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Why not? People take depression meds, blood pressure meds, all kinds of meds for their whole life. I'll be on omeprazole for reflux my whole life. It doesn't so

by wpm 4mo ago

Why not? People take depression meds, blood pressure meds, all kinds of meds for their whole life. I'll be on omeprazole for reflux my whole life. It doesn't solve the underlying problem of my gut being prone to overpumping acid into my stomach. So omeprazole is problematic? The underlying issue is being treated, it's treated by taking the drug. It works. It's doing its job. I'd be curious as to how you came to this conclusion.

joshuamcginnis 4mo ago
I think there's a distinct difference between taking medicine for things you can fix on your own (diet + exercise) vs things you cannot (excess acid production).
- ceejayoz 4mo ago
  > things you can fix on your own (diet + exercise) We have decades of research showing this is more in the "excess acid production" realm of things.
  - applfanboysbgon 4mo ago
    We also know there's a replication crisis in psychology and medicine, that it's easy to publish results that show the effect you're looking for, that there are rich, developed countries with obesity rates <5%, and that the obesity rate for Western countries spiked in recent years. This idea that Americans are genetically pre-ordained to be fat seems like fanciful thinking.
    - ceejayoz 4mo ago
      > We also know there's a replication crisis in psychology and medicine… It seems unlikely to extend to bariatric surgery outcomes. > This idea that Americans are genetically pre-ordained to be fat seems like fanciful thinking. This idea that Americans are genetically pre-ordained to lack willpower seems like fanciful thinking.
      - applfanboysbgon 4mo ago
        Of course they aren't genetically pre-ordained to lack willpower. That's why they could stop being fat, if only they chose to. The issue is cultural, not genetic. You don't go from 12% obesity to 40% obesity in 40 years due to a genetic shift, but rather a cultural one.
        ceejayoz 4mo ago
        > That's why they could stop being fat, if only they chose to. This seems like one of those "replication crisis" claims. > That's why they could stop being fat, if only they chose to. So they're pre-ordained not to? I have a loved one who certainly chooses to, to the point of having had bariatric surgery; GLPs have been an important follow-up. It's really not as simple as you make it out to be. > You don't go from 12% obesity to 40% obesity in 40 years due to a genetic shift, but rather a cultural one. What if that cultural one is letting the processed foods industry engineer everything to be deeply addicting?
        applfanboysbgon 4mo ago
        > So they're pre-ordained not to? No. I'm saying it's within their power, so they aren't pre-ordained either way. You were suggesting that it's impossible for a large percentage of the population to not be obese without medical intervention, that it was comparable to excessive acid production which is a genetic anomaly and out of an individual's own control. > What if that cultural one is letting the processed foods industry engineer everything to be deeply addicting? Sure, the industry bears some blame and is part of the cultural issue, but even if presented with addicting substances, it is both an individual choice to consume them and a collective cultural choice not to regulate them.
        cflewis 4mo ago
        Yeah, you see, this is the same thinking that leads you to say "People who are depressed should just think happier thoughts."
        4mo ago
    - thereisnospork 4mo ago
      >This idea that Americans are genetically pre-ordained to be fat seems like fanciful thinking. The idea that it being genetic or not should matter is odd? Who cares why people are fat? They inarguably are fat and will by all available evidence be skinnier and healthier on a glp drug. I fail to see the need for additional analysis or consideration? Digging into the root cause or petitioning to tweak the food supply to reduce HFCS are admirable, but entirely orthogonal to the questions: "will taking ozempic et al make an overweight person's life better?" and "will making ozempic et al widely available improve America as a whole?"
      - applfanboysbgon 4mo ago
        > I fail to see the need for additional analysis or consideration? Having 40% of your population on a lifetime drug seems like it could cause significant issues in the long-term, especially if there are unforeseen longterm side effects. Medical intervention seems like it should be a last resort, not something half the population is subscribed to by default, so if the problem can be addressed by other means, it really should be.
        ceejayoz 4mo ago
        > especially if there are unforeseen longterm side effects GLP-1s have been used widely for 20+ years now.
        dghlsakjg 4mo ago
