6 ms·

Novo Nordisk launches Wegovy weight-loss pill in US, triggering price war

143 points by andsoitis 10mo ago

wmf 10mo ago
Obligatory reminder that this pill is much less effective than Zepbound, not to mention reta.
- toomuchtodo 10mo ago
  That might be okay! I'm on the lowest dose of Zepbound (tirzepatide), 2.5mg, and I'm losing 5lbs a week, which is almost too much. It will be helpful to switch to something perhaps not as good in pill form (versus my weekly injections) once I reach my target weight. For those who need pill form and the effectiveness available, it's a slam dunk imho. Orforglipron [1] (small molecule by Lilly vs a peptide) will be potentially available shortly for those needing more effectiveness. We're making incremental improvements in this system rapidly. HN Search: orforglipron - https://hn.algolia.com/?dateRange=all&page=0&prefix=false&query=Orforglipron&sort=byDate&type=story https://hn.algolia.com/?dateRange=all&page=0&prefix=false&qu...
  - notJim 10mo ago
    Could also be great for maintenance dosing. I'm reaching the end of my ~weight loss journey~, and it's not a sure thing that the insurance company will continue paying for the injections once I'm no longer overweight. I'm definitely willing to keep taking it. If insurance won't pay for it, I could pay for the pill out of pocket if I had to, which would be cost prohibitive for the injections.
  - trueismywork 10mo ago
    2.5kg per week? Wow.
    - toomuchtodo 10mo ago
      Indeed, I have to make a conscious effort to remember to eat, and consume 800 calories (two servings) of Creamy Chocolate Soylent (premade, liquid bottles) daily, along with fiber gummies to keep everything moving in my digestive track. I do strength training to preserve muscle mass. Desire to eat anything sweet or alcohol has gone to zero (RIP my craft beer desires and my sweet tooth).
      - marstall 10mo ago
        How long did those effects take to come into effect? I have been on 2.5 for a week and haven't noticed a change in my appetite, though I have lost 2 pounds.
        toomuchtodo 10mo ago
        First week. You might need a higher dose, check with your prescriber. My partner needed to go to 5mg to see improved results, but dropped back down due to side effects (which I did not have).
      - mrguyorama 10mo ago
        You are consuming only 800 calories a day? From a starting weight of 170ish? Was this plan made with your doctor?
        toomuchtodo 10mo ago
        My doctor does not approve or reject my actions, they simply make recommendations and provide guidance. I work with people who understand my risk appetite, which is aggressive. If you are not aggressive as a practitioner, I will work with someone who is. Unsophisticated humans need protection, which I understand and appreciate, but I need coaches and subject matter experts who will push me to my limits.
  - blobbers 10mo ago
    5 lbs a week is crazy? Are you expecting asymptotic approach to healthy weight? I'm 185 and would prefer to be more like 170, but 3 weeks seems too fast.
    - toomuchtodo 10mo ago
      I started at 170lbs and my target is 135lbs (early 40s male). My blood panel looks good per my PCP, and as long as I'm not losing weight so fast I have excess skin or I experience liver, kidney, or pancreas failures of any degree, that meets my success criteria. I am trying to shed as much unhealthy visceral fat as possible while using the pharma intervention to dissuade me from unhealthy consumption habits. At $300/month cash pay through https://lilly.com https://lilly.com, I find the ROI to be exceptional.
      - SoftTalker 10mo ago
        135lbs seems very low for an adult male. How tall are you? Why is that your target?
        toomuchtodo 10mo ago
        While I think BMI is fairly suboptimal and would defer to a DEXA scan, that weight puts me right in the middle of a healthy BMI for a human of my gender, height, and age. As mentioned, I lift weights, three days per week. This also increases my metabolism and daily caloric budget (beyond basal and resting metabolic rates). My goal is to drop fat, gain muscle, and be strong with good cardio performance, and a GLP-1 turns off the part of my brain that made me carry excess unhealthy fat and eat the foods that made that fat. GLP-1s also promote thermogenesis, so it is turning on the switch to tell your body to burn fat that you would have to fast or get into ketosis via a ketogenic diet otherwise to get into (by first depleting your glycogen reserves). I do not get any fatigue such that I would when fasting or on a keto diet needed to encourage thermogenesis and burning up fat reserves, which is awesome imho. My brain says "you are fine" instead "you must eat, feel hungry, and get hangry, even though you already have all of this fat." A bug has been patched. https://pubmed.ncbi.nlm.nih.gov/?term=glp-1+thermogenesis https://pubmed.ncbi.nlm.nih.gov/?term=glp-1+thermogenesis (think like a hacker, the body is just another system to hack)
  - yarrowy 10mo ago
    Even if you water fasted, you would not lose 5 lbs a week sustained. It was probably your first week and mostly water weight
    - etyhhgfff 10mo ago
      It depends on your starting weight. If you weigh north of 300lbs than this is very much possible for several month.
- chrisco255 10mo ago
  Its still effective though and there is no oral form of the other GLPs as of yet.
- ramoz 10mo ago
  Reminder that Reta has yet to actually hit the market, and social media is flooded with counterfeit resellers.
