GLP-1s are breaking life insurance

https://www.glp1digest.com/p/how-glp-1s-are-breaking-life-insurance

441 571 1 year ago

It sounds like aligning incentives here is requiring the weight stay off for the policy to remain in effect with an annual physical for monitoring, similar to what employers require for health insurance premium reductions. Point in time underwriting is suboptimal considering current state of the art of GLP-1s (unless newer protocols that can update metabolic profiles are delivered soon).

prasadjoglekar• 1 year ago

Or life insurers paying for ongoing GLP-1s instead of potentially the health insurer.

But to your broader point, at least in the US, incentive mis-alignment on all healthcare and health insurance is possibly irredeemably broken.

toomuchtodo4• 1 year ago

Nailed my broader point. Could we go through contortions to see who is going to pay unreasonable costs for GLP-1s (health insurance, life insurance)? We could, but that's silly accounting to see who still gets to make the profit and who has to end up with the bill for empowering the human to fix their reward center. The shortcut is to provide GLP-1s to everyone who needs them at scale, as inexpensively as possible (to pull forward the improvement in health and quality of life outcomes until improved protocols arrive). The semaglutide patent is about to expire in Canada, China, India, and Brazil, for example.

https://www.labiotech.eu/in-depth/novo-nordisk-semaglutide-p...

jgalt212• 1 year ago

I guess, but this is sort of the same as going on a statin to get your cholesterol down for a better insurance rate. Then going off because of reasons...

arn3n• 1 year ago

Obesity is highly correlated with other medical conditions, from cancer to diabetes to heart disease. I wonder if there is a point at which it is cheaper for health insurance companies to offer subsidized or even free GLP-1s to patients than pay out for other specialized medications. For example, my insurance covers flu shots in my community every year because it's presumably less expensive to pay for the shots compared to the increased rate of hospitalization that the flu causes.

aqme28• 1 year ago

You’re thinking too highly about the incentives of the US healthcare system. Since insurance is tied to your employer (and therefore changing every few years), and most people die on Medicare, there’s not much incentive for insurance companies to pay for preventative care that won’t actually help you for several decades.

ethbr1• 1 year ago

That’s one reason the ACA shifted it to a mandatory (in most cases) category: https://www.healthcare.gov/preventive-care-adults/

Minimal, but minimal progress in the US was/is still progress.

helicalmix3• 1 year ago

hmm...doesn't this possibly incentivize ozempic subsidies even more?

If you know a "customer" of yours (an individual employee) is only going to be with you until they either change jobs or go on Medicare, then it seems the name of the game then is to make sure that nothing catastrophic happens to them until you can hand them off to someone else.

In which case, they should definitely go on ozempic. Even if the effects of ozempic immediately come off after usage, it's a short-term enough solution that benefits the insurance company, no?

Aurornis5• 1 year ago

You’re thinking too highly about the incentives of the US healthcare system. Since insurance is tied to your employer (and therefore changing every few years)

Most people don’t change jobs or insurance companies every few years. When they do, it’s often within similar regions and industries so the chances of ending up right back under the same insurance company are significant.

Regardless, the issue is more complicated than your line of thinking. Insurance companies have very small profit margins. Current GLP-1 drugs are expensive, around $1,000 per month.

So each patient on GLP-1 drugs costs an extra $12K per year (roughly) or $120K per decade. That would have to offset a lot of other expenditures to break even from a pure cost perspective, which isn’t supported by the math. So the only alternative would be to raise everyone’s rates.

I know the insurance industry is the favorite target for explaining everything people dislike about healthcare right now, but at the end of the day they can’t conjure money out of nothing to cover everything at any cost demanded by drug makers. These drugs are super expensive and honestly it’s kind of amazing that so many people are getting them covered at all.

raldi• 1 year ago

Then wouldn’t the government want to subsidize it?

coredog642• 1 year ago

This misunderstands how employer-provided insurance works for most people. Large employers sign up with a company like Cigna to provide a network and administrative process. But the actual healthcare is covered by the employer. So really, Cigna or BCBS don't really give a rip if you're taking a bunch of money out of the pool.

darkwizard42• 1 year ago

Actually from what I have heard, GLP-1 are maybe the first category of drugs which have impact within the median tenure of people on a medical plan (~2 years). It is so significant that you can see ROI within that window which justifies in subsidizing/encouraging patients to use it.

Doesn't disagree with your original claim that there is low incentive for any private insurance to care regarding longevity, but figured I could add some color

dragonwriter4• 1 year ago

For example, my insurance covers flu shots in my community every year because it's presumably less expensive to pay for the shots compared to the increased rate of hospitalization that the flu causes.

In the US, insurance companies are generally legally mandated to cover ACIP recommended vaccines at no cost to the insured, which includes flu vaccines for everyone six months or older without contraindications.

jameshart• 1 year ago

We have no idea what the long tern actuarial numbers are of 30 year GLP-1 use though.

alvah3• 1 year ago

Well no, obviously not, but we do have 20 years of data, and aside from a still-tiny-but-slightly-elevated thyroid cancer risk, there’s really not much showing up in that data.

petesergeant5• 1 year ago

I wonder if there is a point at which it is cheaper for health insurance companies to offer subsidized or even free GLP-1s to patients than pay out for other specialized medications.

That the NHS is getting to a place where it’ll provide it, I’d say yes.

Aurornis5• 1 year ago

Everyone likes to bash the US healthcare system, but at the same time it’s remarkable how much subsidized GLP-1 access Americans are getting compared to much of the world. The paradox of discussing healthcare online.

michaelbuckbee• 1 year ago

Add heart disease and blood pressure meds to the list of "we'd be better off as a group if more people took them as preventatives".

massung• 1 year ago

I don’t know if your topic switch was intentional - if so, my apologies and this is just for people outside the US who don’t know…

The article is about life insurance, which is very different from medical insurance.

Medical insurance companies often already go out of their way to pay early to save in the long run (e.g. free preventative care, checkups, etc.). I can’t speak to GLP-1s, but it’s possible that right now there are still active patents when used for obesity that make them crazy expensive for a few more years.

Life insurance is all about models and predictions about when you’re going to die. Any sudden change that massively impacts those models suck, because life insurers are basically gamblers with gobs of historical data they use to hedge their bets.

silotis• 1 year ago

Medical insurance companies often already go out of their way to pay early to save in the long run

Literally LOLed when I read this. Health insurance companies might pay lip service to this and make some token gestures like free preventative care, but in my experience health insurance companies frequently shoot themselves in the foot by denying care that later ends up costing them even more when the patient's untreated condition worsens.

_9ptr7• 1 year ago

It's not a gamble, it's an application of the law of large numbers. But yes, changes in the underlying assumptions (e.g. mortality rates) can make the whole calculation untenable.

terminalshort3• 1 year ago

Medical insurance in the US is not incentivized to save money. In fact it's just the opposite. The ACA requires that 80% of premiums be paid out to medical expenses. If an insurance company encourages people to get preventive care and lowers its expenses, that means they also have to lower premiums. So they actually want costs to be as high as possible since they get to keep 20%.

paulpauper10• 1 year ago

After it goes generic it will be cheaper. right now, it's not.

DrillShopper9• 1 year ago

I wonder if there is a point at which it is cheaper for health insurance companies to offer subsidized or even free GLP-1s to patients than pay out for other specialized medications

Some do. My insurance requires a prior authorization due to the previous shortage, but it's $12/mo

Medicaid in my state also covers it for $3/mo

Jach2• 1 year ago

I don't think GLP-1s are particularly expensive, so my top preference would be to just see them easily available. While not quite the same, it's a win that Rogaine/Minoxidil were once prescription-only but for a long time now can be bought at any grocery store and taken to the self-checkout. Still, I think the subsidy approach has been done for smoking problems via nicotine products before, and e.g. nicotine gum cost never seemed that high to me (especially compared to cigarettes).

But it's also worth remembering the relative risks involved. Obesity isn't quite the ticking time bomb / public menace it's often made out to be... For smoking, you'll find studies with relative risk numbers for lung cancer over 5 for casual 1-4 times a day smokers, and the number quickly exceeds 20 for heavier smokers. In contrast, with obesity, the most severe relative risks for things like heart disease or diabetes you'll find topping out around 4 to 5 for the most obese, even then often under 3, with milder 1.1 to 2 for the bulk of obese people. (Here, ~31% of the US has BMIs between 30-40, and ~9% have BMIs over 40.) For other harms, like there was a study on dementia a few years back, you'll also find pretty mild (1.1ish) relative risks, but these end up being similar with other factors like "stress", "economic status", or "low educational attainment". Just some thought for people thinking about subsidizing or providing free stuff, the cost tradeoff with paying for other things later might not work out so neatly, and there's reason to not focus solely on obesity but also do the same sort of analysis with other factors and severity of a factor as well.

Aurornis5• 1 year ago

I don't think GLP-1s are particularly expensive

On-patent GLP-1s (all of them right now) are actually extremely expensive. Right around $1000 per month.

I don’t want to discourage anyone who needs them from seeking treatment, but their discontinuation rate can be somewhat higher than you’d think from a life-changing drug because many people don’t like certain effects or even encounter side effects.

Weight loss drugs are also a challenging category for OTC because they’re a target of abuse. People with eating disorders and body dysmorphia already seek out black market GLP-1s at a high rate and it would be a difficult situation if they could pick them up impulsively from the medicine aisle. It’s also common for people to misuse OTC medications by taking very high doses hoping for faster results, which has to be considered.

