5 ms·

> However, the study authors emphasize that more research is needed to confirm these mechanisms and determine whether the survival benefit observed in this real

by jl6 11mo ago

> However, the study authors emphasize that more research is needed to confirm these mechanisms and determine whether the survival benefit observed in this real-world analysis represents a direct anti-cancer effect or an indirect result of improved metabolic health Given it’s an observational study, I would bet on the latter. It’s really hard to know you’ve controlled for all confounding factors, and there’s a strong null hypothesis because we know that losing weight can have huge and wide-ranging health benefits.

stavros 11mo ago
Yeah, most GLP-1 benefits (or even adverse effects, like muscle loss) seem to be caused by the weight loss. We already knew obesity massively increases risk from a host of diseases, but GLP-1s are still treated with scepticism of the "oh but what about the side-effects we don't know about?!" variety?
- ed 11mo ago
  Source? There’s growing evidence of cardioprotective effects independent of weight loss. Eg https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01375-3/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... > The cardioprotective effects of semaglutide were independent of baseline adiposity and weight loss and had only a small association with waist circumference, suggesting some mechanisms for benefit beyond adiposity reduction.
  - rickydroll 11mo ago
    They also help with slowing the progression of CKD https://www.kidneyfund.org/treatments/medicines-kidney-disease/glp-1-ras https://www.kidneyfund.org/treatments/medicines-kidney-disea...
- anovikov 11mo ago
  Someone has to start a study where they give GLP-1 to skinny people and see what happens. Why it hasn't been done yet?
  - stavros 11mo ago
    Because they lose weight and it's too dangerous.
    - anovikov 11mo ago
      They won't, GLP-1 has almost no direct effect on skinny people. Many women with BMI around 22-23 are trying them to lose weight to match beauty standards and usually end up disappointed, not able to drop more than 1-2 kilos.
cyrusradfar 11mo ago
Agreed. I'm a big fan of intermittent and water fasting. Have seen things in my blood work that doctors would require me on meds to reverse. Outside of that, I can't speak to the positive impacts on my mood, and general ability to focus. The simplest solution to a lot of problems is consuming less with the assumption that, most of us (maybe not you), have a lot of spare energy sitting around. A lie that we don't unlearn as we grow up is we "require" three meals a day. This is true for children who need obscene amounts of energy to grow, but, not for us desk-bound adults. In the end, giving the body a break to heal by fasting or just consuming significantly less is going to leave more resources for the body energy to deal with other things.
- trallnag 11mo ago
  Awesome insight. It's not the disability I have, it's that I have never tried healing by fasting. Of course. Because my body was always busy trying to eat food instead of fixing and regrowing all the malformed tissue. Because that's how it works. When a person without legs starts to fast, the legs will suddenly develop.
  - amenhotep 11mo ago
    It would be sensible for you to examine and interrogate why reading a general and fairly anodyne opinion about what might be a solution to a problem some people have led you to interpret it as a prescriptive and judgemental suggestion about the specific problem you specifically have.
    - cyrusradfar 11mo ago
      Appreciate the thoughtful retort. Have a good one.
    - trallnag 11mo ago
      In my mind it is a slippery slope that leads to a sickly Steve Jobs eating kilograms of raw carrots. Obviously a healthy lifestyle is good. And this includes not eating over your requirements. But sometimes there is actually something wrong. And in these cases, first trying out to just eat healthy can worsen the situation by delaying proper treatment. And proper treatment does equal a bunch of pharmaceutical drugs.
p00dles 11mo ago
Interesting that GLP-1s might have different effects on cancer _incidence_ vs. cancer _survival_. A different study "GLP-1 Receptor Agonists and the Risk of Thyroid Cancer" was published in the Diabates Care journal in February 2023* The conclusion of the 2023 study: "we found increased risk of all thyroid cancer and medullary thyroid cancer with use of GLP-1 RA, in particular after 1–3 years of treatment." I wonder what the mechanistic hypothesis could be for GLP-1s increasing thyroid cancer _incidence_ (the probability of thyroid cancer occurring in patients taking GLP-1s) but increasing colon cancer _survival_ (the probability of surviving in patients taking GLP-1s who have colon cancer). Of course there are numerous important differences across the studies (cancer type, France vs. USA data, etc.), I'm just curious about a why this might be the case. *https://diabetesjournals.org/care/article-abstract/46/2/384/147888/GLP-1-Receptor-Agonists-and-the-Risk-of-Thyroid?redirectedFrom=fulltext https://diabetesjournals.org/care/article-abstract/46/2/384/...
- mr_luc 11mo ago
  I'd be cautious for the same reason: thyroid cancers are also positively associated with obesity, and people who take GLP-1s are often obese. Below a table, it says "adjusted for social deprivation index, hypo- and hyperthyroidism, and use of other antidiabetic drugs..." -- but nothing about obesity. What if the GLP-1-prescribed patients tended to be more obese?
freetime2 11mo ago
The article also says that the effects persist after adjusting for BMI: > After adjusting for age, body mass index (BMI), disease severity and other health factors, GLP-1 users still showed significantly lower odds of death, suggesting a strong and independent protective effect. The observed reduction in mortality is also quite large: > Health sites, researchers found that those taking glucagon-like peptide-1 (GLP-1) medications were less than half as likely to die within five years compared to those who weren’t on the drugs (15.5% vs. 37.1%). More research is needed, but if I were diagnosed with colon cancer I would definitely be asking my doctor about the risks vs. potential benefits of getting on GLP-1 meds based on this study alone.