  - sowbug 10mo ago
    "Counterfeit" is a tricky word when the Eli Lilly product in question isn't actually available for sale, meaning that nobody is selling anything purported to be a branded version. Nobody even knows yet what the Eli Lilly brand of retatrutide will be called. There isn't anything yet to counterfeit. You're correct that the amino acid with the sequence YA¹QGTFTSDYSIL²LDKK⁴AQA¹AFIEYLLEGGPSSGAPPPS³ is being manufactured and sold. And people are justified in being wary whether the substance they get is actually a pure version of retatrutide. But it's not counterfeit. It's an important distinction. Counterfeiters are by definition liars, and it's reasonable to assume that liars are cutting corners. But someone correctly manufacturing a specific amino acid is truthfully selling what they claim to be selling. It might turn out that retatrutide causes you to grow extra eyes in five years, and the FDA trials are on the brink of discovering as much, in which case Eli Lilly-branded retatrutide will never come into existence. For that reason it would be prudent to wait for FDA approval.
    - ramoz 10mo ago
      I would say that it seems the vast majority of the social media buyers think they're buying the drug from Eli Lilly. So maybe I'm grammatically and formally incorrect. But a lot of this feels very scammy.
      - sowbug 10mo ago
        If bros are saying they're selling something manufactured by/for Eli Lilly, then yes, that's scammy. The chatter I've encountered has been clear it's gray market from China.
- Someone1234 10mo ago
  Indeed; there is a MASSIVE market demand for pills since few like needles and or the storage requirements of injectable Semaglutide. HOWEVER, this pill is ineffective both in terms of medicine and cost, unfortunately. Several GLP-1 pills are in the pipeline, and there is near bottomless R&D budgets being spent on the area currently, but it isn't here yet and this isn't "it." I'd strongly suggest people ignore this release, and keep using injectable Semaglutide/Tirzepatide.
  - JumpCrisscross 10mo ago
    > this pill is ineffective both in terms of medicine and cost Source?
    - Someone1234 10mo ago
      Novo Nordisk's own clinical trials (OASIS 4, OASIS 1 Vs, STEP 1). In order for oral Semaglutide to be effective you need to substantially increase the oral dosages for the same effect. Meaning you need more Semaglutide for the same action-of-effect, which increases side effects (+2.6% Nausea, +6.9% Vomiting, based on 2.4mg Vs. 25mg). As I said above, this is being worked on (inc. by Novo Nordisk), but oral Semaglutide is a very naive early attempt. They got first to market, but that doesn't mean it makes sense for people who can handle injections; you cannot compare doses 1:1 because of how weak oral is, you need to compare action-of-effect. Once you look at effectiveness, oral costs more than injection.
      - JumpCrisscross 10mo ago
        > you need more Semaglutide for the same action-of-effect Sounds not ineffective. > oral costs more than injection Are these being marketed to the same populations?
  - cm2187 10mo ago
    To me, anyone who tried injections quickly gets over the needle anxiety, it's pretty easy and painless. I don't think the market is people switching from injection to pills (particularly if less effective), to me the market is in people who are too anxious to start injections but would use a pill.
JumpCrisscross 10mo ago
”From 2013–2014 through August 2021–August 2023, the age-adjusted prevalence of obesity did not change significantly, while severe obesity prevalence increased from 7.7% to 9.7%” [1]. What fraction of America’s severely obese are being treated for it? (What fraction refuse treatment?) [1] https://www.cdc.gov/nchs/products/databriefs/db508.htm https://www.cdc.gov/nchs/products/databriefs/db508.htm
- dado3212 10mo ago
  I would've expected that uptake was only beginning in 2022 and still vastly increasing through 2023 (plus the compounding loophole that allowed telehealth companies like Ro to really expand the target audience). 2024 and 2025 data are likely to be better telltales of the impacts of GLP-1s.
jmward01 10mo ago
Insurance companies should be paying people to take this considering the other costs it reduces.
- jl6 10mo ago
  I think their desired cash flow direction is: customers should be paying to take this in order to avoid the punitive deductible for being overweight.
  - lotsofpulp 10mo ago
    The ACA makes it illegal for insurers to make the “punitive deductible” a function of one’s probability of needing healthcare, hence the financial incentive is for the insurer (who can bring down cost of claims, and hence be able to sell insurance at lower premiums). Of course, the insured has the quality of life incentive of not having to deal with complications from consuming excess calories.
- xxpor 10mo ago
  You're missing the time aspect: Obesity mostly causes expensive problems years later. People stay in their jobs for an average of something like 3-4 years. By the time anyone has an issue, it's the next guy's problem (or ideally, Medicare's).
- antisthenes 10mo ago
  The incorrect assumption here is that insurance companies want costs to be reduced. They don't. Because despite being labeled as not-for-profit, they will always scale up their "cost" to match their revenues, and live on the 1-2% difference. They want the absolute nominal dollar values for care to be as high as humanly possible.
  - lotsofpulp 10mo ago