There’s a libertarian-minded angle where people say “Who cares, that’s their own problem. Medications should be free for everyone to take.” I was persuaded by those arguments when I was younger, but now I have a very different perspective after hearing about the common and strange world of OTC medicine abuse from my friends in the medical field. Just ask your doctor friends if they think Tylenol should still be OTC if you want to hear some very sad stories.

paulpauper10• 1 year ago

yeah this is true. When people say that obesity is worse than smoking, I'm like "Have you looked at the actual stats on this?"

interestica• 1 year ago

Fluoridated water? Nah. GLP water.

jajko4• 1 year ago

Fuck that, not everybody here has massive self-control (on top of other mental) issues. Keep your chemical shit with bad side effects away from me and my kids, we know how to live well and raise kids similarly.

bagacrap3• 1 year ago

https://www.cbsnews.com/pittsburgh/news/west-virginia-insura...

I think the short answer is that these drugs are only cost effective when applied to people actually experiencing costly diseases, rather than simply being obese. A large part of that has to do with the drugs being very expensive still.

YetAnotherNick• 1 year ago

For the first insurer for the first year, sure. But just within few years their premium will drop if population start getting less sick.

thefz2• 1 year ago

What about not ingesting shit

dlcarrier• 1 year ago

It's never cheaper for insurance to buy something for everyone. There's extra administrative costs to them being the middle man, so it makes much more sense for insurance to incentivize you to buy it yourself, through premium pricing.

For example, fire extinguishers and security cameras will reduce crime by more than their costs, but instead of charging you for them, plus administrative costs, and shipping them to you, your insurance provider will offer you a discount if you have them. (Really it's a price increase if you don't have them, but regulators don't like it when they call it that.)

Not everyone will benefit from GLP-1, so in this case, the most beneficial solution would be to charge higher premiums for anyone that could benefit from GLP-1 but doesn't use it.

llm_nerd• 1 year ago

This is a fun read, however-

"Life insurers can predict when you'll die with about 98% accuracy."

This conclusion isn't supported by the linked document. The document instead is talking about expected vs actual deaths among demographic groups as a whole, not individual people. And that expected vs actual is just history + trends. This doesn't mean that insurance can say that Joe Blow is going to die in June of 2027 with "98% accuracy", obviously.

PaulDavisThe1st• 1 year ago

Put a little differently, they can predict that of your cohort (defined somehow), after June 2027, only X percent of you will still be alive.

Will you be one of them? Click here to find out!

etothepii3• 1 year ago

For mortality tables age and sex are pretty much sufficient to get to 98% accuracy.

astrange3• 1 year ago

This doesn't mean that insurance can say that Joe Blow is going to die in June of 2027 with "98% accuracy", obviously.

Pretty easy to predict if you're willing to make it happen.

_9ptr7• 1 year ago

Life insurance is just another word for bounty

crazygringo• 1 year ago

Yeah that was a bizarre line in the article. Not to mention it's meaningless because it doesn't say within what time interval. But even if you assume a year (i.e. predict your age of death) it's obviously false. Life insurers are very much not predicting the year an individual will die and getting it right 98% off the time. That would be absurd.

ks2048• 1 year ago

I can predict pretty well "Will person X die this year" by saying "No". Yeah, this number seems meaningless without more context.

Qem• 1 year ago

Unless the preson in question is over 102 years. IIRC that is roughly the age when mortality rates on average surpass 50% per year. Up until tha age you can celebrate your birthday and reasonably expect is more likely to still be alive by the next than not.

paulpauper10• 1 year ago

They can predict it in the sense most people will die within some specified window in which the insurer makes a profit. This is why its so profitable for the insurer. They have a very wide window where it's profitable and the vast majority of people, 98%, fall within this window. .

popupeyecare3• 1 year ago

The link even has the source being ChatGPT - it hallucinated!

vslira• 1 year ago

I've always felt that there's some trade to be done here, with life and health insurers basically giving glp-1 et all for free bc they lower the cost of everything else

edit: and then Big Annuity lobbying to oppose this

lesam• 1 year ago

Aren’t “Big Life Insurance” and “Big Annuity” pretty much the same companies?

hiAndrewQuinn9• 1 year ago

They are, they're basically mathematical inverses of the same product.

Big Annuity can charge you more, in fact, if it has reason to believe you're going to live unusually long, so playing the GLP-1 dance with them would only be profitable in reverse. Pretend to be the unhealthiest person on the planet, lock in an annuity, then get on the drip stat.

meltyness• 1 year ago

Well I guess a GLP-1 pacemaker would address this. A lifetime of doses weighs at much as a nickel?

MPSimmons• 1 year ago

I believe it has to be kept at refrigerated temperatures over its relatively short shelf-life (1 year, I believe).

foota2• 1 year ago

I realize this is a fraught question, because not everyone is overweight by choice (whether due to a subsisting on whatever they can afford, time, genetics, injury, etc,.) but I believe that insurers are able to consider whether someone smokes cigarettes when setting premiums for ACA based healthcare. With the above caveats that would make this difficult, it would be nice if we could treat "voluntary" obesity similarly.

etothepii3• 1 year ago

I think the article is making the point that that is what they have traditionally been able to do but they no longer can. Since the magic drugs are giving people the will power to be able to make these changes.

foota2• 1 year ago

The article is about life insurance, not health insurance (I should have made it clear I was talking about health insurance).

romaaeterna3• 1 year ago

The problem (not new with GLP-1s) is that people lose weight, get life insurance, and then regain.

The biggest part of that equation is regain part. Most people quit GLP-1s because of costs. Let's fix that.

beepbopboopp• 1 year ago

Get ready for health/weight based credit scores, Its probably a genuinely good idea.

paulpauper10• 1 year ago

I think they quit also because they see it is working and no longer feel like they need to use it

apwell232• 1 year ago

i have hard time believing ppl go through all that only to sign up for cheap life insurance.

cm21872• 1 year ago

I don't know, I tend to notice the effect wears off over time. Not sure it's a good idea to consume it permanently. Perhaps a better use would be for short periods to course correct.

romaaeterna3• 1 year ago

Anecdotally, the dose required to maintain a stable weight seems to be lower than the dose required to lose weight. Most people tend to regain some weight when going cold turkey.

The safety profile of the drugs with diabetics, and the health benefits that come from the associated weight loss may make permanent use a net benefit for most people. There appears to be little, if any, "course correction" effect from taking it for short periods of time.

jstummbillig4• 1 year ago

Can you explain what you mean? What you say seems to strictly contradict how the meds are supposed to work.

rrrrrrrrrrrryan• 1 year ago

According to all the studies, this is absolutely the worst thing that you can do. GLP-1s are revolutionary, but when you go on them, you should intend to stay on them for life. When patients first go on them, they lose both muscle and fat, and when they go off them, they regain just fat, and in many cases they're in a worse situation than they would be if they hadn't gone on them in the first place.

Letting your weight fluctuate up and down in giant swings is, in many ways, harder on the body than just staying at a steady weight, even if it's overweight.

cjbgkagh3• 1 year ago

I’ve been on it for years, at a lower dose though, the counter action by the body is probably dose dependent so my theory is lower for longer is more sustainable. I think people get attached to the rapid weight loss, coupled with the high expensive, incentivizes higher doses. I take gray market supply and it’s rather cheap.

Also it should be mostly used as an adjunct to strict diet and exercise.

cameronh90• 1 year ago

I have found the same thing, but my experience (YMMV; not recommended that you take my advice!) is that a one week break almost entirely resets it.

I now take a one week break every few months and have not noticed any decline in effects over time.

My suggestion would be to find an endocrinologist that specialises in obesity and these weight loss drugs. They will have dealt with patients who have experienced tolerance and have developed ways to work around it from real life experience. Obviously well-studied protocols with evidence would be preferable, but with how new these drugs are there hasn't been long enough to collect it yet.

msgodel• 1 year ago

"Measuring" people for the sake of insurance just sounds hard. Partly because people are complex but also because people just hate being measured.

arp2427• 1 year ago

Are the long-term (>20 years) effects of taking GLP-1s really all that well understood? Because that's kind of what you're suggesting here.

Making millions of people dependent on a drug to maintain basic health does not strike me as the best of ideas regardless. I understand why it's a good idea for many from an individual perspective and I'm not judging anyone, but from a societal perspective it does not seem like a reasonable solution.

Spivak3• 1 year ago

Why not? We have an overweight and obesity epidemic that has persisted through everything else we've gotten enough political capital to try thus far. The "miracle" drug is the most promising direction we've had in a long time. Whatever possible adverse long term effects have to be (plausibility they actually happen) x (harm they cause) > known harms of being overweight.

The scale of the solution is allowed to match the scale of the problem which is on the order of 2/3 of adults or 200,000,000 people.

paul79865• 1 year ago

I believe AI along with smart glasses that shows and calculates your daily caloric intake will be a SUBSTITUTE (another option) to the Ozempics.

With AI glasses doing this automatically for you upon seeing what your eating without u having to do anything some people may be shocked to learn how many calories they consume daily.

Currently, it's too time consuming now for the majority to do (i use GPT via texting it or talking to it to keep track as I eat out daily at healthy chains) but if it was done automagically I believe it definitely would be a substitute to Ozempic. I bet some or more would use that easily captured data that's shown to them (in the glasses or on their mobile device) to strive, make and possibly compete with their friends/family to eat less calories and carry less weight on them (be healthier). You can train your body to eat less to a lot less and for some that would definitely help them shed weight. The glasses could as well deduct calories burned from your daily walk, jog, etc.

*Being downvoted hmmm do you think AI by seeing it can't via an image calculate the calories of a burrito bought from Chipolte and other chains? All chains have nutrition information on their websites now that GPT goes and fetches. As for home cooked prepared meals I have taken pics of my food via GPT and it seemed to come close.

__turbobrew__2• 1 year ago

I don’t think awareness of caloric intake is the problem, there are standardized labels on most foods (especially the bad ones). Most people who are obese know that the calories make them overweight, but they still have the need to eat food — which is what makes obesity a result of addiction. Similarly meth addicts know that meth is bad for them, but they still do it anyways.

astrange3• 1 year ago

How often do people control their own diets? That assumes they buy and cook all their own food, which is only true if you live on your own.

paul79865• 1 year ago

Sure and I didnt say it would replace Ozempics rather it's a substitute that would help a portion of the population.

