28 ms·

Much has been said about the GLP drugs and their interactions with all kinds of addictive disorders. Alcohol, drugs, even gambling... Anecdotally, I "struggled"

• georgeburdell 1y ago
  I'm going to put on my Boomer pull-yourselves-up-by-the-bootstraps hat, but are you concerned about the loss of grit resulting from changing your behaviors without the drug?
  • afthonos 1y ago
    Definitely not GP, but I think it’s pretty clear that whatever grit there was to have, GP did not have it. “Die an early death due to being overweight or build the grit” is strictly worse than “lose the weight without building the grit, or build the grit”, and it’s even more so when you realize that “or build the grit” was never in the cards. Because then the choice becomes “die an early death or don’t“. Building the grit can be done on other, hopefully less lethal, projects.
    • a-french-anon 1y ago
      Preface: I'm going to sound quite harsh by changing scales, so put your tough skin on before continuing. This is certainly worse for the individual, but at society scale, the cost being the obvious devaluation of willpower is way too high. Way too high because everything good in that society was built almost exclusively by driven and strong-willed individuals.
      • nwienert 1y ago
        I'll give a reply a go - of course we want strong people. That said, we've introduced incredible amounts of weird new things to the world. Advertising, shit food, tech, and a litany of responsibilities. Some of these are very bad and we all paying heavy prices for it. I don't think we need to treat every bad thing society does as only needing a "toughen up" solution, instead we should fix the root cause. An extreme example would be if the government poisons your water, maybe some medicine is ok. We should un-poison the water too, but I'm ok with medicine in the meantime.
      • phil21 1y ago
        Then we should start selecting strong willed individuals who do not fit into the “normie” path as those we uphold and show to be role models and examples. Instead we collectively shit on them and force them into the most useless lifestyles ever devised - effectively pushing paper on rigid schedules or they don’t get to eat. I’ve thought about this one quite a bit. The world has narrowed a whole lot to define acceptable behavior and who is allowed a seat at the table. Almost all those “strong willed” individuals of the past who actually built things had lifestyles that would have gotten them entirely shunned from society today. It’s not impossible but even compared to 30 years ago it’s an entirely different world for such folks. The way I “came up” in life would not be possible today due to the gatekeepers of “respectable society”. Needing drugs to fit into that incredibly narrow and basic framework of a life should be of no surprise to anyone. Only a few of incredible luck and willpower and probably even naivety will survive that filter. This whole topic is the epitome of “show me the incentives and I’ll show you the outcome” - entirely predictable, and it’s what society seems to want.
      • 11mo ago
  • inopinatus 1y ago
    Turns out that this attitude was bullgrit all along.
  • hiddencost 1y ago
    [flagged]
  • _yb2s 1y ago
    I think this is a valid point, and the reason I haven’t tried these drugs and don’t plan to. There are huge benefits to developing the mental strength and discipline to lean into discomfort consistently and just do what needs to be done- and all types of addiction provide one of the hardest, and therefore most valuable and useful obstacles here. As Marcus Aurelius said “The impediment to action advances action. What stands in the way becomes the way.” I’ve found that the general act of leaning into challenges and mild physical discomfort has a ripple effect on my mind, and all types of addiction and dopamine seeking behaviors become automatically less interesting- almost exactly like what people report on these drugs. If I take a cold shower or work out every morning even when I don’t feel like it- pretty soon I’m eating healthier and limiting my alcohol, caffeine, and screen time without even really trying to. That said, it only works if you manage to actually do it. It’s much better to get over addiction with a drug than to continue suffering from the addiction, and be unable to escape, especially something that causes as much damage as alcohol can. One idea I had was to set a deadline for overcoming an addiction, and to just use the drug if you reach the deadline and the mental approach is still unsuccessful.
    • ridgeguy 1y ago
      If you're wired like Marcus Aurelius, maybe it'll work out ok. Peoples' neurochemistry differs enormously. One person's positive reinforcing experience is another's nociceptive hell. (source: Ph.D. neurophysiologist here) Arguments like yours presuppose humans have free will, that it's widely distributed, and if $whoever would just get on it, they'd progress. More and more, it appears what we have is the perception of free will, not the real thing - whatever that actually might be.
