Ozempic drug supresses desire to smoke, drink and more?

https://www.theatlantic.com/health/archive/2023/05/ozempic-addictive-behavior-drinking-smoking/674098/

by explosion-s • 3 years ago

288 433 3 years ago

crakenzak2• 3 years ago

Now if only it didn’t cost so damn much every month even under insurance =(

Going to be huge when it goes off patent off exclusivity. I'd also expect you'll be able to get it when it's made in jurisdictions that will ignore the patent. Up to you to get it from those places, either via mail or travel runs.

tboyd47• 3 years ago

They will find some way to prevent people from acquiring it and promote some other in-patent drug.

justinbaker844• 3 years ago

A lot of clinics are administering the generic form and it is still very expensive.

BizarroLand• 3 years ago

You can buy it as a "research chemical" and save money, but then the potential consequences of diy medicine and all that that entails are all on you.

Hopefully the price will come down more as it becomes more prevalent or as generics become available.

rektide3• 3 years ago

I'm not that afraid of swallowing random chemicals but self injecting is a bit hardcore for me.

scheme2713• 3 years ago

GLP-1 agonists are a bit more tricky since they are temperature sensitive and need to be injected. You'll really need to be careful to keep it sterile and handle it properly. Whether the "research chemical" will receive the proper care until it gets into your hands is something that you're literally gambling your health on.

scheme2713• 3 years ago

It's not the only GLP-1 agonist out there. Victoza is another GLP-1 agonist and should be going generic in the US in a little over a year. It might already be available as a generic outside the US. There might be other GLP-1 agonists that are going generic soon as well.

reaperman20• 3 years ago

You can get these wholesale from China from "reputable" gray-market wholesalers who get the chemicals made at contract manufacturing facilities. BYO QA/QC though, as with all non-FDA drugs. That's the huge catch, and it sucks for consumers. Testing just for active ingredient is >$100 and takes about a month. Testing for proper buffering agents, harmful contaminants, microbial contamination, etc is essentially unavailable at all.

Semaglutide is very, very cheap in the gray market. It's somewhat less effective than Tirzepatide and has slightly more side effects if you ramp up the dosage too quickly.

If an annual amount is purchased on the gray market, this brings the monthly cost down to:

- Semaglutide: $10/month

- Tirzepatide: $60/month

- Liraglutide: $87/month

- LY3437943: I have not yet seen this available, but it looks like distributors are notifying manufacturers of latent demand and are working to build up a supply chain.

Note that in the USA, it is legal to import certain amounts of FDA-approved drugs if you have a prescription for them. However, just because something is the exact same chemical as an FDA-approved drug does not make it an FDA-approved drug. It must be manufactured in an FDA certified facility and be the same brand/manufacturer/packaging/labeling/etc as the approved drug.

e.g. importing generic Sildenafil/Viagra is legal if you can find the Teva(tm) brand generic sildenafil in, say, Mexico or Canada for a better price. But it must be the pills manufactured by Teva in the appropriate facility with NDC #0093-5342-56[0].

If you import generic sildenafil "Cenforce" from the (very legitimate but not FDA-approved) Indian pharmaceutical manufacturer "Centurion Laboratories"...

...that would still be potentially criminal smuggling. Even if the pills you import show via laboratory test that they precisely match your medical prescription, they are not "FDA approved" and therefore not legal to import.

A lot of people do though!

0: https://ndclist.com/ndc/0093-5342/package/0093-5342-56

etchasketch3• 3 years ago

Interesting.

chriscappuccio4• 3 years ago

where is this grey market? apparently it's not as simple as just searching aliexpress :)

crakenzak2• 3 years ago

Wow this is incredible, thanks for sharing! I was quoted $800/mo after insurance for a moderately low dose of Semaglutide (Ozempic)

akiselev2• 3 years ago

https://archive.ph/1waP9

mym199010• 3 years ago

A drug that promotes weight loss, lessens the desire to smoke, drink, etc...sounds too good to be true?

From what I have heard, all of these issues come back as soon as someone comes off the drug. So either a person is committing to a lifetime of being dependent on this drug, or a person is committing to some period of time of ideal living, followed by a possible time of depression after reverting to the status quo.

karaterobot2• 3 years ago

For a lot of people, it's kind of a choice of which substance you are going to be dependent on. It's all expensive and sad, but between Ozempic and cigarettes, alcohol, or overeating, Ozempic has got to be healthier, and quite possibly cheaper in the long run.

nancyhn• 3 years ago

Is a drug or drug-like-food (ie, sugar) dependency really the only option?

justinbaker844• 3 years ago

I took it and started out with a small dose. The impact of that dose wore off eventually and the plan at my clinic was to raise it over time.

I am concerned that maybe there isn't a dose where you can stop taking more and keep the results. I am worried that everybody will need to keep taking more as they build up more tolerance to it. The study that showed how effective the drug is was 60 weeks long.

That is a long time, but it doesn't show what happens if somebody plans on staying on the drug for years.

mym199010• 3 years ago

Healthier in what sense? There is little knowledge of long term side effects and it isn't even approved for weight loss, it is specifically for people with diabetes.

trasz42• 3 years ago

From what I have heard, all of these issues come back as soon as someone comes off the drug

Same as with drugs for hypertension, depression, hyperglycemia and many, many others. Not every drug is supposed to somehow permanently cure you.

hombre_fatal5• 3 years ago

The same could be said even for interventions like "don't eat surplus calories" and "life weights". Once you stop, you don't get the benefits and you'll regress.

"But you have to do it forever" shouldn't be a convincing dismissal after 10 seconds of thought.

aplusbi• 3 years ago

A lot of addiction is caused by social issues or mental health issues, but it's really hard to deal with those issues when someone is also dealing with the effects of addiction. A drug like this could provide an opportunity to fix the underlying issues causing addiction in the first place.

And for some people they will have to take this for life, which isn't so different from many other medications.

SOLAR_FIELDS• 3 years ago

Yeah, I honestly don’t see a problem with taking a drug for life, as long as the side effects are minimal and the logistics are simple. I’m in my early 30’s and have a family history of bad cholesterol. So once a day I will take a statin for the rest of my life. Not a problem, little to no side effects and pretty easy to manage, and not the end of the world if I miss one day every so often. Twice a day is not so easy to manage and plan but once a day is definitely manageable for a lot of people

standardUser2• 3 years ago

The first days, weeks and months are often the hardest time when quitting a substance. If this drug helps a smoker not smoke for 3 months, by that time the nicotine addiction has weakened considerably. They've gotten past the hardest part. I see no downside to that.

Similarly, if a person loses 30 pounds on this drug, then stops using the drug and reverts to normal habits, it will take a while to regain those 30 pounds. And the long term shift of maintaining the new body weight doesn't require any radical changes (unlike losing 30 pounds, which does require sustained radical changes).

justinbaker844• 3 years ago

That is not what happened to me. I took it for 2 months and then I wanted to get off. I did not go back to normal. Mentally I felt like I needed more food and more junk food than I ever did before using the drug.

My hypothesis is that it supressed my body's natural production of whatever chemical in my brain helps me not go overboard with food. With that supressed by the drug I had an uncontrollable desire for food and currently I am fatter than I was before taking the drug in the first place.

raducu• 3 years ago

The first days, weeks and months are often the hardest time when quitting a substance. If this drug helps a smoker not smoke for 3 months, by that time the nicotine addiction has weakened considerably.

I love(d) nicotine and it was the only substance that I ever was addicted to. I tried dozens of times to quit and the only thing that helped was getting treatment for my ADHD. Quitting nicotine was easy for me on methylphenidate. I only tried combining them and nearly went to the ER, so I quickly learnt that I can't take them both. But when I'm on methylphenidate I just don't crave nicotine that much. It took 2-3 years to completely not get any nicotine cravings at all.

mym199010• 3 years ago

This is what I thought as well, that the habits that drive some of these activities would be dramatically weakened, but it looks like the body is not actually re-aligning to a new homeostatis level, so when a person gets off the drug, the body is trying to get back to the old level. I don't think it all comes back to habits, often your body is working really hard against you to get back a level it feels is right(whether that level is 'healthy' or not).

sneak3• 3 years ago

Nicotine physical addiction is over with in less than a week. The remainder is psychological habit and classical conditioning.

justinbaker844• 3 years ago

This is exactly what happened to me. The clinic I went to recommended starting out with 1/10 the normal dose for the first month to make sure I would tolerate it. Then we would move up each month.

It worked so well I didn't want to move up so for month 2 I stuck with 1/10th the amount. During that month the effects wore off so I had to take more to get the same impact. I chose to just quit.