by jl6 11mo ago

stavros 11mo ago

Yeah, most GLP-1 benefits (or even adverse effects, like muscle loss) seem to be caused by the weight loss. We already knew obesity massively increases risk from a host of diseases, but GLP-1s are still treated with scepticism of the "oh but what about the side-effects we don't know about?!" variety?

ed 11mo ago
Source? There’s growing evidence of cardioprotective effects independent of weight loss. Eg https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01375-3/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... > The cardioprotective effects of semaglutide were independent of baseline adiposity and weight loss and had only a small association with waist circumference, suggesting some mechanisms for benefit beyond adiposity reduction.
- rickydroll 11mo ago
  They also help with slowing the progression of CKD https://www.kidneyfund.org/treatments/medicines-kidney-disease/glp-1-ras https://www.kidneyfund.org/treatments/medicines-kidney-disea...
anovikov 11mo ago
Someone has to start a study where they give GLP-1 to skinny people and see what happens. Why it hasn't been done yet?
- stavros 11mo ago
  Because they lose weight and it's too dangerous.
  - anovikov 11mo ago
    They won't, GLP-1 has almost no direct effect on skinny people. Many women with BMI around 22-23 are trying them to lose weight to match beauty standards and usually end up disappointed, not able to drop more than 1-2 kilos.

cyrusradfar 11mo ago

Agreed. I'm a big fan of intermittent and water fasting. Have seen things in my blood work that doctors would require me on meds to reverse. Outside of that, I can't speak to the positive impacts on my mood, and general ability to focus. The simplest solution to a lot of problems is consuming less with the assumption that, most of us (maybe not you), have a lot of spare energy sitting around. A lie that we don't unlearn as we grow up is we "require" three meals a day. This is true for children who need obscene amounts of energy to grow, but, not for us desk-bound adults. In the end, giving the body a break to heal by fasting or just consuming significantly less is going to leave more resources for the body energy to deal with other things.

trallnag 11mo ago
Awesome insight. It's not the disability I have, it's that I have never tried healing by fasting. Of course. Because my body was always busy trying to eat food instead of fixing and regrowing all the malformed tissue. Because that's how it works. When a person without legs starts to fast, the legs will suddenly develop.
- amenhotep 11mo ago
  It would be sensible for you to examine and interrogate why reading a general and fairly anodyne opinion about what might be a solution to a problem some people have led you to interpret it as a prescriptive and judgemental suggestion about the specific problem you specifically have.
  - cyrusradfar 11mo ago
    Appreciate the thoughtful retort. Have a good one.
  - trallnag 11mo ago
    In my mind it is a slippery slope that leads to a sickly Steve Jobs eating kilograms of raw carrots. Obviously a healthy lifestyle is good. And this includes not eating over your requirements. But sometimes there is actually something wrong. And in these cases, first trying out to just eat healthy can worsen the situation by delaying proper treatment. And proper treatment does equal a bunch of pharmaceutical drugs.

p00dles 11mo ago

Interesting that GLP-1s might have different effects on cancer _incidence_ vs. cancer _survival_. A different study "GLP-1 Receptor Agonists and the Risk of Thyroid Cancer" was published in the Diabates Care journal in February 2023* The conclusion of the 2023 study: "we found increased risk of all thyroid cancer and medullary thyroid cancer with use of GLP-1 RA, in particular after 1–3 years of treatment." I wonder what the mechanistic hypothesis could be for GLP-1s increasing thyroid cancer _incidence_ (the probability of thyroid cancer occurring in patients taking GLP-1s) but increasing colon cancer _survival_ (the probability of surviving in patients taking GLP-1s who have colon cancer). Of course there are numerous important differences across the studies (cancer type, France vs. USA data, etc.), I'm just curious about a why this might be the case. *https://diabetesjournals.org/care/article-abstract/46/2/384/147888/GLP-1-Receptor-Agonists-and-the-Risk-of-Thyroid?redirectedFrom=fulltext https://diabetesjournals.org/care/article-abstract/46/2/384/...

mr_luc 11mo ago
I'd be cautious for the same reason: thyroid cancers are also positively associated with obesity, and people who take GLP-1s are often obese. Below a table, it says "adjusted for social deprivation index, hypo- and hyperthyroidism, and use of other antidiabetic drugs..." -- but nothing about obesity. What if the GLP-1-prescribed patients tended to be more obese?

freetime2 11mo ago

The article also says that the effects persist after adjusting for BMI: > After adjusting for age, body mass index (BMI), disease severity and other health factors, GLP-1 users still showed significantly lower odds of death, suggesting a strong and independent protective effect. The observed reduction in mortality is also quite large: > Health sites, researchers found that those taking glucagon-like peptide-1 (GLP-1) medications were less than half as likely to die within five years compared to those who weren’t on the drugs (15.5% vs. 37.1%). More research is needed, but if I were diagnosed with colon cancer I would definitely be asking my doctor about the risks vs. potential benefits of getting on GLP-1 meds based on this study alone.