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Ozempic drug supresses desire to smoke, drink and more?

theatlantic.com

451–460 of 504 posts

Re: Ozempic drug supresses desire to smoke, drink and more?

#451

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

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

> downright laughable

*criminal

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

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

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

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

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

Re: Ozempic drug supresses desire to smoke, drink and more?

#452

Earlier quoted context omitted.

Obese people can actually be pretty muscular in my experience, due to their need to heft around their size. It's their endurance that isn't there since their hearts are quite weak.

It still won't get you to the 2/3 point making sense. If someone is 250 lbs and 35% BF and they lost 50 lbs, 2/3 of which was lean, they'd end up 200 lbs and 35.5% BF. That's possible, but I don't know if anyone would be recommending it at that point.

Peter Attia made a video recently using precisely that observation as the reason he avoids prescribing it except as a last resort, and only then when he can get patients to increase their protein intake and start strength training while getting a DEXA before and after to keep track of the relative changes in body fat percentage.

The problem is apparently that studies only use change in weight instead of body composition, so doctors have to be aware of that and get the patient measured themselves to make sure they're actually getting leaner instead of losing weight but getting "more obese".

Re: Ozempic drug supresses desire to smoke, drink and more?

#453

Earlier quoted context omitted.

Drugs that target the GLP-1 and GIP pathways can suppress appetite, potentially leading to a significant caloric deficit. This can lead to the body to break down muscle tissue to obtain protein for energy which could lead to a loss of lean muscle mass However, maintaining regular exercise and consuming sufficient protein can help to minimize the impact of lean muscle mass loss

Protein is not what the body reaches for first in the absence of glucose/glycogen.

This is true but it's still extremely well established that you lose some muscle along with fat if you're in a prolonged caloric deficit without sufficient protein and strength training.

Re: Ozempic drug supresses desire to smoke, drink and more?

#454

Just a heads up “weight loss” is a poor metric if it comes at the cost of lean muscle mass. It seems that 39% of weight loss associated with Ozempic comes from lean muscle mass which isn’t great. https://peterattiamd.com/the-downside-of-glp-1-receptor-agon...

I’m generally skeptical of pharmaceutical weight loss solutions as a bandaid over the underlying problem, but for this statement to mean anything you’d have to compare it to traditional methods of weight loss. If you simply eat at a calorie deficit and aren’t taking specific steps to preserve muscle (resistance training and high protein), a lot of the weight you lose will be muscle mass.

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

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

Re: Ozempic drug supresses desire to smoke, drink and more?

#455
post #444

Earlier quoted context omitted.

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

Do some research into compound pharmacies as a worst picture backup. I know several people on them successfully. Peptides can't be patented. Semaglutide is a peptide. They are patenting the delivery mechanism AFAICT. As to sides, ramp up slowly. Maybe you won't have any. Also, there are new drugs coming that are even better. I'm sure the shortages and whatnot will be sorted out. The solution is out there. They can't…

> Peptides can't be patented.

This is...mostly wrong. Like both normal wrong, and "x-y problem" wrong. There is definitely some truth in there, but the full explanation would require an actual lawyer, because there's a LOT of layers of complication.

Just so people don't have to simply take my word against yours, here's Jacob Sherkow, JD, a professor of law and medicine at the Illinois College of Medicine on the topic:

> semaglutide that's "made, used, sold, offered to be sold, or imported into the United States is possibly an act of infringement, if Novo were to sue them"

But this isn't just about patents -- that's the "x-y problem" that I was talking about. It may not be legal to import active ingredients of FDA-approved drugs. Most peptides (AOC-9604, BPC-157, Ibutamoren, Ipamorelin, etc) are "legal" because they're not considered drugs. Once they're FDA approved, they become not legal to import/re-sell unless you're a compounding pharmacy. It wouldn't generally be legal to import fexofenadine (OTC allergy medication), for example, even though it's not a controlled substance. Because importing non-FDA drugs is generally not legal unless you're a licensed part of the medical supply chain.

So yes, compounding pharmacies can provide it to you and you offload the legal gray areas onto them. But just saying "they can't be patented" kind of hides most of the legal quandaries. From a practical perspective, many organizations and individuals do import these things without worrying about legal consequences, because enforcement is very low. But I wouldn't formally pretend the legal issues don't exist at all levels.

https://www.medpagetoday.com/special-reports/exclusives/9962...

Re: Ozempic drug supresses desire to smoke, drink and more?

#456
post #437

Earlier quoted context omitted.

You are comparing apples to oranges my friend.