2 months after quiting I am 7 pounds fatter than I was when I started with the drug. I suspect that most people will need to keep taking more and more of it to get the same benefits they got from the recommended dose. I am really concerned this is going to lead to a bigger health crises than the one it purported to solve.

spondylosaurus4• 3 years ago

I am really concerned this is going to lead to a bigger health crises than the one it purported to solve.

A lot of diabetics taking it to regulate blood sugar (particular the feedback loop with insulin and hunger) have said it's changed their life... but for people who are merely overweight I think the benefits may not always be worth the side effects. IMO the correlation between weight and health is not as strong as people often assume.

Anecdotal, but if you looked at me and my partner, you'd probably assume I was the "healthier" one based on our respective body types. But they're strong, fit, and rarely get sick (knock on wood); meanwhile I'm a lifelong wimp with a host of autoimmune issues. I outsource all of the heavy lifting to them, literally—if the trash is too heavy for me to take to the dumpster, they get to do it instead :P

So to your point about health crises, yeah. It seems foolish to put my partner on a weight loss drug just so they could "look" healthier while nursing a bunch of unpleasant side effects that would make them far sicker than they were before.

coffeebeqn• 3 years ago

If something affects so many basic functions of the body, the side effects must be intense as well

jameshart• 3 years ago

A drug that promotes weight loss, lessens the desire to smoke, drink, etc...sounds too good to be true?

What other desires does it lessen? Does it suppress every hedonistic impulse? What does it do to creativity? Impulsivity? Does it make you more susceptible to or resistant to persuasion? Feels like reporting ‘oh it has these other unintended psychological/behavioral responses. Neat!’ is ignoring a whole can of worms that that opens.

mym199010• 3 years ago

I think the body of work around what this drug does outside of its impact on patients with diabetes is pretty limited, which is what is scary about everyone jumping on this one.

thomascgalvin• 3 years ago

A drug that promotes weight loss, lessens the desire to smoke, drink, etc...sounds too good to be true?

It does sound too good to be true. However, it's possible that the drug is working on all of these through the same mechanism: by altering the brain's reward system.

If that's true, the drug doesn't make you not want to eat, it makes you not want stuff, in general. That could potentially suppress a wide array of addictive behaviors. I also wonder if that suppression might look a lot like clinical depression, though.

reaperman20• 3 years ago

Reports from people using this don't indicate that they feel depressed at all. They either get a ton of nausea if their dose is too high, or they just don't get cravings to eat tons of "bad" food. Most people I've talked with on low doses report they can still eat large meals, but it has to be a pretty conscious, determined decision.

No one's been reporting depression that I've seen. And these groups ('fitness enthusiasts') experiment with enough other things that do cause depression that they're quite sensitive to changes in "well-being", "outlook on life", "mood", and "energy levels". It would be more widely reported in these circles if it did resemble depression.

iwanttocomment5• 3 years ago

I'm not sure why "it stops working when you stop taking it" is used as an argument against these new peptides. This is the way almost every medication we encounter works.

Tylenol might get rid of your headache, but that headache can come back tomorrow. Stop taking birth control and you might get pregnant. Stop taking Claritin and your allergies return. Stop taking insulin, and, as with these new peptides, you lose control over your blood sugar. Stop taking Adderall, and not only will your ADHD symptoms come back, you'll also experience withdrawal.

Almost no medications are "one and done", and I'm not sure why Ozempic or Mounjaro are being held to needing to be a cure when it's clear that they're effective, repeatable treatments for blood sugar control and (likely related) weight gain.

iwanttocomment5• 3 years ago

(If the answer is "because you'll learn to eat less or eat in a more healthy fashion", it may well be that the metabolic issues that are creating heightened blood sugar or appetite issues may not be able to be resolved by diet alone in those who respond well to these peptides.)

mym199010• 3 years ago

I am not holding Ozempic to needing to be the cure for anything. My point is that people without diabetes are looking to this drug for weight loss, at which point they create a dangerous dependency, with no hard evidence that their actual health improves. This is opposed to coming up with long term solutions that involve re-evaluating daily decisions that lead to some of these diseases in the first place. If Ozempic is a good treatment for blood sugar control, which could be a good factor to consider in weight fluctuation, maybe reduce the amount of sugar one eats?

015UUZn8aEvW2• 3 years ago

From what I have heard, all of these issues come back as soon as someone comes off the drug. So either a person is committing to a lifetime of being dependent on this drug, or a person is committing to some period of time of ideal living, followed by a possible time of depression after reverting to the status quo.

This is true of every weight loss intervention: Weight Watchers, low-carb, keto, Whole 30, etc. Once people stop complying with them, they gain the weight back.

Most people don't realize how dismal the stats on long-term weight loss are. Almost no one maintains a substantial amount of weight loss for many years by following "just eat healthy and exercise" advice. The only intervention that does reliably work is bariatric surgery. The jury is still out on the new GLP drugs.

akiselev2• 3 years ago

The only intervention that does reliably work is bariatric surgery.

My understanding is surgery only works reliably because failure to comply with life style changes post-op is easily fatal and ethical doctors only perform the operation after patients have demonstrated that ability. In all but the most extreme patients, about a fifth to a third of the target weight loss has to happen pre-op for doctors to even consider the procedure. The surgery is essentially a sword of Damocles hanging over patients, reminding them that they'll die much faster than normal if they over eat.

paulpauper7• 3 years ago

Diets fail because ppl lose willpower. These new drugs in theory make this easier

rolisz2• 3 years ago

Isn't that the case for every diet? You can lose weight on diets and then gain it back when you start eating the way you used to.

atchoo3• 3 years ago

What if the greatest harm is that the easy path of modifying our biology prevents us ever needing to gain the self-knowledge and build the fulfilling lives that lets us thrive in a world surrounded by potential addictions?

I consider myself a much wiser and stronger person in recovery than I was before addiction. Who would I be if I took a magic pill and was still the person that sought oblivion? What will humanity be if it doesn't need such self-knowledge and resilience? What impact will that make in say, our future politics?

chadlavi• 3 years ago

This feels like the same logic as "I had to pay off my student loans, so other people should have to suffer like that too." Suffering does not make you better later despite what millennia of Christian theology has told people about its supposed purgative effects. It seems pretty rad to me to be able to just not suffer through the bad part of getting over a major life problem, and I for one am happy that people will be able to skip that part and get on to the part where they live well.

AnIdiotOnTheNet3• 3 years ago

Could be worse. Omeprazole not only stops working after you get off it, your issues actually become much more severe. Once you're on it, you are unlikely to ever be able to get off of it.

joedevon5• 3 years ago

Imagine being 250 lbs and feeling like you are starving constantly, despite eating a lot every day. You decide to lose weight. You do something you hate, like calorie restriction and working out like a dog. You lose 80 lbs in 1 year. Bravo. Everyone tells you how great you look. You feel great. All that hard work was worth it. The fatness and a million other things really motivated you to do the hard work. I've done this a couple of times.

Next day after hitting your goal, the starvation is still there. The desire to eat is still there. Hating working out is still there. But now you have to do this herculean effort every day not to get better. Not to lose weight. Just to maintain. Your brain wants you to gain 80 lbs and will never stop nagging you. Not on a good day. Not on a bad day.

Then something really shitty happens in your life. Like it does for everyone. You slip. Eventually you start to gain back the weight. You just want to die. You feel like a failure. You hate yourself.

That's the trick. Hitting goal weight the first time or two is relatively "easy". But you've achieved nothing if you aren't able to maintain weight loss. That's the failure of all approaches prior to these GLP1 and similar drugs.

Having set the scene, now compare it to semaglutide. You have a drug that regulates your brain. Gets rid of the constant nagging to eat. You get normal brain. You lose weight.

Now you have to pick, take a once a week drug for life to maintain, or do a herculean effort to fight the brain urges and work out to maintain.

Which do you think will be more successful?

tgmatt• 3 years ago

This perfectly encapsulates my experience. I'm hesitant to ask for this medication because of side effects and because it's got a 2 year limit in my country, so I don't want to go through it all then have to stop and ultimately put it all back on. Shit sucks, bro.

lost_tourist• 3 years ago

do you have stats to confirm your assertion about this drug because it seems as speculation as saying "well maybe if I was 100lbs less I would have more energy, be happier with myself and therefore have more willpower to have a more healthy relationship with food".

myshpa• 3 years ago

Psilocybin too.

rektide3• 3 years ago

I'm surprised Ozempic gets all the press. Supposedly Mounjaro is all that and more.

