn 1y ago
      I dont think there is any confusion about that. How would "excreting fat" even work?
      - Auracle 1y ago
        DNP makes you burn fat, so technically it’s possible. It’s also dangerous as hell.
  - 1y ago
glp1guide 1y ago
Tried to list them all here: https://glp1.guide/content/are-glp1-side-effects-all-the-same/ https://glp1.guide/content/are-glp1-side-effects-all-the-sam... It was a while ago, but IMO the list still plays
- glp1guide 1y ago
  Oh also, the side-effect category is a good place to watch: https://glp1.guide/tag/category-side-effects/ https://glp1.guide/tag/category-side-effects/ https://glp1.guide/tag/category-risks/ https://glp1.guide/tag/category-risks/ I try to tag all the new news of negative side effects there
- esperent 1y ago
  Which of these are issues that diabetic/pre-diabetic/obese people would be likely to suffer from anyway? And which of them are issues that people massively changing their diet and dropping weight, while also making lifestyle changes like exercising more (due to finding it easier after losing weight) would be likely to experience?
wonderwonder 1y ago
I cant think of anything. I take 18 shots a week, including the GLP-1 shot once a week. I don't even notice it. I even give my wife her shot. Gotten to the point where I don't have a lot of belly fat to inject into so I have to lean forward but that's really it. I've never had a side effect from GLP-1. No nausea, nothing. Only side effect is I now have the will power not to kill a pint of ice-cream after 6pm. Its been 100% a willpower increase for me vs a physical change. Started in January at 240lbs. 210.8lbs as of this morning. Every ab is defined. Stuff is great, no idea why anyone would want to come off. I can still eat whatever I want I just choose not to. For example, had burgers, fries and ice-cream for lunch on Saturday with the family and then just a protein shake for dinner. I also don't snore anymore. I used to snore terribly, my wife would wake me up at least once a night to tell me to roll over. Not at all now. Most importantly, even though I am on a ton of test and deca, my blood pressure is normal, and my cholesterol has actually gone down.

jiveturkey 1y ago

For a single person, perhaps fortunate. What about in aggregate? What if the math is so bad that your life insurer goes bankrupt?

hiAndrewQuinn 1y ago
... I just switch life insurance providers? Seriously, that's just not that big of a deal. It takes like a few days at most for simple term life. Can't speak to the other policies, which I understand are mostly tax vehicles anyway, but it's not hard to simply get a new life insurance policy if your current one goes kaput.
- FabHK 1y ago
  ... and the question was about the aggregate effect. What happens if all life insurers go bankrupt?
  - hiAndrewQuinn 1y ago
    Every single life insurer? All at once? Jeez.... I guess in that scenario I become a billionaire because it will be very easy to scoop up some VC money to snoop up some of those newly unemployed actuaries to monopolize the market at a profit margin an order of magnitude larger than any of my now non-existent competition, because this is a financial product and doesn't require months of building a factory or something to offer.
    - ecb_penguin 1y ago
      If you think it's that simple, you have no idea what you're talking about. How many years experience do you have in the insurance industry that you're so confident to talk like this? > because this is a financial product and doesn't require months of building a factory or something to offer. How many financial instruments have you launched? If the answer is zero, you should refrain from any conversations on the topic because your opinion literally means nothing.

petesergeant 1y ago

> admittedly, it kind of sucks in the moment to be on I don’t think that’s a typical experience for most people, other than the price

mattmanser 1y ago
There's often side effects, including nausea, diarrhea, headaches, bloating, discomfort, etc. As far as I can tell from forums, it's not like 5% have the side effects, it's like 80-90%. But for the first time in decades, I felt full. I didn't want to finish a meal, it was too much. My body regulated my food intake in what felt like a natural way. I hadn't even realized my body had somehow lost that fundamental mechanism of appetite control. It made me realize I wasn't weak willed, something is different about my body than other people. But it comes with a price. The side effects I had were quite bad and so I stopped (though I now read that if I switch to a different brand, I might be ok). I often didn't want to leave the house due to a dicky tummy. It could come/go in waves. But often can last a whole week. Plus you've got to inject yourself every week. Often you can't drink as it makes you sick. Even when you're doing everything 'right' you can feel a bit off. If you do over-indulge (with food or drink) the side effects can sometimes be massively amplified and you feel terrible for days. So amazing in some ways, but it's not like taking a vitamin tablet. There are costs and making one slip up can result in suddenly feeling awful for a day or two. Perhaps I was just particularly prone to the side effects, but it seems to happen to a lot of people (I found Mumsnet threads about it useful, they are quite revealing as they seem to be fairly honest and willing to share their experiences)
- loeg 1y ago
  I had more side effects ramping up the dose than after a while at the same dose. But they were all fairly mild. (I'm on 5mg/week of Tirzepatide; higher doses probably have more side effects.) > If you do over-indulge (with food or drink) the side effects can sometimes be massively amplified and you feel terrible for days. Never had anything like that.
- DrillShopper 1y ago
  The one thing that helped blunt the side effects for me was cannabis. Just a few puffs at night on the three nights after my injection made a huge difference. I wouldn't recommend that to everyone, but it helped a lot for me.

