I've been seeing headlines about most people regaining all of the fat lost, and more, when they finally go off those drugs. Such is the case with any appetite suppressing modality or intense...
When Americans begin taking appetite-suppressing drugs like Ozempic and Wegovy
I've been seeing headlines about most people regaining all of the fat lost, and more, when they finally go off those drugs.
Such is the case with any appetite suppressing modality or intense calorie restriction.
It has a lot to do with whether you can tolerate the side effects in the first place and continue to do so, and afford the medication long term. Many of the initial studies sort of ignore the...
It has a lot to do with whether you can tolerate the side effects in the first place and continue to do so, and afford the medication long term. Many of the initial studies sort of ignore the percentage of people that quit and why. This one was just an abstract so idk what it considers.
Personally being on a med that fucks up my appetite half the time is miserable. I wouldn't go on a long acting med for weight loss anyway, but I am not surprised people quit.
Seems like that description covers a lot of drugs available today, like psych meds. Psych meds mostly suck, we all know they do, people cant stay on them cause they suck and they’re expensive, but...
Seems like that description covers a lot of drugs available today, like psych meds.
Psych meds mostly suck, we all know they do, people cant stay on them cause they suck and they’re expensive, but the alternative is being crazy so a lot of people use them anyway.
I guess here the alternative would be “being overweight” and all the medical nuance that comes with cause like also for a lot of people “being crazy” could be resolved without meds if only they had access to things like not having to work for a soulless corporation and deal with rude people all day. Being overweight could be resolved without meds if people had access to better food and cities were more walkable. But they don’t, and they’re not, so Ozempic it is.
As someone with a fairly walkable city and great access to better food (Australia) ironically, the key to my weight problems is probably also “not having to work for a soulless corporation and...
like also for a lot of people “being crazy” could be resolved without meds if only they had access to things like not having to work for a soulless corporation and deal with rude people all day.
Being overweight could be resolved without meds if people had access to better food and cities were more walkable. But they don’t, and they’re not, so Ozempic it is.
As someone with a fairly walkable city and great access to better food (Australia) ironically, the key to my weight problems is probably also “not having to work for a soulless corporation and deal with rude people all day” — there are very few actual barriers to me being able to buy fresh veggies and cooking healthy for myself, except for the fact that at the end of the day, I’m exhausted and have very little energy left to put towards planning or cooking better meals.
hahaha, I feel that. Also that 1500 calories in a meal greasy ass burger is so good after a whole day of working for said soulless megacorp. There are other things that feel good, but man, that...
hahaha, I feel that. Also that 1500 calories in a meal greasy ass burger is so good after a whole day of working for said soulless megacorp. There are other things that feel good, but man, that just hits the spot.
Yes, and as we all know the two options are appetite suppressants for life or death at 40. I'm not interested in hyperbole or hearing how I'm five seconds from keeling over today, thanks.
Yes, and as we all know the two options are appetite suppressants for life or death at 40.
I'm not interested in hyperbole or hearing how I'm five seconds from keeling over today, thanks.
Not my intention to speak about you directly, and it slightly irks me you thought I did. Even so, I apologise for making you feel targeted. Fact of the matter is that this drug saves lives and...
Not my intention to speak about you directly, and it slightly irks me you thought I did. Even so, I apologise for making you feel targeted.
Fact of the matter is that this drug saves lives and reduces the risk of obesity related diseases such as, but certainly not limited to, a significantly elevated risk of heart failure at 40 and up.
There is clearly more nuance behind the statement of my previous post and I thought the short post sufficed but your personal judgement clouded the intent. That is not a slight, but on me for not realising I could unintentionally elicit such response by being needlessly taciturn.
No, you didn't target me, though I'm in the category of people you are talking about. I was being preemptive because I've had these conversations before. I'm not interested in all of the nuance...
No, you didn't target me, though I'm in the category of people you are talking about. I was being preemptive because I've had these conversations before.
I'm not interested in all of the nuance being flattened into taciturn statements. And it does sound incredibly dismissive to all of the concerns people have, financial, psychological and medical, to taking the drugs to flatten it to "well better than a heart attack by 40."
I could reply with "better a heart attack by 40 than suicide by 35.". Those are not the only two options.
Unfortunate you would feel the need to preempt and assert a position for me. I would prefer you didn't. You'll find me far more reasonable if you had just asked. It's clear this topic puts you on...
Unfortunate you would feel the need to preempt and assert a position for me. I would prefer you didn't. You'll find me far more reasonable if you had just asked.
It's clear this topic puts you on defense and, as we would say in the Netherlands, I can't sail this land with you. So I'll drop it and refrain from broaching this topic with you.
I do not clock/retain most folks usernames so it wasn't personal for whatever that is worth. It was a response to that lack of nuance. I appreciate your preference, my response is based on...
I do not clock/retain most folks usernames so it wasn't personal for whatever that is worth. It was a response to that lack of nuance. I appreciate your preference, my response is based on multiple conversations on Tildes going in precisely that direction regardless of how I ask. I'll make the attempt to notice you specifically in the future
I would imagine the majority stop less from the side effects, and more that people just aren't normally inclined to 1) feel comfortable to stick themselves with needles (or even have others do...
Many of the initial studies sort of ignore the percentage of people that quit and why. This one was just an abstract so idk what it considers.
I would imagine the majority stop less from the side effects, and more that people just aren't normally inclined to 1) feel comfortable to stick themselves with needles (or even have others do it), and/or 2) keep up with the weekly cadence.
I found that the side effects kind of sucked for the first two months (mostly gas), but after that became pretty manageable, but to each their own. The appetite suppression is my favorite part, I like the feeling of being pretty well satiated throughout the day - and it makes my enjoyment of really good things just a little bit better when I get a major craving for it (like gryos, or dark chocolate pudding). Makes the things worth eating, just a little bit more enjoyable.
I'm not sure anyone has actually studied a lot of the "whys" but the side effects were cited in one study near the beginning and I haven't seen much since. Usually those folks are just mentioned...
I'm not sure anyone has actually studied a lot of the "whys" but the side effects were cited in one study near the beginning and I haven't seen much since. Usually those folks are just mentioned as drop outs and moved on from.
My appetite being suppressed is absolutely the worst part of my Adderall and I pay for it daily when I end up with a headache and stomach ache and still don't want to eat, as I usually end up skipping lunch and not drinking enough water. I'm sure it works for folks, but it would be misery for me.
Oh, the appetite suppression on Adderall is very different than on these meds in my case. On Adderall, it's kind of nausea induced suppressant, whereas w/ Tirzepatide it's just... not there. No...
Oh, the appetite suppression on Adderall is very different than on these meds in my case.
On Adderall, it's kind of nausea induced suppressant, whereas w/ Tirzepatide it's just... not there. No appetite until I am actually hungry.
Conversely, a lot of antidepressants and mood stablizers I've been on basically smash the "You're full" switch with a hammer. Even with the most begnin medicines, long term complaince is an issue,...
Conversely, a lot of antidepressants and mood stablizers I've been on basically smash the "You're full" switch with a hammer.
Even with the most begnin medicines, long term complaince is an issue, even when ignoring costs or inconvienience.
An awful lot of people just have a subconcious "whelp, I don't need that anymore" attitude to meds that are working long term, because they don't realize how much the meds are helping.
I think it stands out the most with bipolar and schizophrenia for sure, because of how quickly people can decompensate due to mania or delusions. Depression is probably more common but less...
I think it stands out the most with bipolar and schizophrenia for sure, because of how quickly people can decompensate due to mania or delusions. Depression is probably more common but less obvious from the outside.
I never had that reaction to anti-depressants but our management of side effects with mental health meds is particularly poor IMO.
Even just remembering to take a pill daily (or shot weekly) can be hard for folks with busy lives, executive dysfunctions, and other people they're responsible for.
