4 ms·

If GLP-1 Drugs Are Good for Everything, Should We All Be on Them?

33 points by gamechangr 1y ago

andsoitis 1y ago
> 3. So, should we all be on GLP-1s? > No. Certainly not now. While I’m excited about the future of these drugs’ development, the side effect profile isn’t worth the risk for otherwise healthy patients. The anti-inflammation and cognitive benefits of the drugs still come with weight-loss effects that many Americans shouldn’t accept. Another way to fight inflammation is taking Metformin, popular in longevity circles.
- genocidicbunny 1y ago
  > popular in longevity circles. Also with medical practitioners dealing with anything renal. Though for them, it's more that it's one of the drugs you get asked about specifically whenever you have any injections that might be harsh on the kidneys. There's a reason they ask about it when you get contrast for a CT.
- burnt-resistor 1y ago
  It's been suggested before that metformin could be safely taken by almost all adults who aren't underweight to improve quality of life and longevity.
falcor84 1y ago
That was really well written, and I love how it arrived at the hopeful: > If the steam engine was the little machine that accidentally explained the universe, the GLP-1 hormone may one day be regarded as the peptide that accidentally decoded the body, the mind, and basis of human health.
andsoitis 1y ago
> Some people think of Science, with a capital-“S”, as the official declaration of eternal truths. I prefer to think of science, with a lower-case “s”, as a messy scrabble toward half-truths that are often overturned with further research. Yes! It is a process: systematic study of the natural world through observation, experimentation, and evidence-based reasoning. It is a world view: a way humans try to understand how things work. It is not a set of immutable facts etched into a stone tablet somewhere in the cosmos waiting to be decoded.
classichasclass 1y ago
I remember the first patient I put on exenatide, years ago. She was a diabetic that was very brittle and we were having trouble managing it, and I said it was worth a try and she agreed. "It might even cause a bit of weight loss, which I'm sure you won't object to," I said, which we had a good laugh over. She lost 10 pounds and a whole point off her A1c. And that was just the first of the drug class. She was very pleased with it. Also, pedantic nitpick: the anglerfish in the photo is female.
BryantD 1y ago
Very good article. As someone who is currently on GLP-1 drugs, I will say that if I didn't need to be on them to control my diabetes, I would seriously consider stopping. I am undoubtedly healthier and have lost substantial weight, but the effects on my quality of life are substantial -- I simply don't enjoy food right now. This is in part psychological, because what I used to enjoy was the psychological effect of eating, but not completely. I hope this will ease out over time and if it doesn't, well, I'll cope. I'm still very interested in the ongoing research.
- genocidicbunny 1y ago
  How long have you been on a GLP-1? It took me about a year to start to change my relationship to food. Initially, I had the same reaction -- I stopped enjoying food, which led to problems with caloric deficiency, and especially the lack of protein. But eventually my brain started to rewire itself from thinking food == good, to good food == good. If you've spent a significant part of your life treating food as an addiction, even if the physical urges go away, the mental side takes longer. Funny enough though, is that it's caused me to spend way more time thinking about food because it's no longer a mindless activity. A bag of crisps can last me a month. The last pint of ice cream I bought got freezer burn because of how long it took me to finish it. If I'm cooking something, it's no longer going to be some recipe where you throw a bunch of stuff together and get a giant pot of food to stuff your face with, it's going to be something that takes effort and time and skill to prepare because it has to be _good_.
  - BryantD 1y ago
    Coming up on five months now! Thank you very much for your comment -- I've been hoping based on research and talking to people I know that you do rewire eventually, and you reinforced all of that. Appreciated. And yeah, caloric intake is a concern. The diabetes means I'm also changing my diet a fair bit which doesn't help; I haven't had ice cream in months. I am pretty sure I'm overcompensating and have recently pushed myself into more experimentation with food; the availability of real time glucose sensors is huge even if I feel weird walking around with a Bluetooth device plugged into my arm.
ivape 1y ago
Isn’t it $200/mo vanity drug for regular people (no medical reason for it)?. You can up with bullshit to get it, but even then it’s expensive.
- bicx 1y ago
  I don’t think weight loss is vanity (assuming that’s what you mean). There are many health issues caused by obesity, and a lot of us end up paying for the advanced medical care (regardless of being obese or not) for obesity-caused illness through increased premiums and taxes to cover high Medicare costs.
  - ivape 1y ago
    I consider obesity a medical condition. By regular people I meant those that let go but are within diet/exercise range (not obese on paper or the eye).
- raincom 1y ago
  You can make it for less than $1 per gram. So, it costs about $10 per month.
  - sfn42 1y ago
    Are you suggesting that people manufacture their own pharmaceuticals?
    - metalman 1y ago
      there are serious efforts to do just that, and as bench top chemical anslysis gets cheaper and cheaper there is an inevatabily to the comming availibility of high quality indivualy customised medications that are very inexpensive
      - sfn42 1y ago
        There already is a community of "amateur" drug manufacturers, and they're not known for consistent quality nor safety.

