13 ms·

I was kind of scared of these when Ozempic starting picking of steam for weight loss. I was worried that this would be having more negative effects. Turns out,

by jjice 1y ago

I was kind of scared of these when Ozempic starting picking of steam for weight loss. I was worried that this would be having more negative effects. Turns out, generally speaking, if used with you doctor, these things are pretty safe, especially comparatively to some of the negatives of being overweight. And then I saw some of the stories on HN about how it's changed peoples lives for the better. And then people in my life started taking it and singing its praises. I'm very bullish on GLP-1s now and I've very excited to see all the lives it improves. I'm not saying this thing is 100% miracle with no downsides, but this seems to be a generally large net positive. It's a bit hard for me to comprehend how big of an impact this can have for someone since I've been very fortunate to never struggle with my weight, but I'm (slightly embarrassingly) tearing up writing this because of how many people I've seen have huge positive effects on their physical and mental health (due to body image).

radiofreeeuropa 1y ago
It's great because we had no other way to address this problem at a population level. Not any realistic ones, anyway. Like, I figured we were just never going to solve it, given the two possibilities were "radically re-engineer US culture such that moving to the US doesn't make previously-skinny people fatter" (with other countries heading the same direction as us needing to make similar moves, one supposes) or "find a miracle drug". Neither seemed likely. Turns out, decent odds we've managed the latter! Which was always the more likely of the two, but I still wouldn't have rated it as very likely.
- throwawaylaptop 1y ago
  I helped my dad lose 50 lbs by finally, after 10 years, getting him to give up bread, sugar, potatoes. It took buying him 2 months of a bluetooth glucose monitor. Once he saw what certain foods do, he believed me finally. At 65 years old, healthier than I remember since he was 40 and I was a teen. It doesn't require some weird injection.
  - XorNot 1y ago
    No but its a lot easier for people who've had trouble and gets results, which is all that matters.
    - throwawaylaptop 1y ago
      Heroine would also help them lose weight also. Maybe cocaine too, but I'm not sure. So it's not "all that matters". What matters is, are the negative side effects and long term consequences better for you than the alternatives. One of them is "remaining fat". The other is "doing what other people have proven works.. cut all carbs".
      - KPGv2 1y ago
        You are showing your own ass with this ridiculous analogy. What are the negative effects of ozempic? Because the negative effects of heroin (not "heroine") and cocaine are well known and grossly outweigh "not being fat." Is ozempic worse than being fat?
        Thlom 1y ago
        From people I know that have used Ozempic/Wegovy, the side effects are basically that they get a bit nauseated a few hours after an injection. That's it.
  - radiofreeeuropa 1y ago
    There's anecdotes, and there's science. Individually, there's (previously) been nothing better to suggest than "try harder (and, maybe, smarter)". Statistically it was almost useless, but it's the best we had. It's not bad advice exactly, it's just extremely unlikely to work for long-term, sustained weight loss. It also very much appears to be the case that weight gain and loss are heavily influenced by environmental factors. Skinnier countries aren't skinnier because the people there have more willpower, it seems, but because they live in a skinnier country and are surrounded by the culture, laws, physical layouts of the created world, et c., that come with that. It'd be kinda weird if we expected "just try harder" to work very well when that's evidently not the mechanism by which skinny countries are skinny. Alternatively, if it is willpower doing it, we're just adding a step, because then it appears that environment strongly influences willpower, instead, since the same observations hold. Sure, sometimes it works for individuals. In fact, it often works temporarily, causing a yo-yo effect. It can work for long periods (many years without a slip) but that's rare. If your solution to the obesity crisis is "people need to try harder" your solution is demonstrably not helpful. Can it work for one person? Yes. Over a population, will it? No, it won't, it's amazingly ineffective, even very expensive high-touch interventions involving multiple experts aimed at weight loss and lifestyle change and such are wildly less effective than "inject GLP-1 agonists" or "move somewhere skinnier".