But the Adderall doesn't give me nausea at all, it makes me uninterested in food, but not full, with no real internal hunger cue. When my body starts reacting with physical signs of hunger it can turn into a nauseated feeling but usually it's more of a light-headed stomach ache situation. One that's hard to resolve not being hungry. Similarly I'll drink water if it's in front of me but not go get it. Having that last for a week would be hell on my ability to recognize my hunger and thirst and respond appropriately
That makes a lot of sense - I guess my thinking is that for those who can tolerate it long term, it seems like doing so is a solid option from a health outcomes perspective. For those who can't,...
That makes a lot of sense - I guess my thinking is that for those who can tolerate it long term, it seems like doing so is a solid option from a health outcomes perspective. For those who can't, or just don't want to, they stop taking it and the question is kinda moot anyway because at worst they're back where they started after a relatively short attempt.
I dunno, a lot of the mainstream coverage I see about regaining weight after cessation just has a bit of a "see, that's cheating, it wasn't real weight loss because it's undone if you stop taking the meds" tone to it, and that's part of what motivates me to keep an eye on the "why not just keep taking it?" option. (Not accusing you of that, @BeanBurrito, it's a reasonable question to bring up in and of itself, that's just the subtext I tend to get from the way those pieces are often written).
In terms of cost (and insurance - @IarwainBenAdar's point about being cut off is an interesting, if disappointing one), the wholesale price even for the branded Novo Nordisk stuff is only actually $100/month or so, and mass manufactured generics should come out substantially cheaper than that. Obviously small comfort to US patients who can't avoid the 10x markups here and now [edit: although maybe less of an issue now, looking at the additional replies below?], but it's going out of patent in a few major markets this year, and globally in seven years. Which isn't a short time, sure, but it's not that long in the context of population-level health interventions either, so it seems reasonable to look ahead to a world where it's potentially a lot more prevalent if we want it to be.
I'd argue that isn't the "at worst" - you can fuck up your hunger cues and have some psychological side effects especially if you have a history of disordered eating. But even $100 a month is out...
I'd argue that isn't the "at worst" - you can fuck up your hunger cues and have some psychological side effects especially if you have a history of disordered eating.
But even $100 a month is out of reach for many people and if your insurance goes from covering it to not due to your A1C or weight going below a threshold suddenly you're cut off without a step down.
I'm not coming from a "it's cheating" perspective, and most critics of IWL and the diet industry as a whole aren't. It's far more about pretty much all weight loss products lying about or hiding side effects, how many people keep the weight loss off long term, and how many people continue the intervention after 2+ years. And the bonus fat phobia inherent in the system. No one cares if you're healthy, they care if you're fat. As long as you're thin, you can be unhealthy as hell, and if you lose weight in an unhealthy way (like anorexia) you're still praised for it.
Those aren't criticisms of the people using the drugs, they're criticisms of the industry and society. I can be opposed to IWL and the industry and also not judge people for their actions with their own body. I will judge how every decade or two we get a magic diet pill with big claims (it fixes gambling addiction AND being fat) and little acknowledgement of, for example, how folks on ozempic might need to force themselves to eat, not just take the lack of appetite as a sign that they're good to starve their bodies or that this other pill will give you massive diarrhea or that this other one is literally amphetamines.
I don't want it to be more prevalent. I don't think it's a good goal. But again not because it's cheating, because I lived through the 90s and the era when the slightest stomach pooch is a sign you're a disgusting fat. I want to exist in my body without other people who aren't my dietician or my doctor insisting on telling me how they know what's best for me including ignoring when I ask or tell them not to. And the ozempic era has only been making that worse, not better.
I'll fully accept I wasn't considering the potential psychological impact of a "failed" short term try - I'll take that on board, it makes sense and it's something that's obliquely familiar to me...
I'll fully accept I wasn't considering the potential psychological impact of a "failed" short term try - I'll take that on board, it makes sense and it's something that's obliquely familiar to me in the context of other medication.
Cost, I probably wasn't being super clear there: if Novo Nordisk are willing to sell it for $100/month while they still have the monopoly, it's going to be $20-30/month when competition from other major manufacturers is on a secure legal footing. I'm looking a few years ahead more than I'm looking here and now. I wasn't at all meaning to suggest you were calling it cheating either - didn't even realise I'd implied it, or I would've said that disclaimer was pointed in your direction too!
I hear you on the societal effects, and frankly you're probably right. My faith in... anything working out in any way other than the maximum monkey's paw is pretty low right now anyway. Looking at the inexorable climb of obesity and related conditions, with the whole complex web of socioeconomic causes driving it, all the numbers I've seen suggest that extremely widespread use of these type of drugs really will save very substantial numbers of years of people's lives - and from the conversations I've had with the (surprisingly large) number of people I know taking them, from hearing how pleased they are to have the option, my gut (no pun intended) still does say to me that more availability is a good thing.
But then I don't have a real way to offset that good against the constant dents in people's mental health if that availability leads society as a whole to become even more unpleasant about each others' bodies. It's a real problem, with a fair probability of happening, and a high likelihood of being ignored if it does. I'm kind of inclined to think that people will just find a different axis to be shitty to each other on if this one changes, so it might shift who's targeted but not the net amount of interpersonal shittiness in the world, but perhaps that's a cop out. I honestly don't know, but I do appreciate the perspective.
Yeah look if folks want to take it, they do what's best for them. I just don't want people to feel pressured into taking medication because society makes them feel like shit all the time. I had an...
Yeah look if folks want to take it, they do what's best for them. I just don't want people to feel pressured into taking medication because society makes them feel like shit all the time. I had an experience on an airplane last week that reminded me that despite fitting in the seat and seatbelt fine and having broad shoulders (so I kept my arms crossed most of the flight ) my body shape doesn't let me use the tray table at all. It sucks. And I see so little care for the impact of that sort of thing. among the "well actually it's better for you to lose weight no matter what" crowd.
My partner takes ozempic and I don't begrudge him doing it at all, and it's managing his diabetes magnificently. Losing weight will help him manage his paraplegia better and technically make my life easier, but I don't want him to feel he has to do any of that. But his heart and blood work are otherwise fine, and losing weight won't fix his primary disability which is the one thing he'd really want.
I am not personally convinced that it is a long term healthy option to simply suppress someone's appetite, but I don't have to be. I just want folks to see this larger picture and not make blanket statements about "this or a heart attack" basically.
The worst is that they end up with more excess fat than before. That is often the case with appetite suppressant and harsh calorie restriction. Not the vibe I got nor the vibe I intended. My...
at worst they're back where they started after a relatively short attempt
The worst is that they end up with more excess fat than before. That is often the case with appetite suppressant and harsh calorie restriction.
I dunno, a lot of the mainstream coverage I see about regaining weight after cessation just has a bit of a "see, that's cheating,
Not the vibe I got nor the vibe I intended. My motivation in writing was to make a warning.
Long term weight loss involves behavioral and attitude changes. Given the cost of surgery & drugs, it begs the question of why not just straight to working on behavioral and attitude changes, perhaps using part of the money spent on drugs or surgery for really good support programs for changing behavior and attitude?
The problem with this is that the drugs are really expensive, and from what I’ve heard the insurance company will cover it until they hit an ‘ideal’ weight, then they cut you off and when the...
The problem with this is that the drugs are really expensive, and from what I’ve heard the insurance company will cover it until they hit an ‘ideal’ weight, then they cut you off and when the cravings come back they regain all the weight or more.
It's gotten much cheaper. The pill can be had on Amazon now for $150/month without insurance. Yes, without insurance. And yes, the real deal Wegovy sold by Novo Nordisk, not a fake or third party.
It's gotten much cheaper. The pill can be had on Amazon now for $150/month without insurance. Yes, without insurance. And yes, the real deal Wegovy sold by Novo Nordisk, not a fake or third party.
Not as expensive as one would think, the actual manufacturing and production is cheap. You can buy the exact same material on the 'grey-market' legally for 'research purposes' (that is even...
Not as expensive as one would think, the actual manufacturing and production is cheap.
You can buy the exact same material on the 'grey-market' legally for 'research purposes' (that is even independently lab graded and checked for purity!).