        Look up what percentage of people take statins long term at some point in their life. For people in certain age brackets it's more than the 40% of people taking GLP-1s that you are so concerned with. Why don't they just lower their cholesterol via other means? Look up what percentage of people take antidepressants. Why don't they just try being happy? Look up what percentage of people regularly take OTC pain killers, Benadryl, etc. Why don't they just tough it out? You are only picking on GLP-1s which happen to treat obesity among other illnesses. All of the other medications I listed are treating conditions with non-pharmaceutical interventions, but you haven't stated a problem with a huge percentage of the population using them. If your problem is with chronic medication use, this isn't the one to pick on. It is insanely effective. > not something half the population is subscribed to by default, so if the problem can be addressed by other means, it really should be. What makes you think that these people haven't tried other options. What makes you think this is the default option, and not a later option? Do you think they are unaware of diet and exercise? Do you think that they choose to be fat? Do you think that people that can get PHDs doing world changing science, climb mountains, run Fortune 500 companies, hell - run marathons, are just too undisciplined or stupid to lose weight?
- habinero 4mo ago
  Why? They both get you to the same place, and one is vastly more likely to work. I don't get the weird moralizing around this.
- crooked-v 4mo ago
  I'm not on GLP-1s, but I've been looking at very seriously because something I can't "fix on my own" is just... always feeling hungry. That's just how my body works. Exercise doesn't help; there's no reasonable amount of exercise that will help with my office-worker stomach wanting 3000 calories a day. So far through my life I've just lived with it and managed my diet as best I can and it just absolutely sucks.
  - saberience 4mo ago
    [flagged]
    - SpaceNugget 4mo ago
      They said exercise doesn't help them with reducing the feeling of hunger. I don't know why they thought it would, because generally if you do a lot of exercise you get more hungry not less hungry, but regardless, you are responding to something that wasn't said.
      - crooked-v 4mo ago
        My meaning was more that indulging in that hunger would result in me just eating an exorbitant number of calories, way past anything it would be reasonable to burn off without spending 4 hours a day every day in the gym... but you're completely right that even if I did spend that time in the gym it wouldn't help with the calories-in-calories-out equation, because it would just make me more hungry.
    - Aaargh20318 4mo ago
      The problem with exercise is that our bodies are quite efficient with their energy usage. A few minutes of ‘calories in’ takes many hours of ‘calories out’ to burn. You can’t really exercise enough to offset the food you can eat in a day, even if you somehow were able to dedicate all your time to exercising you would still have to limit your food intake. Add to that the fact that exercise is mind numbingly boring and you have to conclude it is not a practical solution at all.
9x39 4mo ago
If they were a normal weight they would not have been prescribed the drug. The underlying issue is they're overweight because they eat too much. Anything more is speculation. There is usually no free lunch when it comes to pharma, and extrapolating long term or lifetime dependence as being equivalent to short term interventions is an unsupported leap.
- Aaargh20318 4mo ago
  That’s the problem with these new weight loss drugs. Ultimately they work by reducing food intake. For many people food is one of the few things in life that gives them some form of joy. I won’t ever take any drug that will take that away from me. Life is depressing enough as is. What we need is a weight loss drug that lets you eat unlimited amounts of food, preferably even suppressing the feeling of fullness, without gaining weight.
  - JumpCrisscross 4mo ago
    > that will take that away from me They don’t stop eating, just overeating. Getting joy from food is different from self medicating with overconsumption. (For the record, I love food. I also don’t have an issue maintaining a healthy weight and physique.)
    - cflewis 4mo ago
      This is it. I am on GLP-1 (Zepbound). I have done Weight Watchers multiple times. I'd lose the weight for a little bit, then it would come back. The reason was _I was hungry all the time_. It's not sustainable. As someone else in WW told me: "The easy bit is losing the weight. The hard part is continuing to eat that way your whole life." It's simply a faulty hunger sensor in my body. It was not what I was eating, simply how much. GLP-1s fix the sensor. It's really simple. Nothing else to it. I still enjoy food (although my palette has turned away from anything greasy, which is for the better anyway), but I can finally understand why someone would eat half a plate of something and say "I'm good" and actually mean it rather than trying to diet/starve themselves.
hamhock666 4mo ago
If you can find a way to use your own free will and self-discipline to stop the bad condition then that seems preferable to using a drug. Maybe someone doesn't have the willpower in which case it's good that we have the drug. With regards to omeprazole, I changed my diet a bit and no longer needed the omeprazole. I don't know exactly what it was, but if you can get off of a drug because you don't need it anymore that seems ideal.
- paulddraper 4mo ago
  I mean…that’s just like depression medication. It’s possible to ignore sadness as well as hunger.
  - hamhock666 4mo ago
    There are usually ways to fix the problems in your life, like sadness and hunger, without resorting to using drugs. Maybe not everyone but it is something we should strive for.
    - tuckerman 4mo ago
      Why is that something to strive for though? Maybe for some people that mental energy is better spent everywhere. If there is a simple and safe pharmaceutical solution for a problem, that sounds like great progress to me!
    - habinero 4mo ago
      Why? There's zero prizes for unnecessary struggle. It doesn't make you a better person, it just means you struggled more.