How so? We don't know of any cure for depression, but with ketamine we have an effective rapid treatment. Ketamine has a great therapeutic range, a well-understood side effect profile, and can bring a patient back from the brink of suicide in a matter of hours. It's also incredibly inexpensive to produce, on par with aspirin. Why shouldn't we use it?

That’s the thing. We don’t know a cure, but we know of people who were cured. We just don’t really know how or why, scientifically speaking. And as far as I know there was never someone getting cured from t1 diabetes. That’s what I meant by apples and oranges.

Ketamine or suffering & death? Ketamine no question. I agree, but it’s not so black and white how you may perceive it. It might be ketamine or death for you, I don’t know. For me it was certainly. So sorry, if it is for you now. I’m not telling you it’s bad or that you shouldn’t do it. Do whatever you think is the best for you. I went through all of that and found other methods of treatment actually effective of solving the root causes of my suffering and not just the symptoms. Meditation, somatic experiencing and mdma therapy[1] are the main methods I found the most effective, in no particular order.

I’m not looking to argue about your choice of treatment. If you want to share your experience or hear mine, give me a way to contact you. Have a good night/day. [1]https://www.nature.com/articles/s41591-021-01336-3

Re: Ozempic drug supresses desire to smoke, drink and more?

#457
post #435

Earlier quoted context omitted.

Yes I did have two treatments. After the first treatment I really liked it and I thought I had my life back. All my debilitating symptoms were gone. Weeks after the second treatment I noticed that my depression and trauma is not gone. It just made me not constantly aware of it, if that makes sense. I was not clinically dissociated as well, just dissociated from the things that caused my suffering. I didn’t think that…

> Ketamine didn’t heal me, my perspective just changed I thought that was the entire point of the treatment. Is that not the case?

I don’t know it might be. I went in with the mindset of wanting it to help me end my suffering, not change my perspective. I think that’s the case for most people.

Re: Ozempic drug supresses desire to smoke, drink and more?

#458
post #452

Earlier quoted context omitted.

It still won't get you to the 2/3 point making sense. If someone is 250 lbs and 35% BF and they lost 50 lbs, 2/3 of which was lean, they'd end up 200 lbs and 35.5% BF. That's possible, but I don't know if anyone would be recommending it at that point.

Peter Attia made a video recently using precisely that observation as the reason he avoids prescribing it except as a last resort, and only then when he can get patients to increase their protein intake and start strength training while getting a DEXA before and after to keep track of the relative changes in body fat percentage. The problem is apparently that studies only use change in weight instead of body composit…

> The problem is apparently that studies only use change in weight instead of body composition

Misinformation. Many of the studies track total fat, lean body mass, visceral fat, and literally dozens of other secondary outcomes/endpoints. See an example of such results here: https://clinicaltrials.gov/ct2/show/results/NCT03548935

This has already been covered yesterday in sibling comments about the NCT03548935 study and Peter Attia being in general a source of misinformation.

Here are some other semaglutide studies which track lean body mass specifically: https://clinicaltrials.gov/ct2/results?cond=Semaglutide&term...

Re: Ozempic drug supresses desire to smoke, drink and more?

#459
post #337

Earlier quoted context omitted.

how could you separate actually will power from the illusion of will power?

I always thought that it’s uncertain if free will exists, but you have to behave as if it does otherwise the world falls into chaos.

That's just what the people with free will power tell those without.

Re: Ozempic drug supresses desire to smoke, drink and more?

#460

Earlier quoted context omitted.

Do some research into compound pharmacies as a worst picture backup. I know several people on them successfully. Peptides can't be patented. Semaglutide is a peptide. They are patenting the delivery mechanism AFAICT. As to sides, ramp up slowly. Maybe you won't have any. Also, there are new drugs coming that are even better. I'm sure the shortages and whatnot will be sorted out. The solution is out there. They can't…

> Peptides can't be patented. This is...mostly wrong. Like both normal wrong, and "x-y problem" wrong. There is definitely some truth in there, but the full explanation would require an actual lawyer, because there's a LOT of layers of complication. Just so people don't have to simply take my word against yours, here's Jacob Sherkow, JD, a professor of law and medicine at the Illinois College of Medicine on the topic…

I believe you.

Look, I read a bunch of contradictory stuff on the internet about this and am close to a good number of people in healthcare who told me compound pharmacies are legit and that there's a lot of FUD on the internet.

But I'm not pretending to be an expert in law or medicine.

People need to research this and do what they feel comfortable with.

That said, I'd personally prefer if the prices came down, the supply remained highly available and it was covered by insurance and the companies like Novo who spent money to create these solutions got paid for it. It's a miracle and they deserve what money they make off it.

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