All you have to do is add bacteriostatic water ($5 for a bottle that lasts years) or reconstitution solution (say that out loud, its intoxicating just how much fun it is), and the peptide (the grey-market ozempic/tirzepatide/zepbound/etc) this can easily be found in a ten pack of 30mg vials (or about a years worth of weekly injections), for just around $200 (or, ~$20 a month), and that's the grey-market making a lot of profit on each sale. I will not source this for anyone in the comment section, but I know some reputable sellers and if you're research-inclined, or curious, you can PM me.
The only reason for the current cost direct from the manu is the insurance companies (and the money the manufacturer can make off of them). Once generics hit the market, which is the same formulation as the grey-market, the overall price will absolutely drop to less than $15/month, and the grey-market will inevitably be sub $5/month.
The generics will be on the market sooner than you would expect (so no need for the grey-market), especially if a country in the EU, or Canada, make it so.
Wow, that's an incredible price drop. Will those turn up for sale in the EU as well, if they're made there, or will they be locked behind prescriptions?
Wow, that's an incredible price drop. Will those turn up for sale in the EU as well, if they're made there, or will they be locked behind prescriptions?
Initially when it was released there was a huge shortage (due to overwhelming demand), but now competitors have emerged and production capacity has exploded, so prices have been cratering.
Initially when it was released there was a huge shortage (due to overwhelming demand), but now competitors have emerged and production capacity has exploded, so prices have been cratering.
I sort of dislike the way people talk about gaining fat back, as if it just automatically comes back no matter what you do. The problem is you need to pair whatever you used to lose the fat with...
I sort of dislike the way people talk about gaining fat back, as if it just automatically comes back no matter what you do.
The problem is you need to pair whatever you used to lose the fat with actual lifestyle changes.
It's frustrating watching people talking about this aspect and not mentioning lifestyle changes.
I'm not a fan of Ozympic if for no other reason than most of the people I know who went on it now look sickly and skeletal.
Looking at them and examples in the entertainment industry, if I were to go on Ozympic to lose some weight, I would have a target weight and gameplan for lifestyle changes for when I got to that weight, as well as an ideal BMI.
Plus, you still have a net loss in vast majority of cases, those who end up gaining back the weight only regain 75% of the weight, very few gain it all back. You still lose a decent chunk, and its...
I sort of dislike the way people talk about gaining fat back, as if it just automatically comes back no matter what you do.
Plus, you still have a net loss in vast majority of cases, those who end up gaining back the weight only regain 75% of the weight, very few gain it all back. You still lose a decent chunk, and its after a period of about two years to reach that point. It's not instant, its a slow return to a better state than you were previously.
Slight tangent on the ones who are making this seem like a drug-addled, life-throwing away, choice to take it- but, if someone stops taking their blood pressure meds their blood pressure goes up. Stop taking your antidepressant? Guess what - the depression comes back. Cholesterol medication? yep, you have high levels of cholesterol. It's almost like weight-management or weight-loss treatment, is a treatment, not a solution.
I wear glasses every day, otherwise I am pretty blind to the world, I'm not going to stop wearing them because I live in fear of having to wear them everyday.
It is the same with gastric bypass surgery, appetite suppressants, or any other enforced significant calorie reduction. A few disciplined people escape that fate. It even happens to gastric bypass...
It is the same with gastric bypass surgery, appetite suppressants, or any other enforced significant calorie reduction. A few disciplined people escape that fate. It even happens to gastric bypass patients who get counseling before the surgery.
I don't mention it to be a party pooper, but it begs the question that if behavior and attitude changes are needed to make those things work why not just seek out very supportive programs for behavior change ( and spare your body & wallet those other modalities ) - like going to weight watchers support groups?
I mean, that begs the question of why the obesity rate keeps increasing despite the fairly widespread knowledge in the populace of what it takes to lose weight. Weight watchers has existed for a...
begs the question that if behavior and attitude changes are needed to make those things work why not just seek out very supportive programs for behavior change
I mean, that begs the question of why the obesity rate keeps increasing despite the fairly widespread knowledge in the populace of what it takes to lose weight. Weight watchers has existed for a long time. Ozempic has managed to caused the obesity rate in the US to decrease after just a few years.
In practice, it seems that once you put on weight, it’s very difficult to change that habit. It’s a one way trap door. If medication can help people overcome that, then considering the health and quality of life benefits, it seems good to pursue.
Then they will continue to on the drug for the rest of their life. It’s no different than blood pressure medication. The cost is already quite low, and will only get lower when Novo Nordisk’s...
Then they will continue to on the drug for the rest of their life. It’s no different than blood pressure medication. The cost is already quite low, and will only get lower when Novo Nordisk’s patent expires in about 5 years.
For their sake I hope so. It has been my observational experience that the body does not like drastic calorie addiction and eventually the metabolism will catch up ( crank down ) to make up the...
For their sake I hope so.
It has been my observational experience that the body does not like drastic calorie addiction and eventually the metabolism will catch up ( crank down ) to make up the difference.
Because $150 a month and taking a pill is much cheaper, easier, and faster than attending the support groups and therapy needed to achieve the same thing? I'm doing it the way you suggest, but...
Because $150 a month and taking a pill is much cheaper, easier, and faster than attending the support groups and therapy needed to achieve the same thing? I'm doing it the way you suggest, but it's definitely not cheaper, faster, or easier.
Where weight loss is concerned, statistics say that "permanent" lifestyle change is very rare. It might be the case that obesity creates a lifelong problematic relationship with food in some people.
Where weight loss is concerned, statistics say that "permanent" lifestyle change is very rare. It might be the case that obesity creates a lifelong problematic relationship with food in some people.
Indeed. Excess fat intensifies feelings of hunger, reduces the amount of time it takes for hunger to manifest, and increases resistance to satiety. You eat more, more often, and are less satiated...
It might be the case that obesity creates a lifelong problematic relationship with food in some people
Indeed. Excess fat intensifies feelings of hunger, reduces the amount of time it takes for hunger to manifest, and increases resistance to satiety. You eat more, more often, and are less satiated afterwards when you are overweight.
For some people, losing weight and returning to a healthy level of body fat does not reverse these effects. That is to say, for some formerly obese people, the effects on their hunger and satiety are permanent.
From what I remember from a graduate lecture, generally gaining adipose tissue can/often increases your permanent defended weight (aka the natural equilibrium weight your body will target). AFAIK,...
For some people, losing weight and returning to a healthy level of body fat does not reverse these effects. That is to say, for some formerly obese people, the effects on their hunger and satiety are permanent.
From what I remember from a graduate lecture, generally gaining adipose tissue can/often increases your permanent defended weight (aka the natural equilibrium weight your body will target). AFAIK, the only current treatment that has consistently worked in permanently lowering the defended weight is some sort of gastric bypass/vertical sleeve gastrectomy.
I always have to remind myself that even though I've got my own hang-ups about food, I'll never really be able to understand what it's like to look at food as a source of comfort. If anything, my...
I always have to remind myself that even though I've got my own hang-ups about food, I'll never really be able to understand what it's like to look at food as a source of comfort. If anything, my former career as a chef makes food more of a source of stress and something that's only meant for paying customers.
You're right that it takes permanent lifestyle changes to keep the weight off permanently, but beyond just being overwhelmed trying to learn what a healthy diet and activity level looks like, the root issue might come down to a deeper relationship with food and how someone copes with stress, likes to show or be shown love, etc.
With so much conflicting information and downright misinformation in the health and fitness industry, it's easy to see why nobody wants to listen to boring advice like "just do a bit of activity every day and try to eat healthy most of the time" and chases the quick fixes instead. It's easy for me to say that, but how does someone who might have been surrounded by disordered eating their whole life learn those things on their own?
There can also be a biological component to it. To give a (somewhat odd) anecdotal example, I have two dogs who have very different reactions to stress, like visiting the vet or a stranger...
There can also be a biological component to it.
To give a (somewhat odd) anecdotal example, I have two dogs who have very different reactions to stress, like visiting the vet or a stranger knocking on the door. One of them is soothed by being petted/held, while the other is soothed by food. If I soothe them the wrong way, they will continue to freak out. Both dogs are the same breed, from the same breeder, and both raised together the same way, yet they have entirely different mechanisms for coping with stress.