    I love the two claims about health insurance companies: simultaneously denying coverage for needed healthcare, and "scaling" up their healthcare costs to increase profit.
A_Duck 10mo ago
I expect a second-order effect of cheap GLP-1s ending obesity will be to relieve the pressure on food manufacturers to make their products actually healthier There are many other risks* than obesity from consuming UPFs, and we may find we've just removed the main stop-loss on worse outcomes *Diabetes, all the biome/gut stuff which is getting better understood, colon cancer, etc etc
- triceratops 10mo ago
  On the contrary, it may force them to make the products healthier. I've heard many GLP-1 users reporting an aversion to processed foods and cravings for healthy food.
  - dexwiz 10mo ago
    Ancedata, but those around me on it seem to have a lower tolerance for fatty and oily food, also increased sensitivity to sugar.
    - mrguyorama 10mo ago
      Eating healthier for a while itself will reduce your palette for these foods, and make normal food taste better. If you limit your sugar intake for a bit, American bread becomes quite the tasty treat. It might not be direct action of the medication, but the medication making it easier to fix your habits can have huge dividends, similar to how giving an ADHD person stimulant meds make them less likely to die from misadventure or substance use because they self medicate less.
  - sergioisidoro 10mo ago
    I was thinking exactly this. People consume processed foods because they highjack our evolutionary responses. If GLP1 agonists make people immune to those high fat, big carb diets, perhaps we would see a decline of these strategies and instead seeing companies compete for the low appetite of people through smaller quantity yet high quality foods, rather than fast large quantity food.
wileydragonfly 10mo ago
Still ridiculously expensive. This sells for virtually nothing as a “research chemical.” Reminds me of the markups on AZT back in the day.
- ramoz 10mo ago
  I'm assuming by “research chemical” you mean "counterfeit chemical" - Quite a signal for society, of individuals willing to inject themselves with these due to lack of funds or lack of effort.
  - wmf 10mo ago
    Not everything is counterfeit.
  - A_D_E_P_T 10mo ago
    That analogy would hold if a counterfeit dollar were perfectly identical to a real dollar, totally indistinguishable, and nobody could possibly tell the difference. Most of the "research chemical" drugs out there are chemically identical to the marked-up pharmaceutical products. Not similar, identical.
    - ramoz 10mo ago
      They are literally synthesized drugs that are not from the manufacturer.
      - A_D_E_P_T 10mo ago
        They are synthesized drugs that are from a different manufacturer. (Usually synthesized the same way, via the same methods.)
    - andsoitis 10mo ago
      > Not similar, identical. Without coming from the manufacturer or being validated by an independent, trusted third party, you do not know that the chemical composition is what is purported.
nickpinkston 10mo ago
I really hope the addiction engineers at Frito-Lay, etc. don't figure out a good workaround for these wonder drugs. There's a billion-dollar prize if you figure this out, and the food industry is already openly discussing it. https://www.foodnavigator.com/Article/2025/07/22/glp-1-drugs-what-food-brands-need-to-know/ https://www.foodnavigator.com/Article/2025/07/22/glp-1-drugs...
- JumpCrisscross 10mo ago
  Frito-Lay switching from Cheetos to protein bars still seems like a net win.
  - nickpinkston 10mo ago
    Yea, agreed. I'm more worried there's some plausible way (like the ginger discussed) to negate the GLP-1 agonist's function itself or its net effects. They're not going to talk about it in open industry journals, but Big Tobacco actually did do this with engineered high nicotine tobacco used to adjust addictivity levels. https://en.wikipedia.org/wiki/Y1_(tobacco)#Legal_controversy https://en.wikipedia.org/wiki/Y1_(tobacco)#Legal_controversy
    - bb88 10mo ago
      I've been on Zepbound and Wegovy, and n=1. It seems like the more complex the flavors (at least to me) the less appealing the food is. So Doritos is too much. A butter or white cheese puffed corn snack tastes pretty good -- but I don't crave them.
    - phil21 10mo ago
      Interesting ginger is discussed. The one thing I will literally eat an entire Costco sized pack of even while on my max GLP-1 dosage was Biscoff cookies. Not much else that I could "eat through" the drug when I was at my peak weight loss phase.
- SirFatty 10mo ago
  "There is a real risk, especially for brands that are slow to adapt." Such insight! Of course that could be said about almost anything.
999900000999 10mo ago
At 150$ a month this is tempting, but I'm worried it's going to cause cancer or something.
- atonse 10mo ago
  I fear the same thing but then people that know more about this say that these GLP-1 drugs have been used for many years (by diabetics) so they aren't untested or un-studied. Don't know how accurate that is, though.
  - JumpCrisscross 10mo ago
    > Don't know how accurate that is Literally from the Wikipedia article: “In 2002, Eli Lilly partnered with Amylin to develop exenatide and secure approval to market the drug. Exenatide's 2005 approval by the U.S. Food and Drug Administration showed that targeting the GLP-1 receptor was a viable strategy and inspired other pharmaceutical companies to focus on that receptor” [1]. [1] https://en.wikipedia.org/wiki/GLP-1_receptor_agonist https://en.wikipedia.org/wiki/GLP-1_receptor_agonist