The wonderful Paul Ford has the best writeup I've seen that discusses these more meta levels, the post-human implications of a drug we can genuinely widescalely reprogram ourselves with. Paul's so great. https://www.wired.com/story/new-drug-switched-off-appetite-m... https://news.ycombinator.com/item?id=34660232

HDThoreaun3• 3 years ago

Ozempic has been around longer and there were a bunch of celebrities taking it and talking about it on twitter so I think it has more cultural cachet. Most people probably don't know about mounjaro, I don't even think it's approved for weight loss yet.

kristofferR2• 3 years ago

Massive text: "People taking Mounjaro lost up to 25 LBS"

Small text underneath: "Mounjaro is not a weight loss drug."

Man, the US pharma industry/marketing is so weird.

https://www.mounjaro.com/#:~:text=mounjaro%20is%20not%20a%20....

iwanttocomment5• 3 years ago

Mounjaro is not yet approved for weight loss in the US even though there is strong evidence that it will be, and there's little question that there has generally been weight loss in those taking it for diabetes.

Recent studies have very clearly shown it's effective for weight loss even in those without diabetes, but there's a lag as the FDA reviews those studies. Until then, Lilly simply can't advertise it as a treatment for obesity.

refurb2• 3 years ago

It’s not weird at all if you’re aware of the regulations.

Drug companies can’t promote a drug for something it’s not FDA approved for (off-label promotion). Companies face multi-billion dollar penalties for doing so.

Mounjaro is approved for type 2 diabetes. And weight loss is a great way to help get your type 2 diabetes under control.

So highlighting that it helps type 2 patients lose weight, while having an FDA mandated disclosure that it’s not approved for weight loss alone, makes perfect sense.

shrimp_emoji2• 3 years ago

My favorite Linux distro; it's basically a user-friendly Arch with goodies like a GUI kernel switcher thrown in.

ec109685• 3 years ago

How is it for weight loss?

reaperman20• 3 years ago

Semaglutide gets all the press because it's a lot cheaper and actually available (barely available, but available). Tirzepatide is much more difficult to get access to, though IMO it should be the one that people default to if they're going to take this class of drug.

Semaglutide will probably have the most side effects because it only has one action (GLP-1 agonist). Tirzepatide has slightly lower side effects because it adds a dual action (GLP-1 agonist + GIP analogue) so it can act at a lower magnitude on the GLP-1 receptors to avoid strong side effects, while still having higher efficacy due to its additional, separate, GIP action.

LY3437943 looks even more promising, with fewer side effects. LY3437943 retains both the actions of Tirzepatide but adds a third action, glucagon receptor agonist. So it should be able to have higher efficacy at a lower equivalent dose than the other two (less action on GLP-1 and GIP mechanisms, fewer side effects).

mchannon• 3 years ago

Eli Lilly's scientific name for LY3437943 is retatrutide.

lumb632• 3 years ago

I’m glad people are enjoying Ozempic. My experience from seeing a family member on it, is I would not touch it if I were a 500-pound alcoholic smoking two packs of cigarettes a day. That’s an exaggeration since it probably outweighs the health issues there, but only slightly.

The person I know taking Ozempic has only lost weight (35 lbs) due to the fact that eating now makes her sick. She has been sapped of all energy and has developed issues with her bladder, circulatory system, joints, thyroid, and digestive system since starting Ozempic. I’m not saying it’s due to Ozempic, but I am saying all these issues have cropped up in the few months since she started taking it, and she never had any chronic health issues prior. At least she lost some weight, I guess.

ikekkdcjkfke• 3 years ago

Same experience here, gallstone attacks

shrimp_emoji2• 3 years ago

You can get those from rapid weight loss, I thought. Maybe it's working TOO well if that's the case.

burnte• 3 years ago

I take it, and when I started I got violently nauseous and had GI issues. I wasn't informed I needed to slowly ramp up.

I still have pretty big appetite suppression, and only minimal nausea sometimes if I eat too much, but what it's done to my blood glucose is AMAZING. And I lost some weight when I started which was a great bonus. It can be hard to start but it's truly worth it, just adjust the dose. I take 0.5mg as I can't handle the larger 1.0mg dose.

reaperman20• 3 years ago

I wasn't informed I needed to slowly ramp up.

In a fair world that would be considered severe malpractice :-( It's nearly common knowledge. A huge number of people are suffering under these medications because of starting at a dose to high or raising doses too quickly / too much at a time.

LY3437943 looks even more promising, with fewer side effects. Semaglutide will probably have the most side effects because it only has one action (GLP-1 agonist). Tirzepatide has slightly lower side effects because it adds a dual action (GLP-1 agonist + GIP analogue) so it can act at a lower magnitude on the GLP-1 receptors to avoid strong side effects, while still having higher efficacy due to its additional, separate, GIP action.

LY3437943 retains both the actions of Tirzepatide but adds a third action, glucagon receptor agonist. So it should be able to have higher efficacy at a lower equivalent dose than the other two (less action on GLP-1 and GIP mechanisms, fewer side effects).

kristofferR2• 3 years ago

While others have none or barely any side effects, it is a drug after all.

For those people who tolerate the drug well, it can be revolutionary in their lives, but it's unfortunately not a good fit for everyone.

I hope your family member gets better soon.

ortusdux2• 3 years ago

>due to the fact that eating now makes her sick.

Reminds me of the first FDA approved weight loss drug, Alli, that basically just gastrointestinally punishes you if you eat more than a few grams of fat.

https://en.wikipedia.org/wiki/Orlistat#Side_effects

spondylosaurus4• 3 years ago

The manual for Alli makes it clear that orlistat treatment involves aversion therapy, encouraging the user to associate eating fat with unpleasant treatment effects.

Christ. This is like Crohn's disease in pill form. One too many teaspoons of olive oil and you're in for an unpleasant evening...

vrc3• 3 years ago

Never trust a fart on orlistat. The horror stories I’ve read of people soiling themselves after eating seemingly normal meals is nuts. On par with Olestra/Haribo sugar-free stories. Also it makes absorbing fat soluble vitamins a huge issue.

User23• 3 years ago

My favorite fat loss drug along these lines is dinitrophenol. It is the true miracle fat burning drug. It interferes with cellular metabolism in such a way that the body just nonstop oxidizes fat. Fat mass loss in the order of a pound a day or more is entirely possible and some bodybuilders use it to get to a ludicrously low bodyfat percentage. Unfortunately oxidizing that much fat generates a lot of heat, so much that an overdose can be lethal because your body literally roasts itself to death and titration is extremely difficult. Oh and blindness is a common side effect. And for added fun it’s an high explosive. Needless to say it’s not FDA approved.

etchasketch3• 3 years ago

You want to know what's even crazier, you can literally but it over the counter. I was at kroger the other day and I saw it next to the vitamins and I did a double take.

MandieD• 3 years ago

Your relative’s sad story reminds me of a short story I read a few years ago about a miracle pill that leaves about 90% of its takers perfectly slim and able to stay that way eating anything, after a few truly disgusting initial days of elimination, but kills the other 10% gruesomely.

Because it’s so wonderfully effective for the majority, there ends up being a ton of social and economic pressure for anyone even slightly overweight to take it, despite said 10% risk of death.

(Edited to add):

“The Pill,” by Meg Elison

https://escapepod.org/2022/11/03/escape-pod-861-the-pill-par...

https://escapepod.org/2022/11/10/escape-pod-862-the-pill-par...

Dan42• 3 years ago

Thank you, thank you so much for sharing that. It's been a while since the last time my mind was blown away that much.

hayst4ck• 3 years ago

I have to admit, I would probably have taken the pill depending on how gruesome (or mitigatible) the death is. I've been obese and I've been thin, and life is not worth living when obese.

10 years ago, I was reading about nootropics and ran across an interesting piece on the ethics of drugs (that has probably been lost to time). The question it was asking was "why can we take drugs to bring us to normal, but we can't take drugs that make us better than normal?"

The interesting consequence is that it de facto forces people who don't need drugs to take them or be at a disadvantage. (think adderall at a competitive college or testosterone for lifting).

kennyloginz• 3 years ago

How does this remind you of this strange story.

taneq• 3 years ago

Sounds a little bit like the “fatkins diet” in Makers by Cory Doctorow.

ennasila• 3 years ago

Great story. There were parts that made me think the pill was a metaphor for the covid vaccine, but this story was written several months before the vaccine was released

HyperSane• 3 years ago

That is pretty unrealistic with 10% odds but I wonder what the odds would actually have to be for a drug like that to get so popular.

ex3ndr• 3 years ago

Super weird since once you get thyroid problems, you have to drop this medication.

vrc3• 3 years ago

The risk of pancreatitis is also increased substantially [0]. And for people who may already be predisposed to pancreatitis but haven’t had an attack, severe pancreatitis has a 10-30% mortality rate [1]. But even mild acute pancreatitis will make you want to crawl out of your own skin in pain.