It's not that simple, for example the gut microbiome can send signals to you brain, telling it to start craving even specific types of food. Also your gut can digest different kinds of food with...
It's not that simple, for example the gut microbiome can send signals to you brain, telling it to start craving even specific types of food. Also your gut can digest different kinds of food with different efficiency based on the microbiome composition, making CICO more complicated.
Bad covid fucked up my gut microbiome (this is pretty common, though the symptoms can be completely different), the result was that I had returning stomach pains for almost a year, and I started gaining weight despite eating the same diet the whole time. And I'm sure I did not increase the amount of food because the stomach pains reduced my appetite slightly. In 10 months I gained 10 kg. After that the pain gradually stopped and my weight stabilized. It has been almost 3 years now I think and the weight comes back to that new normal if I get sick and lose a few kgs, going over it is quite hard - the same as it has always been for me, except now the stable weight is 10 kg higher than it was.
I have had my microbiome sequenced before and during this (I have a chronic illness that's closely linked to it) and I did notice a significant temporary raise of bacteria associated with obesity. No idea how exactly it works though. I was on the low end of normal BMI, now I'm in the middle, so I have no idea how hard losing the weight would be since I have no reason to try.
Many technologies are only good so long as they can be provided on a permanent basis. Pull them out from under people and they’ll fall. How well would we survive without our modern comforts and...
Many technologies are only good so long as they can be provided on a permanent basis. Pull them out from under people and they’ll fall. How well would we survive without our modern comforts and tools?
If you can take a GLP-1 for the rest of your life it doesn’t matter that your health would fall apart without it. But any plans to take them for a year and then maintain your new weight aren’t sound.
I think what the conversation above is suggesting is that if you take a glp-1 and cant commit to it, you could end up worse off. The anxiety here is that doctors aren’t taking that into account...
I think what the conversation above is suggesting is that if you take a glp-1 and cant commit to it, you could end up worse off.
The anxiety here is that doctors aren’t taking that into account when prescribing because in the studies the people who “drop out” are no longer monitored.
I’m really bothered that all the headlines and articles keep referring to these medications as appetite suppressants. They were first approved for diabetes, and is described as a medication that...
I’m really bothered that all the headlines and articles keep referring to these medications as appetite suppressants. They were first approved for diabetes, and is described as a medication that lowers blood sugar for diabetes, but suppresses appetite for folks who take it for weight loss. I was on Ozempic for almost a decade to control my chronic hypoglycemia, and it did a decent job of that with the help of some other medications.
There’s not a switch you can flip to make it do one thing for some people and something else for others based on the intention of a doctor. If appetite suppression alone were enough to cause weight loss, there would not be overweight smokers or coffee drinkers.
Does there need to be? A medicine can simply do two things at once, with one of the effects only applicable to certain groups of people. For people with insulin resistance, GLP-1s help insulin...
There’s not a switch you can flip to make it do one thing for some people and something else for others based on the intention of a doctor
Does there need to be? A medicine can simply do two things at once, with one of the effects only applicable to certain groups of people. For people with insulin resistance, GLP-1s help insulin production and suppress appetite. The way it promotes insulin production is glucose-dependent - as such, for patients with normal blood sugar levels, it does not cause insulin overproduction (which would lead to low blood sugar) and only the appetite suppression effect remains
Critically, this does not affect the glucagon response to hypoglycemia as this effect is also glucose-dependent.
Clearly the amount of appetite restriction from GLP-1 medication is far longer lasting and effective than the mild and temporary effects from tobacco and coffee. On an extreme side, certainly meth abusers do not tend to be overweight.
The grocery-study actually has a note in it somewhere near the end, about how people that quit taking the drugs, have their grocery bills go up to even more than they were paying before they...
The grocery-study actually has a note in it somewhere near the end, about how people that quit taking the drugs, have their grocery bills go up to even more than they were paying before they started, and explicitly due to buying unhealthy fat-and-sugar-rich foodstuffs.
Someone else already noted that these drugs need to be used as part of a lifestyle change in dietary and health/exercise habits. Broadly speaking, I think the worst problem with these drugs is that they appeal to exactly the kind of people who either can't--or simply aren't willing--to make those kinds of hard lifestyle changes. They want/need the "quick fix".
I guess it's good to have them available as an option, but they really should be treated as a last resort, right up there with lap-band surgery and the like.
I kind of disagree? Food companies have entire teams of scientists come up with addictive qualities to apply to taste, crunch/mouth feel, smell, colours, packaging, price points, where they are in...
I kind of disagree?
Food companies have entire teams of scientists come up with addictive qualities to apply to taste, crunch/mouth feel, smell, colours, packaging, price points, where they are in the store, link to memories and pleasantness, as escape from harsher and harsher life etc.
We're just single cave persons being pushed and stretched too far.
Yes healthy lifestyles are the goal, but GLP-1 seems like an important and safe way for people defeated by food mega Corp teams to get started towards empowerment and meaningful long term change. It's like wearing a cast or doing the rehab exercises carefully: it's a scaffolding.
For folks who relapse, I wonder if they quit taking GLP-1 willingly or if their insurance ran out. Maybe they felt extra defeated by a system that refuses to help them when it easily can help.
A joke I have seen on social media a lot is that the same people who refuse vaccines, especially for the pandemic, don't have a problem taking a drug that hijacks their metabolism for long periods...
A joke I have seen on social media a lot is that the same people who refuse vaccines, especially for the pandemic, don't have a problem taking a drug that hijacks their metabolism for long periods of time.
Walmart was saying this back in late 2023, that they were (and continue) to see this directly affect them. I can't find it now, but there was a brilliant article at some point that showcased how...
Walmart was saying this back in late 2023, that they were (and continue) to see this directly affect them.
I can't find it now, but there was a brilliant article at some point that showcased how major food and snack producers were working on new 'sugar-like' additives designed specifically to overcome the craving-reduction and appetite suppression of GLP-1s, nasty stuff, but markets will market. Cash is king and all that. If I find it, I will link it here.
I believe this is the article you're referring to: Ozempic Could Crush the Junk Food Industry. But It Is Fighting Back. Note that it's an opinion piece from the New York Times, so the author plays...
Note that it's an opinion piece from the New York Times, so the author plays fast and loose with the facts in order to spin a compelling narrative. The multinational food conglomerates cited are almost certainly concerned about their profit margins, but I don't think selling the moustache twirling villain angle is really the sort of level headed analysis we need in this contemporary, post-truth era.
It wasn't that article, it was talking about a specific set of chemical additives, or modifications of additives, to induce cravings. The research angle is quite interesting from a scientific...
It wasn't that article, it was talking about a specific set of chemical additives, or modifications of additives, to induce cravings. The research angle is quite interesting from a scientific perspective, but the usage of it is certainly something a 'moustache twirling villain' (cough $ociopathic finance bro$) would certainly incentivize and work to use.
Ah, gotcha! I was thinking of this quote in particular when I responded to you: I suppose there could've been some development afterwards (or it was simply missed by the journalist).
Ah, gotcha! I was thinking of this quote in particular when I responded to you:
Given Big Food’s track record, it’s likely that the companies will succeed at finding products Ozempic users crave. But what if they’re too successful? I asked Nicole Avena, a professor of neuroscience at Mount Sinai who studies sugar addiction, if she believed it could be possible for food companies to engineer, intentionally or not, compounds that would make GLP-1 drugs less effective. Avena told me it was plausible. The food industry, she pointed out, has cabinets of formidable reward-triggering compounds with which to experiment. Companies could end up counteracting the drugs to some degree in their efforts to make foods more rewarding, she said.
I suppose there could've been some development afterwards (or it was simply missed by the journalist).
^ I cut out as much fluff as I could. Certainly seems like the explicit goal is to make food that can reignite the harmful food behaviours which GLP-1 users have successfully fought back.
Right now, the industry’s adaptation to Ozempic is in its infancy. A few companies have tested the waters: Nestlé, for example, has started a line of frozen meals targeted at people taking GLP-1s called Vital Pursuit [...]