- dexwiz 10mo ago
  Nah, you'll just be on it for the rest of your life. Drug companies prefer chronic illnesses since they cannot be cured, and recipients take the drug for life. All these hormones (GLP, testosterones, hrt) will need to be taken forever. Very few people come off GLP-1 and keep weight off.
  - JumpCrisscross 10mo ago
    > Drug companies prefer chronic illnesses Gilead has made bank on Solvadi, a drug that cures a previously-chronic disease [1]. > Very few people come off GLP-1 and keep weight off Rebound can be close to 100% if you’re severely obese, but for most people it’s much less [2]. (Everyone I know who was taking it two years ago is off it, and they eat and exercise healthier than they did.) [1] https://en.wikipedia.org/wiki/Sofosbuvir https://en.wikipedia.org/wiki/Sofosbuvir [2] https://pubmed.ncbi.nlm.nih.gov/35441470/ https://pubmed.ncbi.nlm.nih.gov/35441470/
robotnikman 10mo ago
I've been thinking of trying GLP-1's since I have not been able to put off the extra weight I've gained since covid. I'm in my 30's now and I feel like around this age I am starting to feel the effects of this extra weight on my body. What is HN's experience with using GLP-1 inhibitors, for those who have used them? I've heard of side effects like bone density loss, but I've heard those side effects are caused by taking too large of a dose.
- aappleby 10mo ago
  Constipation and nausea. You won't want to eat much, and if you do try to eat a full meal (if for example you went out to eat) you'll feel like crap for a few days. But yes, otherwise it works as advertised.
  - ryanmcgarvey 10mo ago
    To be clear, that is the advertised effects, not the side effects. The idea is that if you over eat you feel terrible, but also you won't want to overeat since you'll be full.
- lm28469 10mo ago
  > I have not been able to put off the extra weight I've gained since covid. What have you tried ?
  - robotnikman 10mo ago
    Intermittent fasting, lifting, calorie counting. The problem is that I am only able to stick to those maybe for a few weeks at a time before I get off track and end up back where I started. Except with weightlifting, I was able to stick with that for a few years, but unfortunately you can't outlift a bad diet. My relationship with food has never been a healthy one, and it's been that way ever since I wad a kid.
    - estearum 10mo ago
      I highly recommend trying CBT. In particular the app Noom was excellent at (permanently) reframing my relationship with food.
annoyingnoob 10mo ago
If you start a GLP-1 drug, how do you ever stop? Seems like GLP-1's are not a cure but treat the symptoms. You need to keep treating the symptoms forever unless you solve the issue.
- JumpCrisscross 10mo ago
  > how do you ever stop? By not taking it. > Seems like GLP-1's are not a cure but treat the symptoms This goes against all of the evidence around rebound, improved diet and exercise after folks have lost weight, et cetera.
  - s1artibartfast 10mo ago
    It is mixed. It can be a cure for some people. Last time I looked my impression it seemed like about half the people has only moderate rebound or less. You have a lot of results that look like this, with an average bounce rebound of 2/3s of the loss. https://pubmed.ncbi.nlm.nih.gov/35441470/ https://pubmed.ncbi.nlm.nih.gov/35441470/ However, detailed analysis usually shows a bimodal distribution, with people who maintain or even lose more, and those that go back or even gain relative to baseline.
- resoluteteeth 10mo ago
  It's not really different than losing weight by any other method in that respect. There is always the risk of regaining weight unless you continue to do whatever caused you to lose weight (e.g. restricting calories) to some extent. I guess a "cure" would be good but since we don't have one having to periodically go back on glp drugs if you gain weight is no different from periodically having to go on a diet if you gain weight. On the other hand most people tend to naturally gain weight pretty slowly (e.g. a pound a year) so having to go on glp drugs for a period every few years wouldn't even be that bad, especially if they're available in pill form.
- rimunroe 10mo ago
  Treating the symptoms can be helpful in the long term if symptoms are a contributing cause to the disease. I used to ride my bike 150+ miles a week, but after not being able to do so for a bit due to other reasons I gained some weight. At the level of riding I was doing, an extra 20-30 lb of weight makes riding far less pleasurable, particularly when it comes to going uphill or on dirt paths. Just finding 10-12 hours in which to exercise every week is challenging on its own. It's much more difficult when the exercise itself becomes harder and less rewarding.
deleted 10mo ago
[deleted]
1970-01-01 10mo ago
What is absolutely shocking isn't that we have a weird drug that finally makes you stop consuming too many calories. What isn't shocking isn't that you eventually lose weight by eating much less. What is absolutely shocking is that people are using it correctly; existing with heavy obesity can finally return to being a somewhat obscene life choice and not a cruel fate of luck.
mannyv 10mo ago
The amount of ingredient in the pill is huge relative to the shot, and you need to take it daily...which shows how hard it is to get drugs into the body. Real question: given the dosage, how would you go about getting the pill and liquefying it? That would provide a huge, cheap supply of semaglutide.

