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I would think eventually all of the additional positives of the drug will resolve to obesity is bad and reducing obesity has health benefits. Which should be pe

I would think eventually all of the additional positives of the drug will resolve to obesity is bad and reducing obesity has health benefits. Which should be perfectly fine as its valid and results in massive positives in both health and quality of life.

estearum 11mo ago
We already know that's not the case though. A huge portion of the benefits are downstream of obesity, yes, but we already know GLPs have positive effects even without weight loss.
- deleted 11mo ago
  [deleted]
- wpasc 11mo ago
  genuinely curious if you have some sources I can read on the subject? most of the benefits/papers I've seen have not touched on or included studies for patients on GLP's where weight loss was ruled out as the factor?
  - nwienert 11mo ago
    Actually even in the very beginning I saw numerous studies showing effects outside weight loss, I'm sure a search would find them. I remember seeing at least 3-4 a couple years ago.
  - AWebOfBrown 11mo ago
    https://www.medlink.com/news/from-blood-sugar-to-brain-relief-glp-1-therapy-slashes-migraine-frequency https://www.medlink.com/news/from-blood-sugar-to-brain-relie...
flir 11mo ago
Nah, obesity reduction is itself a downstream effect of messing with neurotransmitters. There have to be other consequences of that - both good and bad.
- estearum 11mo ago
  There don't have to be any other consequences, certainly not both good and bad ones. Biology doesn't actually have some scale of justice that means good things must be offset by bad things. But yes, it's very probable (in fact we already know) the drug is doing several things in the body.
  - flir 11mo ago
    I was more thinking that evolved systems rarely have convenient switches you can flip and just get a single outcome. You perturb the system, and you get a cascade of changes. It's not like engineering. Nothing about justice was implied, so lets say desirable and undesirable instead of good and bad.
    - estearum 11mo ago
      Yes you’re right to be concerned about this, I’m taking issue with your assumption that there must be undesirable effects.
astura 11mo ago
>eventually all of the additional positives of the drug will resolve to obesity is bad and reducing obesity has health benefits. This is not true. Ozempic appears to affect the brain's rewards system and its known to decreased cravings and urges for a range of unhealthy behaviors, from alcohol consumption and smoking to gambling and shopping to nail biting and skin picking. Beyond that, Ozempic appears to lower the risk of heart attacks and strokes in overweight people well beyond what weight loss alone would explain. Maybe due to the above (less drinking and smoking) or another unknown mechanism of action. https://www.scientificamerican.com/article/weight-loss-drug-wegovy-slashes-risk-of-death-in-some-people-with-heart-disease/ https://www.scientificamerican.com/article/weight-loss-drug-...
- toraway 11mo ago
  I started taking prescription Zepbound (tirzepatide) right when it was approved for about 6 months and lost 30 pounds, later switched to a low dose of much cheaper grey market semaglutide for maintenance. The anti-drinking side effect was unexpected and somewhat shocking to experience. I had heavily drank in the evening for almost a decade to varying degrees and then pretty much stopped overnight once hitting the 5mg dose of Zepbound on the second month. After ending the Zepbound I had a few months where I wasn't taking anything before resuming the maintenance semaglutide, and although food cravings slowly started returning, I still had/have zero interest in drinking whatsoever unless in a social setting where I may have 1-2 drinks (but usually avoid it altogether without requiring any conscious effort). There is definitely massive variance in the individual psychology/biology that leads to habitual alcohol overuse so I'm sure others might not have the same experience. But for me I'm pretty confident that breaking that deeply engrained habit of starting the first of 6-10 drinks at 6-7pm every day was what did it (without feeling like I was being forced to do something I didn't want). Which was pretty much impossible for me to even envision back when it was such a normal part of my day-to-day coping strategy for stress/depression/etc. Although I always knew my drinking was excessive and terrible for my health, past my early 20s I was super high functioning and wasn't interfering with my job or life (other than holding me back and probably slowly killing me), and so being an "alcoholic" was never part of my identity (rightly or wrongly), which I kinda think ironically made it easier to just take the win and move on with my life without nagging self-doubt or fixation on whether my "addiction is cured". But it's been about 2 years now and I hardly ever think about alcohol even when super stressed so something, somewhere in my brain changed thanks to tirzepatide and whatever the mechanism I'm grateful for that happy accident of a positive side effect!
SubiculumCode 11mo ago
It is a reasonable thought, but that exact question has been investigated and benefits were not totally explained by weight loss. I don't recall the link, but it was featured on HN

estearum 11mo ago

We already know that's not the case though. A huge portion of the benefits are downstream of obesity, yes, but we already know GLPs have positive effects even without weight loss.