33 points by gamechangr 1y ago

> 3. So, should we all be on GLP-1s? > No. Certainly not now. While I’m excited about the future of these drugs’ development, the side effect profile isn’t worth the risk for otherwise healthy patients. The anti-inflammation and cognitive benefits of the drugs still come with weight-loss effects that many Americans shouldn’t accept. Another way to fight inflammation is taking Metformin, popular in longevity circles.

genocidicbunny 1y ago
> popular in longevity circles. Also with medical practitioners dealing with anything renal. Though for them, it's more that it's one of the drugs you get asked about specifically whenever you have any injections that might be harsh on the kidneys. There's a reason they ask about it when you get contrast for a CT.
burnt-resistor 1y ago
It's been suggested before that metformin could be safely taken by almost all adults who aren't underweight to improve quality of life and longevity.

falcor84 1y ago

That was really well written, and I love how it arrived at the hopeful: > If the steam engine was the little machine that accidentally explained the universe, the GLP-1 hormone may one day be regarded as the peptide that accidentally decoded the body, the mind, and basis of human health.

andsoitis 1y ago

> Some people think of Science, with a capital-“S”, as the official declaration of eternal truths. I prefer to think of science, with a lower-case “s”, as a messy scrabble toward half-truths that are often overturned with further research. Yes! It is a process: systematic study of the natural world through observation, experimentation, and evidence-based reasoning. It is a world view: a way humans try to understand how things work. It is not a set of immutable facts etched into a stone tablet somewhere in the cosmos waiting to be decoded.

classichasclass 1y ago

I remember the first patient I put on exenatide, years ago. She was a diabetic that was very brittle and we were having trouble managing it, and I said it was worth a try and she agreed. "It might even cause a bit of weight loss, which I'm sure you won't object to," I said, which we had a good laugh over. She lost 10 pounds and a whole point off her A1c. And that was just the first of the drug class. She was very pleased with it. Also, pedantic nitpick: the anglerfish in the photo is female.

BryantD 1y ago

Very good article. As someone who is currently on GLP-1 drugs, I will say that if I didn't need to be on them to control my diabetes, I would seriously consider stopping. I am undoubtedly healthier and have lost substantial weight, but the effects on my quality of life are substantial -- I simply don't enjoy food right now. This is in part psychological, because what I used to enjoy was the psychological effect of eating, but not completely. I hope this will ease out over time and if it doesn't, well, I'll cope. I'm still very interested in the ongoing research.

genocidicbunny 1y ago
How long have you been on a GLP-1? It took me about a year to start to change my relationship to food. Initially, I had the same reaction -- I stopped enjoying food, which led to problems with caloric deficiency, and especially the lack of protein. But eventually my brain started to rewire itself from thinking food == good, to good food == good. If you've spent a significant part of your life treating food as an addiction, even if the physical urges go away, the mental side takes longer. Funny enough though, is that it's caused me to spend way more time thinking about food because it's no longer a mindless activity. A bag of crisps can last me a month. The last pint of ice cream I bought got freezer burn because of how long it took me to finish it. If I'm cooking something, it's no longer going to be some recipe where you throw a bunch of stuff together and get a giant pot of food to stuff your face with, it's going to be something that takes effort and time and skill to prepare because it has to be _good_.
- BryantD 1y ago
  Coming up on five months now! Thank you very much for your comment -- I've been hoping based on research and talking to people I know that you do rewire eventually, and you reinforced all of that. Appreciated. And yeah, caloric intake is a concern. The diabetes means I'm also changing my diet a fair bit which doesn't help; I haven't had ice cream in months. I am pretty sure I'm overcompensating and have recently pushed myself into more experimentation with food; the availability of real time glucose sensors is huge even if I feel weird walking around with a Bluetooth device plugged into my arm.

ivape 1y ago

Isn’t it $200/mo vanity drug for regular people (no medical reason for it)?. You can up with bullshit to get it, but even then it’s expensive.

bicx 1y ago
I don’t think weight loss is vanity (assuming that’s what you mean). There are many health issues caused by obesity, and a lot of us end up paying for the advanced medical care (regardless of being obese or not) for obesity-caused illness through increased premiums and taxes to cover high Medicare costs.
- ivape 1y ago
  I consider obesity a medical condition. By regular people I meant those that let go but are within diet/exercise range (not obese on paper or the eye).
raincom 1y ago
You can make it for less than $1 per gram. So, it costs about $10 per month.
- sfn42 1y ago
  Are you suggesting that people manufacture their own pharmaceuticals?
  - metalman 1y ago
    there are serious efforts to do just that, and as bench top chemical anslysis gets cheaper and cheaper there is an inevatabily to the comming availibility of high quality indivualy customised medications that are very inexpensive
    - sfn42 1y ago
      There already is a community of "amateur" drug manufacturers, and they're not known for consistent quality nor safety.