- wpm 3mo ago
  > Maybe someone doesn't have the willpower in which case it's good that we have the drug. This is all that needs to be said and this is also not that profound of a point. It's literally just harm reduction. Why do people have such a problem with harm reduction? Why do they feel the need to feel oh-so-smart and point out "weeellll acccktschually there is still some harm so its better if you didn't need the harm reduction therapy and instead just i dunno magically not require it"
htk 4mo ago
No, the symptom is being treated, not the underlying issue. And that's ok, but treating the underlying issue, when possible, is better, as the problem ceases to exist.
- crooked-v 4mo ago
  For many people, the "underlying issue" is fundamentally just being too hungry for how they live. GLP-1s absolutely treat that.
  - faangguyindia 4mo ago
    for many people the underlying issue is serious lack of education when it comes to nutrition. Not understanding calorie balance, not understanding calorie density of the food they eat. How many people know 1kg fat = 7700kcal that if they could create deficit of 7700kcal they could potentially lose 1kg bodyfat? Ofc, i know the relationship isn't that simple but for most people this roughly holds true. If you are eating granolas in breakfast, it may come across as a shock how many calories they pack, go ahead look it up many people believe that's a low calorie health breakfast option. Many people don't know 1g of carb or protein = 4kcal 1g of fats = 9kcal.
    - crooked-v 4mo ago
      Being aware that there are deceptively calorie-dense foods doesn't help the basic equation there. Anecdotes are not data, but my anecdotal experience is that if I ate nothing but bulk vegetables whenever my hindbrain wanted food, I would still be eating over my maintenance calories every day.
      - faangguyindia 4mo ago
        What's your maintenance calories and how did you calculate it? Most people calculate it wrong.
        4mo ago
soared 4mo ago
Omeprazole is not great long term FYI - worth talking to your doctor or getting a second opinion to discuss.
- catigula 4mo ago
  I’ve been taking high doses long term for over a decade and I don’t really have any substantial issues.
  - dotcoma 4mo ago
    Good for you, but this mere fact does not mean it’s ideal. Not a doctor, but I would at least try to look into this. Best of luck!
    - catigula 3mo ago
      Why do you think I haven’t looked into it? You’re not providing anything of note, so merely saying “I’ve looked into it. I’m good” seems like it’s the correct reply.
  - derekja 4mo ago
    The primary concern is reduced stomach acid leading to nutrient deficiencies, particularly b12. There have been some long term studies correlating to dementia as a result. And some studies that have not found this. So the jury is still out, but keeping an eye on some nutritional markers is not a bad idea.
    - catigula 3mo ago
      The dementia meta-analyses are a wash. It doesn’t lean strongly either way. I wouldn’t worry about it.
  - mapkkk 4mo ago
    Definitely not a good idea to be on it longer than 2 months. If we can't treat the underlying condition and the patient needs life-long acid suppression therapy, we switch to H2 receptor antagonists, like cimetidine. Long term PPI use has non-trivial risks, including magnesium and other micronutrient deficiencies, and can lead to things like SIBO and other primarily gut related morbidity. I would definitely suggest sitting down with your doctor if you were not specifically instructed to take it for that long.
ElProlactin 4mo ago
> People take depression meds, blood pressure meds, all kinds of meds for their whole life. And a lot of these medications have side effects that can affect quality of life negatively in other ways. That doesn't mean they're not helpful, or shouldn't be taken. But the "no free lunch" rule usually applies, sometimes to a noticeable degree.
- ab5tract 4mo ago
  And? It’s not like those of us on lifetime-prescriptions have any real choice in the matter. Oh, there’s consequences? One of those is an almost universal weight gain measured in the dozens of kilos? You want help with that? Sorry, it’s against Calvinist/puritan morality to help you with that by providing a medicine to counteract that. You need to do it the hard way (regardless of the statistics that show you will just be obese now until you die thanks to the meds which, I maintain, that you must take).
- wpm 3mo ago
  OK, so is the point being made that "drugs have side effects"? Wow. I had no idea. Come on, why is it that whenever GLP-1s come up on this site, the comments are filled with people helpfully pointing out this fact as if no one knows it already?
  - ElProlactin 3mo ago
    > ...the comments are filled with people helpfully pointing out this fact as if no one knows it already? First, I don't personally have it out for GLP-1s specifically. Second, here's the thing about side effects: there are a good number of examples across multiple categories of drugs showing that some people experience side effects doctors and pharmaceutical companies have insisted aren't real or are exceedingly rare, with evidence later showing this not to be the case. For instance, there is a growing body of evidence that a subset of people who take SSRIs experience life-altering sexual dysfunction that persists long after the SSRIs are discontinued. Up until fairly recently, that this was happening at all was basically dismissed by all but a small number of practitioners. Now, there's a name for this and even some warning labels. In the US, which is only one of two developed countries in the world that allows pharma companies to advertise directly to consumers, there are huge incentives to minimize side effect profiles and even to bias clinical trials so that benefits are exaggerated and downsides are underestimated. https://jamanetwork.com/journals/jama/fullarticle/198809 https://jamanetwork.com/journals/jama/fullarticle/198809