143 points by andsoitis 10mo ago

wmf 10mo ago

Obligatory reminder that this pill is much less effective than Zepbound, not to mention reta.

toomuchtodo 10mo ago
That might be okay! I'm on the lowest dose of Zepbound (tirzepatide), 2.5mg, and I'm losing 5lbs a week, which is almost too much. It will be helpful to switch to something perhaps not as good in pill form (versus my weekly injections) once I reach my target weight. For those who need pill form and the effectiveness available, it's a slam dunk imho. Orforglipron [1] (small molecule by Lilly vs a peptide) will be potentially available shortly for those needing more effectiveness. We're making incremental improvements in this system rapidly. HN Search: orforglipron - https://hn.algolia.com/?dateRange=all&page=0&prefix=false&query=Orforglipron&sort=byDate&type=story https://hn.algolia.com/?dateRange=all&page=0&prefix=false&qu...
- notJim 10mo ago
  Could also be great for maintenance dosing. I'm reaching the end of my ~weight loss journey~, and it's not a sure thing that the insurance company will continue paying for the injections once I'm no longer overweight. I'm definitely willing to keep taking it. If insurance won't pay for it, I could pay for the pill out of pocket if I had to, which would be cost prohibitive for the injections.
- trueismywork 10mo ago
  2.5kg per week? Wow.
  - toomuchtodo 10mo ago
    Indeed, I have to make a conscious effort to remember to eat, and consume 800 calories (two servings) of Creamy Chocolate Soylent (premade, liquid bottles) daily, along with fiber gummies to keep everything moving in my digestive track. I do strength training to preserve muscle mass. Desire to eat anything sweet or alcohol has gone to zero (RIP my craft beer desires and my sweet tooth).
    - marstall 10mo ago
      How long did those effects take to come into effect? I have been on 2.5 for a week and haven't noticed a change in my appetite, though I have lost 2 pounds.
      - toomuchtodo 10mo ago
        First week. You might need a higher dose, check with your prescriber. My partner needed to go to 5mg to see improved results, but dropped back down due to side effects (which I did not have).
    - mrguyorama 10mo ago
      You are consuming only 800 calories a day? From a starting weight of 170ish? Was this plan made with your doctor?
      - toomuchtodo 10mo ago
        My doctor does not approve or reject my actions, they simply make recommendations and provide guidance. I work with people who understand my risk appetite, which is aggressive. If you are not aggressive as a practitioner, I will work with someone who is. Unsophisticated humans need protection, which I understand and appreciate, but I need coaches and subject matter experts who will push me to my limits.
- blobbers 10mo ago
  5 lbs a week is crazy? Are you expecting asymptotic approach to healthy weight? I'm 185 and would prefer to be more like 170, but 3 weeks seems too fast.
  - toomuchtodo 10mo ago
    I started at 170lbs and my target is 135lbs (early 40s male). My blood panel looks good per my PCP, and as long as I'm not losing weight so fast I have excess skin or I experience liver, kidney, or pancreas failures of any degree, that meets my success criteria. I am trying to shed as much unhealthy visceral fat as possible while using the pharma intervention to dissuade me from unhealthy consumption habits. At $300/month cash pay through https://lilly.com https://lilly.com, I find the ROI to be exceptional.
    - SoftTalker 10mo ago
      135lbs seems very low for an adult male. How tall are you? Why is that your target?
      - toomuchtodo 10mo ago
        While I think BMI is fairly suboptimal and would defer to a DEXA scan, that weight puts me right in the middle of a healthy BMI for a human of my gender, height, and age. As mentioned, I lift weights, three days per week. This also increases my metabolism and daily caloric budget (beyond basal and resting metabolic rates). My goal is to drop fat, gain muscle, and be strong with good cardio performance, and a GLP-1 turns off the part of my brain that made me carry excess unhealthy fat and eat the foods that made that fat. GLP-1s also promote thermogenesis, so it is turning on the switch to tell your body to burn fat that you would have to fast or get into ketosis via a ketogenic diet otherwise to get into (by first depleting your glycogen reserves). I do not get any fatigue such that I would when fasting or on a keto diet needed to encourage thermogenesis and burning up fat reserves, which is awesome imho. My brain says "you are fine" instead "you must eat, feel hungry, and get hangry, even though you already have all of this fat." A bug has been patched. https://pubmed.ncbi.nlm.nih.gov/?term=glp-1+thermogenesis https://pubmed.ncbi.nlm.nih.gov/?term=glp-1+thermogenesis (think like a hacker, the body is just another system to hack)
- yarrowy 10mo ago
  Even if you water fasted, you would not lose 5 lbs a week sustained. It was probably your first week and mostly water weight
  - etyhhgfff 10mo ago
    It depends on your starting weight. If you weigh north of 300lbs than this is very much possible for several month.
chrisco255 10mo ago
Its still effective though and there is no oral form of the other GLPs as of yet.
ramoz 10mo ago
Reminder that Reta has yet to actually hit the market, and social media is flooded with counterfeit resellers.
- sowbug 10mo ago
  "Counterfeit" is a tricky word when the Eli Lilly product in question isn't actually available for sale, meaning that nobody is selling anything purported to be a branded version. Nobody even knows yet what the Eli Lilly brand of retatrutide will be called. There isn't anything yet to counterfeit. You're correct that the amino acid with the sequence YA¹QGTFTSDYSIL²LDKK⁴AQA¹AFIEYLLEGGPSSGAPPPS³ is being manufactured and sold. And people are justified in being wary whether the substance they get is actually a pure version of retatrutide. But it's not counterfeit. It's an important distinction. Counterfeiters are by definition liars, and it's reasonable to assume that liars are cutting corners. But someone correctly manufacturing a specific amino acid is truthfully selling what they claim to be selling. It might turn out that retatrutide causes you to grow extra eyes in five years, and the FDA trials are on the brink of discovering as much, in which case Eli Lilly-branded retatrutide will never come into existence. For that reason it would be prudent to wait for FDA approval.
  - ramoz 10mo ago
    I would say that it seems the vast majority of the social media buyers think they're buying the drug from Eli Lilly. So maybe I'm grammatically and formally incorrect. But a lot of this feels very scammy.
    - sowbug 10mo ago
      If bros are saying they're selling something manufactured by/for Eli Lilly, then yes, that's scammy. The chatter I've encountered has been clear it's gray market from China.
Someone1234 10mo ago
Indeed; there is a MASSIVE market demand for pills since few like needles and or the storage requirements of injectable Semaglutide. HOWEVER, this pill is ineffective both in terms of medicine and cost, unfortunately. Several GLP-1 pills are in the pipeline, and there is near bottomless R&D budgets being spent on the area currently, but it isn't here yet and this isn't "it." I'd strongly suggest people ignore this release, and keep using injectable Semaglutide/Tirzepatide.
- JumpCrisscross 10mo ago
  > this pill is ineffective both in terms of medicine and cost Source?
  - Someone1234 10mo ago
    Novo Nordisk's own clinical trials (OASIS 4, OASIS 1 Vs, STEP 1). In order for oral Semaglutide to be effective you need to substantially increase the oral dosages for the same effect. Meaning you need more Semaglutide for the same action-of-effect, which increases side effects (+2.6% Nausea, +6.9% Vomiting, based on 2.4mg Vs. 25mg). As I said above, this is being worked on (inc. by Novo Nordisk), but oral Semaglutide is a very naive early attempt. They got first to market, but that doesn't mean it makes sense for people who can handle injections; you cannot compare doses 1:1 because of how weak oral is, you need to compare action-of-effect. Once you look at effectiveness, oral costs more than injection.
    - JumpCrisscross 10mo ago
      > you need more Semaglutide for the same action-of-effect Sounds not ineffective. > oral costs more than injection Are these being marketed to the same populations?
- cm2187 10mo ago
  To me, anyone who tried injections quickly gets over the needle anxiety, it's pretty easy and painless. I don't think the market is people switching from injection to pills (particularly if less effective), to me the market is in people who are too anxious to start injections but would use a pill.