While Ozempic is threatening to turn off the industrial palate, Mattson believes that industrial foods may just need to be tweaked. Though many ultraprocessed foods and drinks turn off a lot of GLP-1 users, some are breaking through: On GLP-1 forums, people celebrate Fairlife, a line of sweet protein shakes owned by Coca-Cola. And Mattson has already dreamed up an arsenal of other potential winners.
[...] Mattson scientists prepared for me some of its foods tailored to GLP-1 users [...] She explained that she had enriched each NourishFit brownie bite with two grams of whey protein, for maintaining lean muscle mass during rapid weight loss. A peanut-butter swirl would push that protein level even higher. Whey protein can have a grainy texture and chalky off notes, but the NourishFits were defectless, smooth and sweet with remote echoes of cocoa. Approximately one-third sugar and about 15 percent fat, the bite-size portions were “self-limiting,” Sinrod said. Servings could be packaged individually.
Then there was a chicken stick, wrapped in see-through plastic, that looked like a riff on string cheese. “A supercharged mozzarella stick,” Sinrod said. It had 13 grams of protein, and its grill lines were real — for now. (To scale up, the quadrillage, or char marks, might be faked using caramel coloring.) It was a grown-up rendition of a classic kid’s snack, Sinrod said, that an adult could throw in a purse. It tasted felicitously of citrus. (GLP-1 users report craving fresh, acidic flavors.)
^ I cut out as much fluff as I could. Certainly seems like the explicit goal is to make food that can reignite the harmful food behaviours which GLP-1 users have successfully fought back.
Nothing in there sounds particularly nefarious? The examples were… adding whey protein (not even for the taste, the marketing seems to be to “extra protein to counteract muscle loss during caloric...
Nothing in there sounds particularly nefarious?
The examples were… adding whey protein (not even for the taste, the marketing seems to be to “extra protein to counteract muscle loss during caloric restrictions” is which is fair enough - that works, it’s how body builders handle cutting stages)
and, uh, adding lime flavor to things?
Idk, if that’s what the mustache twirlers are doing, I guess I can sleep easy.
Maybe the next avengers movie they can stop the evil plot of the corporations adding fresh citrus flavor to their products.
Okeydoke. I think it's rather sus to expend effort trying to re-addict people to food, after they've successfully received medical intervention to alleviate their addiction. Also, my original...
Nothing in there sounds particularly nefarious?
Okeydoke. I think it's rather sus to expend effort trying to re-addict people to food, after they've successfully received medical intervention to alleviate their addiction.
Also, my original comment was this:
but I don't think selling the moustache twirling villain angle is really the sort of level headed analysis we need in this contemporary, post-truth era.
I was not saying that this is moustache twirling evil. I was saying that the framing of the article -- in my opinion, so apologies if this is not aligned with your opinion -- makes it seem like the food industry is a bunch of moustache twirling villains, even though they aren't. They are, in fact, corporate cogs inside of machines designed to shake the entire world upside-down for its lunch money. Understanding that this is a systemic problem is important; just removing a couple food scientists or corporations does nothing to fix the incentive structure which rewards food manufacturing companies for developing and selling addictive products.
Not really sure what we're debating, so I'ma just bail now.
Again, it’s also simply making food taste better. I’d hardly call a company evil for adding citrus flavor to their food because their consumers like it. Which was the only example in the article...
Again, it’s also simply making food taste better. I’d hardly call a company evil for adding citrus flavor to their food because their consumers like it. Which was the only example in the article of food companies adapting their food to taste better to people on Ozempic - the whey protein shake is going after it from a different angle (and pretty ethically).
What’s the difference between that and a chef perfecting their recipe at their restaurant? By making food taste better, you inherently are making it “more addicting”. Because it tastes better.
Are we really drawing a line at making things taste like lime? That just seems like bizarre fear mongering.
The study, published Dec. 18 in the Journal of Marketing Research, links survey data on GLP-1 [...] with detailed transaction records from tens of thousands of U.S. households. [...]
[...]Within six months of starting a GLP-1 medication, households reduce grocery spending by an average of 5.3%. Among higher-income households, the drop is even steeper, at more than 8%. Spending at fast-food restaurants, coffee shops and other limited-service eateries falls by about 8%.
Among households who continue using the medication, lower food spending persists at least a year, though the magnitude of the reduction becomes smaller over time,[...]
[...]
Ultra-processed, calorie-dense foods – the kinds most closely associated with cravings – saw the sharpest declines. Spending on savory snacks dropped by about 10%, with similarly large decreases in sweets, baked goods and cookies. Even staples like bread, meat and eggs declined.
Only a handful of categories showed increases. Yogurt rose the most, followed by fresh fruit, nutrition bars and meat snacks.
[...]
The study also sheds light on who is taking GLP-1 medications. The share of U.S. households reporting at least one user rose from about 11% in late 2023 to more than 16% by mid-2024. Weight-loss users skew younger and wealthier, while those taking the drugs for diabetes are older and more evenly distributed across income groups.
Notably, about one-third of users stopped taking the medication during the study period. When they did, their food spending reverted to pre-adoption levels – and their grocery baskets became slightly less healthy than before they started, driven in part by increased spending on categories such as candy and chocolate.
Without insurance think 10x that for the name brand. (Other brands, other formulations will be different. But ozempic without insurance is still expensive. This does not consider coupons. )
Without insurance think 10x that for the name brand.
(Other brands, other formulations will be different. But ozempic without insurance is still expensive. This does not consider coupons. )
For the injectable. But the A.I assisted search is pulling up the pill price, which was recently FDA approved, which is $25/month with insurance or $150/month without insurance. That is from Novo...
For the injectable. But the A.I assisted search is pulling up the pill price, which was recently FDA approved, which is $25/month with insurance or $150/month without insurance. That is from Novo Nordisk, name brand Wegovy.
According to clinical trials the pill is +-1% of the effectiveness of the injectable.
I've been seeing headlines about most people regaining all of the fat lost, and more, when they finally go off those drugs.
Such is the case with any appetite suppressing modality or intense calorie restriction.
I'm not fully up to date, but most of what I'm seeing suggests that staying on the drugs is a better option than not taking them in the first place.
It has a lot to do with whether you can tolerate the side effects in the first place and continue to do so, and afford the medication long term. Many of the initial studies sort of ignore the percentage of people that quit and why. This one was just an abstract so idk what it considers.
Personally being on a med that fucks up my appetite half the time is miserable. I wouldn't go on a long acting med for weight loss anyway, but I am not surprised people quit.
I can imagine it sucks, it blunts part of what humans can feel.
Though for most that's likely better than dying at 40 due to heart disease.
Seems like that description covers a lot of drugs available today, like psych meds.
Psych meds mostly suck, we all know they do, people cant stay on them cause they suck and they’re expensive, but the alternative is being crazy so a lot of people use them anyway.
I guess here the alternative would be “being overweight” and all the medical nuance that comes with cause like also for a lot of people “being crazy” could be resolved without meds if only they had access to things like not having to work for a soulless corporation and deal with rude people all day. Being overweight could be resolved without meds if people had access to better food and cities were more walkable. But they don’t, and they’re not, so Ozempic it is.
As someone with a fairly walkable city and great access to better food (Australia) ironically, the key to my weight problems is probably also “not having to work for a soulless corporation and deal with rude people all day” — there are very few actual barriers to me being able to buy fresh veggies and cooking healthy for myself, except for the fact that at the end of the day, I’m exhausted and have very little energy left to put towards planning or cooking better meals.
hahaha, I feel that. Also that 1500 calories in a meal greasy ass burger is so good after a whole day of working for said soulless megacorp. There are other things that feel good, but man, that just hits the spot.
Yes, and as we all know the two options are appetite suppressants for life or death at 40.
I'm not interested in hyperbole or hearing how I'm five seconds from keeling over today, thanks.
Not my intention to speak about you directly, and it slightly irks me you thought I did. Even so, I apologise for making you feel targeted.
Fact of the matter is that this drug saves lives and reduces the risk of obesity related diseases such as, but certainly not limited to, a significantly elevated risk of heart failure at 40 and up.