Netcob 4mo ago
Because usually you can't study long-term effects before releasing a drug, and even then it can take a long time for them to surface. I took antihistamines basically throughout my 20s. My allergy specialist said there's no reason not to. I developed some other issues and wanted to stop taking antihistamines to see if that would help (or get a hint whether they were causing it) - but that got me into itching hell for weeks. In some online forums people reported the same and shared ways to get out of that "addiction" without going insane from itching. My doctor didn't want to believe it and there was no research on it. That only appeared a few years later in the form of a paper called "Unbearable Pruritus After Withdrawal of (Levo)cetirizine" (2016). In the US, the FDA issued a warning in 2025, which is also the time when I heard about it. None of the doctors I went to back then reported this to anyone, so I'm surprised it got discovered at all. As for my other issues I have no way of knowing whether they had anything to do with long-term antihistamine use. I'm a sample size of one, and none of the other stuff is quite as clear-cut as "unbearable itching". I've had other issues with prescription drugs that didn't make the official list of side-effects and sometimes those side-effects don't just go away once I stop taking the drug. That's why I'm very cautious when trying drugs I never had before, and even more so when it comes to taking them long-term.
- Obscurity4340 4mo ago
  Do you think going thru an allergy shot regime from an MD allergy Dr is a viable alternative to actually dealing with the undelying allegie(s)? Seems like the issue is unsettled last Inchecked
  - Netcob 4mo ago
    Do you mean "hypo-sensitization" aka "allergen immunotherapy"? I tried that too but couldn't really tell whether it worked either. My experience was about antihistamines, which are definitely effective.
    - Obscurity4340 3mo ago
      But how long was your regime before you turned back to antihs? My impression was it was weekly at first for 1-few months then monthly for like 5 years. Wish i had started like yestercade :(
herbst 4mo ago
I know several people who stopped both of your examples and only used them for a while until the underlaying issues got fixed. I am just in the progress of stopping with anti depression meds. Without bigger issues. Maybe in America you do, here in Europe I am not so sure about that
jbaber 4mo ago
First, I agree with your comment. But since you specifically bring up omeprazole: I backed off of pantoprazole by getting a prescription for half-dose pills (since they're time released, you can't just cut them in half), then decreasing frequency (alternating days, then tapering off) and retained the benefits. There are plenty of confounding factors in my case, but checking occasionally if you can back out of a drug is worthwhile.
spicyusername 4mo ago
Because it's pretty likely some of these have negative long term effects. And some of those long-term effects are probably pretty serious. Many people taking these kind of drugs are gambling with their well being. No doubt that in many cases that gamble is worth it. But issues that can be solved with non-pharmaceutical solutions, such as with weight loss and lifestyle changes, are really better solved that way if possible. There's no risk of longterm effects and it helps foster a larger culture of healthy living in society generally, reducing the lilihood of the problem in the general population.
- fooker 3mo ago
  The negative long term effects are unlikely to be worse than the negative long term effects of obesity.
- credit_guy 4mo ago
  > Because it's pretty likely some of these have negative long term effects. And some of those long-term effects are probably pretty serious. > Many people taking these kind of drugs are gambling with their well being. No doubt that in many cases that gamble is worth it. You use the word "gamble" and it is correct, but the connotation is a negative one. We take a risk in everything we do. We seldom know the long term effects of anything. Right now I drink tea, and I drink tea quite often. Is this healthy? Does it have long term negative effects? With GLP-1 medications, deciding to not take one, if you are overweight, is also a gamble. A pretty huge one. Obesity very often leads to type-2 diabetes, and the first step is prediabetes. Should someone with high BMI and high A1C avoid GLP-1 because we don't yet know the long term effects? We do know the long term effects of being overweight.
- estearum 4mo ago
  > Because it's pretty likely some of these have negative long term effects. And some of those long-term effects are probably pretty serious. No, it's really not "pretty likely." These drugs are extremely well studied, have been for a long time across now hundreds of thousands of clinical trial participants over decades. The downsides of obesity however are immense. Far, far worse than people intuit. Agreed non-pharmaceutical interventions are preferable when they work. But it turns out – empirically – that it's very hard to implement these successfully.
butlike 3mo ago
But isn't the point to not have to be tethered to a medication forever?