Yet majority of all people have no idea the amount of calories they eat daily. Im sure being shown this automagically will be valuable data to all people just how they choose to use this optional feature to make changes or not.

dragonwriter4• 1 year ago

which is what makes obesity a result of addiction.

Obesity is not (in general) a result of addiction.

lbrito• 1 year ago

People with poor restraint will remain unfazed.

If what you're suggesting worked, then the horrible cancer pics on cig packs would have long eliminated smoking.

paul79865• 1 year ago

I did say it will be a substitute to the Ozempics not a replacement.

For those who don't have the will power there's the Ozempics to utilize at their discretion. For those who do have some or a lot of will power to change their lifestyle forever then this is going to be extremely helpful and those types wont be using Ozempics as Im sure such types are using it now.

ChadNauseam2• 1 year ago

I agree with you. However, smoking rates have gone down, probably in part because of those pictures and awareness campaigns in general

paul79865• 1 year ago

well for those mid level to have strong restraint this is going to be helpful!

I already do this with chatGPT but i have to do something vs. just living and glasses doing it automatically.

lumost3• 1 year ago

You're being downvoted as many people who try to count calories fail to achieve meaningful results. From my own experience, weight gain follows a simple progression.

1. Expected high stress work day -> Coffee w/ food item in the morning

2. Stress during the day -> No exercise + large lunch.

3. Post-day -> door dash due to not feeling up for cooking.

4. Sleep -> Get 6 hours of sleep due to not having the energy to maintain bedtime discipline, getting paged, or late night meetings + childcare obligations.

5. Repeat.

This cycle continues for a few months leading to 10-20 pounds of weight gain, followed by a year long push to rebalance life and lose the weight. There is nothing that a magic calorie counter could do for this cycle other than guilt me over my door dash order at the end of the night.

pmg102• 1 year ago

People seem to be taking it as given that "someone else preparing the food for you" == "the food is more likely to lead to weight gain".

Why should that be? Is it not possible to order healthy food in? If not this would surprise me as it seems a number of people would be seeking this.

I'm asking as I don't have personal experience.

9x39• 1 year ago

I think of a calorie tracker as a compass as I navigate an overly calorie-dense world that doesn't make us exert ourselves to the point of caloric deficits any longer.

For the aware user, combined with a scale, it helps normalize estimations of calories which can be incredibly deceptive. For example, try getting a group of people to estimate how many calories are in a store-bought muffin or donut, a bowl of nuts, a sweetened coffee drink from a drive-thru, or their typical bowl of a favorite cereal. I'm used to the casual observer's guess being about 1/3 of the true total if you weigh the item and read the label.

So in your scenario, the calorie counter would be a signal that you need to cut portions or cal density if your weight is going in the wrong direction, not unlike how a compass is just a tool if you're lost - you still need to know how to use it.

gbcbooks• 1 year ago

In 2013, my weight was around 48kg, and I increased it to 55kg through fitness and dietary control. In 2016, my body shape reached its peak at 60kg, with a body fat percentage of 12%. In 2022, my weight was 63kg, but my body fat percentage was around 22%. I still managed to regain a weight of around 57kg and a body fat percentage of 18% through fitness and dietary control. I just want to emphasize that controlling diet is very important for shaping the body, and the method of controlling diet is to calculate the calories of food. Only then will you realize what foods you should consume. For example, when you are thirsty but don't want to drink pure water, you want to drink a beverage with a taste like coffee or tea. If you understand the calorie percentage of these foods, you can know that if you choose coffee, it's best to drink an Americano, and if you prefer tea, you can drink almost all types of tea. Even tea is considered beneficial for weight loss. Find tea here,https://teayucafe.com/ The reason why many people fail to achieve their weight change goals by calculating calories is that they cannot persist. Remember, this is a long process.

hiAndrewQuinn9• 1 year ago

So... There's a miracle drug powerful enough to robustly lower people's all cause mortality, but since health insurance and life insurance are industries with vastly different time preferences, this is not a good thing for the life insurers because people just keep getting off the magic longevity drug and screwing up their predictions. Because, admittedly, it kind of sucks in the moment to be on.

And I'm guessing just based on my own experience paying for term life that the actual premia differences aren't actually enough in most cases for the life insurer to simply pay out of pocket themselves; the differences probably add up to a few hundred per year per customer, whereas a year's worth of a GLP-1 agonist probably costs a couple thousand (for now, in 2025, and probably dropping rapidly).

Huh. Second order implementation details aside, this is an extremely fortunate turn of events for us.

ramoz• 1 year ago

Can you explain what sucks about being on the prescriptions?

hiAndrewQuinn9• 1 year ago

I'm just reporting my cached knowledge of people saying they experienced some adverse side effects. Also injections are not fun, even though they are probably a lot less annoying than they look.

DrillShopper9• 1 year ago

Hi there - Mounjaro user here. I've been using it for about a year at this point.

I feel sick for three days in a row after taking it. Even after several months on the same dose. I get horrible gut cramps, sour stomach, near constant nausea, and occasionally vomiting and diarrhea. I have to take my shot on Thursday night because I'll feel bad the next day and supremely sick the next two days. If I took it earlier or later in the week it would absolutely impact my ability to work during the work week.

It has had amazing effects. I've lost about 60 lbs in the last year and my A1c is now around 6.2.

It's a very effective drug, but it is brutal on my body. I'm not sure anything in the medication is causing the weight loss. It just makes me feel so sick that even if I'm hungry I don't feel like eating.

glp1guide10• 1 year ago

Tried to list them all here:

https://glp1.guide/content/are-glp1-side-effects-all-the-sam...

It was a while ago, but IMO the list still plays

wonderwonder5• 1 year ago

I cant think of anything. I take 18 shots a week, including the GLP-1 shot once a week. I don't even notice it. I even give my wife her shot. Gotten to the point where I don't have a lot of belly fat to inject into so I have to lean forward but that's really it. I've never had a side effect from GLP-1. No nausea, nothing. Only side effect is I now have the will power not to kill a pint of ice-cream after 6pm. Its been 100% a willpower increase for me vs a physical change. Started in January at 240lbs. 210.8lbs as of this morning. Every ab is defined. Stuff is great, no idea why anyone would want to come off.

I can still eat whatever I want I just choose not to. For example, had burgers, fries and ice-cream for lunch on Saturday with the family and then just a protein shake for dinner.

I also don't snore anymore. I used to snore terribly, my wife would wake me up at least once a night to tell me to roll over. Not at all now.

Most importantly, even though I am on a ton of test and deca, my blood pressure is normal, and my cholesterol has actually gone down.

jiveturkey• 1 year ago

For a single person, perhaps fortunate. What about in aggregate? What if the math is so bad that your life insurer goes bankrupt?

hiAndrewQuinn9• 1 year ago

... I just switch life insurance providers?

Seriously, that's just not that big of a deal. It takes like a few days at most for simple term life. Can't speak to the other policies, which I understand are mostly tax vehicles anyway, but it's not hard to simply get a new life insurance policy if your current one goes kaput.

petesergeant5• 1 year ago

admittedly, it kind of sucks in the moment to be on

I don’t think that’s a typical experience for most people, other than the price

mattmanser2• 1 year ago

There's often side effects, including nausea, diarrhea, headaches, bloating, discomfort, etc.

As far as I can tell from forums, it's not like 5% have the side effects, it's like 80-90%.

But for the first time in decades, I felt full. I didn't want to finish a meal, it was too much.

My body regulated my food intake in what felt like a natural way.

I hadn't even realized my body had somehow lost that fundamental mechanism of appetite control. It made me realize I wasn't weak willed, something is different about my body than other people.

But it comes with a price. The side effects I had were quite bad and so I stopped (though I now read that if I switch to a different brand, I might be ok).

I often didn't want to leave the house due to a dicky tummy. It could come/go in waves. But often can last a whole week.

Plus you've got to inject yourself every week. Often you can't drink as it makes you sick. Even when you're doing everything 'right' you can feel a bit off.

If you do over-indulge (with food or drink) the side effects can sometimes be massively amplified and you feel terrible for days.

So amazing in some ways, but it's not like taking a vitamin tablet. There are costs and making one slip up can result in suddenly feeling awful for a day or two.

Perhaps I was just particularly prone to the side effects, but it seems to happen to a lot of people (I found Mumsnet threads about it useful, they are quite revealing as they seem to be fairly honest and willing to share their experiences)

linsomniac• 1 year ago

There's a miracle drug powerful enough to robustly lower people's all cause mortality

Did I misread the article, my TL;DR of the article is that GLP-1 reduce the indicators or mortality without modifying the actual mortality (because most users return to normal indicators within about 2 years).

yumraj• 1 year ago

because most users return to normal indicators within about 2 years

Because they stop taking GLP-1s after 1-2 years, not, it seems, because the meds stop working.

readthenotes12• 1 year ago

"If we assume about 65% of people who start GLP-1 medications quit by the end of year one, that creates a big problem. When someone stops the medication, they'll usually regain the weight they lost, and in two years, most of those key health indicators (like BMI, blood pressure, blood sugar and cholesterol) bounce back to their starting point. "

So in addition to the quitters returning back to normal after they got life insurance underwritten when they were healthy, we have the unknown of the longevity of people on the glp-1 drugs.

refulgentis4• 1 year ago

Subtly different: you read "most...return to normal...within 2 years", it says "When someone stops the medication, they'll [return to baseline]"

Then from there, I click through the 65% #, assuming they have a good study on 65% of people stop after a year. Nah, they don't. It's super complex but tl;dr: specific cohort, and somehow the # getting on it in year 2 is higher than the # of people who quit in year 1.