There is clearly more nuance behind the statement of my previous post and I thought the short post sufficed but your personal judgement clouded the intent. That is not a slight, but on me for not realising I could unintentionally elicit such response by being needlessly taciturn.
No, you didn't target me, though I'm in the category of people you are talking about. I was being preemptive because I've had these conversations before.
I'm not interested in all of the nuance being flattened into taciturn statements. And it does sound incredibly dismissive to all of the concerns people have, financial, psychological and medical, to taking the drugs to flatten it to "well better than a heart attack by 40."
I could reply with "better a heart attack by 40 than suicide by 35.". Those are not the only two options.
Unfortunate you would feel the need to preempt and assert a position for me. I would prefer you didn't. You'll find me far more reasonable if you had just asked.
It's clear this topic puts you on defense and, as we would say in the Netherlands, I can't sail this land with you. So I'll drop it and refrain from broaching this topic with you.
I do not clock/retain most folks usernames so it wasn't personal for whatever that is worth. It was a response to that lack of nuance. I appreciate your preference, my response is based on multiple conversations on Tildes going in precisely that direction regardless of how I ask. I'll make the attempt to notice you specifically in the future
I would imagine the majority stop less from the side effects, and more that people just aren't normally inclined to 1) feel comfortable to stick themselves with needles (or even have others do it), and/or 2) keep up with the weekly cadence.
I found that the side effects kind of sucked for the first two months (mostly gas), but after that became pretty manageable, but to each their own. The appetite suppression is my favorite part, I like the feeling of being pretty well satiated throughout the day - and it makes my enjoyment of really good things just a little bit better when I get a major craving for it (like gryos, or dark chocolate pudding). Makes the things worth eating, just a little bit more enjoyable.
I'm not sure anyone has actually studied a lot of the "whys" but the side effects were cited in one study near the beginning and I haven't seen much since. Usually those folks are just mentioned as drop outs and moved on from.
My appetite being suppressed is absolutely the worst part of my Adderall and I pay for it daily when I end up with a headache and stomach ache and still don't want to eat, as I usually end up skipping lunch and not drinking enough water. I'm sure it works for folks, but it would be misery for me.
Oh, the appetite suppression on Adderall is very different than on these meds in my case.
On Adderall, it's kind of nausea induced suppressant, whereas w/ Tirzepatide it's just... not there. No appetite until I am actually hungry.
That's not my experience with Adderall. I'm just not hungry.
Conversely, a lot of antidepressants and mood stablizers I've been on basically smash the "You're full" switch with a hammer.
Even with the most begnin medicines, long term complaince is an issue, even when ignoring costs or inconvienience.
An awful lot of people just have a subconcious "whelp, I don't need that anymore" attitude to meds that are working long term, because they don't realize how much the meds are helping.
It's especially pronounced with schizophrena.
I think it stands out the most with bipolar and schizophrenia for sure, because of how quickly people can decompensate due to mania or delusions. Depression is probably more common but less obvious from the outside.
I never had that reaction to anti-depressants but our management of side effects with mental health meds is particularly poor IMO.
Even just remembering to take a pill daily (or shot weekly) can be hard for folks with busy lives, executive dysfunctions, and other people they're responsible for.
But the Adderall doesn't give me nausea at all, it makes me uninterested in food, but not full, with no real internal hunger cue. When my body starts reacting with physical signs of hunger it can turn into a nauseated feeling but usually it's more of a light-headed stomach ache situation. One that's hard to resolve not being hungry. Similarly I'll drink water if it's in front of me but not go get it. Having that last for a week would be hell on my ability to recognize my hunger and thirst and respond appropriately
That makes a lot of sense - I guess my thinking is that for those who can tolerate it long term, it seems like doing so is a solid option from a health outcomes perspective. For those who can't, or just don't want to, they stop taking it and the question is kinda moot anyway because at worst they're back where they started after a relatively short attempt.
I dunno, a lot of the mainstream coverage I see about regaining weight after cessation just has a bit of a "see, that's cheating, it wasn't real weight loss because it's undone if you stop taking the meds" tone to it, and that's part of what motivates me to keep an eye on the "why not just keep taking it?" option. (Not accusing you of that, @BeanBurrito, it's a reasonable question to bring up in and of itself, that's just the subtext I tend to get from the way those pieces are often written).
In terms of cost (and insurance - @IarwainBenAdar's point about being cut off is an interesting, if disappointing one), the wholesale price even for the branded Novo Nordisk stuff is only actually $100/month or so, and mass manufactured generics should come out substantially cheaper than that. Obviously small comfort to US patients who can't avoid the 10x markups here and now [edit: although maybe less of an issue now, looking at the additional replies below?], but it's going out of patent in a few major markets this year, and globally in seven years. Which isn't a short time, sure, but it's not that long in the context of population-level health interventions either, so it seems reasonable to look ahead to a world where it's potentially a lot more prevalent if we want it to be.
I'd argue that isn't the "at worst" - you can fuck up your hunger cues and have some psychological side effects especially if you have a history of disordered eating.
But even $100 a month is out of reach for many people and if your insurance goes from covering it to not due to your A1C or weight going below a threshold suddenly you're cut off without a step down.
I'm not coming from a "it's cheating" perspective, and most critics of IWL and the diet industry as a whole aren't. It's far more about pretty much all weight loss products lying about or hiding side effects, how many people keep the weight loss off long term, and how many people continue the intervention after 2+ years. And the bonus fat phobia inherent in the system. No one cares if you're healthy, they care if you're fat. As long as you're thin, you can be unhealthy as hell, and if you lose weight in an unhealthy way (like anorexia) you're still praised for it.
Those aren't criticisms of the people using the drugs, they're criticisms of the industry and society. I can be opposed to IWL and the industry and also not judge people for their actions with their own body. I will judge how every decade or two we get a magic diet pill with big claims (it fixes gambling addiction AND being fat) and little acknowledgement of, for example, how folks on ozempic might need to force themselves to eat, not just take the lack of appetite as a sign that they're good to starve their bodies or that this other pill will give you massive diarrhea or that this other one is literally amphetamines.
I don't want it to be more prevalent. I don't think it's a good goal. But again not because it's cheating, because I lived through the 90s and the era when the slightest stomach pooch is a sign you're a disgusting fat. I want to exist in my body without other people who aren't my dietician or my doctor insisting on telling me how they know what's best for me including ignoring when I ask or tell them not to. And the ozempic era has only been making that worse, not better.
Edited for typos and clarifying parenthetical
I'll fully accept I wasn't considering the potential psychological impact of a "failed" short term try - I'll take that on board, it makes sense and it's something that's obliquely familiar to me in the context of other medication.
Cost, I probably wasn't being super clear there: if Novo Nordisk are willing to sell it for $100/month while they still have the monopoly, it's going to be $20-30/month when competition from other major manufacturers is on a secure legal footing. I'm looking a few years ahead more than I'm looking here and now. I wasn't at all meaning to suggest you were calling it cheating either - didn't even realise I'd implied it, or I would've said that disclaimer was pointed in your direction too!
I hear you on the societal effects, and frankly you're probably right. My faith in... anything working out in any way other than the maximum monkey's paw is pretty low right now anyway. Looking at the inexorable climb of obesity and related conditions, with the whole complex web of socioeconomic causes driving it, all the numbers I've seen suggest that extremely widespread use of these type of drugs really will save very substantial numbers of years of people's lives - and from the conversations I've had with the (surprisingly large) number of people I know taking them, from hearing how pleased they are to have the option, my gut (no pun intended) still does say to me that more availability is a good thing.
But then I don't have a real way to offset that good against the constant dents in people's mental health if that availability leads society as a whole to become even more unpleasant about each others' bodies. It's a real problem, with a fair probability of happening, and a high likelihood of being ignored if it does. I'm kind of inclined to think that people will just find a different axis to be shitty to each other on if this one changes, so it might shift who's targeted but not the net amount of interpersonal shittiness in the world, but perhaps that's a cop out. I honestly don't know, but I do appreciate the perspective.