[0] https://www.hopkinsmedicine.org/news/media/releases/johns_ho...

[1] https://www.aafp.org/pubs/afp/issues/2007/0515/p1513.html

mattzito• 3 years ago

So I was able to find an aggregate of the study results:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8294388/

out of an n of >3000 patients getting medication, 34 ended up having some form of pancreatitis. At least 12 people on placebo got pancreatitis. That's a much higher rate, but the odds are still pretty low.

nullc• 3 years ago

I'm somewhat dubious of the severe pancreatitis mortality rates-- the issue is that most cases of severe pancreatitis are caused by very severe alcoholism, and by the time the pancreatitis shows up everything else is already failing.

crazygringo• 3 years ago

Yeah, that's definitely always been my challenge with weight loss. I have zero problem with self control -- I can easily cut calories in half or less (e.g. 1000-1200 cal/day), but it's simply that my body suffers immensely. I lose all energy, can't concentrate on anything, and my immune system weakens so I start getting colds constantly.

I'm sure I'd easily lose weight with Ozempic but I'd still be suffering health issues. Not because of Ozempic itself but just because I wouldn't be getting enough calories, despite still being above a healthy weight.

skulk• 3 years ago

my body suffers immensely

Does the same thing happen if you slowly wean yourself down? Are you cutting out essential nutrients that your body needs to function properly rather than the unnecessary carbs/junk? The reason I'm asking these things is that people I know who have reduced their caloric intake usually report feeling better, not worse.

lumb632• 3 years ago

You may have better success in a smaller caloric deficit. 1000-1200 calories a day is very few and that’s a very fast pace of weight loss. Try removing 500 calories or 10% of your calories. Progress will be slower, but you may feel much better.

Also, as a sibling comment alluded to, when you have fewer calories to eat, the micronutrients in the few foods you do eat matter that much more. The nutritional quality of food you need to stay healthy increases greatly when in a caloric deficit. Fruits and veggies are great for helping that, and multivitamins are cheap insurance policies to make sure you aren’t deficient in anything important, IMO. YMMV. Best of luck with your goals!

jjeaff5• 3 years ago

That reaction may have to do with too much cutting, as another commenter alluded to, but it may also have to do with the types of nutrients you are missing when cutting.

kika2• 3 years ago

Calories are not created equal. They are equal in physics sense, but your body is not a "bomb calorimeter" (device to measure caloric content of whatever). So maybe instead of cutting your calories in half, you cut less and replace carb calories with fat calories or protein calories. Or maybe you can even cut to 1000-1200 by replacing your calorie source with something else. For some weird reason carrots with butter work very well for me and I love the taste :-)

MagicMoonlight4• 3 years ago

That sounds like a convenient excuse not to change

smith7018• 3 years ago

I know someone that took it and his gallbladder burst. Doctors couldn’t say if it was related to the drug, though.

cameronh90• 3 years ago

As a counterpoint, I've been using it for several months and have had no side effects to speak of other than occasionally some mild reflux.

If anything, my energy levels actually went up immediately after starting it. Normally I was pretty sluggish but it felt like some extra firepower was unlocked.

Everything has risks and benefits, and might harm some people. I hope your family member gets better soon.

mgarfias2• 3 years ago

I’ve been on it (at 1mg, then 2mg doses) for 3-4 years now. Worst side effect for me is the tendency to have sulfur smelling burps if I have any kind of stomach upset.

reaperman20• 3 years ago

As a counter-counter-point I've read most (~90%) of the papers that come out of trials registered at http://clinicaltrials.gov/ for all GLP-1 agonists, including ones that haven't been approved. The vast, vast, vast majority of secondary outcomes, for things like

- blood pressure

- lipids (HDL, LDL)

- insulin sensitivity

- blood glucose

- strokes

- cardiovascular events + deaths

- myocardial infarctions

- hemoglobin A1C,

- revascularization,

- etc, etc, etc

are literally all affected positively (to the benefit of the imaginary "mean" patient) in bulk.

Note though, that doesn't mean 100% of patients are have positive results, just that each of these are, in bulk, positive across the tested subjects when averaged together. There's little in the data to suggest that cases like your family member aren't happening or couldn't happen.

There's also evidence that GLP-1 agonists increase the rate of glucose use in the brain, accelerating learning rates. (The brain accounts for 2% of body weight but up to 25% of glucose consumption, it really is fueled by glucose)

https://clinicaltrials.gov/ct2/show/NCT00256256?term=stroke&...

ESTheComposer2• 3 years ago

I started Wegovy about 5 months ago. The first couple months you feel sick but after it passes your appetite is extremely curbed (in a good way). Would highly recommend people to try it as it's made me healthier in pretty much every way.

transcriptase• 3 years ago

Bold move to name their pharmaceutical like a Chinese Amazon “brand” of AliExpress-sourced electronics.

SystemOut2• 3 years ago

My story / anecdata.

About 6 months ago there was a posting about Ozempic and I had said something to the effect that it wasn't worth it watching some of the side effects my wife had from it. And then I went to the doctor for a check-up and lo and behold I had diabetes. Asymptomatic, but an A1C of 11. My doctor re-ran the test because he didn't believe it and it doesn't run in my family. My cholesterol had also jumped and he said he was going to put me on a statin after the initial 3 months of adjusting to the diabetes medication.

My Dr. puts me on Ozempic and I grumble about it but with that test results I had, I knew I had to do something. Fast forward 3 months, I dropped 20 pounds, and every other measurement is back in the green, including my A1C. Now, I made some serious lifestyle changes and ate a diabetic diet (limiting carbs, the types of carbs, etc), and have been keeping up with being more active but my entire relationship with food has changed because of Ozempic. Before I had a near compulsion to eat more than I should. Now, I don't because one, I feel fuller quicker and two, I know I'll feel horrible for hours if I over-eat. It only took one of those events to never want to do that again. I can't really explain why but I also don't have as strong of a desire to eat foods that are bad for me. I really thought I'd battle the cravings more after going cold turkey from "bad" foods. I can't say why it is but it's true. Side note, going to the grocery story was really difficult at first....there is so much sugar in the American food supply.

Energy wise I will say that I did struggle with low energy initially as my body adapted to lower calorie intake but I also learned that when I found the right balance of protein/complex carbs for me that my energy levels came back up and I now feel better than ever.

My doctor was shocked. I've never seen him that animated when I came back in for the 3 month follow-up. I didn't need to add any additional medications and they're slowly adjusting me back towards a single medication.

justinclift2• 3 years ago

Out of curiosity, do you drink much water each day?

I'm kind of wondering if the people having a bad result don't drink enough water each day to clear out their systems? Yeah, that's a simplistic take... but still, curiosity. :)

r00tanon• 3 years ago

I have had a nearly identical experience. Thanks for sharing.

etchasketch3• 3 years ago

I know this isn't your family member, but if they were a 500-pound alcoholic smoking two packs of cigarettes a day, I suspect they probably felt like crap before the ozempic.

omgmajk• 3 years ago

I was on ozempic for a bit but it raised my resting pulse from 65ish to 95ish just sitting at my computer so I had to stop taking it.

glonq• 3 years ago

What happens when you reach your target weight with drugs like this?

After having learned potentionally nothing about nutrition, exercise, and self-control, are you stuck on these meds for life out of fear of binge-eating back to your original weight?

FWIW I'm on a hundred-pound roller coaster ride from 300lbs to 200lbs; currently ~215. I've learned a lot about discipline and sustainable habits along the way.

opportune3• 3 years ago

I’ve never been obese but after losing 30+ lbs of weight I found it a lot easier to live an active lifestyle and keep the weight off. Partly it was just that moving around was physically easier and less strenuous, but also that I was less self conscious and had higher self esteem.

I imagine Ozempic will help with this even if people don’t learn about nutrition per se. Though I think basically everybody knows nutrition, it’s more about self control IME.

op00to• 3 years ago

What happens when someone who was previously deeply depressed but feels better goes off an antidepressant? They learn to handle life, or they return to the drug if further treatment is needed. It’s not a moral failing.

jasonfarnon3• 3 years ago

I don't think you need to bring morality into it. OP is just asking, do you develop your own tools to address the problem, or rely on another's forever? There are lots of practical non-moral answers to that question.

gnulinux• 3 years ago

As an anecdote: at my worst (when I was clearly suicidal, insomniac and emotionally unstable) I was on antidepressants (Prozac) and it helped me a lot. It made me very emotionally stable. I got off Prozac after a couple years to try it out and I felt much better. Over that year, I started feeling similarly terrible due to COVID world. Went back to Prozac. Once again made me very stable. Stopped using Prozac in mid 2022, again to see if I feel good without it. Since then have been feeling much, much better. Of course, mental health is a constant battle, you fight one day at a time, but I consider my depression as close to "cured" as possible because over the last year I felt pretty normal without any drugs.