by wpm 4mo ago

joshuamcginnis 4mo ago

I think there's a distinct difference between taking medicine for things you can fix on your own (diet + exercise) vs things you cannot (excess acid production).

ceejayoz 4mo ago
> things you can fix on your own (diet + exercise) We have decades of research showing this is more in the "excess acid production" realm of things.
- applfanboysbgon 4mo ago
  We also know there's a replication crisis in psychology and medicine, that it's easy to publish results that show the effect you're looking for, that there are rich, developed countries with obesity rates <5%, and that the obesity rate for Western countries spiked in recent years. This idea that Americans are genetically pre-ordained to be fat seems like fanciful thinking.
  - ceejayoz 4mo ago
    > We also know there's a replication crisis in psychology and medicine… It seems unlikely to extend to bariatric surgery outcomes. > This idea that Americans are genetically pre-ordained to be fat seems like fanciful thinking. This idea that Americans are genetically pre-ordained to lack willpower seems like fanciful thinking.
    - applfanboysbgon 4mo ago
      Of course they aren't genetically pre-ordained to lack willpower. That's why they could stop being fat, if only they chose to. The issue is cultural, not genetic. You don't go from 12% obesity to 40% obesity in 40 years due to a genetic shift, but rather a cultural one.
      - ceejayoz 4mo ago
        > That's why they could stop being fat, if only they chose to. This seems like one of those "replication crisis" claims. > That's why they could stop being fat, if only they chose to. So they're pre-ordained not to? I have a loved one who certainly chooses to, to the point of having had bariatric surgery; GLPs have been an important follow-up. It's really not as simple as you make it out to be. > You don't go from 12% obesity to 40% obesity in 40 years due to a genetic shift, but rather a cultural one. What if that cultural one is letting the processed foods industry engineer everything to be deeply addicting?
        applfanboysbgon 4mo ago
        > So they're pre-ordained not to? No. I'm saying it's within their power, so they aren't pre-ordained either way. You were suggesting that it's impossible for a large percentage of the population to not be obese without medical intervention, that it was comparable to excessive acid production which is a genetic anomaly and out of an individual's own control. > What if that cultural one is letting the processed foods industry engineer everything to be deeply addicting? Sure, the industry bears some blame and is part of the cultural issue, but even if presented with addicting substances, it is both an individual choice to consume them and a collective cultural choice not to regulate them.
        cflewis 4mo ago
        Yeah, you see, this is the same thinking that leads you to say "People who are depressed should just think happier thoughts."
      - 4mo ago
  - thereisnospork 4mo ago
    >This idea that Americans are genetically pre-ordained to be fat seems like fanciful thinking. The idea that it being genetic or not should matter is odd? Who cares why people are fat? They inarguably are fat and will by all available evidence be skinnier and healthier on a glp drug. I fail to see the need for additional analysis or consideration? Digging into the root cause or petitioning to tweak the food supply to reduce HFCS are admirable, but entirely orthogonal to the questions: "will taking ozempic et al make an overweight person's life better?" and "will making ozempic et al widely available improve America as a whole?"
    - applfanboysbgon 4mo ago
      > I fail to see the need for additional analysis or consideration? Having 40% of your population on a lifetime drug seems like it could cause significant issues in the long-term, especially if there are unforeseen longterm side effects. Medical intervention seems like it should be a last resort, not something half the population is subscribed to by default, so if the problem can be addressed by other means, it really should be.
      - ceejayoz 4mo ago
        > especially if there are unforeseen longterm side effects GLP-1s have been used widely for 20+ years now.
      - dghlsakjg 4mo ago
        Look up what percentage of people take statins long term at some point in their life. For people in certain age brackets it's more than the 40% of people taking GLP-1s that you are so concerned with. Why don't they just lower their cholesterol via other means? Look up what percentage of people take antidepressants. Why don't they just try being happy? Look up what percentage of people regularly take OTC pain killers, Benadryl, etc. Why don't they just tough it out? You are only picking on GLP-1s which happen to treat obesity among other illnesses. All of the other medications I listed are treating conditions with non-pharmaceutical interventions, but you haven't stated a problem with a huge percentage of the population using them. If your problem is with chronic medication use, this isn't the one to pick on. It is insanely effective. > not something half the population is subscribed to by default, so if the problem can be addressed by other means, it really should be. What makes you think that these people haven't tried other options. What makes you think this is the default option, and not a later option? Do you think they are unaware of diet and exercise? Do you think that they choose to be fat? Do you think that people that can get PHDs doing world changing science, climb mountains, run Fortune 500 companies, hell - run marathons, are just too undisciplined or stupid to lose weight?
habinero 4mo ago
Why? They both get you to the same place, and one is vastly more likely to work. I don't get the weird moralizing around this.
crooked-v 4mo ago
I'm not on GLP-1s, but I've been looking at very seriously because something I can't "fix on my own" is just... always feeling hungry. That's just how my body works. Exercise doesn't help; there's no reasonable amount of exercise that will help with my office-worker stomach wanting 3000 calories a day. So far through my life I've just lived with it and managed my diet as best I can and it just absolutely sucks.
- saberience 4mo ago
  [flagged]
  - SpaceNugget 4mo ago
    They said exercise doesn't help them with reducing the feeling of hunger. I don't know why they thought it would, because generally if you do a lot of exercise you get more hungry not less hungry, but regardless, you are responding to something that wasn't said.
    - crooked-v 4mo ago
      My meaning was more that indulging in that hunger would result in me just eating an exorbitant number of calories, way past anything it would be reasonable to burn off without spending 4 hours a day every day in the gym... but you're completely right that even if I did spend that time in the gym it wouldn't help with the calories-in-calories-out equation, because it would just make me more hungry.
  - Aaargh20318 4mo ago
    The problem with exercise is that our bodies are quite efficient with their energy usage. A few minutes of ‘calories in’ takes many hours of ‘calories out’ to burn. You can’t really exercise enough to offset the food you can eat in a day, even if you somehow were able to dedicate all your time to exercising you would still have to limit your food intake. Add to that the fact that exercise is mind numbingly boring and you have to conclude it is not a practical solution at all.