Yeah look if folks want to take it, they do what's best for them. I just don't want people to feel pressured into taking medication because society makes them feel like shit all the time. I had an experience on an airplane last week that reminded me that despite fitting in the seat and seatbelt fine and having broad shoulders (so I kept my arms crossed most of the flight ) my body shape doesn't let me use the tray table at all. It sucks. And I see so little care for the impact of that sort of thing. among the "well actually it's better for you to lose weight no matter what" crowd.
My partner takes ozempic and I don't begrudge him doing it at all, and it's managing his diabetes magnificently. Losing weight will help him manage his paraplegia better and technically make my life easier, but I don't want him to feel he has to do any of that. But his heart and blood work are otherwise fine, and losing weight won't fix his primary disability which is the one thing he'd really want.
I am not personally convinced that it is a long term healthy option to simply suppress someone's appetite, but I don't have to be. I just want folks to see this larger picture and not make blanket statements about "this or a heart attack" basically.
The worst is that they end up with more excess fat than before. That is often the case with appetite suppressant and harsh calorie restriction.
Not the vibe I got nor the vibe I intended. My motivation in writing was to make a warning.
Long term weight loss involves behavioral and attitude changes. Given the cost of surgery & drugs, it begs the question of why not just straight to working on behavioral and attitude changes, perhaps using part of the money spent on drugs or surgery for really good support programs for changing behavior and attitude?
The problem with this is that the drugs are really expensive, and from what I’ve heard the insurance company will cover it until they hit an ‘ideal’ weight, then they cut you off and when the cravings come back they regain all the weight or more.
It's gotten much cheaper. The pill can be had on Amazon now for $150/month without insurance. Yes, without insurance. And yes, the real deal Wegovy sold by Novo Nordisk, not a fake or third party.
I’m glad to hear it’s gotten better, I should have looked it up instead of just posting, I was trying to give another perspective.
Not as expensive as one would think, the actual manufacturing and production is cheap.
You can buy the exact same material on the 'grey-market' legally for 'research purposes' (that is even independently lab graded and checked for purity!).
All you have to do is add bacteriostatic water ($5 for a bottle that lasts years) or reconstitution solution (say that out loud, its intoxicating just how much fun it is), and the peptide (the grey-market ozempic/tirzepatide/zepbound/etc) this can easily be found in a ten pack of 30mg vials (or about a years worth of weekly injections), for just around $200 (or, ~$20 a month), and that's the grey-market making a lot of profit on each sale. I will not source this for anyone in the comment section, but I know some reputable sellers and if you're research-inclined, or curious, you can PM me.
The only reason for the current cost direct from the manu is the insurance companies (and the money the manufacturer can make off of them). Once generics hit the market, which is the same formulation as the grey-market, the overall price will absolutely drop to less than $15/month, and the grey-market will inevitably be sub $5/month.
The generics will be on the market sooner than you would expect (so no need for the grey-market), especially if a country in the EU, or Canada, make it so.
Wow, that's an incredible price drop. Will those turn up for sale in the EU as well, if they're made there, or will they be locked behind prescriptions?
Initially when it was released there was a huge shortage (due to overwhelming demand), but now competitors have emerged and production capacity has exploded, so prices have been cratering.
I sort of dislike the way people talk about gaining fat back, as if it just automatically comes back no matter what you do.
The problem is you need to pair whatever you used to lose the fat with actual lifestyle changes.
It's frustrating watching people talking about this aspect and not mentioning lifestyle changes.
I'm not a fan of Ozympic if for no other reason than most of the people I know who went on it now look sickly and skeletal.
Looking at them and examples in the entertainment industry, if I were to go on Ozympic to lose some weight, I would have a target weight and gameplan for lifestyle changes for when I got to that weight, as well as an ideal BMI.
Plus, you still have a net loss in vast majority of cases, those who end up gaining back the weight only regain 75% of the weight, very few gain it all back. You still lose a decent chunk, and its after a period of about two years to reach that point. It's not instant, its a slow return to a better state than you were previously.
Slight tangent on the ones who are making this seem like a drug-addled, life-throwing away, choice to take it- but, if someone stops taking their blood pressure meds their blood pressure goes up. Stop taking your antidepressant? Guess what - the depression comes back. Cholesterol medication? yep, you have high levels of cholesterol. It's almost like weight-management or weight-loss treatment, is a treatment, not a solution.
I wear glasses every day, otherwise I am pretty blind to the world, I'm not going to stop wearing them because I live in fear of having to wear them everyday.
It is the same with gastric bypass surgery, appetite suppressants, or any other enforced significant calorie reduction. A few disciplined people escape that fate. It even happens to gastric bypass patients who get counseling before the surgery.
I don't mention it to be a party pooper, but it begs the question that if behavior and attitude changes are needed to make those things work why not just seek out very supportive programs for behavior change ( and spare your body & wallet those other modalities ) - like going to weight watchers support groups?
I mean, that begs the question of why the obesity rate keeps increasing despite the fairly widespread knowledge in the populace of what it takes to lose weight. Weight watchers has existed for a long time. Ozempic has managed to caused the obesity rate in the US to decrease after just a few years.
In practice, it seems that once you put on weight, it’s very difficult to change that habit. It’s a one way trap door. If medication can help people overcome that, then considering the health and quality of life benefits, it seems good to pursue.
Temporarily.
When most people go off of the drug all of the weight they lost will come back.
Then they will continue to on the drug for the rest of their life. It’s no different than blood pressure medication. The cost is already quite low, and will only get lower when Novo Nordisk’s patent expires in about 5 years.
Oh man, if I stop taking Tremfya, my psoriasis would come back. That's why I...don't do that.
For their sake I hope so.
It has been my observational experience that the body does not like drastic calorie addiction and eventually the metabolism will catch up ( crank down ) to make up the difference.
Because $150 a month and taking a pill is much cheaper, easier, and faster than attending the support groups and therapy needed to achieve the same thing? I'm doing it the way you suggest, but it's definitely not cheaper, faster, or easier.
Of course not, but that approach has a better chance of making permanent change.
Where weight loss is concerned, statistics say that "permanent" lifestyle change is very rare. It might be the case that obesity creates a lifelong problematic relationship with food in some people.
Indeed. Excess fat intensifies feelings of hunger, reduces the amount of time it takes for hunger to manifest, and increases resistance to satiety. You eat more, more often, and are less satiated afterwards when you are overweight.
For some people, losing weight and returning to a healthy level of body fat does not reverse these effects. That is to say, for some formerly obese people, the effects on their hunger and satiety are permanent.
From what I remember from a graduate lecture, generally gaining adipose tissue can/often increases your permanent defended weight (aka the natural equilibrium weight your body will target). AFAIK, the only current treatment that has consistently worked in permanently lowering the defended weight is some sort of gastric bypass/vertical sleeve gastrectomy.
I always have to remind myself that even though I've got my own hang-ups about food, I'll never really be able to understand what it's like to look at food as a source of comfort. If anything, my former career as a chef makes food more of a source of stress and something that's only meant for paying customers.
You're right that it takes permanent lifestyle changes to keep the weight off permanently, but beyond just being overwhelmed trying to learn what a healthy diet and activity level looks like, the root issue might come down to a deeper relationship with food and how someone copes with stress, likes to show or be shown love, etc.
With so much conflicting information and downright misinformation in the health and fitness industry, it's easy to see why nobody wants to listen to boring advice like "just do a bit of activity every day and try to eat healthy most of the time" and chases the quick fixes instead. It's easy for me to say that, but how does someone who might have been surrounded by disordered eating their whole life learn those things on their own?
There can also be a biological component to it.
To give a (somewhat odd) anecdotal example, I have two dogs who have very different reactions to stress, like visiting the vet or a stranger knocking on the door. One of them is soothed by being petted/held, while the other is soothed by food. If I soothe them the wrong way, they will continue to freak out. Both dogs are the same breed, from the same breeder, and both raised together the same way, yet they have entirely different mechanisms for coping with stress.