- mensetmanusman 1y ago
  It does solve itself due to natural selection based on fertility rate effect of being obesity prone. Life finds a way.
- astrange 1y ago
  > Like, I figured we were just never going to solve it, given the two possibilities were "radically re-engineer US culture such that moving to the US doesn't make previously-skinny people fatter" (with other countries heading the same direction as us needing to make similar moves, one supposes) Moving to higher elevations in the US causes people to become less fat, so you can do this by moving to Colorado. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0093493 https://journals.plos.org/plosone/article?id=10.1371/journal...
- lm28469 1y ago
  It's not like we tried very hard... our whole system is designed around instant gratification, comfort, consumerism and low cost feel good food.
- skeezyboy 1y ago
  > It's great because we had no other way to address this problem at a population level. Not any realistic ones, anyway. um, go out and exercise? compared to your ancestors from a century ago, you live a relative life of luxury. THIS IS WHY YOU ARE FAT. Too much food in, not enough burning calories. So simple. Im sure there are people who are clinically fat, broken metabolism, but there are tens of millions of obese in the USA alone, are they all metabollically disabled? I doubt it
  - radiofreeeuropa 1y ago
    Yep, overeating (and, to some degree, not enough moving around) is the reason. True. But “just personally do better” doesn’t work very well when applied as a medical intervention (they have tried, and checked, over and over, a hundred different ways), even with lots of follow-up and monitoring, and it also doesn’t appear to be how other countries manage to be skinnier than the US. Between those two things, it really doesn’t look like a viable way to solve the obesity crisis—it doesn’t work when we try it, and it doesn’t seem to be what’s working anywhere else.
  - desert_rue 1y ago
    It has more to do with the American food supply than anything else. The obesity rate skyrocketed as we started to consume food-like substances instead of food. Strip out all the signals that let the body know it has enough, and it is easier to overeat.
matwood 1y ago
And not just weight loss, but the people I know on GLP-1's have also significantly cut back on alcohol. I think there are ongoing trials around GLP-1's and general addiction.
- nosignono 1y ago
  I find my compulsion towards videogames is decreased. Not eliminated, but I feel much less compelled to be playing all the time.
  - CoastalCoder 1y ago
    I'm curious if this affects smartphone usage. E.g., "compulsive" feed-checking and doom scrolling.
    - garbawarb 1y ago
      I wonder how it compares to Adderall.
      - nosignono 1y ago
        Adderall produces a very, very different experience and is prescribed to address a very, very different root cause.
        slavik81 1y ago
        However, amphetamines such as Adderall were also sometimes prescribed for weight loss. I'm surprised it was done so rarely before Ozempic was a thing. They were quite effective.
        ses1984 1y ago
        The side effects of adderall are pretty bad. If I'm on a dose that's high enough to suppress my appetite, then I get a very bad crash in the evening. I start to feel like if I want to enjoy life after work, I need to take another adderall to feel normal. That disrupts sleep, and then things start to get really bad.
dawnerd 1y ago
The same thing with keto. People will swear it's unhealthy but like, the alternative (outside of Ozempic and co) is being overweight...
- shlant 1y ago
  in no world is keto the only option for most people. Some may personally feel it's easier than other dietary/lifestyle options for losing weight but it is not uniquely different than many other options in that category (and absolutely has risks depending on how it's done)
glp1guide 1y ago