      • _yb2s 1y ago
        Not doubting your expertise, but I am skeptical of the idea that this method of intentionally leaning into discomfort only works for some minuscule abnormal subset of people that are just wired differently. Instead, I suspect it's tapping into something deeper about how our reward system is structured, something extremely related to how these GLP-1 agonists work, which explains why they are both effective against a shockingly wide array of seemingly different situations. The basic idea seems to be at the core of both a lot of modern self help gurus advice that seems to actually work for a huge fraction of the people that really commit to them (David Goggins, Wim Hof, etc.) as well as modern psychotherapy systems like CBT and ACT that are proven clinically effective. How many people are really trying this approach, and it not working for them? More often, I see people saying it sounds like it royally sucks (which is true and basically the entire point), and never trying it- which is valid, but doesn't really demonstrate that it wouldn't work for them. It absolutely is a "nociceptive hell" at first for everyone that tries it, but when you connect that with intention, purpose, and meaning it eventually transforms into something almost enjoyable. Becoming strong enough to meet discomfort or pain feels amazing, especially for someone that usually experiences the opposite of that. I also have ADHD, which is explained in part as a developmental disability of executive control, but I find this approach to be extremely effective for regaining executive control, even to levels that people without ADHD lack. Basically, I suspect ADHD isn't a loss of executive control at all, but the executive control is being blocked by something like the feeling of pain or drug withdrawal, and that once you are okay with just having that bad feeling all of the time, you get your executive control back. I'm curious if GLP-1 drugs also help with ADHD? My prediction is that they would.
  • smiley1437 1y ago
    Not the GP, but do you think Serena Williams - world number 1 womens tennis player for 319 weeks, who trained for 5 hours per day at her peak - has insufficient grit? Because she went on GLP-1 to lose weight.
    • justinator 1y ago
      [flagged]
    • Leherenn 1y ago
      Grit, or willpower, or whatever you want to name it isn't a unique, constant value. There are plenty of athletes who could spent hours training every day but are overcome by addictions. People who grind at work but cannot fill paperwork to save their life. That will diligently do something for months then stops after an unexpected interruption. There's probably generally a bit of correlation. But just because someone can be very focused and go to extreme lengths in one aspect of their life doesn't mean they can consistently do it in every aspect of their life.
    • justinator 11mo ago
      My last comment was flagged, but the fact remains that Serena Williams is a paid spokesperson for Ro. https://ro.co/weight-loss/serena/ https://ro.co/weight-loss/serena/ Her use is an advertisement, it's marketing. Her story as to why she's using it is a fiction, a fabrication.
  • WheatMillington 1y ago
    The idea that some people are overweight simply because they don't have grit, determination and self-discipline is asinine.
    • BurningFrog 1y ago
      I'm overweight for those reasons.
    • lurking_swe 1y ago
      _some_ of the overweight people? most certainly! Most of them? I don’t think so. Life is more complicated than that. We all know that.
      • galagawinkle489 1y ago
        [flagged]
    • vintermann 1y ago
      If people want to believe in "grit", they at the very least have to also believe in Undset's dictum: the hearts of men do not change, not in any age. If it's an inherent quality, then there's no reason we should have any less of it than "the greatest generation", or whoever we should want to idolize. The difference has to be external, not internal. Let's work on what we can change, the external. What you are might change, but you can't change it - that's the core realization behind both European pagan obsession with fate, and Christian obsession with sin.
      • galagawinkle489 1y ago
        [flagged]
        • vintermann 1y ago
          You haven't understood what I'm saying. Call it grit, call it character, whatever: it can maybe be developed or change, but not on its own. Circumstance, including other people, can change it for better or worse, but you can't change it on your own. You are exactly what you are. Without input from outside, you'll never turn into anything that isn't already implicitly there. To explain it in computer science terms, since this is HN: suppose you have a method which takes no input. Even if it's self-modifying code, can it change into something else? Can it "improve"? No. Whatever it will turn into after overwriting its own code is essentially already there. You have all the "character", "grit", whatever, that you started off with. If you get some or lose some throughout your life, it's from outside yourself: it can go either way, and you can't take credit for it anyway. This is something that all sorts of pagans, and Christians, have understood for thousands of years, but the modern Horatio Alger "conservative" doesn't understand it.