Things to note are, along the way I stopped drinking alcohol which helped me tons. Before 2020 I was a huge drinker (not alcoholic, but every day heavy drinker). Initially, I started smoking weed. This helped a ton because I stopped drinking completely, but I wasn't getting very high every day and I thought THC helped quite a bit too. Eventually, in late 2022 I stopped using THC too. I'm completely drug free now. I believe that both Prozac and THC helped me significantly to get out of depression. In addition to drugs, CBT (cognitive behavioral therapy), therapy in general and getting a cat has been extremely helpful as well.

This is just an anecdote, every brain is different. Never self medicate, see a doctor and a therapist!

mastax• 3 years ago

Presumably the dose can be altered such that for a given individual their appetite creates a caloric equilibrium at close to the target weight. I don't think this is something that is done currently.

The side effects of chronic use don't appear to be that significant and would need to be weighed against the side effects of chronic obesity.

sneak3• 3 years ago

Not everyone that is overweight is overweight because of binge eating.

There is no data to suggest that those that don't engage in binge eating will suddenly begin doing so when ceasing this medication.

beefman• 3 years ago

https://archive.is/MfXlm

Avshalom• 3 years ago

"Semaglutide does not dull all pleasure, people taking the drug for weight loss told me. They could still enjoy a few bites of food or revel in finding the perfect dress; they just no longer went overboard. Anhedonia, or a general diminished ability to experience pleasure, also hasn’t shown up in cohorts of people who take the drug for diabetes, says Elisabet Jerlhag Holm, an addiction researcher at the University of Gothenburg."

So it doesn't dull all pleasure just almost all so it's not technically anhedonia...

I dunno, still seem pretty fucking bleak to me.

kevviiinn• 3 years ago

Our experience exists on a series of spectrums, some people experience pleasure way too intensely and it actually causes problems which is why this might be a good thing

Obviously there are people who like the pleasure given to them by food a bit too much and they consistently overindulge, it can be that way for many things as well. I'm not saying that the cause is always related but for many it may be

Taywee• 3 years ago

Addiction is often extremely distressing. Dulled pleasure can be far better than drinking yourself into a stupor every single night.

contravariant• 3 years ago

I'm not sure it is pleasure driving people to go overboard. I'm pretty sure it is dissatisfaction that is driving excess. In which case a drug that means you're more easily satisfied is far from bleak.

If anything the opposite is far more bleak. Imagine if there was a drug that meant you're less easily satisfied, who on earth would want that?

tetrep• 3 years ago

If anything the opposite is far more bleak. Imagine if there was a drug that meant you're less easily satisfied, who on earth would want that?

That sounds like stimulants. You wouldn't be motivated to do things if you were satisfied, so any drugs that motivate people would seem to need to have to have such an effect.

Dylan16807• 3 years ago

So it doesn't dull all pleasure just almost all

That is not what that quote says.

throwaway5959• 3 years ago

Wasn’t this the plot of the Firefly movie? It didn’t work out well for them.

pixl972• 3 years ago

I mean the opposite where we're fattening up ourselves like lambs for the slaughter isn't working out great either. We've had recent downward trend in longevity.

arcadeparade• 3 years ago

Some people really love to moralize and cite anecdotes about Ozempic.

armchairhacker• 3 years ago

Moralizing about weight loss is upsetting, as someone whose thankfully considers themselves "naturally thin".

It's 100% true the vast majority (including me) needs to put some discipline into eating and exercise: normal people can't just eat whatever they want whenever they feel hungry. But normal people don't get fat eating whole foods, working out, eating below their demographic's daily intake; and normal people don't suffer immense fatigue on tiny calorie deficits or even maintenance. People with thyroid and other metabolic issues do. Which IMO completely destroys the "moral" argument for weight.

(And it's also probably true that most overweight people don't eat whole foods and work out daily. That doesn't mean its right to call out some random fat person eating a mildly-unhealthy meal. You have no idea what else they've eaten that day, what else is going on around them, and you wouldn't call out a skinny person who eats the same.)

mrcrumb1• 3 years ago

I'm a person who has vacillated between being close to normal weight and obese. I think people who don't have problems controlling their diet tend to underestimate just how hard it can be to eat at a calorie deficit or even just maintenance when you've lost a large amount of weight. When I'm at my lowest weight I literally am thinking about food constantly and my maintenance calorie intake drops to about 1500-1800 calories.

jjeaff5• 3 years ago

It's also interesting to note that while thyroid and other similar issues are not usually the cause of a person's initial weight gain, those types of issues are much more common in obese people. So it makes it much more likely that an obese person has some underlying medical issues making their battle to lose weight even more difficult.

caycep• 3 years ago

it's funny in that a few years ago we were (and still are) excited by the potential cellular protective properties of GLP1 agonists, not just in the pancreas but in brain glial cells or whatnot. So much so that it seems to be the most neuroprotective of recent candidates for Parkinson's disease disease-modifying-therapies (DMTs).

to whit, (like botox), all the initial promises of the stuff have been waaaay overshadowed by...cosmetic value.

(I'm oversimplifying a bit...for those who are morbidly obese, yes, the weight loss really helps, but then they also have diabetes most likely which is the primary indication of the drug)

SamoyedFurFluff2• 3 years ago

How long is the research info ozempic and other hormonal weight loss drugs? Remember the last miracle drug that went to the market for weight loss had to be retracted for killing people or damaging their hearts to the tune of over 10 billion dollars in damages paid out.

ESTheComposer2• 3 years ago

These types of medications have been around since the 2000s, semaglutide (ozempic) specifically since 2012.

dillydogg• 3 years ago

At least in this case GLP-1 antagonists have been in clinical use for diabetes since around 2010

jjeaff5• 3 years ago

While I am not saying that this drug is definitely safe, I think the fact that Fen-phen turned out to be more dangerous doesn't really implicate these new drugs because while the desired outcome is the same, the class and type of drugs seem to be entirely different. My understanding is that fen-phen is a stimulant and increased blood pressure and heart rate. It also includes some other drugs that affect serotonin levels.

These new drugs are peptide analogs that affect your body's digestion and how it deals with sugar and fat production and insulin.

reaperman20• 3 years ago

Drugs acting on GLP-1 (ozempic), GIP, and glucagon receptors are largely shown to help hearts and cardiovascular health specifically (and independently of weight loss). They also improve lipid profiles (HDL/LDL), and have a multitude of other benefits.

Whether they, for example, increase the rate of glial brain cancer ... they really haven't been out long enough to know.

jmpman6• 3 years ago

I’ve been on Mounjaro since August. Down almost 60lbs, and it’s been a life changer. Have I had some gastrointestinal issues, sure, but expected. I feel great and my brain seems to be functioning as well as when I was in my 20’s. Now, when I go to the bar with friends, I end up having maybe 2 beers and although enjoyable, I don’t feel that light switch turning on which encourages me to drink more. Can I force myself to keep drinking, say if my good friends are in town and we’re going out all night? Sure, but there’s some reward center that’s no longer lighting up. I just get drunker, but it’s not more pleasurable. I was never a big drinker at home by myself. Maybe a glass of wine or two with dinner if my in-laws are coming over. Now I’ve literally had zero drinks at home by myself. Seems to have started changing about 3 month in.

Work also seems more interesting, but my untreated ADHD seems to be getting worse.

raincom• 3 years ago

I heard Mounjaro is even more effective than Semaglutide.

yieldcrv5• 3 years ago

the most surprising thing to me is how you’re describing normal behavior that I can relate to all my life, but the community of strugglers is so big that this is a whole testimonial people feel comfortable and exalted to share

like thats not something I’m deriding its just news to me

makes me wonder what this drug actually does, flush gut bacteria? just the right ones?

andbberger• 3 years ago

it's a GLP-1 agonist

ramraj07• 3 years ago

For a long time we have known the existence of a network of hormones controlling our apetite on the gut brain axis, with names like ghrelin, leptin, glp-1, orexin, somatostatin, list goes on [1]. Issue was the network was tres complicé and hard to perturb without getting the opposite effect than what we wanted. Finally with glp-1, sglt2 and pcsk9 inhibition we are starting to be able to correct in the right way.

To answer your question, yeah turns out it was never about will power. Some people just had hormone drive to be healthier than others and finally we can pharmacologically start to level the field.