I have a weak to medium prior, after 10m evaluating, that the entire thing might be built on more sand than it admits.

Lot of little slants that create an absolute tone - ex. multiple payouts over the "lifetime" of a life insurance policy. (sure, it's technically possible)

Also there's no citation for the idea this mortality slippage happened because of GLP-1, and it's been out for...what...a year? Maybe two?

That's an awful lot of people who were about to die, saved in the nick of time by...losing weight? Again, possible, I'm sure it even happened in some cases.

Enough to skew mortality slippage from 5.3% to 15.3%?

I thought they were 98% accurate?

Wait...is the slippage graph net life increase slippage? Or any slippage?

Because it's very strange this explosion happened in exactly the year of a global pandemic that had sky-high mortality rates for older people.

pie_flavor• 1 year ago

No, it's a miracle drug that drops mortality by a ton. The indicators aren't being faked. The weight causes the mortality, and the weight loss reduces it, and the weight regain reintroduces it. GLP1RAs introduce some noise to the indicators but not enough to cause what you're implying.

dragonwriter4• 1 year ago

It's a maintenance medicine, not a cure, so if people stop taking it, they return to the same problems they had without it.

paulpauper10• 1 year ago

The drugs do not reduce mortality much or even at all. Such drugs may improve quality of life though. Except for severe obesity, 40+ BMI, life expectancy is not lowered much in men and even less in women in the setting of obesity. It's just that being obese makes all sorts of markers worse, yet people do not die much sooner. It's more about improving quality of life.

loeg15• 1 year ago

They aren't even that awful in maintenance -- just expensive. The unpleasant part is when you're increasing the dose. After a while at the same dose, it's more or less unnoticeable IMO.

gregw134• 1 year ago

Unnoticable meaning doesn't have any effect at all, or just no bad side effects?

stingraycharles• 1 year ago

I wouldn’t say unnoticeable, but rather a trade-off that’s fine. My stomach is definitely more sensitive, can’t handle coffee in the morning anymore, etc. It probably depends on the person.

zer00eyz• 1 year ago

And I'm guessing just based on my own experience paying for term life that the actual premia differences aren't actually enough in most cases for the life insurer to simply pay out of pocket themselves; the differences probably add up to a few hundred per year per customer, whereas a year's worth of a GLP-1 agonist probably costs a couple thousand (for now, in 2025, and probably dropping rapidly).

I wonder why life insurance isnt funding more research into things like metformin, where we have amazing long standing data but haven't done the real research. See: https://www.afar.org/tame-trial

loeg15• 1 year ago

Because metformin is super unpleasant.

exabrial2• 1 year ago

I think this is pretty far off the cusp and seems like a bit of reddit logic "health insurance is scam, internet said so".

Health insurance is one of the rare services where incentives between consumer and business are well aligned. The vast majority of people are healthy. Healthcare is expensive in the US because the uninsured population continues to rise out of "they're not making me pay for it": There are entire tranches (in the US) also don't buy insurance and use the ER and abuse EMTALA for their primary care (most of this is actually unintentional in my opinion, it's less educated populations in the US who are repeatedly taken advantage of and left to ride on government, which is extremely eye-wateringly bad at spending money). Personal experience here working in an ER.

The real pathway in the US to success is getting those populations onto private health insurance. Obama tried a heavy handed "health insurance mandate" that hilariously somehow passed the supreme court, but was so laughable mis-aligned with American ideals even Biden wouldn't enforce it.

What is apparent though is these populations are completely willing to pay bills like their cell service, gasoline, car payments, etc before investing in the most important thing (their health). This gives me hope there is a way forward by riding these perceived essential services somehow. I'm not really sure what the answer is here, but there is at least opportunity for some creative solutions.

I also think the disagreement here between red vs blue isn't the outcome: both want people to be healthy. Red doesn't want single payer, whereas blue does. Red ignores the fact these systems don't exist, blue ignores the fact that no other country in the world has the diversity of America and there are not functional examples.

multjoy• 1 year ago

Universal healthcare is a human right.

hippich2• 1 year ago

I thought about it quite a bit and I came to conclusion that it is not 100% alignment between consumer and insurance, like it would appear on the surface. To me it seems insurance in the long term is interested in health services becoming more expensive (bigger pie they can manage), but steadily. I.e. it will affect insurance negatively if costs will suddenly increase by alot in a single year while premiums are locked in. But if it will keep inflating steadily and predictable - it only gives them a larger chunk of cash to manage and profit from. There are of course limits, so it needs to align with income inflation to avoid situation where their pie is shrinking because people/government simply can't afford it anymore.

imtringued• 1 year ago

It's not different time preferences. According to time preference theory the insurers have perfect information about the future so they would have taken the change in lifespan induced by GLP-1 into account before it was even invented. The assumption that mistakes are impossible is one of the core foundations of neoclassical economics. In time preference theory the bias towards the present or future is a moral issue that you get beaten over with to enact a just world fallacy.

In liquidity preference theory insurers do not have perfect information so they must make a tradeoff between collecting information and acting on the information they already have. There will be a bias towards the present and the past, because more information is available about the past and present than the future. What's being "discounted" is uncertainty, not time. Hence there is also a general bias towards stability and conservatism (sticking with existing decisions, even if they are bound to become obsolete).

Now let's apply this to the article:

The insurers don't know if you can stick with your weight loss, so they will conservatively deny coverage until they are certain that they know your health/risk profile. According to time preference theory this would never happen since the insurer already knows whether you will succeed at weightloss or not.

eru22• 1 year ago

The assumption that mistakes are impossible is one of the core foundations of neoclassical economics.

[citation needed]

PeterStuer2• 1 year ago

Pharmaceuticals generally do not drop in price while they are under patent. They will lobby like crazy to get on the approved 3rd party payment schemes though as that makes it "affordable" to more as then everybody pays regardless of wether you use or not. And a treatement that you have to continue forever or fall back? Pure gold!

Insurers certaily don't mind you living longer. More payments, less payouts. They just need to update their predictive models or coverage policies to safeguard their margins. The 'problem' is transitory.

tonyhart7• 1 year ago

I think this is US only problem

fhdkweig• 1 year ago

Insurers certaily don't mind you living longer. More payments, less payouts.

There are times when this is a problem, but even then it isn't the insurance companies that are complaining. There was a big "problem" during the beginning of the AIDS epidemic. For reasons I don't quite understand, the holder of the policy (the insured) can sell their policy to a random third party. The seller sells because they need immediate cash for end of life hospice treatment. The buyer buys because they know this person is about to die and they are going to get a cash payout of more than they paid for. This was a guaranteed payout because there was no treatment. This was a rare example of an investment with zero risk and high return. If you got the virus, you were going to be dead in a few months. This is a win-win for both the deceased and the new buyer, and it is neutral for the life insurance company because either way they have to pay the same amount to someone at the time of death.

The arrival of AZT cocktails threw a monkey wrench into the whole plan because suddenly a guaranteed death is no longer guaranteed and it leads to an ethical quandary because the "investor" doesn't get a return for their "investment" unless that person dies, and now they are literally wishing death on someone. (see also: There is no such thing as a risk free investment.)

https://www.theatlantic.com/health/archive/2018/10/viatical-... "The Gay Men Who Have Lived for Years With Someone Waiting on Their Death"

downrightmike• 1 year ago

Insurance companies need to go after processed food companies if they don't like it, not their customers

firesteelrain16• 1 year ago

I was on Mounjaro for two months. I was also dieting and walking 10k steps a day. I lost 25 lb and my A1C went down to 5.0 from 5.7. All my cholesterol numbers were in range. I stopped taking it and lost 25 more. I haven’t regained the weight. People who gain it back did not learn the lesson and did not effectively change their habits. You need the discipline - and a good support system. But if you don’t have that and continue old habits then you will gain weight back. The original problem isn’t solved.

petesergeant5• 1 year ago

People who gain it back did not learn the lesson and did not effectively change their habits. You need the discipline

This is deeply misguided. I’m glad that the little assist was enough for you, but if “healthy habits” were enough then people who’d lost weight the traditional way would keep it off.

Further, unless you’ve been off it for more than six months, I’d hold your judgement on this one.

firesteelrain16• 1 year ago

I have been off since Oct 2024. Also, I did continue to lose weight the traditional way.

After I stopped, a coworker told me about Vida which my work offers as a health benefit.

Using the Vida service where I got a registered dietician to show me what to eat, I tracked my food and water intake and tracked my exercise. I had protein and fiber goals to hit.

You can’t do it all on the medicine - it is a lifestyle change. The medicine was the catalyst but not the reason I kept the weight off. I wanted it. But because I wanted it, I wanted to use the support system that my work paid for.

I think there is a lesson to be learned here

mschuster912• 1 year ago

but if “healthy habits” were enough then people who’d lost weight the traditional way would keep it off.

That's because a lot of the "traditional way" methods are pseudoscience at best, outright quackery that's going to send you into serious malnutrition issues or eating disorders at worst. Every two or three months you see a new diet fad pushed through the yellow press rags, and none of it anywhere near being considered scientifically valid - usually it's some VIP shilling some crap story to explain how they lost weight, of course without telling the people that they have the time for training and the money to pay for proper food, 1:1 training and bloodwork analysis.

vkazanov• 1 year ago

I know some serious cases where there were non-habitual problems but... "healthy habits" is nothing to laugh about. People literally are what their habits are. All of our behaviour is habits, and changing behaviour takes time and effort.

The good news is that it is not impossible, and it really is possible to change bit by bit for most people suffering from obesity.