  • Nursie 1y ago
    Good god no. If I can change my behaviour and achieve good health outcomes, relatively painlessly, why on earth would I not? This comes across to me like people who won't use painkillers - I should feel the pain, masking it is fake, there is virtue in suffering etc. Turns out those people often end up with secondary complications to (for example) muscle damage, because they've adapted their movements so much to avoid using the painful muscle that now everything else is tense, strained and locked up. Better living through chemistry, 100%.
  • hbosch 1y ago
    What do you mean "grit"? Does doing something more efficiently mean you lose it? What's the difference, say, between someone using an LLM to help them code and someone else using a drug to help them diet? Is the coder using an LLM losing their "grit"? Do you walk to work in 30 inches of snow, uphill both ways, in the rain? Are you concerned about your loss of "grit" by not doing so? This argument continues to baffle me. I didn't take the GLP to help me with addictive behavior traits beyond my diet, but I observed tertiary benefits of the drug. As I've titrated my dose down to zero, I've retained those habits and my weight. I'm in the best shape of my life and mentally healthier than I've been in over a decade.
    • tsimionescu 1y ago
      I think the comparison to LLM use is a bad idea, because LLM use has pretty clear adverse effects on your capacity to program unassisted, and almost certainly long term limits your potential growth as a programmer, in ways that the LLM can't compensate (at least, not with current tech). Basically using LLMs extensively as a junior may well make you a better junior, but guarantee you'll never be a senior. My understanding is that that GLP1 drugs don't actually have this effect, as much as we know so far.
  • slv77 1y ago
    Maybe if moral virtues can be purchased they were never moral virtues to begin with? Many moral vices naturally decline with age as physical senses and hormones dull and life loses novelty. It may be a comforting fantasy that we can somehow link our inevitable physical decline to a story of moral progress and assume that our accumulated wisdom would protect us from the folly of youth if we were somehow thrust again into our younger bodies. But what if instead moral progress is about finding the right way of living? About spending more time with your kid than with a screen. Maybe the virtue wasn’t in getting over the wall but finding yourself on the other side and choosing it because it is better? Society puts up walls all the time to prevent people from finding themselves on the wrong side of the wall. Nobody ever talks about the “grit” of the addict persistently dodging law enforcement to score their next fix. Maybe the problem is society putting walls in the wrong place. If that’s true, does it really matter how you get over the wall?
  • pjc50 1y ago
    Maybe "grit", like phlogiston, isn't real, and neurotransmitters are?
    • inglor_cz 1y ago
      This would be my suspicion as well. Once upon a time, diseases like scurvy, leprosy and cholera were described as caused by insufficient moral fibre of the patient. Maybe this sort of moralizing is the best indicator that the underlying cause of the disease is, in fact, unknown yet.
      • mrguyorama 1y ago
        The current scare mongering over an "increase" in Autism rates is entirely driven by the fact that we stopped diagnosing autistic people as having other intellectual disabilities Done by the same people who demonstrably treat ADHD as just "laziness"
  • coderenegade 11mo ago
    What if it were possible to get grit from a pill? People who have taken it and come off of it are saying that they haven't reverted. You get good at what you practice, which is as true for grit as it is of anything else. If some people need assistance in getting that practice, this can probably help them. I've taken ritalin for ADHD for a long time, and if I don't take my treatment, I'm still far more focused and productive than I ever was before treatment, because I developed habits through the medication that stuck. I wouldn't be surprised if something similar were at work here.
• dalyons 1y ago
  side question - has retatrutide been different enough to tirzepatide for you that you would recommend going to the extra effort to source it?
  • hbosch 1y ago
    I think it depends. With tirzepatide (my first encounter with GLP1 meds) I got acute appetite suppression, perhaps too acute. I living comfortably on sometimes 1500 calories or less per day, and I track my calories religiously. We are talking maybe 1 cup of yogurt with frozen berries in the morning, and 1 whey protein shake around 3pm (Fairlife milk + 2 scoops whey) and I would be absolutely full until bed. No energy deficiencies to note. I worked out regularly 5 days a week. This caused rapid weight loss. A side effect of this rapid weight loss and lack of food intake I also attribute to my thinning hair and dry, splotchy skin outbreaks. Any sort of overeating on tirzepatide (for me) caused severe sickness, or nausea. Retatrutide, by contrast, causes far less pure appetite suppression (my dosage is also lower) and has another mechanism which helps me maintain leanness while also eating extra calories. I think I prefer the reta, but if I ever felt the need to very simply destroy my appetite again I wouldn't hesitate to use tirzepatide again. I procured both tirzepatide and retatrutide through the peptide "grey markets" so one was not harder to come by than the other.