JumpCrisscross 10mo ago

”From 2013–2014 through August 2021–August 2023, the age-adjusted prevalence of obesity did not change significantly, while severe obesity prevalence increased from 7.7% to 9.7%” [1]. What fraction of America’s severely obese are being treated for it? (What fraction refuse treatment?) [1] https://www.cdc.gov/nchs/products/databriefs/db508.htm https://www.cdc.gov/nchs/products/databriefs/db508.htm

dado3212 10mo ago
I would've expected that uptake was only beginning in 2022 and still vastly increasing through 2023 (plus the compounding loophole that allowed telehealth companies like Ro to really expand the target audience). 2024 and 2025 data are likely to be better telltales of the impacts of GLP-1s.

jmward01 10mo ago

Insurance companies should be paying people to take this considering the other costs it reduces.

jl6 10mo ago
I think their desired cash flow direction is: customers should be paying to take this in order to avoid the punitive deductible for being overweight.
- lotsofpulp 10mo ago
  The ACA makes it illegal for insurers to make the “punitive deductible” a function of one’s probability of needing healthcare, hence the financial incentive is for the insurer (who can bring down cost of claims, and hence be able to sell insurance at lower premiums). Of course, the insured has the quality of life incentive of not having to deal with complications from consuming excess calories.
xxpor 10mo ago
You're missing the time aspect: Obesity mostly causes expensive problems years later. People stay in their jobs for an average of something like 3-4 years. By the time anyone has an issue, it's the next guy's problem (or ideally, Medicare's).
antisthenes 10mo ago
The incorrect assumption here is that insurance companies want costs to be reduced. They don't. Because despite being labeled as not-for-profit, they will always scale up their "cost" to match their revenues, and live on the 1-2% difference. They want the absolute nominal dollar values for care to be as high as humanly possible.
- lotsofpulp 10mo ago
  I love the two claims about health insurance companies: simultaneously denying coverage for needed healthcare, and "scaling" up their healthcare costs to increase profit.