1. https://www.cell.com/cell/pdf/S0092-8674(14)01503-7.pdf

reaperman20• 3 years ago

Any effects on gut bacteria will be very downstream of its primary effects, which are on:

- GLP-1 (semaglutide)

- optionally, that and also GIP (tirzepatide)

- optionally, both of those and also glucagon receptor (retatrutide)

But these hormones directly make you not hungry, among other things. They are probably some of the things that your gut bacteria manipulate to commandeer your behavior.

paulpauper7• 3 years ago

Good job, nice to see it works on reducing alcohol consumption too. I do not need this drug but it's nice knowing the option exists it need be. It gives hope to others too.

remote_phone• 3 years ago

I heard that 2/3 of the weight loss is muscle, do you find that to be the case?

paulpauper7• 3 years ago

this is likely incorrect because people are confusing lean body weight loss for muscle loss. lean body weight loss does not mean only muscle loss. lean weight includes non muscle like skin, organs, etc.

voldacar• 3 years ago

Obese people do not have enough muscle mass for 2/3 of their weight loss to be muscle

reaperman20• 3 years ago

In an actual study of this with published results on clinicaltrials.gov …

Semaglutide users lost 16% bodyweight overall but only 3.4% of their lean mass.

This is study NCT03548935 if you’d like to look it up, there are other statistics of interest in it as well.

hombre_fatal5• 3 years ago

That’s not what the research says though. Just FUD that some influencers like Attia are spreading for some reason.

rblatz10• 3 years ago

Yeah that was some dude on TikTok selling some diet scam stuff saying that. Or at least that’s where I saw it.

jmpman6• 3 years ago

I don’t have any quantifiable data, but although I’m certain the majority of the weigh has been fat, I’m sure I’ve lost quite a bit of muscle too.

usernew9• 3 years ago

If you're interested - not pushing an agenda. Here's what worked for this weird dude to not drink and stay fit.

I used to lift and be real fit till about 40. Like bulky-lean looking, bench 400 10x with a 6pack. Had a lot to do with being on the road for work all over the world, and you sit at the gym at the hotel for an hour every night because of nothing else to do, and there are girls there also on business who you'll never see again. I drank A Lot, ate anything I wanted, and did lots of blo on weekends.

It was getting out of control, so I did months of google-foo, went to a pharmacy in eastern europe, got like a thousand 150mg disulfiram pills under the counter for fifty bucks, and took one pill every morning for 2 years. You don't drink, you can't drink or you die, you forget drinking exists and after a couple of months don't even think about it, yet still do all the same stuff you used to - like dancing and clubs if that's your thing. And it's even more fun. There were no side effects.

Then things changed with age, testosterone went to crap, joints hurt. I got married and settled down. Can't work out too much now - just a couple of hours per week, and no heavy weights. Within 2 years I couldn't fit into my clothes and had high blood pressure and high cholesterol.

I realized I don't eat because I'm hungry, but because it keeps away sadness. So I changed my diet so I could eat however much I want. I now have a 4-pack instead of 6, fit into my pants, and eat however much I want.

I cut out fat completely. No oil when I cook besides a light spray on the frying pan. No nuts. Tuna - not salmon. Real expensive lean filet if I want cow in my mouth. Only white meat from birds. All the pasta, rice, and potatoes I want, but zero sugar added to anything. Lots of splenda and sweet n low. Fat free fairlife milk (lactose filtered out = less sugar calories). I eat normal sized meals.

Then, I have fruit and berries, and I eat as much of that as I want. I'm stuffing my face the whole day. Today, I had a pint of blueberries, 5 medium apples, 2 mangoes, and a pound of grapes.

Speaking of gastrointestinal issues, my poo is now soft and gentle, and smells delicious.

tysam_and• 3 years ago

That last line does not belong on most respectable websites on the internet.

vore4• 3 years ago

This is such a "one weird trick your doctor doesn't want you to know!" anecdote. Mounjaro and Ozempic are generally prescribed in instances where dietary interventions are insufficient and perhaps one of the last resorts before bariatric surgery. If your dietary interventions worked for you -- great! But there is only a certain class of people for which they work for, and it is rude to assume the OP hasn't tried these methods already (it would be surprising if they hadn't, since so many people can't help themselves from offering this kind of advice unsolicited).

With regards to cutting out fat, if you are advocating for a weight management plan for the general person, it is really too prescriptive and doesn't take into account that someone following your diet should not be accidentally increasing your carbohydrate intake (fruit sugars are still sugars!), resulting in the diet being a total wash. The gold standard for diet-based weight management is food journaling, and not cutting out an entire group of macronutrients without holistic consideration of your diet.

orhmeh092• 3 years ago

What's your bloodwork and cardio like now and what does your doctor say? No fat + high carbs flies in the face of everything I've read that was published in the last 20 years. Maybe you've found another path to health?

tremere• 3 years ago

I stopped using cocaine and for some reason gained weight, the post

gateorade2• 3 years ago

This is kind of weird because there’s a lot more data to suggest now that dietary fats are almost never the problem when it comes to obesity, and in fact dietary fats are really important for a lot of critical processes (brain function, neuroprotection, hormone synthesis). I get it for caloric restriction though since fat is denser than protein or carbs.

helsinkiandrew• 3 years ago

but there’s some reward center that’s no longer lighting up.

Do you find other pleasures (non food and drink) as enjoyable? Interesting to hear if it’s selective or dampens everything.

jmpman6• 3 years ago

Sex, sure. Video games - maybe.

rblatz10• 3 years ago

I started taking it in November and I’m down 30 pounds and my retina has detached 2x for no apparent reason since then. My drinking is unchanged, except I get full sooner and drink slower. Because of the discomfort.

ShadowBanThis01• 3 years ago

"my retina has detached 2x for no apparent reason since then"

I'd say that's a pretty huge deal. Did you report that?

eshack94• 3 years ago

Oh my, is retinal detachment a known potential side effect of the drug? Or is that a complication of diabetic retinopathy or some other condition that you already had? This sounds frightening. Hope they were able to reattach it, and hope you're doing alright.

hammyhavoc• 3 years ago

Wishing you excellent health, mate. That's rough.

CapstanRoller8• 3 years ago

I feel great and my brain seems to be functioning as well as when I was in my 20’s
but my untreated ADHD seems to be getting worse.

I had very similar results after taking ketamine for treatment-resistant depression. It eliminated all my compulsive tendencies for getting cheap dopamine hits (food, doomscrolling, etc), reset my tolerance to everything (caffeine, ADHD meds, alcohol), and made my ADHD worse while improving throughput and ability to Get Shit Done.

I wonder if they affect the same parts of the brain in a roundabout way? Ketamine is also used to treat addiction (opioids, primarily).

Do you experience any anhedonia while using Mounjaro? Did your overall pleasure response get blunted?

369337• 3 years ago

Ketamine treatments help people, because ketamine is a dissociative drug. It makes you not feel your suffering, also makes you not feel the positive feelings. That’s why you’re not eg doomscrolling. It doesn’t feel good for you anymore. If you’re not getting treatments regularly, you will be back to suffering in a few months likely. In my opinion, there are better alternatives and more effective treatments than living a life of disassociation.

jmpman6• 3 years ago

anhedonia

Possibly slightly, but not life impacting.

c7DJTLrn• 3 years ago

Based on what you've said it sounds like the drug may have an effect on release of dopamine, though I'm sure the trials would have caught that if so.

LazyMans5• 3 years ago

Yes. On a compounded semaglutide. I can finally control my hunger and a nice unexpected effect has been losing a desire to drink large quantities of alcohol. I don’t drink during the week anyway, but it seems to be the volume that turns me off to drinking. Thus a few cocktails are all I can tolerate. For context, Im 30, male, would be defined as a binge drinker on weekends. Oh, and I’ve given up nicotine entirely. I can’t tell if the drug is helping or it was just a point in my life that I finally decided I accept it makes me feel ill most of the time.

AtlasBarfed2• 3 years ago

I'd hazard a guess that nicotine is one of the two or three most addictive substances known to humanity. Opiates/heroin is probably worse, world of warcraft is probably third :-)

The drug probably helped.

Waterluvian• 3 years ago

Don’t forget caffeine!

LazyMans5• 3 years ago

Society makes it hard as well. It’s unacceptable to be falling asleep high on opiates. Hitting a vape on a video call with coworkers is considerably more acceptable.

sergiomattei• 3 years ago

Factorio is third.