linsomniac 1y ago

>There's a miracle drug powerful enough to robustly lower people's all cause mortality Did I misread the article, my TL;DR of the article is that GLP-1 reduce the indicators or mortality without modifying the actual mortality (because most users return to normal indicators within about 2 years).

yumraj 1y ago
> because most users return to normal indicators within about 2 years Because they stop taking GLP-1s after 1-2 years, not, it seems, because the meds stop working.
- alistairSH 1y ago
  They do? I was under the impression people stopped taking them because they’re massively expensive. And weekly injections is a bit annoying (though should be less annoying than diabetes or death or whatever else).
  - saratogacx 1y ago
    There is a set of the population, and not a small one, that will quit the drug as soon as they hit the weight they feel is good enough. Even if they can afford it and are used to the shots they just feel that it is done and don't feel like they'll rebound (although most do) once off it.
readthenotes1 1y ago
"If we assume about 65% of people who start GLP-1 medications quit by the end of year one, that creates a big problem. When someone stops the medication, they'll usually regain the weight they lost, and in two years, most of those key health indicators (like BMI, blood pressure, blood sugar and cholesterol) bounce back to their starting point. " So in addition to the quitters returning back to normal after they got life insurance underwritten when they were healthy, we have the unknown of the longevity of people on the glp-1 drugs.

loeg 1y ago

They aren't even that awful in maintenance -- just expensive. The unpleasant part is when you're increasing the dose. After a while at the same dose, it's more or less unnoticeable IMO.

gregw134 1y ago
Unnoticable meaning doesn't have any effect at all, or just no bad side effects?
- throwawaysleep 1y ago
  As in I cannot identify anything wrong with me most of the time while on them.
- loeg 1y ago
  Just in terms of bad side effects. Hunger was still suppressed. (Might be worse on the higher doses, I'm not on a very high dose.)
  - PeterStuer 1y ago
    Why would that be a 'bad' side effect? Isn't that the whole point of the medication?
    - coldtea 1y ago
      Parent is not saying hunger supression is a bad side effect, they just clarify that the difference in noticabeality talked about a few comments up refers to the bad ones - but the good one's remain the same.
- craz8 1y ago
  I have 2 measurable ones on Zepbound. My lowest sleeping heart rate is now at least 10 beats higher than before starting (it comes down during the week to about 10 over) The night after taking the injection my sleep is crap, and the heart rate is 5+ higher again I have lost 20lbs since mid March with no real effort, and we’re about to do some blood tests for specific cholesterol numbers, which was one of the reasons to try this out.

zer00eyz 1y ago

> And I'm guessing just based on my own experience paying for term life that the actual premia differences aren't actually enough in most cases for the life insurer to simply pay out of pocket themselves; the differences probably add up to a few hundred per year per customer, whereas a year's worth of a GLP-1 agonist probably costs a couple thousand (for now, in 2025, and probably dropping rapidly). I wonder why life insurance isnt funding more research into things like metformin, where we have amazing long standing data but haven't done the real research. See: https://www.afar.org/tame-trial https://www.afar.org/tame-trial

loeg 1y ago
Because metformin is super unpleasant.

blackqueeriroh 1y ago

[flagged]

AlphaAndOmega0 1y ago
I would appreciate citations. I'm a doctor on GLP-1s,who had previously convinced my mother to commence the same. In her case, it was driven clearly by failure of other methods to control her obesity and worsening liver fibrosis, on top of pre-existing diabetes. On my end, no such issues at present, but I consider it safe enough that it's a first-choice approach to robust weight loss, and I personally use it in conjunction with diet and exercise. "Relatively high levels of significant side effects" is a vague and unhelpful claim: High compared to what? What counts as a significant side effect here? What actually are the side effects in question? Are those side effects permanent and irreversible? Can they be avoided by adjusting the dose? Dozens of such considerations come into play. No drug I'm aware of is perfectly safe, and I know many drugs indeed. To the best of my knowledge, the combined risk of taking semaglutide utterly pales in comparison to the clear and present harms of obesity. The only clear downside is cost, and while I'm lucky enough to to have access to cheaper sources, they're not even that expensive when you consider the QOL and health benefits.
- friendzis 1y ago
  https://pubmed.ncbi.nlm.nih.gov/38629387/ https://pubmed.ncbi.nlm.nih.gov/38629387/ > Conclusion: Semaglutide displays potential for weight loss primarily through fat mass reduction. However, concerns arise from notable reductions in lean mass, especially in trials with a larger number of patients. That's a significant long-term damage to health, quite possibly permanent for 40+ patients.
  - Daishiman 1y ago
    That has nothing to do with GLP-1 agonists and everything to do with the fact that rapid weight loss without exercise and sufficient protein intake leads to substantial lean mass reduction. It's still better unless you were woefully weak, in which case a doctor should have prescribed adequate nutrition and physical activity.