We think obesity is basically going to be gone in <7 years. GLP1s don't work for everyone, and the side effects can be severe, but this these drugs are basically safe, and incredibly effective. This is going to accelerate when every one and their mother (with industrial capacity) starts making generic Ozempic/Wegovy (Semaglutide) next year due to Canada's patent protection lapse[0]. https://glp1.guide/content/novo-nordisk-patent-protections-lapse-in-canada/ https://glp1.guide/content/novo-nordisk-patent-protections-l...
- fortran77 1y ago
  I think that, just like with stomach reduction surgery, people are going to find a way to overeat and gain weight while taking Ozempic too.
  - glp1guide 1y ago
    Nope, because the change is actually in the brain. https://glp1.guide/content/research-on-glp1-signaling-in-the-brain/ https://glp1.guide/content/research-on-glp1-signaling-in-the... https://glp1.guide/content/research-suggesting-glp1-is-a-brain-drug/ https://glp1.guide/content/research-suggesting-glp1-is-a-bra... https://glp1.guide/content/are-glp1s-primarily-brain-drugs/ https://glp1.guide/content/are-glp1s-primarily-brain-drugs/ This is the killer feature of Semaglutide and GLP1 Receptor Agonists widely. They were originally commonly thought about as digestion-slowing, and while that is part of it, the real change is that it's a brain drug. Oh also, on whether people gain back the weight: https://glp1.guide/content/do-people-regain-all-the-weight-lost-on-glp1-receptor-agonists/ https://glp1.guide/content/do-people-regain-all-the-weight-l... tl;dr - most people (i.e. over 50%) do not.
    - redwood 1y ago
      Is glp1guide a neutral source? Honest question
  - loeg 1y ago
    Uh, so, first, I'll say that bariatric surgery is largely a successful (if extremely invasive) intervention. It is not the case that people who do that surgery somehow compensate eat back to the same level -- on average, they don't. And second, the GLP-1s just massively reduce the urge to snack/eat. I'm sure they are less effective for some people than others, but on the whole they are miraculously effective for the population that overate habitually (the obese).
mbac32768 1y ago
The skepticism people have towards metabolic dysregulation models of obesity is too much. We know for a fact the inverse happens: girl starves herself for years to slim down to become a ballerina, eventually decides it's not worth it and tries to stop being so dangerously thin and... can't. She never feels hungry. Every time she eats she can only stomach a few bites before pushing it away. Just eat ice cream? Instant puke. She cannot gain weight no matter what. Obviously she broke her metabolic system and she obviously did it through diet. Yes it's possible for some skinny people to gain weight. But that doesn't mean every skinny person simply can decide to be fat just by eating. It's like climbing Mount Everest for some skinny people to put weight on, even if they really desperately want to. I don't think the situation with obese people is all that different.
- aianus 1y ago
  Is there a drug I can take to gain weight?
  - beAbU 1y ago
    Ice cream and cheese
  - tortilla 1y ago
    mj
    - astrange 1y ago
      Fun fact: eating a bunch of black pepper cancels that out.
      - ggsp 1y ago
        [flagged]
        astrange 1y ago
        I meant it cancels out the effect of THC. Which is handy if you've taken an edible and are getting tired of it. But yes, that too.
RataNova 1y ago
There's still plenty to learn about long-term effects, but it's hard to ignore the sheer volume of real-world stories from people saying it gave them their lives back
DanielHB 1y ago
I have a friend using it and he said the worst thing (for him, he didn't have nausa/constipation/etc) is that food is not enjoyable anymore. He says he feels hungry, eats, doesn't feel full but doesn't want to eat anymore. If he overeats he said he feels kinda bad (with heartburn the next day).
jart 1y ago
It's far from being a miracle. People get fat because they have a broken endocrine system that refuses to burn calories and over aggressively digests food. Ozempic solves that by making your body only desire a few mouthfuls of food each day, but does nothing to actually fix your metabolism. Other better drugs are undergoing trials which will actually do that.