deleted 11mo ago
[deleted]
wpasc 11mo ago
genuinely curious if you have some sources I can read on the subject? most of the benefits/papers I've seen have not touched on or included studies for patients on GLP's where weight loss was ruled out as the factor?
- nwienert 11mo ago
  Actually even in the very beginning I saw numerous studies showing effects outside weight loss, I'm sure a search would find them. I remember seeing at least 3-4 a couple years ago.
- AWebOfBrown 11mo ago
  https://www.medlink.com/news/from-blood-sugar-to-brain-relief-glp-1-therapy-slashes-migraine-frequency https://www.medlink.com/news/from-blood-sugar-to-brain-relie...

flir 11mo ago

Nah, obesity reduction is itself a downstream effect of messing with neurotransmitters. There have to be other consequences of that - both good and bad.

estearum 11mo ago
There don't have to be any other consequences, certainly not both good and bad ones. Biology doesn't actually have some scale of justice that means good things must be offset by bad things. But yes, it's very probable (in fact we already know) the drug is doing several things in the body.
- flir 11mo ago
  I was more thinking that evolved systems rarely have convenient switches you can flip and just get a single outcome. You perturb the system, and you get a cascade of changes. It's not like engineering. Nothing about justice was implied, so lets say desirable and undesirable instead of good and bad.
  - estearum 11mo ago
    Yes you’re right to be concerned about this, I’m taking issue with your assumption that there must be undesirable effects.

astura 11mo ago

>eventually all of the additional positives of the drug will resolve to obesity is bad and reducing obesity has health benefits. This is not true. Ozempic appears to affect the brain's rewards system and its known to decreased cravings and urges for a range of unhealthy behaviors, from alcohol consumption and smoking to gambling and shopping to nail biting and skin picking. Beyond that, Ozempic appears to lower the risk of heart attacks and strokes in overweight people well beyond what weight loss alone would explain. Maybe due to the above (less drinking and smoking) or another unknown mechanism of action. https://www.scientificamerican.com/article/weight-loss-drug-wegovy-slashes-risk-of-death-in-some-people-with-heart-disease/ https://www.scientificamerican.com/article/weight-loss-drug-...

toraway 11mo ago
I started taking prescription Zepbound (tirzepatide) right when it was approved for about 6 months and lost 30 pounds, later switched to a low dose of much cheaper grey market semaglutide for maintenance. The anti-drinking side effect was unexpected and somewhat shocking to experience. I had heavily drank in the evening for almost a decade to varying degrees and then pretty much stopped overnight once hitting the 5mg dose of Zepbound on the second month. After ending the Zepbound I had a few months where I wasn't taking anything before resuming the maintenance semaglutide, and although food cravings slowly started returning, I still had/have zero interest in drinking whatsoever unless in a social setting where I may have 1-2 drinks (but usually avoid it altogether without requiring any conscious effort). There is definitely massive variance in the individual psychology/biology that leads to habitual alcohol overuse so I'm sure others might not have the same experience. But for me I'm pretty confident that breaking that deeply engrained habit of starting the first of 6-10 drinks at 6-7pm every day was what did it (without feeling like I was being forced to do something I didn't want). Which was pretty much impossible for me to even envision back when it was such a normal part of my day-to-day coping strategy for stress/depression/etc. Although I always knew my drinking was excessive and terrible for my health, past my early 20s I was super high functioning and wasn't interfering with my job or life (other than holding me back and probably slowly killing me), and so being an "alcoholic" was never part of my identity (rightly or wrongly), which I kinda think ironically made it easier to just take the win and move on with my life without nagging self-doubt or fixation on whether my "addiction is cured". But it's been about 2 years now and I hardly ever think about alcohol even when super stressed so something, somewhere in my brain changed thanks to tirzepatide and whatever the mechanism I'm grateful for that happy accident of a positive side effect!

SubiculumCode 11mo ago

It is a reasonable thought, but that exact question has been investigated and benefits were not totally explained by weight loss. I don't recall the link, but it was featured on HN