A_Duck 10mo ago

I expect a second-order effect of cheap GLP-1s ending obesity will be to relieve the pressure on food manufacturers to make their products actually healthier There are many other risks* than obesity from consuming UPFs, and we may find we've just removed the main stop-loss on worse outcomes *Diabetes, all the biome/gut stuff which is getting better understood, colon cancer, etc etc

triceratops 10mo ago
On the contrary, it may force them to make the products healthier. I've heard many GLP-1 users reporting an aversion to processed foods and cravings for healthy food.
- dexwiz 10mo ago
  Ancedata, but those around me on it seem to have a lower tolerance for fatty and oily food, also increased sensitivity to sugar.
  - mrguyorama 10mo ago
    Eating healthier for a while itself will reduce your palette for these foods, and make normal food taste better. If you limit your sugar intake for a bit, American bread becomes quite the tasty treat. It might not be direct action of the medication, but the medication making it easier to fix your habits can have huge dividends, similar to how giving an ADHD person stimulant meds make them less likely to die from misadventure or substance use because they self medicate less.
- sergioisidoro 10mo ago
  I was thinking exactly this. People consume processed foods because they highjack our evolutionary responses. If GLP1 agonists make people immune to those high fat, big carb diets, perhaps we would see a decline of these strategies and instead seeing companies compete for the low appetite of people through smaller quantity yet high quality foods, rather than fast large quantity food.

wileydragonfly 10mo ago

Still ridiculously expensive. This sells for virtually nothing as a “research chemical.” Reminds me of the markups on AZT back in the day.

ramoz 10mo ago
I'm assuming by “research chemical” you mean "counterfeit chemical" - Quite a signal for society, of individuals willing to inject themselves with these due to lack of funds or lack of effort.
- wmf 10mo ago
  Not everything is counterfeit.
- A_D_E_P_T 10mo ago
  That analogy would hold if a counterfeit dollar were perfectly identical to a real dollar, totally indistinguishable, and nobody could possibly tell the difference. Most of the "research chemical" drugs out there are chemically identical to the marked-up pharmaceutical products. Not similar, identical.
  - ramoz 10mo ago
    They are literally synthesized drugs that are not from the manufacturer.
    - A_D_E_P_T 10mo ago
      They are synthesized drugs that are from a different manufacturer. (Usually synthesized the same way, via the same methods.)
  - andsoitis 10mo ago
    > Not similar, identical. Without coming from the manufacturer or being validated by an independent, trusted third party, you do not know that the chemical composition is what is purported.

nickpinkston 10mo ago

I really hope the addiction engineers at Frito-Lay, etc. don't figure out a good workaround for these wonder drugs. There's a billion-dollar prize if you figure this out, and the food industry is already openly discussing it. https://www.foodnavigator.com/Article/2025/07/22/glp-1-drugs-what-food-brands-need-to-know/ https://www.foodnavigator.com/Article/2025/07/22/glp-1-drugs...

JumpCrisscross 10mo ago
Frito-Lay switching from Cheetos to protein bars still seems like a net win.
- nickpinkston 10mo ago
  Yea, agreed. I'm more worried there's some plausible way (like the ginger discussed) to negate the GLP-1 agonist's function itself or its net effects. They're not going to talk about it in open industry journals, but Big Tobacco actually did do this with engineered high nicotine tobacco used to adjust addictivity levels. https://en.wikipedia.org/wiki/Y1_(tobacco)#Legal_controversy https://en.wikipedia.org/wiki/Y1_(tobacco)#Legal_controversy
  - bb88 10mo ago
    I've been on Zepbound and Wegovy, and n=1. It seems like the more complex the flavors (at least to me) the less appealing the food is. So Doritos is too much. A butter or white cheese puffed corn snack tastes pretty good -- but I don't crave them.
  - phil21 10mo ago
    Interesting ginger is discussed. The one thing I will literally eat an entire Costco sized pack of even while on my max GLP-1 dosage was Biscoff cookies. Not much else that I could "eat through" the drug when I was at my peak weight loss phase.
SirFatty 10mo ago
"There is a real risk, especially for brands that are slow to adapt." Such insight! Of course that could be said about almost anything.