UberFly• 3 years ago

18 years later I still freebase WoW on occasion, but I can stop any time I want.

burnished• 3 years ago

Nicotine was the hardest thing I have ever given up - three years later and I still get the occasional craving or dream where I have an excuse to smoke. This tracks with the experience of other smokes I have known. All else being equal and given you have reason to believe the drug reduces cravings, I'd guess that it is a strong factor

rjbwork• 3 years ago

Can you share this "compounded semaglutide" source? My doctor mentioned it but I'm a bit anxious about it. Everything out there seems so sketchy.

chriscappuccio4• 3 years ago

wellsrx is a reliable source

LazyMans5• 3 years ago

HenryMeds. It’s a US pharmacy. I wouldn’t be afraid, it’s no different than picking up generic medications from your local pharmacy.

monkeycantype• 3 years ago

the genetics of obesity are amazing. we all have a unique combination of genes, and epigenic features that influece the endocrine and neuronal pathways that drive the desire to eat, these different genotypes affect our behaviour. Ozempic is putting a thumb on the scales of this pathway, but this pathway is balanced differently in all of us. Think of the most hungry you have ever been, in some people this never stops, in others it's dialed up or down.

there are some great papers on fat labradors that hint at how these different genotypes are linked to our desire to eat and how that shifts our behaiour. Guide dogs are highly selected for trainability, and positive reinforcement with food reward plays an important role in their training. I think it was Yeo, found 22% of pet Labradors and 80% of Labrador guide dogs sampled carried a 14 BP deletion in the POMC gene, which forms part of this pathway.

https://doi.org/10.1007/s00125-016-4187-x https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4873617/

Jun8• 3 years ago

So, instead is suppressing the desire to eat, how about inventing a drug that blocks the absorption or breakdown of carbohydrates in the gut? Or maybe control the gut biome so that growth of bacteria that breaks down high calorie food is minimized.

Is this faster-than-light-like impossible daydream or is there any plausible path to it?

paulpauper7• 3 years ago

this is what gastric bypass tries to do. it bypasses part of the digestive process

coke12• 3 years ago

Consider Alli, the drug that blocks fat absorption in the body. It already exists and works reasonably well for weight loss. The side effects can be gross and unpleasant though.

AuryGlenz2• 3 years ago

I don’t know if I want a drug to exist that allows people to be gluttons without consequence. It’s like a modern (and real) vomitorium.

cromulent• 3 years ago

Some people will tell you though that they can eat anything and not put on weight - this is simply allowing others to do the same, right.

A vomitorium is simply the large exit pathway in stadia for rapid egress of many people. The idea that ancient Romans had facilities dedicated to vomiting has been debunked.

piyh• 3 years ago

I don't know about you but I don't want to be shitting loaves of bread everyday

hombre_fatal5• 3 years ago

Imagine the side effects of food passing through the gut without being broken down.

Reminds me of Olestra, the zero calorie oil substitute that failed because of similar sounding side effects. Olestra wasn't consumed/absorbed in the gut so you'd just shit out oil and your half digested food would glide out with it since it didn't block stomach emptying like real food.

refurb2• 3 years ago

That’s what lactose intolerance is.

Does gas, painful cramping and diarrhea sound like a good approach?

TeaBrain• 3 years ago

Your first proposal is what acarbose does. It is widely used in Asia, but is much less popular in Western countries. It inhibits alpha glucosidase and alpha amylase, which has the effect of decreasing the rate that complex carbohydates are broken down and absorbed.

tomcam• 3 years ago

Ozempic did nothing for me

PostOnce• 3 years ago

Exercise is free and the side effects are you get stronger, more energetic, and better looking.

Ozempic costs money and its side effects include cancer, kidney failure, and ruining your eyes.

https://www.ozempic.com/faqs.html

edit: many point out calorie intake is the real problem, it's true: buy a kitchen scale, weigh your food, count your calories, and you will lose weight. Exercise is optional compared to that. Still, both are free and have more benefits.

caymanjim• 3 years ago

Exercise does nothing for weight loss if you're eating too much. Exercise has health benefits, but weight loss is not one of them for the vast majority of people. People wildly overestimate how many calories they're burning.

dmix• 3 years ago

s/calories/carbs

Calories can still be a useful metric as a proxy but low calorie (“diet”) foods tend to compensate with more carbs. At least the ones I see regularly at my grocery store.

As a side note: It’s actually difficult to find pre-packaged low carb food at regular grocery stores sadly. It requires effort to make yourself, just like going to the gym. Like most good things in life.

justsomehnguy• 3 years ago

People wildly overestimate how many calories they're burning.

And people wildly underestimate how many calories they need. Just by limiting the one portion to 50g of pasta, instead of my preferred 150+g, I can go under 100kg in less than a week. My 'how much should I cook' habits formed when I was young and spent at least a couple of hours commuting, but nowadays I'm quite literally just sit on my ass all day. It's bothersome and isn't fulfilling to use scales cut down on the food (especially if it's tasty) but...

tuatoru2• 3 years ago

Yeah, you can exercise enough for weight loss. Ultramarathoning, the Tour de France, digging canals by hand.

It only takes ten or twelve hours of high-output exercise per day. Everyone's got that time to spare, right?

tehjoker• 3 years ago

Exercise can help control hunger and insulin levels so it's a good idea to pair moderate exercise with diet. I find it harder to resist snacking when I'm not regularly exercising.

chaostheory• 3 years ago

It’s just like intermittent fasting. Nearly everyone can afford it, but only a few people are willing to pay.

While aerobic exercise is more for a healthy circulatory system, anaerobic exercise has proven effective in weight loss.

nwienert5• 3 years ago

Exercise has many side effects too, including a risk of injury.

Meanwhile GLP-1 protects and even improves the function of brain, lungs, heart, muscles, bones, and kidneys, it improves sleep quality and reduces sleep duration, it definitely decreases addictive behavior, and even seems to help with some immune issues (anecdotally, but the effect is so strong it’s remarkable).

https://en.m.wikipedia.org/wiki/Glucagon-like_peptide-1#/med...

htag2• 3 years ago

Exercise has many side effects too, including a risk of injury.

This feels like saying chocking is a side effect of eating vegetables.

Most negative side effects from exercise come in a few camps.

* The exercise of choice comes with a risk of accidents. Accidents happen everywhere, but they happen to skiers more frequently than mall power walkers.

* The exercise of choice is well known to put strain on certain body parts. Usually this is a joint or tendon. Pitchers and arms. Power lifting and knees.

* The exerciser did not prepare well for exercise. Do they have proper equipment? Did they stretch? Did they warm up? Did they drink enough fluid? Are they attempting a goal they aren't ready for? Are they over training? Did they get training to establish proper technique? Are they distracted when they should have been focused?

lexandstuff• 3 years ago

They're not mutually exclusive. You can exercise regularly and still have a substance abuse problem. In fact, substance abuse is a major problem amongst high-performing athletes [1]

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4140700/

Danjoe42• 3 years ago

Exercise is not an effective weight loss intervention. It's something you should do for your cardiovascular health, strength, and cardiovascular health.

shadowpho2• 3 years ago

Exercise is free and the side effects are you get stronger, more energetic, and better looking.

And that works for what, 3% of the people that try it?

pton_xd2• 3 years ago

And that works for what, 3% of the people that try it?

Exercise is medicine!

Far too few people understand that unfortunately. Something is wrong with our culture when the majority have the attitude that exercise isn't worth doing.

hombre_fatal5• 3 years ago

You did it. You solved obesity.

ingenika• 3 years ago

maybe useful to treat drug addiction ?

clementmas• 3 years ago

Is this mostly a US drug? I never heard about it in France. I can't believe people love it so much without thinking about the actual source of their problem.

throwawayadvsec• 3 years ago

The source of the problem is that animals are wired to eat as much food as possible as quickly as possible. You can't blame half of the population for something that is deeply wired into our brain and bodies.

prawn• 3 years ago

I think you can ultimately blame them, but you can also accept that for many it's a very difficult problem to overcome and that finding other ways to tackle it has value to the individual and community.

benrapscallion2• 3 years ago

No, it is approved by EMA. https://www.has-sante.fr/jcms/c_2906429/fr/ozempic-semagluti...

TeeMassive• 3 years ago

I am taking Contrave to lose weight. Lost 30 lbs in 4 months. It is a drug that's composed of an anti-depressant and an opioid antagonist. Together they have a synergistic effect that represses binging envy and cuts appetite.

It also has a repressive effect on drinking and smoke, to my great surprise. And it also has had an effect on my addiction to video games.

Drugs companies get a lot of slack (most of the time deserving) but sometimes they create miracles pills.

olegious• 3 years ago

Just a heads up “weight loss” is a poor metric if it comes at the cost of lean muscle mass. It seems that 39% of weight loss associated with Ozempic comes from lean muscle mass which isn’t great.

https://peterattiamd.com/the-downside-of-glp-1-receptor-agon...