I don't think somebody who walks 10k+ a day, maybe goes to gym a couple of time a week, limits calorie intake to a comfortable and reasonable 2000 kcal per day, would suddenly bounce back to 130kg!

throaway9554• 1 year ago

Some people DO keep it off. Ive never been obese but ive been overweight, extremely unhealthy, pre diabetic, couch-potato for years at a time. For me, it's always a matter of getting into the mindset that these things are not just "not good," they are literally poison for me!

I've seen a few obese friends of mine lose weight and gain it back. And while I can't put words in their mouths, I have never noticed them have the attitude that "being obese will kill me."

furyofantares2• 1 year ago

How long ago was this?

firesteelrain16• 1 year ago

I started in Aug 2024 and stopped in Oct 2024. I paid for it from one of the pharmacies that made it in Florida. I injected myself with insulin needles that they send you.

apwell232• 1 year ago

suprised your a1c was only 5.7 despite being obese .

firesteelrain16• 1 year ago

From what I understand you don’t have to be obese and have type 2 diabetes. In my case, I was obese and did not have diabetes but I might have been going down that road

nerevarthelame• 1 year ago

This is akin to saying a severely anxious person should be able to take an SSRI for a few months, learn how to change their thinking, and stay off antidepressants for the rest of their life. So simple. Must be their fault if they can't pull it off.

Perhaps that works for some people. I'm glad it seems to have worked for you. But the facts of the world we live in show that it doesn't work for most. "Learn the lesson and be disciplined!" is not effective advice.

firesteelrain16• 1 year ago

The analogy to your example is that someone who has to take Mounjaro for diabetes will always have to take it even after losing say 100 pounds. Or Metaformin even.

GLP-1 in those cases helps manage the problem better.

But for those who are not in those cases where Type 2 Diabetes has sunk in, then they need to use the opportunity to get better while on it and kick themselves into high gear or they will have learned nothing from the experience

treyd• 1 year ago

That is the ideal model for treatment of those types of mental health disorders. Often patients have blockers that prevent them from resolving underlying issues. But through a drug they can get into a headspace that allows them to work through them with talk therapy, and then learn new habits and eventually go off the drug.

In practice, this doesn't happen that often, no, but it's a theoretical goal. Probably because we're in the pre-GLP-1 era with regard to mental health meds. Maybe that will change.

make35• 1 year ago

I feel like your example shows the inverse of what you want. SSRI are actually great at helping the person develop healthy mechanisms (compared to GLP-1s), because they reduce the mood swings & negative thoughts, allowing the person to be more productive & be more involved in their therapy, in reading, journaling, doing sports, etc. It's just that it might take two or three years and not months, which is fine because SSRI also have much more limited side effects compared to GLP-1s.

GLP-1s don't do that directly.. but at least they might help people move more, and give them confidence to do more for their health instead of seeing it as a lost cause.

jajko4• 1 year ago

Very wrong analogy. Anxiety is not something that you gain by buying junkfood due to low budget or laziness or simply being raised with very wrong values re food and health. On the other hand, every single ice cream, pizza, burger with fries, cupcake or beer contributing to resulting weight is a voluntary choice (with some mental drama around).

There is simply no way around the simple fact that there is only 1 way to eating well long term - that is lesser, more healthy portions. GLP1 may show a person what things could and should look like, what is achievable but the path needs to be walked by themselves. The alternative is either lifelong consumption of this chemical with various bad side effects or premature death (or both, to be seen since nobody has a clue).

SirMaster2• 1 year ago

You think that controlling your anxiety and controlling what you put into your mouth are equal things?

I would say that controlling what you put into your mouth is easier than controlling your anxiety.

reverendsteveii3• 1 year ago

As someone who took SSRIs for a while my plan w my doctor was always to use meds for support as I developed a toolkit to deal with my emotions without medication and then to re-evaluate periodically to see if the meds were still necessary. It took a few years, but eventually we weaned me off. I'm glad we did, now that my life is in a better place and I'm a bit more agile with my thinking I'm quite glad to be rid of all the gross side effects of the drug, but when I was having a rough time those side effects were well worth the stabilization the drug brought me.

jstummbillig4• 1 year ago

People who gain it back did not learn the lesson

Considering it took you a miracle drug to learn the lesson, that seems like a humorously arrogant take.

arp2427• 1 year ago

I lost almost 15 kg (~33 lbs) over the last two months and I didn't even try that hard. I never had problems with my weight, but over the last few years it slowly crept up to ~107kg (at ~1.95cm), at which point I realised I had to do something. Reasonably sure I could do a The Machinist Christian Bale if I wanted to.

I also quit smoking with relatively little effort twice (once in my early 20s, and then again a few years ago after I picked up smoking again during COVID). It wasn't easy-easy, but if I hear the struggles some other people go through, it was relatively easy.

Some people are just wired different. I have plenty of other issues, but on this sort of thing, for whatever reason I seem to be lucky.

MisterSandman• 1 year ago

Someone who had to take a drug to learn how to control their weight should not be lecturing others on how to do it.

firesteelrain16• 1 year ago

Posting what I posted below:

I have been off since Oct 2024. Also, I did continue to lose weight the traditional way. After I stopped, a coworker told me about Vida which my work offers as a health benefit.

Using the Vida service where I got a registered dietician to show me what to eat, I tracked my food and water intake and tracked my exercise. I had protein and fiber goals to hit.

I think there is a lesson to be learned here

almosthere• 1 year ago

so surreal reading comments... a month after non-stop threads about glp causing a billion issues, everyone is talking about how wonderful they are again.

humanity

brokensegue• 1 year ago

billion issues? i saw some reporting on rare cases of blindness. what else?

paulpauper10• 1 year ago

1-2 years ago there was considerable skepticism about "taking the easy way out" or unforeseen risks like like with Fenfluramine/phentermine. Now sentiment has changed given that more people realize these drugs are safe and effective.

octo888• 1 year ago

Pancreas issues and hair loss IIRC?

nwienert9• 1 year ago

It's a once in a generation drug with less side effects than most OTC, likely net positive even for healthy weight people. I'd bet within the decade it'll be approved for a whole basket of other benefits - at the least a whole array of immune system disfunctions and a cure-all for addiction.

Likely protective of a wide array of internal organs, likely life extending.

saturneria• 1 year ago

What is well studied and has a billion issues is obesity.

Imagine that, people make up bullshit that isn't grounded in reality. Who would have thought!

Gothmog69• 1 year ago

That's interesting I keep reading about a billion issues glp1 help like addiction, alzheimers and more

throwaway019254• 1 year ago

Is there any research on whether GLP-1s are also beneficial for generally healthy and not overweight people?

paulpauper10• 1 year ago

More sensationalism. Insurers can simply adjust the policy accordingly to account for patients discontinuing the drug. They can also raise premiums if patients go off the drug, and there can be a cluse that stipulates this. This is literally the job of an actuary to reprice premiums . Insurers take a short-term hit and then adjust premiums to ensure it never happens again. This happened with California fire risk for example. Moreover, this drug will not increase life expectancy by that much even with lifetime patient compliance. The majority of obese people ,especially men, who take these drugs will still be overweight or obese, but just not as much as before.

bagacrap3• 1 year ago

The idea is that the insurer doesn't even know the customer is on glp1, and I guess doesn't require a full physical often enough to reprice frequently.

wjnc• 1 year ago

The article is missing some key points about insurance. An ideal book balances mortality and longevity risks. This cancels out the risk GLP-1s or many other actuarial shifts in mortality. Insurers swap risks, reinsure risks etc to move towards an ideal book. Nice products to balance are pensions and longevity. Problem is that the scale is quite different on a per policy basis, and also very location specific.

The article also misses regarding slippage is that Swiss Re in the link calls it a modest increase And that is mainly due to insurers Not performing the same level of medical intake (accelerated versus full underwriting). Increased competition leads to less profits. That’s pretty straightforward and not per se GLP-1s related.

And then the kicker. For not diversified portfolios of mortality risks. Those have been massively profitable for decades, in line with the general increase in age and health. GLP-1s just expands on that profitable aspect. Did I mention that the long term expected rate of return on an insurers book is quite good?

Insurers can weather a bit of slippage. Reinsurers will kick the worst offenders back in line with their AUC performance, because without diversification Or reinsurance it’s hard to stay in the market. (Capital requirements strongly favor diversification. Mono line is very hard.) That’s why Swiss Re is bringing out such rigorous studies of detailed policy events. Signaling to the reinsurance markets and the insurance companies and their actuaries!

mcherm• 1 year ago

If insurers are suffering from "mortality slippage" because some of their customers purchased insurance while on GLP-1s then later discontinue the medication, then there must also be "mortality slippage" in the opposite direction. There must be customers who were not on GLP-1s when they purchased insurance, but could go on them, extending their lives in a way that is very profitable to the life insurance companies.

Furthermore, there are more people not on GLP-1s than on them (even with the recent surge in popularity) so this population that can give life insurance companies "excess" profits must outnumber those the article describes where the insurance company takes a loss.

Why can't they focus on this profit opportunity?

hobom• 1 year ago

At least in part, according to the article, because the not-yet-on-GLP1 folks are NOT customers since they are often denied coverage in the first place.

jakubmazanec• 1 year ago

When someone stops the medication, they'll usually regain the weight they lost

Source? I agree that some people will regain the weight, but "usually" is an unfounded (without some data) generalization.

paulpauper10• 1 year ago

It's variable. some regain all, other regain less. But they basically all regain some.

catdog2• 1 year ago

It probably depends if they also change eating habits. If they change nothing regaining the weight is no surprise.

arp2427• 1 year ago

It's linked in the article.

alluro2• 1 year ago

I don't mean to be overly harsh, but saying "just changing their diet" is quite ignorant. There's been a huge amount of research into the challenges of weight loss, so it should be (more) common knowledge by now that it's not just about deciding to do it and "having discipline" - it takes much more than that, both physically and psychologically.