• Rudybega 1y ago
  I think it's probably still useful to distinguish addictions with hardcore substance related barriers to quitting (think withdrawals) from addictions where the barrier is a lack of dopamine or serotonin or simple habituation. For people with normal executive function, the second category of problems should be fairly tractable to overcome, whereas the first is still quite difficult. The second only really becomes an issue when you have a bit of executive dysfunction. Maybe that distinction is important and one merits the term addiction while the other doesn't? Though both categories seem to be relatively treatable with drugs that massively improve executive function, so the parallels are pretty glaring.
  • hamdingers 1y ago
    The distinction you're reaching for is addiction vs dependance.
    • intrasight 1y ago
      For clinician, this might be an important distinction. But for a layperson, the distinction is not very clear.
  • hyghjiyhu 1y ago
    Idk I think the importance given to withdrawals is overrated. Dealing with withdrawals is just matter of gradually lowering the dose. The lifelong craving is the bigger issue.
  • normie3000 1y ago
    How is a lack of dopamine different from "withdrawals"?
    • Aurornis 1y ago
      “Lack of dopamine” isn’t an accurate description. It’s a reductionist pop culture metaphor that feels scientific but it’s not really accurate. Drugs of abuse involve multiple systems including opioid receptors, which modulate reward. There is much more going on than simple levels of a single neurotransmitter, which can actually be completely normal relative to non-addicts. Dopaminergic systems are actually involved in driving certain addictive and craving mechanisms, which should be a hint that it’s not as simple as “lack of dopamine”. In fact, the side effects of certain drugs that directly increase dopamine levels (L-DOPA) or drugs that directly stimulate dopamine receptors (dopamine agonists like bromocriptine) include a risk of compulsive gambling, shopping, and risky behaviors. Ironically it’s more accurate to simply say “withdrawals” than to try to inject reductionist neurotransmitter speak.
• 0cf8612b2e1e 1y ago
  What do you now do instead of gaming? Do you find you have swapped for a different activity or a more balanced allocation of time among other things? Or do you still spend your off hours in the same way, but kicked the compulsion for gaming all day?
  • ImaCake 1y ago
    Can't speak for OP but I largely spend it reading (and web). I bought a kindle recently because I found the ipad/iphone were too distracting to reliably avoid web surfing instead of a book. I view the switch to long form content as a form of information dieting in the same way as a switch to whole foods.
  • hnmaniala 1y ago
    [flagged]
  • hbosch 1y ago
    I do the work I probably should be doing, or side projects, or spend time with my kids, or go on a walk, or follow up on that thing I've been putting off, or any of the other million things that are more productive and fulfilling than video games are. It's embarrassing to admit that I was a grown man who would put off basic, important tasks just to play games but I did. Now I don't. It's not even really about choosing not to, either... it really does feel fundamentally like I cannot even derive a dopamine response to video games at all anymore, period. Same could probably be said about doom scrolling social media or whatever else. I just get no false positive feedback loop from the act.
    • ragequittah 1y ago
      If it works for you keep it up. As someone who finds video games an art form I find the 'avoidance to do better things' quite similar to someone who might avoid reading or watching movies as a hobby. I suppose if you just play the same game day in and day out and it has no real substance (which admittedly is probably the largest gaming segment) it might be a good thing to get rid of the habit. But some games are masterpieces and they often hit very different than other mediums because you are the protagonist making choices. In my opinion some of the best stories come in the form of games and I find it a real shame there's a portion of the population who think they're a complete waste of time. I think there's also something to be said here about being addicted to work. I know such people and it's just as sad even if it's what society expects of them.
• doctorpangloss 1y ago
  Hard to say, you’d need a study. League of Legends is “used” by a lot of people as medicine. Nobody hides away to play Stanley Parable. Lots of games, lots of genres, difficult to generalize.
  • ch4s3 1y ago
    I hate to imagine what LOL is used to treat, let alone the side effects.
    • resize2996 1y ago
      same things as drugs and alcohol, I imagine the side effects are different but still negative!