9x39 4mo ago

If they were a normal weight they would not have been prescribed the drug. The underlying issue is they're overweight because they eat too much. Anything more is speculation. There is usually no free lunch when it comes to pharma, and extrapolating long term or lifetime dependence as being equivalent to short term interventions is an unsupported leap.

Aaargh20318 4mo ago
That’s the problem with these new weight loss drugs. Ultimately they work by reducing food intake. For many people food is one of the few things in life that gives them some form of joy. I won’t ever take any drug that will take that away from me. Life is depressing enough as is. What we need is a weight loss drug that lets you eat unlimited amounts of food, preferably even suppressing the feeling of fullness, without gaining weight.
- JumpCrisscross 4mo ago
  > that will take that away from me They don’t stop eating, just overeating. Getting joy from food is different from self medicating with overconsumption. (For the record, I love food. I also don’t have an issue maintaining a healthy weight and physique.)
  - cflewis 4mo ago
    This is it. I am on GLP-1 (Zepbound). I have done Weight Watchers multiple times. I'd lose the weight for a little bit, then it would come back. The reason was _I was hungry all the time_. It's not sustainable. As someone else in WW told me: "The easy bit is losing the weight. The hard part is continuing to eat that way your whole life." It's simply a faulty hunger sensor in my body. It was not what I was eating, simply how much. GLP-1s fix the sensor. It's really simple. Nothing else to it. I still enjoy food (although my palette has turned away from anything greasy, which is for the better anyway), but I can finally understand why someone would eat half a plate of something and say "I'm good" and actually mean it rather than trying to diet/starve themselves.

hamhock666 4mo ago

If you can find a way to use your own free will and self-discipline to stop the bad condition then that seems preferable to using a drug. Maybe someone doesn't have the willpower in which case it's good that we have the drug. With regards to omeprazole, I changed my diet a bit and no longer needed the omeprazole. I don't know exactly what it was, but if you can get off of a drug because you don't need it anymore that seems ideal.

paulddraper 4mo ago
I mean…that’s just like depression medication. It’s possible to ignore sadness as well as hunger.
- hamhock666 4mo ago
  There are usually ways to fix the problems in your life, like sadness and hunger, without resorting to using drugs. Maybe not everyone but it is something we should strive for.
  - tuckerman 4mo ago
    Why is that something to strive for though? Maybe for some people that mental energy is better spent everywhere. If there is a simple and safe pharmaceutical solution for a problem, that sounds like great progress to me!
  - habinero 4mo ago
    Why? There's zero prizes for unnecessary struggle. It doesn't make you a better person, it just means you struggled more.
wpm 3mo ago
> Maybe someone doesn't have the willpower in which case it's good that we have the drug. This is all that needs to be said and this is also not that profound of a point. It's literally just harm reduction. Why do people have such a problem with harm reduction? Why do they feel the need to feel oh-so-smart and point out "weeellll acccktschually there is still some harm so its better if you didn't need the harm reduction therapy and instead just i dunno magically not require it"

htk 4mo ago

No, the symptom is being treated, not the underlying issue. And that's ok, but treating the underlying issue, when possible, is better, as the problem ceases to exist.