I understand where you're coming from, though, I used to think the same - I remember a specific situation where an obese person next to me was breathing heavily from doing something easy and me thinking "how do you hear yourself breathing audibly from doing almost nothing and not decide and just change it". Unfortunately, I got into a situation where I now understand the issue and am struggling to lose weight, despite hearing myself breathing audibly after picking up something from the floor and all the rational understanding and knowledge of what I need to do.

IMO, in a lot of cases, the first step should be going to a therapist.

jamesgill• 1 year ago

In 2023, the life insurance industry took in >$3 trillion dollars in premiums.

That same year, it paid out roughly $800B in claims.

TL;DR: there's no violin tiny enough for me to play for the life insurance industry's 'woes'.

paulpauper10• 1 year ago

yes, there is a reason why BRK.A/B stock has done so well ,even while sitting in tons of cash. Geico is a cash cow.

kylecordes• 1 year ago

Seems like insurers should be rating based on your worst health markers, including weight, over the last N years rather than just a current point-in-time snapshot. Someone who somehow has no medical records over the last few years at all that would capture any of that data would be priced on the assumption the past was possibly worse than current.

_9ptr7• 1 year ago

I don't know the situation in the USA, but in Europe you wouldn't find many young (up to ~35) people who have data on any health markers. And these are the main market.

refulgentis4• 1 year ago

Is the slippage graph just for net life increase slippage?

Or any slippage?

It caught my eye this explosion in slippage happened years before GLP-1s, and exactly in the year of a global pandemic that had sky-high mortality rates for older people.

loeg15• 1 year ago

I think it's unlikely that the quoted 65% of GLP-1 users will go off the drug and resume their unhealthy lifestyle as the drugs go off patent and become more affordable. It's not super inconvenient to stay on, just expensive (today, using the name brand formulations). Users benefit from good health more than they benefit from deceiving life insurers.

stego-tech• 1 year ago

Now expand this to other treatments: HIV, PreP, depression/anxiety, ADD, ADHD, you name it. We’ve had data for decades that adherence is the key factor in successfully lowering mortality and increasing quality of life, which in turn increases duration of productive life, which in turn lowers costs in the long run as more people live healthier, longer, more productive lives.

The problem continues to be the pharmaceutical and health insurance industries, particularly in the West. Under pressure to deliver infinite growth forever to shareholders on a quarterly basis, companies have a vested interest in making less medication at a higher price, and lobbying the government to prohibit price negotiations while mandating insurance coverage for many of these drugs.

GLP-1s might be the proverbial straw that broke the camel’s back, but there’s decades of research - and bodies - saying this over, and over, and over again.

Which reminds me: I need to call my new health insurance company to get them to cover my medication, and hopefully extend it to 90 day supplies. Because god forbid that just be an automatic thing for someone who’s taken the same medication daily in some form for a decade without adherence issues.

neaden3• 1 year ago

I don't think this is addressing the thrust of the article, which is that Life Insurance companies are getting "fooled" by patients who on paper are healthier then they are in reality. Someone on PreP to prevent getting HIV is as healthy on paper as they are in reality as far as I can see.

jeremynixon• 1 year ago

This blog post is flawed. "Life insurers can predict when you'll die with about 98% accuracy." Is not even properly framed and is found nowhere in the cited report.

Predictions of when you will die need a range in order to be attached to a number like accuracy. The attached report is not about this but about population-level mortality trends.

dzhiurgis• 1 year ago

Yeah was skimming that report too and it doesn't look even related to that claim.

Jimmc414• 1 year ago

If GLP-1s are working for people, why do they quit taking them?

44520297• 1 year ago

Cost.

technocratius• 1 year ago

They are very expensive

degamad• 1 year ago

It is well known that people are bad at taking drugs that work for them. This is particularly well studied when it comes to heart medication, the kind where you take it regularly or you die, and yet adherence is often around 50%.

From a quick search, Jarrah et al. (2023) "Medication Adherence and Its Influencing Factors among Patients with Heart Failure: A Cross Sectional Study" [0] discusses some of the relevant details.

[0] https://pmc.ncbi.nlm.nih.gov/articles/PMC10224223/

bagacrap3• 1 year ago

I know a couple who self identify as foodies and they started taking it for weight loss. They now complain that date night is no fun because they don't enjoy the food. They have not yet dropped the meds but I can see it happening soon.

theideaofcoffee• 1 year ago

And nothing of value was lost. These industries, insurance in particular, pharma coming in a close second, are just parasites, sucking the vitality out of everything by their sick rent seeking and giving crumbs, if that, in return. The faster they can be torn down and liquidated, the better. Maybe helping the overall population boost their wellness with more-or-less miracle drugs like GLP-1s can hasten that.

fnord772• 1 year ago

Life insurers can predict when you'll die with about 98% accuracy.

I saw this:

https://media.nmfn.com/tnetwork/lifespan/index.html#0

is there anything better?

arp2427• 1 year ago

Looking at the link they give for it, the 98% accuracy isn't for individuals but for aggregate data. That is: they can't predict with 98% accuracy when you or I will die, but they can with a sufficiently large group which averages out all the noise. The phrasing in the article is somewhat unfortunate.

popupeyecare3• 1 year ago

Look at the url source. Ifs ChatGPT generated hallucination

jtrn13• 1 year ago

Clinical psychologist here in Norway, and just my subjective experience: People stop GLP1 agonists for the following reasons, in descending order: - They want to enjoy eating again. - Medications are a hassle. - Worry about long-term effects, even if there is no alarming evidence for now. - Price (we are a spoiled/rich country). - Other (like hating needles, feeling bad for taking medications that others need more, being aggressively lazy).

Often, I think that it’s a bad move, as the clinical effect of losing around 20 kg would have to be matched by some extremely high frequency and severe side effects. Overweight is still not sufficiently appreciated for how dangerous it is, especially after they ramped up production so much that there isn't a real shortage anymore.

Ironically, most of the people who respond well to Ozempic and stay on it have few psychiatric problems. But those who almost desperately want to get off it after a while might be those who have a psychological component to their overeating. The obvious suspect then is eating as emotional regulation. So one could extrapolate, at least as a hypothesis, that the ones who have worse life expectancy due to regained weight after a year of usage are the ones who have a double set of problems stacked against them: overweight and emotional problems. That would have a huge effect on longevity.

This is PURE free association though, no deep analysis behind it.

k__• 1 year ago

How much does it cost right now?

Are there any alternatives coming out soon or generics?

jtrn13• 1 year ago

For semaglutide, the newest and most potent GLP1.

United States: The main patent is expected to expire around 2032. Monthly Price: $950 - $1,350+ (cash price without insurance)

Norway: The main patent is expected to expire around 2031. Monthly Price: $109 - $301 (cash price equivalent in USD)

chhxdjsj2• 1 year ago

Grey market from China is around $250/year for tirzepatide

There are group chats with tens of thousands of people and I havent seen any issues with the drug

glp1guide10• 1 year ago

Liraglutide is now available as a generic, but it is the least effective of the big 3 (Semaglutide, Tirzepatide, Liraglutide):

Basically, Tirz > Sema > Lira

https://glp1.guide/content/semaglutide-vs-tirzepatide-clinic...

https://glp1.guide/content/semaglutide-liraglutide-continue-...

https://glp1.guide/content/another-generic-liraglutide-launc...

Lawliepop• 1 year ago

It’s unlikely new meds will be approved this year (unless the FDA really does speed up approval processes) I made a tool to compare prices: https://www.glpwinner.com/ If you’re on name brand without insurance coverage you’re sitting around $499 a month. On compounded you can get between $150-300 a month. If you live somewhere expensive like the bay and eat out a lot you are likely saving money by being on the medication.

OptionOfT2• 1 year ago

Did you see a decrease in people gambling / drinking when on the medication?

N=1, I'm on ZepBound and in general my brain is less likely to give in to things that give instant satisfaction.

jtrn13• 1 year ago

Actually yes. Not as much as with ADHD medication, but obvious subset of addictive personalities that have relief from addictive behaviors (beyond eating addiction) with semiglutide.

jawilson2• 1 year ago

I can't drink whatsoever now. I've been on Wegovy for ~4 months. I used to be a VERY light drinker, i.e. like 10 drinks per YEAR (rum and diet coke, glass of wine, or 2-3 beers in a night). I would usually get a drink when my band played. A month or so ago, I got a bourbon, which I'll happily sip for an hour while talking, and I had to force it down, and left over half of it. Same with a beer; I went to a baseball game with some friends, someone bought the group some drinks, and it was disgusting.

It was like whatever enjoyment lightbulb that is usually activated was completely unscrewed, or like trying it for the first time as a kid when an adult lets you try a sip on a holiday. Just sitting here typing and thinking about it has me slightly nauseated. I've been telling people recently I CAN'T drink because of some new medicine I've started.

gibagger2• 1 year ago

Having ADHD myself, and a bunch of friends who also have it, I have noticed that the people with this condition rarely have a healthy relationship with food. There is either a tendency to overeat indulgent foods, or a tendency to not think about food that much.

I have also heard about people with ADHD being on GLP1 agonists that it does a lot for their reward seeking behavior and impulse control.

This makes me wonder two things:

- Whether at some point these molecules will also start being used for ADHD and addiction treatment in general. I think they hold a lot of promise for issues rooted in the reward system.

- Whether a sizable portion of people who struggle with their weight have co-morbid ADHD which creates or worsens their overeating issues.

Have you noticed anything along these lines in your practice?

cik• 1 year ago

As someone with diagnosed ADHD. I fully agree. There's some background thread that says "you, now, eat". It's almost impossible to shut off.