    • colonial 1y ago
      Deficient cortisol levels, I'd think. I've seen it bring out quite the attitude in otherwise relaxed people.
    • mrguyorama 1y ago
      In our group LoL was regularly used to treat severe sodium deficiencies. Just a few minutes are sufficient to get your sodium up to healthy levels.
• smiley1437 1y ago
  How do you just start on retatrutide? Did you sign up for a Phase 3 trial?
  • cj 1y ago
    It’s available in powder form online through “research chemical” sites “not for human consumption”. Anyone saying they’re taking retatrutide almost certainly obtained it this way. Quality and purity untested.
    • smiley1437 1y ago
      [flagged]
      • embedding-shape 1y ago
        You're on Hacker News, you're gonna encounter chemical hacking too, and no shame in that, we're all just chemicals anyways.
    • phil21 1y ago
      > Quality and purity untested Not true for everyone, or perhaps even most playing in this space. Every batch friends of mine have ordered has been independently tested for purity and dosing. Random batches also tested for sterility. Plenty of folks yolo it, but it’s not like it was a couple years ago. Lots of group buys being done that order a large batch and then do random sampling for lab testing.
      • andsoitis 1y ago
        > > Quality and purity untested > Not true for everyone, or perhaps even most playing in this space. > Every batch friends of mine have ordered has been independently tested for purity and dosing. Random batches also tested for sterility. Yes, you have to test it because the quality and purity what you get isn’t tested. When someone sells something and they make a statement about the product (e.g. “tested”), they don’t mean the customer has to test it.
• andsoitis 1y ago
  > This was an unintended side effect (benefit?) of the drug for sure, in addition to acute weight loss of course. Is it possible that video games were your escape from a world in which you were obese, with all that it can entail, and losing the weight removed the need to escape?
• deleted 1y ago
  [deleted]
• cm2187 1y ago
  It could also be simply that as you lose weight, you have more tonus (something that I experienced myself), and activities that are inherently passive (watching TV, playing videogame) seem less relatively compeling than more active alternatives.
• thelastgallon 1y ago
  I guess if you can get addicted to work instead of video games, etc companies will start negotiating with GLP-1 drugmakers directly and make them widely available.
• _boffin_ 1y ago
  Question: you mentioned that you had weight loss. By chance, know how much LBM (lean body mass) you lost?
  • gooodvibes 1y ago
    Not the person you asked but I have good data - I lost 32kg over 6 months on tirzepatide, 11kg of it was lean body mass, the rest was fat (based on DEXA scans). In general, lean body mass loss is more of a result of rapid weight loss (I certainly consider mine very rapid), than result of the medication itself. If I was able to lose the same weight in the same period of time without the medication, and kept my protein and resistance training the same, I'd expect a similar ratio of muscle/fat loss. Overall extremely happy with the outcome, very grateful that these drugs exist and that I was able to access them.
    • javiramos 1y ago
      Wow -- That's very rapid weight loss. Congratulations.
  • stewarts 1y ago
    68lbs over 9 months for me on Tirzepatide. No exercise (I should, but I'm traveling an absolute ton right so consistent exercise hasn't been prioritized).
• storus 1y ago
  Maybe try NAD+ boosters next? They seem to be reducing addictive behaviors quite a bit. Liposomal NAD+ or nicotinamide riboside or IV NAD+. The theory is an energetic deficit in the brain that drugs/addictions seem to override temporarily but deepen long-term and NAD+ is essentially bringing the energy back. Maybe GLPs do something similar due to flooding the body with broken down fat?
  • jokowueu 1y ago
    Metabolic dysfunction is the root of many diseases which addiction is one of them .
  • Cthulhu_ 1y ago
    Do GLPs flood the body with broken down fat? I thought they just suppressed appetite and the like.
    • happyPersonR 1y ago
      People overstate some of the secondary effects, but in a nutshell that’s more or less what they do.
• jcutrell 1y ago
  I'm considering starting Tirz, but really want to go to retatrutide. Curious if you have a recommendation.
• PeterStuer 11mo ago
  from what I saw people on GPL still eat as much as they can, they just can't eat as much due to the feeling on "fullness" setting in fast. They seem to push the boundaries further the longer they are on it though, so there seems to be some habituation to overcoming the "feeling full".