crooked-v 4mo ago
For many people, the "underlying issue" is fundamentally just being too hungry for how they live. GLP-1s absolutely treat that.
- faangguyindia 4mo ago
  for many people the underlying issue is serious lack of education when it comes to nutrition. Not understanding calorie balance, not understanding calorie density of the food they eat. How many people know 1kg fat = 7700kcal that if they could create deficit of 7700kcal they could potentially lose 1kg bodyfat? Ofc, i know the relationship isn't that simple but for most people this roughly holds true. If you are eating granolas in breakfast, it may come across as a shock how many calories they pack, go ahead look it up many people believe that's a low calorie health breakfast option. Many people don't know 1g of carb or protein = 4kcal 1g of fats = 9kcal.
  - crooked-v 4mo ago
    Being aware that there are deceptively calorie-dense foods doesn't help the basic equation there. Anecdotes are not data, but my anecdotal experience is that if I ate nothing but bulk vegetables whenever my hindbrain wanted food, I would still be eating over my maintenance calories every day.
    - faangguyindia 4mo ago
      What's your maintenance calories and how did you calculate it? Most people calculate it wrong.
      - 4mo ago

soared 4mo ago

Omeprazole is not great long term FYI - worth talking to your doctor or getting a second opinion to discuss.

catigula 4mo ago
I’ve been taking high doses long term for over a decade and I don’t really have any substantial issues.
- dotcoma 4mo ago
  Good for you, but this mere fact does not mean it’s ideal. Not a doctor, but I would at least try to look into this. Best of luck!
  - catigula 3mo ago
    Why do you think I haven’t looked into it? You’re not providing anything of note, so merely saying “I’ve looked into it. I’m good” seems like it’s the correct reply.
- derekja 4mo ago
  The primary concern is reduced stomach acid leading to nutrient deficiencies, particularly b12. There have been some long term studies correlating to dementia as a result. And some studies that have not found this. So the jury is still out, but keeping an eye on some nutritional markers is not a bad idea.
  - catigula 3mo ago
    The dementia meta-analyses are a wash. It doesn’t lean strongly either way. I wouldn’t worry about it.
- mapkkk 4mo ago
  Definitely not a good idea to be on it longer than 2 months. If we can't treat the underlying condition and the patient needs life-long acid suppression therapy, we switch to H2 receptor antagonists, like cimetidine. Long term PPI use has non-trivial risks, including magnesium and other micronutrient deficiencies, and can lead to things like SIBO and other primarily gut related morbidity. I would definitely suggest sitting down with your doctor if you were not specifically instructed to take it for that long.

ElProlactin 4mo ago

> People take depression meds, blood pressure meds, all kinds of meds for their whole life. And a lot of these medications have side effects that can affect quality of life negatively in other ways. That doesn't mean they're not helpful, or shouldn't be taken. But the "no free lunch" rule usually applies, sometimes to a noticeable degree.

ab5tract 4mo ago
And? It’s not like those of us on lifetime-prescriptions have any real choice in the matter. Oh, there’s consequences? One of those is an almost universal weight gain measured in the dozens of kilos? You want help with that? Sorry, it’s against Calvinist/puritan morality to help you with that by providing a medicine to counteract that. You need to do it the hard way (regardless of the statistics that show you will just be obese now until you die thanks to the meds which, I maintain, that you must take).
wpm 3mo ago
OK, so is the point being made that "drugs have side effects"? Wow. I had no idea. Come on, why is it that whenever GLP-1s come up on this site, the comments are filled with people helpfully pointing out this fact as if no one knows it already?
- ElProlactin 3mo ago
  > ...the comments are filled with people helpfully pointing out this fact as if no one knows it already? First, I don't personally have it out for GLP-1s specifically. Second, here's the thing about side effects: there are a good number of examples across multiple categories of drugs showing that some people experience side effects doctors and pharmaceutical companies have insisted aren't real or are exceedingly rare, with evidence later showing this not to be the case. For instance, there is a growing body of evidence that a subset of people who take SSRIs experience life-altering sexual dysfunction that persists long after the SSRIs are discontinued. Up until fairly recently, that this was happening at all was basically dismissed by all but a small number of practitioners. Now, there's a name for this and even some warning labels. In the US, which is only one of two developed countries in the world that allows pharma companies to advertise directly to consumers, there are huge incentives to minimize side effect profiles and even to bias clinical trials so that benefits are exaggerated and downsides are underestimated. https://jamanetwork.com/journals/jama/fullarticle/198809 https://jamanetwork.com/journals/jama/fullarticle/198809