That being the case, the same behaviours have led me to a compulsive need to plan meals. Doing so has helped me lessen (not eliminate) food noise. Anecdotally, I've noticed with others as well, that this is the way. Prep - be fine. Don't prep - eat a small village.

jtrn13• 1 year ago

As I wrote to another person here: Yes. Not as much as with ADHD medication, but there is an obvious subset of addictive personalities that find relief from addictive behaviors (beyond eating addiction) with semaglutide.

But to add to this, I feel like there are different kinds of addictive behaviors at play that are more susceptible to one medication or the other and are based on different systems.

For instance, the food-craving reduction in GLP-1 is almost certainly not just related to reward and goal-seeking behavior. It literally affects hormone signaling for satiety, and slows down the movement of food through the stomach, and affects, globally in the body, responses to metabolic signals. And it probably has a global effect on the way every cell in the body works, which might be why there are positive health effects beyond just the weight loss.

ADHD medication, on the other hand, targets the goal-directed activity system directly. It seems much more likely to me that reduced appetite is just as much driven by the focus and "let's get shit done" mode that is artificially increased with dopamine. Both result in reduced eating but through massively different pathways. Basically, you pay attention to the biggest wave in the pond (the waves in the pond being a metaphor for all the things your brain COULD pay attention to). So when the goal-stuff gets increased in size, the food-seeking is automatically smaller by comparison, and less likely to drive your behavior and thinking.

I don't think I can say that there is much of a pattern between ADHD and overeating, just based on how easily I can predict if someone is overeating or not if I know they have ADHD. That is, it would be a coin toss.

The simplistic answer would be: Semaglutide reduces addictive behavior if it's driven by emotional regulation needs, and ADHD medication reduces pure drug-like craving. As seen in studies where people that start lisdexamfetamine (ADHD medication common in the EU) have a huge reduction in actual amphetamine abuse.

Case in point: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/... Findings In this Swedish nationwide cohort study of 13 965 individuals, lisdexamphetamine was significantly associated with a decrease in risk of hospitalization due to substance use disorder, any hospitalization or death, and all-cause mortality.

joncrane• 1 year ago

I believe you 100%. I have a history of substance abuse with bad consequences. I quit alcohol and now my drug is food. People tell me I'm a "supertaster." I can taste many of the ingredients in my food that others can't.

I also have BPD and am in therapy for it, but man. Food is the drug that always works. When I get into a certain mode, it's like I don't care that I'm overweight and have high blood pressure. I just crave the deliciousness and the "full feeling." And it never fails to work! I always feel more calm and happy after I eat.

jtrn13• 1 year ago

Reminds me of a client I had once. He said that the only thing that made him reset was to "pig out" with a carb-overdose, then just sit in front of the TV with a sugar high.

Incidentally, I had been nagging him about trying ANYTHING (in addition to the therapy we were doing to find a life goal he believes in) that might help him get SOME help. Be it Adderall or Ozempic. But people are complex, and at best, a person is a Venn diagram with massive overlapping "biological susceptibility," "life situation," "negative thinking style," and inertia. The best one can do is to pull at as many threads as possible to hope the suffering unravels. So one of the threads one can pull at are medication.

Not to give advice, but just for shits and giggles, look into "vulnerable narcissism." Many describe stuff like you do and fit those traits. And don't give a shit about the negative associations and stereotypes regarding this personality. I love narcissists! It's one of the coolest personalities there is! But when you are not allowed to be proud of yourself, and all the desire for status and power gets refocused onto self-hate and learned helplessness, then it's a monster of a situation. Had so many people become awesome versions of themselves when they stop being so afraid of being arrogant :) .

Just to remember when you read about it, that the descriptions are only in the context of things having gone wrong. Every trait can manifest as something good or negative. Even psychopaths can have good and prosocial lives. For instance, some of the best ambulance workers often have high loading on psychopathy, and that makes them better at their job. Because they don't get scared. I’d rather be picked up by an ambulance worker that is curious and thinks the situation is interesting than one that is panicking and losing due to anxiety and empathy overload.

This is just a long-shot association/pattern I noticed, though. It's not worth a dime more than the sentences you put into the machine. :P

xattt• 1 year ago

Can you talk about people who discontinue for GI side-effects? I understand they are present for a short duration, but have heard anectdata that they persist for months for some people.

Have you observed persistent GI side-effects in your own practice, and if so, do you believe these are legitimate? Or… are they a social cover for individuals to get back to eating for psychological coping?

jtrn13• 1 year ago

It's not just GI side effects. Semaglutide is genuinely GI TOXICITY. That's why it's EXTREMELY important to ramp slowly. So yeah, it's a thing. But for basically everybody, it's manageable with slow and controlled ramping of dosage. There has been hard to find any lasting danger if you ramp slowly.

There has been almost a hysteria, it seems, regarding "Pancreatitis." And when I see multiple diagnoses, medications, and reports associated with Pancreatitis, I recognize a pattern I have seen many times before. Both the mental health and medical fields have periodic fixations on certain symptoms or diffuse diagnosis, and when it has the "wave-like" pattern like this, I am willing to bet it's just the latest version of "Fatigue," "Whiplash," "Repetitive Strain Injury", "lactose intolerance" or the dental amalgam controversy. Don't get me wrong. These are real things. But sometimes they just balloon beyond anything reasonable, and an unreasonable amount of people suddenly get diagnosed with it or suspect they have it. Pancreatitis is giving me that vibe over the last year or so. Copy paste this for "Stomach Paralysis".

But let's say the social benefit of alcohol has a value of 100 and a health risk score of 100. I would say that GLP-1 agonists have a health value of 500 and a risk score of 20. Nothing is without risk, but mathematically speaking, if you are overweight, I would be 25x more positive about injecting myself with Ozempic than alcohol... mathematically at least.

And to answer your question, I personally haven't seen many people stop early due to GI symptoms. And if they did stop early, I would think it was because they genuinely had a physical negative response that was horrible for them. Anecdotally, I feel the people that stop so they can get back to eating usually last at least 6 months, and probably more. I am 100% in agreement with the studies that many stop at around 1 year. So if someone stopped at 2 months, I would belive them when they said it was due to GI symptoms. But if they stopped at 1 year and CLAIMED it was due to GI symptoms, I would doubt; and guess that it was driven by missing food.

Please note that I am speculating wildly, and this is just PURELY anecdotal and stream of consciousness.

nopcode• 1 year ago

I'm in the exact situation you describe:

Overweight due to emotion-eating and stress-eating, taking GLP1.

Now I can binge-eat until I'm full or sick (mostly sick) and maintain weight. If I'd go off GLP1 now my weight would skyrocket.

Neywiny• 1 year ago

No mention of Common Side Effects in the discussion? It was pretty predictable (at least for someone healthcare-field [discovery + regulation]-adjacent all my life), but touched on the notion that the miracle wonder drugs are a provider's worst nightmare. It's a business

aredox• 1 year ago

Mortality slippage has also exploded since the COVID pandemic started... And again, nobody seems to wonder if somehow, a virus that invades the whole body (not just a respiratory virus), repeatedly, is causing death by a thousand cuts...

The blind spot related to COVID is huge. There are lots of health data going haywire since 2020 and everyone seems to find any other reason but COVID for it.

brap5• 1 year ago

Just want to share my own experience since were doing it:

Took Wegovy (Semaglutide) for about 6 months. Barely lost any weight, would occasionally get nauseous.

Then the doc switched me to Mounjaro (Tirzepatide) + Phentermine, and holy shit, I just don’t feel like eating, almost ever. Lost 20kg in 6 months, which is all I needed to lose, never had any side effects. None.

I did feel a little weird/buzzed the first time I took Phentermine, but it went away the next day.

I feel like for many people it’s not really the physical hunger that makes them fat, it’s that annoying voice in your head telling you to snack something for no reason at all. It sometimes felt almost like drug addiction.

Tirz+Phent are great for that.

glp1guide10• 1 year ago

It varies case by case, but just want to point out that the research agrees with you here, Tirzepatide is more effective than Sema!

potamic• 1 year ago

Did you lose any muscle mass?

staringback• 1 year ago

They most certainly did, these drugs stop you from eating, not magically burn fat and leave muscle mass alone.

It has the same effect as starving yourself. Go look up pictures of "ozempic face"

brap5• 1 year ago

Most likely.

But I had a lot of muscle mass to begin with, due to years of bodybuilding. And I still have significant muscle after the diet, despite of not touching a weight during all this time (I know I should have). People still ask me about my lifting routine even though I didn't lift in like 2+ years.

Knowing myself, it'll come back within a couple of months of lifting weights and getting proper protein, once I get back to it. And I plan on doing exactly that. Being fat kind of made me lose motivation to go to the gym. It's a vicious cycle I imagine many fat people struggle with. So I prioritized losing fat first and foremost.

snarf21• 1 year ago

Dieting is hard and we still under emphasize the mental and emotional aspects of it. I've found that the easier to "be good" at dieting during the 30 minutes of weekly grocery shopping then during every hour of every day at the house. I try hard to just never buy things that I'm likely to overeat or are super calorie dense because I know I can't eat potato chips responsibly.

throaway9554• 1 year ago

This is the way. Why give yourself the temptation when one slip-up can ruin the whole thing for yourself?

brap5• 1 year ago

It's very true, but it's more difficult when you live right by the grocery store, the office has free food and snacks, and DoorDash is right there when you "need" it.

throaway9554• 1 year ago

I'll echo that addiction feeling! It's amazing to me, how when I ignore the "it's time to eat" feeling (which isn't easy to do!) it suddenly starts to get weaker and even goes away...almost as if I wasn't really hungry at all!

HDThoreaun3• 1 year ago

You need to be careful with phentermine. Unlike the GLPs it very much is physically addictive, basically just adderall.

brap5• 1 year ago

I'm aware, and I was hesitant to use it when the doc first prescribed it. Personally I'm not so worried about this anymore, there are days when I don't take it (either forget or wake up too late in the day) and I don't feel any different. I never felt like I craved it or had any sort of rewarding feeling upon taking it. I never took Adderall so I can't compare, but from what I know the mental effects of Phentermine are much weaker.