WheelsAtLarge• 3 years ago

When you diet to lose weight you lose lean muscle too unless you exercise to minimize it. What's the lean muscle mass loss from just dieting? I would guess that it's a relatively large number too.

paulpauper7• 3 years ago

Though a certain amount of lean loss is inevitable with significant weight reduction (usually about 25% of total weight loss), the goal is to increase the body’s overall proportion of lean mass – in other words, to improve body composition.

lean loss does not mean muscle loss

hombre_fatal5• 3 years ago

There's no shortage of people debunking that charlatan.

https://twitter.com/MichaelAlbertMD/status/16470364172503040...

ddlutz• 3 years ago

Why do you think Peter Attia is a charlatan? Out of all these longevity & health influencers he seems most realistic & knowledgeable.

benrapscallion2• 3 years ago

In 2020, Diabetologia published a body composition analysis of 88 volunteers with type 2 diabetes who used semaglutide for one year. These participants lost an average of 12.5 pounds. Of that weight loss, there was a 7.5-pound reduction in fat mass and a 5-pound reduction in lean mass.

In 2021, a major trial of semaglutide’s weight loss potency examined the body composition of a minority of participants. These patients did not have diabetes, and they took a much larger dose of the drug. The 95 participants to undergo a body scan lost an average of 18 pounds of fat — and 12 pounds of lean mass.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6997246/

gateorade2• 3 years ago

I’m generally skeptical of pharmaceutical weight loss solutions as a bandaid over the underlying problem, but for this statement to mean anything you’d have to compare it to traditional methods of weight loss.

If you simply eat at a calorie deficit and aren’t taking specific steps to preserve muscle (resistance training and high protein), a lot of the weight you lose will be muscle mass.

sn93• 3 years ago

But the people most in need of the intervention are also the ones least likely to take those muscle-preserving steps.

And if you can get them to take those steps, the need for the drug decreases.

xvilka• 3 years ago

I tried Ozempic for two months but wasn't able to continue - the gastrointestinal side effects are unbearable. I can confirm lack of desire to eat and drink alcohol. The hunger didn't go away but after a few bites of anything it quickly evaporated. After dropping the drug the hunger steeply increased, even higher than before, that was hard to contain.

EdwardDiego• 3 years ago

From my experience of addiction, suppressing the sensation of pleasure derived, is only the start.

People who are addicted will repeat the behaviour even without the neurochemical response. Consider the ritual of the addiction as a form of self-soothing.

You have to treat the patterns we've trod in our own minds, as well as removing that biological reinforcement.

jamesfisher• 3 years ago

https://archive.is/BUo29

MagicMoonlight4• 3 years ago

I was always of the opinion that being fat was a moral failing. Trying the drug really changed that.

Normies have it so easy. They take one bite and feel full. My brain would scream at me continuously to try and make me eat and would never be satisfied.

sourcecodeplz• 3 years ago

It's the same for me. I resorted to just eating yogurt, vegetables and fruits in between meals. Give it a try.

MagicMoonlight4• 3 years ago

I'd rather take the medication that stops the addiction. You can't eat your way out of an eating disorder

thegreenswede3• 3 years ago

"they take one bite and feel full"- I strongly disagree with this as the reason some people are just lean.

As someone who's bounced around weight a lot and also had long periods where I had to basically control it (wrestling in college), the main difference I've seen with people who are in shape and people are overeat is that the former group understands that it's 'ok' to not feel full all the time. As in like learning the TRUE difference between appetite and hunger.

I've had periods where I gained 50lb in like 4 months (start of pandemic) and all I had to do to basically get back to baseline is remind myself that I'm not going to die just bc I'm not constantly full.

But i definitely don't get 'full' after a few bites. I can keep eating and eating for sure. It's more that being what we call traditionally "full" is actually just wayyyyy overeating.

gerbilly• 3 years ago

When I'm on vacation my stress is reduced to the point where my 'appetite' drops, and this is despite the fact that I'm increasing my exercise load enormously (surfing, hiking, etc...)

I've noticed that stress causes me mild stomach pain, which can register as hunger. It also causes dry mouth which registers as thirst. If you're satisfying that thirst with sugary drinks long term, then you're going to be in trouble.

There is also so much novelty and more interesting stuff going on while on vacation that I don't find myself poking through the fridge out of boredom.

MagicMoonlight4• 3 years ago

Oh buddy... you're not normal. If you're yoyoing 50 pounds then you also have the eating disorder.

Trust me on this. I also thought it was a self-control thing. It's not at all. When you're normal you actually get full. I don't mean telling yourself you are full, actually full. You do not want to eat anymore. You don't want chocolate straight after eating dinner. You don't go to the fridge randomly to get snacks. You actually have no desire for food. You voluntarily stop eating during meals because you don't want to eat anymore.

It's something you can't really comprehend without experiencing it because you've experienced a lifetime of the hunger constantly telling you to eat. The idea that you could just... not want to eat is just absurd. But that's how it feels. When a normal person eats a small meal and says they are full, they are actually full. There's no self-control for them, no screaming voice or impulses.

Eumenes• 3 years ago

Congrats, you're now a lifetime subscriber to big pharma

fintechie• 3 years ago

I was about to get on semaglutide and after extensive research I thought "wait, the results won't be much better than the periods of IF I've had in the past, and the reported benefits are similar", and without side effects. Dropping 30 pounds in 3 months? easy to achieve with the Warrior Diet or OMAD versions of IF.

The results are exactly the same... you fill full eating less quantity, cravings disappear after 1-2 weeks, increased focus and enhanced mental state. But yeah, you need some self-discipline, tons of coffee/matcha and water.

I've concluded that semaglutide is not for me. Just like self-discipline in pills, with potential side effects. So better to give IF another go... I'm in the 4th week and dropped 10lbs already.

jshaqaw• 3 years ago

It’s interesting to me how much of the hostility to this drug has a moral dimension. I am quite fit for my middle age. It’s a relative superpower which confers a degree of status in this world. It’s not why I originally became fit 5 or so years ago but it’s something I increasingly notice or to be clear others notice and comment on.

I think the “fit” of the world get inherently uncomfortable that our relative social currency is being “devalued” if everyone can be like us with an “unearned” pill. And it comes out as hostility and skepticism.

I admit haven’t done much research on this particular topic. History should caution us that serious medication like this often has serious side effects which are not apparent early on. I get that. But unlike many others I don’t “hope” that happens like some kind of moral balancing. I get that reaction. In my gut I have that “I did it with willpower and lifestyle and sweat and these people shouldn’t just get it at CVS.” But that’s just the primate status brain talking.

Not that it impacts the outcome but I sincerely hope these drugs can improve people’s lives without significant negative problems. I can find my relative status elsewhere or better yet try to grow up past such impulses.

joedevon5• 3 years ago

Well said. I believe you are right. That and ignorance of how Leptin works, setpoint or lipostat theory of bodyweight regulation...once you've gotten fat, your setpoint goes up and the hunger signals are far greater than folks who have never gotten fat. You can have 2 athletes with identical weight height and BF%, but if one had been fat once, their hunger signals from the brain will be far greater than the athlete who was always slim.

briHass• 3 years ago

Those of us that work out, however, have been dealing with 'cheating with drugs' for a while: steroids. When you get close with enough gym rats, it's utterly shocking how many people with a muscular build use steroids. It's to the point where I essentially don't believe anyone claiming 'natty' (natural) status if they have more than a 1 sigma increase in musculature.

It's also downright laughable how the media/Youtube influencers/etc. treat everyone like idiots. Men's Health will run an article on Mr. Moviestar who was 5'11' and 150 pounds before his role as Superhero Character got to 200 pounds and veiny biceps in 6 months by eating eggs, oatmeal, and chicken breast and doing some situps.

reaperman20• 3 years ago

downright laughable

*criminal

Not literally, but it's really, really awful for society to have no idea what physiques/transformations required AAS and which didn't. That type of misinformation should not be allowed, and it would be amazing if there were a reasonable way to ban mass media lying / misrepresentation. Unfortunately, any law like that would instantly get weaponized to obliterate any remaining first amendment protections.

It's crazy how many athletes I tried to keep up with at D2/D3 schools which I now realize were on heavy steroid cycles but at the time I just thought I wasn't eating enough / had bad genetics / whatever.

It's also interesting how the negative effects of light/moderate steroid use are really blown out of proportion, and how many men on "TRT" are getting their testosterone to twice the highest "normal" levels (e.g. reaching testosterone levels of 1500-2000) under a doctor's recommendation.

And men just blame themselves their whole life for simply not trying hard enough.

When I finally started TRT at the relatively very low dose of 120mg/week I laughed/cried for months at how insanely easy it was to build real muscle for the first time in my life. Training at 15-25% of the intensity that I used to over the past 20 years yielded 400% better results.

Ozempic drug supresses desire to smoke, drink and more?

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