Netcob 4mo ago

Because usually you can't study long-term effects before releasing a drug, and even then it can take a long time for them to surface. I took antihistamines basically throughout my 20s. My allergy specialist said there's no reason not to. I developed some other issues and wanted to stop taking antihistamines to see if that would help (or get a hint whether they were causing it) - but that got me into itching hell for weeks. In some online forums people reported the same and shared ways to get out of that "addiction" without going insane from itching. My doctor didn't want to believe it and there was no research on it. That only appeared a few years later in the form of a paper called "Unbearable Pruritus After Withdrawal of (Levo)cetirizine" (2016). In the US, the FDA issued a warning in 2025, which is also the time when I heard about it. None of the doctors I went to back then reported this to anyone, so I'm surprised it got discovered at all. As for my other issues I have no way of knowing whether they had anything to do with long-term antihistamine use. I'm a sample size of one, and none of the other stuff is quite as clear-cut as "unbearable itching". I've had other issues with prescription drugs that didn't make the official list of side-effects and sometimes those side-effects don't just go away once I stop taking the drug. That's why I'm very cautious when trying drugs I never had before, and even more so when it comes to taking them long-term.

Obscurity4340 4mo ago
Do you think going thru an allergy shot regime from an MD allergy Dr is a viable alternative to actually dealing with the undelying allegie(s)? Seems like the issue is unsettled last Inchecked
- Netcob 4mo ago
  Do you mean "hypo-sensitization" aka "allergen immunotherapy"? I tried that too but couldn't really tell whether it worked either. My experience was about antihistamines, which are definitely effective.
  - Obscurity4340 3mo ago
    But how long was your regime before you turned back to antihs? My impression was it was weekly at first for 1-few months then monthly for like 5 years. Wish i had started like yestercade :(

herbst 4mo ago

I know several people who stopped both of your examples and only used them for a while until the underlaying issues got fixed. I am just in the progress of stopping with anti depression meds. Without bigger issues. Maybe in America you do, here in Europe I am not so sure about that

jbaber 4mo ago

First, I agree with your comment. But since you specifically bring up omeprazole: I backed off of pantoprazole by getting a prescription for half-dose pills (since they're time released, you can't just cut them in half), then decreasing frequency (alternating days, then tapering off) and retained the benefits. There are plenty of confounding factors in my case, but checking occasionally if you can back out of a drug is worthwhile.

spicyusername 4mo ago

Because it's pretty likely some of these have negative long term effects. And some of those long-term effects are probably pretty serious. Many people taking these kind of drugs are gambling with their well being. No doubt that in many cases that gamble is worth it. But issues that can be solved with non-pharmaceutical solutions, such as with weight loss and lifestyle changes, are really better solved that way if possible. There's no risk of longterm effects and it helps foster a larger culture of healthy living in society generally, reducing the lilihood of the problem in the general population.

fooker 3mo ago
The negative long term effects are unlikely to be worse than the negative long term effects of obesity.
credit_guy 4mo ago
> Because it's pretty likely some of these have negative long term effects. And some of those long-term effects are probably pretty serious. > Many people taking these kind of drugs are gambling with their well being. No doubt that in many cases that gamble is worth it. You use the word "gamble" and it is correct, but the connotation is a negative one. We take a risk in everything we do. We seldom know the long term effects of anything. Right now I drink tea, and I drink tea quite often. Is this healthy? Does it have long term negative effects? With GLP-1 medications, deciding to not take one, if you are overweight, is also a gamble. A pretty huge one. Obesity very often leads to type-2 diabetes, and the first step is prediabetes. Should someone with high BMI and high A1C avoid GLP-1 because we don't yet know the long term effects? We do know the long term effects of being overweight.
estearum 4mo ago
> Because it's pretty likely some of these have negative long term effects. And some of those long-term effects are probably pretty serious. No, it's really not "pretty likely." These drugs are extremely well studied, have been for a long time across now hundreds of thousands of clinical trial participants over decades. The downsides of obesity however are immense. Far, far worse than people intuit. Agreed non-pharmaceutical interventions are preferable when they work. But it turns out – empirically – that it's very hard to implement these successfully.

butlike 3mo ago

But isn't the point to not have to be tethered to a medication forever?