by jjice 1y ago

radiofreeeuropa 1y ago

It's great because we had no other way to address this problem at a population level. Not any realistic ones, anyway. Like, I figured we were just never going to solve it, given the two possibilities were "radically re-engineer US culture such that moving to the US doesn't make previously-skinny people fatter" (with other countries heading the same direction as us needing to make similar moves, one supposes) or "find a miracle drug". Neither seemed likely. Turns out, decent odds we've managed the latter! Which was always the more likely of the two, but I still wouldn't have rated it as very likely.

throwawaylaptop 1y ago
I helped my dad lose 50 lbs by finally, after 10 years, getting him to give up bread, sugar, potatoes. It took buying him 2 months of a bluetooth glucose monitor. Once he saw what certain foods do, he believed me finally. At 65 years old, healthier than I remember since he was 40 and I was a teen. It doesn't require some weird injection.
- XorNot 1y ago
  No but its a lot easier for people who've had trouble and gets results, which is all that matters.
  - throwawaylaptop 1y ago
    Heroine would also help them lose weight also. Maybe cocaine too, but I'm not sure. So it's not "all that matters". What matters is, are the negative side effects and long term consequences better for you than the alternatives. One of them is "remaining fat". The other is "doing what other people have proven works.. cut all carbs".
    - KPGv2 1y ago
      You are showing your own ass with this ridiculous analogy. What are the negative effects of ozempic? Because the negative effects of heroin (not "heroine") and cocaine are well known and grossly outweigh "not being fat." Is ozempic worse than being fat?
      - Thlom 1y ago
        From people I know that have used Ozempic/Wegovy, the side effects are basically that they get a bit nauseated a few hours after an injection. That's it.
- radiofreeeuropa 1y ago
  There's anecdotes, and there's science. Individually, there's (previously) been nothing better to suggest than "try harder (and, maybe, smarter)". Statistically it was almost useless, but it's the best we had. It's not bad advice exactly, it's just extremely unlikely to work for long-term, sustained weight loss. It also very much appears to be the case that weight gain and loss are heavily influenced by environmental factors. Skinnier countries aren't skinnier because the people there have more willpower, it seems, but because they live in a skinnier country and are surrounded by the culture, laws, physical layouts of the created world, et c., that come with that. It'd be kinda weird if we expected "just try harder" to work very well when that's evidently not the mechanism by which skinny countries are skinny. Alternatively, if it is willpower doing it, we're just adding a step, because then it appears that environment strongly influences willpower, instead, since the same observations hold. Sure, sometimes it works for individuals. In fact, it often works temporarily, causing a yo-yo effect. It can work for long periods (many years without a slip) but that's rare. If your solution to the obesity crisis is "people need to try harder" your solution is demonstrably not helpful. Can it work for one person? Yes. Over a population, will it? No, it won't, it's amazingly ineffective, even very expensive high-touch interventions involving multiple experts aimed at weight loss and lifestyle change and such are wildly less effective than "inject GLP-1 agonists" or "move somewhere skinnier".
mensetmanusman 1y ago
It does solve itself due to natural selection based on fertility rate effect of being obesity prone. Life finds a way.
astrange 1y ago
> Like, I figured we were just never going to solve it, given the two possibilities were "radically re-engineer US culture such that moving to the US doesn't make previously-skinny people fatter" (with other countries heading the same direction as us needing to make similar moves, one supposes) Moving to higher elevations in the US causes people to become less fat, so you can do this by moving to Colorado. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0093493 https://journals.plos.org/plosone/article?id=10.1371/journal...
lm28469 1y ago
It's not like we tried very hard... our whole system is designed around instant gratification, comfort, consumerism and low cost feel good food.
skeezyboy 1y ago
> It's great because we had no other way to address this problem at a population level. Not any realistic ones, anyway. um, go out and exercise? compared to your ancestors from a century ago, you live a relative life of luxury. THIS IS WHY YOU ARE FAT. Too much food in, not enough burning calories. So simple. Im sure there are people who are clinically fat, broken metabolism, but there are tens of millions of obese in the USA alone, are they all metabollically disabled? I doubt it
- radiofreeeuropa 1y ago
  Yep, overeating (and, to some degree, not enough moving around) is the reason. True. But “just personally do better” doesn’t work very well when applied as a medical intervention (they have tried, and checked, over and over, a hundred different ways), even with lots of follow-up and monitoring, and it also doesn’t appear to be how other countries manage to be skinnier than the US. Between those two things, it really doesn’t look like a viable way to solve the obesity crisis—it doesn’t work when we try it, and it doesn’t seem to be what’s working anywhere else.
- desert_rue 1y ago
  It has more to do with the American food supply than anything else. The obesity rate skyrocketed as we started to consume food-like substances instead of food. Strip out all the signals that let the body know it has enough, and it is easier to overeat.

matwood 1y ago

And not just weight loss, but the people I know on GLP-1's have also significantly cut back on alcohol. I think there are ongoing trials around GLP-1's and general addiction.

nosignono 1y ago
I find my compulsion towards videogames is decreased. Not eliminated, but I feel much less compelled to be playing all the time.
- CoastalCoder 1y ago
  I'm curious if this affects smartphone usage. E.g., "compulsive" feed-checking and doom scrolling.
  - garbawarb 1y ago
    I wonder how it compares to Adderall.
    - nosignono 1y ago
      Adderall produces a very, very different experience and is prescribed to address a very, very different root cause.
      - slavik81 1y ago
        However, amphetamines such as Adderall were also sometimes prescribed for weight loss. I'm surprised it was done so rarely before Ozempic was a thing. They were quite effective.
        ses1984 1y ago
        The side effects of adderall are pretty bad. If I'm on a dose that's high enough to suppress my appetite, then I get a very bad crash in the evening. I start to feel like if I want to enjoy life after work, I need to take another adderall to feel normal. That disrupts sleep, and then things start to get really bad.