exabrial 1y ago

I think this is pretty far off the cusp and seems like a bit of reddit logic "health insurance is scam, internet said so". Health insurance is one of the rare services where incentives between consumer and business are well aligned. The vast majority of people are healthy. Healthcare is expensive in the US because the uninsured population continues to rise out of "they're not making me pay for it": There are entire tranches (in the US) also don't buy insurance and use the ER and abuse EMTALA for their primary care (most of this is actually unintentional in my opinion, it's less educated populations in the US who are repeatedly taken advantage of and left to ride on government, which is extremely eye-wateringly bad at spending money). Personal experience here working in an ER. The real pathway in the US to success is getting those populations onto private health insurance. Obama tried a heavy handed "health insurance mandate" that hilariously somehow passed the supreme court, but was so laughable mis-aligned with American ideals even Biden wouldn't enforce it. What is apparent though is these populations are completely willing to pay bills like their cell service, gasoline, car payments, etc before investing in the most important thing (their health). This gives me hope there is a way forward by riding these perceived essential services somehow. I'm not really sure what the answer is here, but there is at least opportunity for some creative solutions. I also think the disagreement here between red vs blue isn't the outcome: both want people to be healthy. Red doesn't want single payer, whereas blue does. Red ignores the fact these systems don't exist, blue ignores the fact that no other country in the world has the diversity of America and there are not functional examples.

multjoy 1y ago
Universal healthcare is a human right.
- eru 1y ago
  Food is even more of a human right, but in most places around the world most people buy their own food. Especially the better run places. (Food assistance is usually coupled with means testing.)
- exabrial 1y ago
  Really? I have the right to demand the services of another person?

imtringued 1y ago

It's not different time preferences. According to time preference theory the insurers have perfect information about the future so they would have taken the change in lifespan induced by GLP-1 into account before it was even invented. The assumption that mistakes are impossible is one of the core foundations of neoclassical economics. In time preference theory the bias towards the present or future is a moral issue that you get beaten over with to enact a just world fallacy. In liquidity preference theory insurers do not have perfect information so they must make a tradeoff between collecting information and acting on the information they already have. There will be a bias towards the present and the past, because more information is available about the past and present than the future. What's being "discounted" is uncertainty, not time. Hence there is also a general bias towards stability and conservatism (sticking with existing decisions, even if they are bound to become obsolete). Now let's apply this to the article: The insurers don't know if you can stick with your weight loss, so they will conservatively deny coverage until they are certain that they know your health/risk profile. According to time preference theory this would never happen since the insurer already knows whether you will succeed at weightloss or not.

eru 1y ago
> The assumption that mistakes are impossible is one of the core foundations of neoclassical economics. [citation needed]

PeterStuer 1y ago

Pharmaceuticals generally do not drop in price while they are under patent. They will lobby like crazy to get on the approved 3rd party payment schemes though as that makes it "affordable" to more as then everybody pays regardless of wether you use or not. And a treatement that you have to continue forever or fall back? Pure gold! Insurers certaily don't mind you living longer. More payments, less payouts. They just need to update their predictive models or coverage policies to safeguard their margins. The 'problem' is transitory.

tonyhart7 1y ago
I think this is US only problem
fhdkweig 1y ago
> Insurers certaily don't mind you living longer. More payments, less payouts. There are times when this is a problem, but even then it isn't the insurance companies that are complaining. There was a big "problem" during the beginning of the AIDS epidemic. For reasons I don't quite understand, the holder of the policy (the insured) can sell their policy to a random third party. The seller sells because they need immediate cash for end of life hospice treatment. The buyer buys because they know this person is about to die and they are going to get a cash payout of more than they paid for. This was a guaranteed payout because there was no treatment. This was a rare example of an investment with zero risk and high return. If you got the virus, you were going to be dead in a few months. This is a win-win for both the deceased and the new buyer, and it is neutral for the life insurance company because either way they have to pay the same amount to someone at the time of death. The arrival of AZT cocktails threw a monkey wrench into the whole plan because suddenly a guaranteed death is no longer guaranteed and it leads to an ethical quandary because the "investor" doesn't get a return for their "investment" unless that person dies, and now they are literally wishing death on someone. (see also: There is no such thing as a risk free investment.) https://www.theatlantic.com/health/archive/2018/10/viatical-settlements-aids-gay-men/572044/ https://www.theatlantic.com/health/archive/2018/10/viatical-... "The Gay Men Who Have Lived for Years With Someone Waiting on Their Death"

downrightmike 1y ago

Insurance companies need to go after processed food companies if they don't like it, not their customers