999900000999 10mo ago

At 150$ a month this is tempting, but I'm worried it's going to cause cancer or something.

atonse 10mo ago
I fear the same thing but then people that know more about this say that these GLP-1 drugs have been used for many years (by diabetics) so they aren't untested or un-studied. Don't know how accurate that is, though.
- JumpCrisscross 10mo ago
  > Don't know how accurate that is Literally from the Wikipedia article: “In 2002, Eli Lilly partnered with Amylin to develop exenatide and secure approval to market the drug. Exenatide's 2005 approval by the U.S. Food and Drug Administration showed that targeting the GLP-1 receptor was a viable strategy and inspired other pharmaceutical companies to focus on that receptor” [1]. [1] https://en.wikipedia.org/wiki/GLP-1_receptor_agonist https://en.wikipedia.org/wiki/GLP-1_receptor_agonist
dexwiz 10mo ago
Nah, you'll just be on it for the rest of your life. Drug companies prefer chronic illnesses since they cannot be cured, and recipients take the drug for life. All these hormones (GLP, testosterones, hrt) will need to be taken forever. Very few people come off GLP-1 and keep weight off.
- JumpCrisscross 10mo ago
  > Drug companies prefer chronic illnesses Gilead has made bank on Solvadi, a drug that cures a previously-chronic disease [1]. > Very few people come off GLP-1 and keep weight off Rebound can be close to 100% if you’re severely obese, but for most people it’s much less [2]. (Everyone I know who was taking it two years ago is off it, and they eat and exercise healthier than they did.) [1] https://en.wikipedia.org/wiki/Sofosbuvir https://en.wikipedia.org/wiki/Sofosbuvir [2] https://pubmed.ncbi.nlm.nih.gov/35441470/ https://pubmed.ncbi.nlm.nih.gov/35441470/

robotnikman 10mo ago

I've been thinking of trying GLP-1's since I have not been able to put off the extra weight I've gained since covid. I'm in my 30's now and I feel like around this age I am starting to feel the effects of this extra weight on my body. What is HN's experience with using GLP-1 inhibitors, for those who have used them? I've heard of side effects like bone density loss, but I've heard those side effects are caused by taking too large of a dose.

aappleby 10mo ago
Constipation and nausea. You won't want to eat much, and if you do try to eat a full meal (if for example you went out to eat) you'll feel like crap for a few days. But yes, otherwise it works as advertised.
- ryanmcgarvey 10mo ago
  To be clear, that is the advertised effects, not the side effects. The idea is that if you over eat you feel terrible, but also you won't want to overeat since you'll be full.
lm28469 10mo ago
> I have not been able to put off the extra weight I've gained since covid. What have you tried ?
- robotnikman 10mo ago
  Intermittent fasting, lifting, calorie counting. The problem is that I am only able to stick to those maybe for a few weeks at a time before I get off track and end up back where I started. Except with weightlifting, I was able to stick with that for a few years, but unfortunately you can't outlift a bad diet. My relationship with food has never been a healthy one, and it's been that way ever since I wad a kid.
  - estearum 10mo ago
    I highly recommend trying CBT. In particular the app Noom was excellent at (permanently) reframing my relationship with food.

annoyingnoob 10mo ago

If you start a GLP-1 drug, how do you ever stop? Seems like GLP-1's are not a cure but treat the symptoms. You need to keep treating the symptoms forever unless you solve the issue.

JumpCrisscross 10mo ago
> how do you ever stop? By not taking it. > Seems like GLP-1's are not a cure but treat the symptoms This goes against all of the evidence around rebound, improved diet and exercise after folks have lost weight, et cetera.
- s1artibartfast 10mo ago
  It is mixed. It can be a cure for some people. Last time I looked my impression it seemed like about half the people has only moderate rebound or less. You have a lot of results that look like this, with an average bounce rebound of 2/3s of the loss. https://pubmed.ncbi.nlm.nih.gov/35441470/ https://pubmed.ncbi.nlm.nih.gov/35441470/ However, detailed analysis usually shows a bimodal distribution, with people who maintain or even lose more, and those that go back or even gain relative to baseline.
resoluteteeth 10mo ago
It's not really different than losing weight by any other method in that respect. There is always the risk of regaining weight unless you continue to do whatever caused you to lose weight (e.g. restricting calories) to some extent. I guess a "cure" would be good but since we don't have one having to periodically go back on glp drugs if you gain weight is no different from periodically having to go on a diet if you gain weight. On the other hand most people tend to naturally gain weight pretty slowly (e.g. a pound a year) so having to go on glp drugs for a period every few years wouldn't even be that bad, especially if they're available in pill form.
rimunroe 10mo ago
Treating the symptoms can be helpful in the long term if symptoms are a contributing cause to the disease. I used to ride my bike 150+ miles a week, but after not being able to do so for a bit due to other reasons I gained some weight. At the level of riding I was doing, an extra 20-30 lb of weight makes riding far less pleasurable, particularly when it comes to going uphill or on dirt paths. Just finding 10-12 hours in which to exercise every week is challenging on its own. It's much more difficult when the exercise itself becomes harder and less rewarding.

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1970-01-01 10mo ago

What is absolutely shocking isn't that we have a weird drug that finally makes you stop consuming too many calories. What isn't shocking isn't that you eventually lose weight by eating much less. What is absolutely shocking is that people are using it correctly; existing with heavy obesity can finally return to being a somewhat obscene life choice and not a cruel fate of luck.

mannyv 10mo ago

The amount of ingredient in the pill is huge relative to the shot, and you need to take it daily...which shows how hard it is to get drugs into the body. Real question: given the dosage, how would you go about getting the pill and liquefying it? That would provide a huge, cheap supply of semaglutide.