dawnerd 1y ago

The same thing with keto. People will swear it's unhealthy but like, the alternative (outside of Ozempic and co) is being overweight...

shlant 1y ago
in no world is keto the only option for most people. Some may personally feel it's easier than other dietary/lifestyle options for losing weight but it is not uniquely different than many other options in that category (and absolutely has risks depending on how it's done)

glp1guide 1y ago

We think obesity is basically going to be gone in <7 years. GLP1s don't work for everyone, and the side effects can be severe, but this these drugs are basically safe, and incredibly effective. This is going to accelerate when every one and their mother (with industrial capacity) starts making generic Ozempic/Wegovy (Semaglutide) next year due to Canada's patent protection lapse[0]. https://glp1.guide/content/novo-nordisk-patent-protections-lapse-in-canada/ https://glp1.guide/content/novo-nordisk-patent-protections-l...

fortran77 1y ago
I think that, just like with stomach reduction surgery, people are going to find a way to overeat and gain weight while taking Ozempic too.
- glp1guide 1y ago
  Nope, because the change is actually in the brain. https://glp1.guide/content/research-on-glp1-signaling-in-the-brain/ https://glp1.guide/content/research-on-glp1-signaling-in-the... https://glp1.guide/content/research-suggesting-glp1-is-a-brain-drug/ https://glp1.guide/content/research-suggesting-glp1-is-a-bra... https://glp1.guide/content/are-glp1s-primarily-brain-drugs/ https://glp1.guide/content/are-glp1s-primarily-brain-drugs/ This is the killer feature of Semaglutide and GLP1 Receptor Agonists widely. They were originally commonly thought about as digestion-slowing, and while that is part of it, the real change is that it's a brain drug. Oh also, on whether people gain back the weight: https://glp1.guide/content/do-people-regain-all-the-weight-lost-on-glp1-receptor-agonists/ https://glp1.guide/content/do-people-regain-all-the-weight-l... tl;dr - most people (i.e. over 50%) do not.
  - redwood 1y ago
    Is glp1guide a neutral source? Honest question
- loeg 1y ago
  Uh, so, first, I'll say that bariatric surgery is largely a successful (if extremely invasive) intervention. It is not the case that people who do that surgery somehow compensate eat back to the same level -- on average, they don't. And second, the GLP-1s just massively reduce the urge to snack/eat. I'm sure they are less effective for some people than others, but on the whole they are miraculously effective for the population that overate habitually (the obese).

mbac32768 1y ago

The skepticism people have towards metabolic dysregulation models of obesity is too much. We know for a fact the inverse happens: girl starves herself for years to slim down to become a ballerina, eventually decides it's not worth it and tries to stop being so dangerously thin and... can't. She never feels hungry. Every time she eats she can only stomach a few bites before pushing it away. Just eat ice cream? Instant puke. She cannot gain weight no matter what. Obviously she broke her metabolic system and she obviously did it through diet. Yes it's possible for some skinny people to gain weight. But that doesn't mean every skinny person simply can decide to be fat just by eating. It's like climbing Mount Everest for some skinny people to put weight on, even if they really desperately want to. I don't think the situation with obese people is all that different.

aianus 1y ago
Is there a drug I can take to gain weight?
- beAbU 1y ago
  Ice cream and cheese
- tortilla 1y ago
  mj
  - astrange 1y ago
    Fun fact: eating a bunch of black pepper cancels that out.
    - ggsp 1y ago
      [flagged]
      - astrange 1y ago
        I meant it cancels out the effect of THC. Which is handy if you've taken an edible and are getting tired of it. But yes, that too.

RataNova 1y ago

There's still plenty to learn about long-term effects, but it's hard to ignore the sheer volume of real-world stories from people saying it gave them their lives back

DanielHB 1y ago

I have a friend using it and he said the worst thing (for him, he didn't have nausa/constipation/etc) is that food is not enjoyable anymore. He says he feels hungry, eats, doesn't feel full but doesn't want to eat anymore. If he overeats he said he feels kinda bad (with heartburn the next day).

jart 1y ago

It's far from being a miracle. People get fat because they have a broken endocrine system that refuses to burn calories and over aggressively digests food. Ozempic solves that by making your body only desire a few mouthfuls of food each day, but does nothing to actually fix your metabolism. Other better drugs are undergoing trials which will actually do that.