It's not that simple, for example the gut microbiome can send signals to you brain, telling it to start craving even specific types of food. Also your gut can digest different kinds of food with different efficiency based on the microbiome composition, making CICO more complicated.
Bad covid fucked up my gut microbiome (this is pretty common, though the symptoms can be completely different), the result was that I had returning stomach pains for almost a year, and I started gaining weight despite eating the same diet the whole time. And I'm sure I did not increase the amount of food because the stomach pains reduced my appetite slightly. In 10 months I gained 10 kg. After that the pain gradually stopped and my weight stabilized. It has been almost 3 years now I think and the weight comes back to that new normal if I get sick and lose a few kgs, going over it is quite hard - the same as it has always been for me, except now the stable weight is 10 kg higher than it was.
I have had my microbiome sequenced before and during this (I have a chronic illness that's closely linked to it) and I did notice a significant temporary raise of bacteria associated with obesity. No idea how exactly it works though. I was on the low end of normal BMI, now I'm in the middle, so I have no idea how hard losing the weight would be since I have no reason to try.
Many technologies are only good so long as they can be provided on a permanent basis. Pull them out from under people and they’ll fall. How well would we survive without our modern comforts and tools?
If you can take a GLP-1 for the rest of your life it doesn’t matter that your health would fall apart without it. But any plans to take them for a year and then maintain your new weight aren’t sound.
I think what the conversation above is suggesting is that if you take a glp-1 and cant commit to it, you could end up worse off.
The anxiety here is that doctors aren’t taking that into account when prescribing because in the studies the people who “drop out” are no longer monitored.
I’m really bothered that all the headlines and articles keep referring to these medications as appetite suppressants. They were first approved for diabetes, and is described as a medication that lowers blood sugar for diabetes, but suppresses appetite for folks who take it for weight loss. I was on Ozempic for almost a decade to control my chronic hypoglycemia, and it did a decent job of that with the help of some other medications.
There’s not a switch you can flip to make it do one thing for some people and something else for others based on the intention of a doctor. If appetite suppression alone were enough to cause weight loss, there would not be overweight smokers or coffee drinkers.
Does there need to be? A medicine can simply do two things at once, with one of the effects only applicable to certain groups of people. For people with insulin resistance, GLP-1s help insulin production and suppress appetite. The way it promotes insulin production is glucose-dependent - as such, for patients with normal blood sugar levels, it does not cause insulin overproduction (which would lead to low blood sugar) and only the appetite suppression effect remains
https://en.wikipedia.org/wiki/Glucagon-like_peptide-1
Clearly the amount of appetite restriction from GLP-1 medication is far longer lasting and effective than the mild and temporary effects from tobacco and coffee. On an extreme side, certainly meth abusers do not tend to be overweight.
Are you saying the description of an being an appetite suppressant is incorrect? That is the term used in the article in the OP.
No, it is correct. I'm saying that's not its only effect.
By that logic there should be no one using ibuprofen experiencing pain.
Maybe different mechanisms of appetite suppression can have different degrees of effectiveness?
The grocery-study actually has a note in it somewhere near the end, about how people that quit taking the drugs, have their grocery bills go up to even more than they were paying before they started, and explicitly due to buying unhealthy fat-and-sugar-rich foodstuffs.
Someone else already noted that these drugs need to be used as part of a lifestyle change in dietary and health/exercise habits. Broadly speaking, I think the worst problem with these drugs is that they appeal to exactly the kind of people who either can't--or simply aren't willing--to make those kinds of hard lifestyle changes. They want/need the "quick fix".
I guess it's good to have them available as an option, but they really should be treated as a last resort, right up there with lap-band surgery and the like.
I kind of disagree?
Food companies have entire teams of scientists come up with addictive qualities to apply to taste, crunch/mouth feel, smell, colours, packaging, price points, where they are in the store, link to memories and pleasantness, as escape from harsher and harsher life etc.
We're just single cave persons being pushed and stretched too far.
Yes healthy lifestyles are the goal, but GLP-1 seems like an important and safe way for people defeated by food mega Corp teams to get started towards empowerment and meaningful long term change. It's like wearing a cast or doing the rehab exercises carefully: it's a scaffolding.
For folks who relapse, I wonder if they quit taking GLP-1 willingly or if their insurance ran out. Maybe they felt extra defeated by a system that refuses to help them when it easily can help.
A joke I have seen on social media a lot is that the same people who refuse vaccines, especially for the pandemic, don't have a problem taking a drug that hijacks their metabolism for long periods of time.
Walmart was saying this back in late 2023, that they were (and continue) to see this directly affect them.
I can't find it now, but there was a brilliant article at some point that showcased how major food and snack producers were working on new 'sugar-like' additives designed specifically to overcome the craving-reduction and appetite suppression of GLP-1s, nasty stuff, but markets will market. Cash is king and all that. If I find it, I will link it here.
I believe this is the article you're referring to: Ozempic Could Crush the Junk Food Industry. But It Is Fighting Back.
Note that it's an opinion piece from the New York Times, so the author plays fast and loose with the facts in order to spin a compelling narrative. The multinational food conglomerates cited are almost certainly concerned about their profit margins, but I don't think selling the moustache twirling villain angle is really the sort of level headed analysis we need in this contemporary, post-truth era.
It wasn't that article, it was talking about a specific set of chemical additives, or modifications of additives, to induce cravings. The research angle is quite interesting from a scientific perspective, but the usage of it is certainly something a 'moustache twirling villain' (cough $ociopathic finance bro$) would certainly incentivize and work to use.
Ah, gotcha! I was thinking of this quote in particular when I responded to you:
I suppose there could've been some development afterwards (or it was simply missed by the journalist).
I mean, another way to frame it is simply that they’re working on making food taste better.
^ I cut out as much fluff as I could. Certainly seems like the explicit goal is to make food that can reignite the harmful food behaviours which GLP-1 users have successfully fought back.
Nothing in there sounds particularly nefarious?
The examples were… adding whey protein (not even for the taste, the marketing seems to be to “extra protein to counteract muscle loss during caloric restrictions” is which is fair enough - that works, it’s how body builders handle cutting stages)
and, uh, adding lime flavor to things?
Idk, if that’s what the mustache twirlers are doing, I guess I can sleep easy.
Maybe the next avengers movie they can stop the evil plot of the corporations adding fresh citrus flavor to their products.
Okeydoke. I think it's rather sus to expend effort trying to re-addict people to food, after they've successfully received medical intervention to alleviate their addiction.
Also, my original comment was this:
I was not saying that this is moustache twirling evil. I was saying that the framing of the article -- in my opinion, so apologies if this is not aligned with your opinion -- makes it seem like the food industry is a bunch of moustache twirling villains, even though they aren't. They are, in fact, corporate cogs inside of machines designed to shake the entire world upside-down for its lunch money. Understanding that this is a systemic problem is important; just removing a couple food scientists or corporations does nothing to fix the incentive structure which rewards food manufacturing companies for developing and selling addictive products.
Not really sure what we're debating, so I'ma just bail now.
Again, it’s also simply making food taste better. I’d hardly call a company evil for adding citrus flavor to their food because their consumers like it. Which was the only example in the article of food companies adapting their food to taste better to people on Ozempic - the whey protein shake is going after it from a different angle (and pretty ethically).
What’s the difference between that and a chef perfecting their recipe at their restaurant? By making food taste better, you inherently are making it “more addicting”. Because it tastes better.
Are we really drawing a line at making things taste like lime? That just seems like bizarre fear mongering.
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A quick A.I. assisted search told me that Ozempic could cost between $25 - $150 a month.
Without insurance think 10x that for the name brand.
(Other brands, other formulations will be different. But ozempic without insurance is still expensive. This does not consider coupons. )
For the injectable. But the A.I assisted search is pulling up the pill price, which was recently FDA approved, which is $25/month with insurance or $150/month without insurance. That is from Novo Nordisk, name brand Wegovy.
According to clinical trials the pill is +-1% of the effectiveness of the injectable.
Right, I was looking at Ozempic, not Wegovy or Rybelsus. Ozempic is still more expensive.
America is cooked