Usually it's prescribed for no more than 3 months, but the doc recommended taking it for longer. He mentioned that addiction risk is negligible for most people. Very solid doctor who specializes in those thing, so I took his word for it after a bit of Googling.

twilo• 1 year ago

“mortality slippage” coincides with Sars2 circulating within our population so I bet it has a lot to do with it

peteforde• 1 year ago

I know that many of the claims are based on clinical data and retention studies, but I find the entire thrust of the post to be incredibly cynical. Fat people often fight the not subtle sensation that a lot of people see them as either a problem/herd to be managed and/or maximally profited from. This is one of those accounts that seems to say the inside part out loud.

The idea that a few pharmas artificially juicing a desperate population [who just want to feel good about themselves and live longer, happier lives for more than many can comfortably afford] is interfering with insurance adjustors ability to maximize profits doesn't leave me heartbroken.

It's precisely this shit that leads to people celebrating when pharma CEOs get tapped.

glp1guide10• 1 year ago

Note that right now there's a problem with people staying on GLP1s[0] so it's not quite clear how this could go any other way. Considering the rate of rebound from other lifestyle methods, GLP1 is among the most effective alternatives we have.

GLP1 significantly reduces the risk of many mobidities and is increasingly prescribed to older people.

Also, this is incredibly likely to resolve itself once the drugs become common place after patent expiries, the actuaries will update their tables and the curve will smoothe out.

[0] https://glp1.guide/content/if-glp1-is-so-great-why-dont-peop...

[1] https://glp1.guide/content/patent-expirations-for-glp1-recep...

mctt• 1 year ago

Can someone explain what is being said here in literal terms please. Can you also identify any dark humour or social commentary because I don't know enough to be sure.

glp1guide10• 1 year ago

Let me try again:

1. People do not stay on GLP1s for long, despite how effective they are

2. People often rebound harder from other forms of weight loss (dieting, temporary lifestyle changes, etc)

3. GLP1 reduces a LOT of health risks linked to obesity (heart disease being the most important IMO)

4. Older people are taking GLP1s in droves

5. Once these drugs are everywhere (they will be soon IMO in < 7 years obesity will probably be ~gone), the effects will get "priced in" to actuary tables.

No social commentary or dark humor intended -- GLP1s aren't miracle drugs but the effects (and relative lack of side effects) is miraculous.

cobertos• 1 year ago

Lost around 14kg using GLP-1s from a D2C provider (no detail on their electronic health record)

Huh? How would one get these electronic health records? I thought each provider keeps these and there's no public database except for vaccines? And it doesn't exist because HIPAA would make it hard?

kbos872• 1 year ago

GLP-1s have legitimately changed my life for the better. I've always been very active but have consistently been moderately overweight. A relatively low dose of Semaglitide has helped me lose 40lbs and keep it off. I'm a year and a half in and have had very few side effects, no loss of efficacy, and my muscle mass has increased slightly despite all the negative press about muscle loss. My diet is similar in composition to what it was before, but I probably eat 25% less by volume. Recognizing I'm a sample of one, but my experience is reflected in the research.

I plan on being a GLP-1 for the rest of my life. Perfectly fine with that. It seems like society has more problems with GLP-1s than its users do.

itake• 1 year ago

my muscle mass has increased slightly

how was this measured?

kbos872• 1 year ago

Day to day I use a home body composition scale (Withings Body Scan), the results of which have been corroborated by two Dexascans I've done at my gym a little less than a year apart.

For me personally, the little bit of help in the form of forward progress on weight loss has given me a reason to be a little more methodical in my strength training, and I'm seeing a slow but consistent payoff. And as far as I can tell, I'm not fighting an uphill battle in terms of adding muscle mass at all because of the GLP-1.

rsyring• 1 year ago

A relatively low dose of Semaglitide

Can you share what dose?

atleastoptimal• 1 year ago

The solution is for life insurance companies to pay people to stay on ozempic

zaptrem• 1 year ago

The “payment” can come in the form of lower rates, with penalties if you stop.

const_cast4• 1 year ago

We already do something similar with smoking cessation. They, essentially, pay you to quit smoking.

The social difference is that we frame smoking as an addiction, and smokers as victims of the Tobacco industry. But we frame obesity as a moral failing. So, the former we're ready to jump in and help. But, the latter, we are much more hesitant.

Theoretically, economic outcomes would override these social and moral effects. But leadership is often stupid, so we'll see.

gitfan86• 1 year ago

Not really, they can just stop insuring people who take them at all.

blindriver• 1 year ago

The last thing I will ever give a rats ass about is insurance companies. They are the scourge of this earth but they have used legislation to embed themselves in our every day lives.

I live in California and have no claims ever. My home insurance has doubled in 4 years to almost $4000 a year. My car insurance is about $2800/yr.

So I hope insurance companies break. Like Danerys said in Gamr of Thrones, I hope someone breaks the wheel.

slyall• 1 year ago

$4000/year might be a lot or a little. If you own a $5m house up against a forest it's probably a bargain. The car price could reflect a bunch of factors.

Pay some broker for a one-off consultation to advise you on how to save money.

Reality is insurance companies are now going though a cycle of "price in the actual risk" rather than "drop prices to gain customers"

ReverseCold• 1 year ago

I live in California

Car insurance companies in CA actually lose money on the state, if that makes you feel better: https://money.com/car-insurance-policies-problems-california...

There are laws that prevent them from charging enough to even break-even on the policies.

timerol• 1 year ago

So you pay less than 1% of the cost to rebuild your home per year in home insurance, in a state that regularly has fires, floods, and earthquakes? That seems fair to me

jbs789• 1 year ago

The reason insurers ask about weight loss is that it could be a sign of a (severe) undiagnosed medical condition - e.g. they should be contacting a doctor(!)

potato37328422• 1 year ago

Call me cynical but it wouldn't surprise me if insurers somehow tried to leverage this "crisis" into some sort of "get written into law, guaranteed profits forever" play the way that health, home and auto have.

johndhi• 1 year ago

Can't they just adjust their model based on whether the patient is on a GLP-1 and account for the likelihood they'll stop taking it?

kccqzy• 1 year ago

The article addressed this. The person could have gotten GLP-1 from a D2C provider and insurance has no record of this person ever taking GLP-1.

popupeyecare3• 1 year ago

Anyone read the source and find the 98% accuracy stat? The source link has a UTM source of ChatGPT. Could it be a hallucination?

astrea• 1 year ago

I believe it’s seeing the 98% mortality rate in 2020 vs 2019 for the same month.

yesfitz• 1 year ago

Maybe more of a misinterpretation by AI and/or author than full on hallucination.

"Life insurers can predict when you'll die with about 98% accuracy."

"98%" appears in the citation[1], but as the ratio of actual deaths to expected deaths. (i.e. 98% of the deaths they expected actually occurred.) Some months that figure was ~104%, so it's not a measure of accuracy.

1: https://www.soa.org/4aa060/globalassets/assets/files/resourc...

nrenegar• 1 year ago

It's extremely incorrect. 98% accuracy on when "you'll" die would imply an R^2 of 0.98 for individual-level lifespan predictions. We are nowhere close to that.

neaden3• 1 year ago

It could mean a lot of things. It could mean "We think you'll die at 87+-5 years" and counting it as a success if you die anywhere in that age range for instance which I could believe they can predict the vast majority of the time. I doubt they are referring to the R Squared.

subarctic• 1 year ago

I saw that too and thought the utm_source=chatgpt was pretty funny, since I only noticed it when I was pasting the link into chatgpt myself to get it to tell me where the "98% accurate" claim was coming from.

Anyway, it's a pretty vague statement. What it sounds like it's saying is for the average person they can predict when they will die, and you have to decide if they mean the day, the year or the decade. But chatgpt gave me an interpretation that seems to make more sense:

The 98 % figure is about aggregate forecasting, not clairvoyance. It means that when an insurer predicts, say, 10 000 deaths across its book in 2024, the actual count typically falls within roughly ±200. For any single customer, the prediction is still just a probability curve, not a calendar appointment with the Grim Reaper.

oger4• 1 year ago

The topic of per-country pricing was mentioned several times.

I was wondering how big the price differences would be so I set up a quick form to collect some data points from several countries and for several products.

It would be cool if you could provide some data - I would then share it back as a reply to this thread within 1-2 days after closing the survey. The latest data entry will be possible on Sunday.

https://forms.cloud.microsoft/e/DjDgH62s21

adolph• 1 year ago

Is the rise of GLPs yet another case of Neal Stephenson called it again? I'm rereading Anathem and struck by similarities of Allswell and the psychoactive components of GLPs. In the book, Allswell is a drug that gives people a sense of calm and well being, and is genetically engineered into food in a way that puts water fluoridation to shame. Otoh, the lower-caste slines of Arbre are also overweight so maybe the parallels are limited.

jollyllama• 1 year ago

Can't the insurance companies just look for stretch marks?

skissane• 1 year ago

They switched from 30-day to 90-day refills. Suddenly, patients had to think about their medication four times a year instead of twelve. Adherence rates shot up almost immediately.

When I have a “refill” (here in Australia we call them “repeats”) due, my pharmacy sends me an SMS… I just reply “yes please” and that goes straight to the pharmacist who dispenses, and I get another SMS telling me the dispensed medication is ready to pick up

I’m on tirzepatide and I’m committed but I’m “going a bit slow” because the side effects started to get a bit too much. Still, my base expectation is I’m taking a GLP-1 agonist for the rest of my life, unless my doctor tells me I have to stop for some reason, or I somehow go bankrupt and can’t afford it any more.

GLP-1s are breaking life insurance

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