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GLP-1 pills are coming, and they could revolutionize weight-loss treatment

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Re: GLP-1 pills are coming, and they could revolutionize weight-loss treatment

#61

Post by vundercind »

andrewmcwatters wrote: post #12

GLP-1 freaks me out after I read from plastic surgeons that it ages your skin from the inside out.

Plastic surgeons and cosmetic companies are rushing to convince people that the same effects you see from any weight loss are worse with GLP-1 agonists, to court a market with demonstrated willingness to spend money on (among other things) their looks.

Plastic surgeons, I expect, are especially concerned about a large reduction in volume of lipo & related procedures, and are eager to get the message out that “no, you still need to come pay us to cut on you!”

Re: GLP-1 pills are coming, and they could revolutionize weight-loss treatment

#62

Post by unshavedyak »

FiReaNG3L wrote: post #5

Overconsumption leading to widespread obesity while a large fraction of the world is hungry - the capitalist solution? Let's invent a pill so we can eat EVEN MORE.

I think of it differently. Capitalism has altered/hijacked peoples reward centers with hyper refined foods and it's a huge struggle for a lot of people to get out of that. We had drug pushers and very little help to get out of the addiction loop.

I used to think people just needed to "eat less", CICO and etc. Just like i thought people needed to just get off drugs. I think that's wrong, now.

These days it seems more apparent that some people are just more prone to addiction. The fact that i don't struggle with drinking or drugs is not due to my own will. Neither do i struggle with food, i'm frankly indifferent to food. So just as much as i seem gifted by nature to not be addicted to these things, others are innately pulled towards addictive substances.

Re: GLP-1 pills are coming, and they could revolutionize weight-loss treatment

#63

Post by nkohari »

elil17 wrote: post #48
HarHarVeryFunny wrote: post #27

Earlier quoted context omitted.

Do we know what the long-term affects are? Is there any lasting benefit if someone stops taking these types of medication? If one does keep taking it indefinitely, does the addiction-suppression effect stay the same, or reduces over time?

We do know that the benefits stop as soon as you stop taking it. You'll start gaining back weight. No negative long term effects have been observed in humans yet, but some animals in trials were at a higher risk of cancer. We haven't observed any evidence that the addiction-suppression effect reduces over time yet. However, we haven't been studying that effect for very long.

> We do know that the benefits stop as soon as you stop taking it. You'll start gaining back weight.

It's more accurate to say that if you're depending on the appetite suppression to eat a sustainable amount of calories, you will begin to gain weight again after stopping the drug.

It's possible to use a GLP-1 agonist to lose weight and then keep it off with a proper diet. I took tirzepatide (Mounjaro) for 6 months, lost ~45 lbs., and have not gained any back after stopping the drug in July.

Re: GLP-1 pills are coming, and they could revolutionize weight-loss treatment

#64

Post by hbosch »

frankzander wrote: post #47

But why? Just eat no crap and work out. This is long lasting if it's a full life change.

There is theory, and then there is practice. A 300lb person will have trouble just "eating less" and "working out", because both of those things put incredible stress on a person's mind and body. Immediately working those lifestyle changes into an obese person's life is not like flicking a light switch, even for the overweight person who looks at themselves in the mirror and cries about how they look, "just eat less" and "just move more" are ideas that are psychologically difficult to put into action.

With GLP-1 medications, it is considerably easier to do the first part of "eating less". An obese person can lose over 20% of their body fat in a year, which will reduce the probability of injury when they begin working out. There is hardly any downside to developing medication to help people manage their weight to below obesity, and incredible upside.

Maybe another example would be: why do you use VSCode to do your programming? Hell, why do you use a computer at all? You should probably do it the hard way, on a sheet of paper... there is no reason to use a keyboard when you could just use your hands, right?

GLP-1 agonists are just tools like anything else. They make difficult tasks easier.

Re: GLP-1 pills are coming, and they could revolutionize weight-loss treatment

#65

Post by mwmisner »

frankzander wrote: post #47

But why? Just eat no crap and work out. This is long lasting if it's a full life change.

Like much of life it's more complicated than simple rules. It works for some people, but does not for everyone. As someone that has struggled with diet for the last decade or so these drugs have been a life saver. I've been able to eat healthy and feel full instead of being stuck in a cycle of eating right for a while and then eventually breaking under load. I've been able to have a consistency in the last 6 months on the drugs that i never thought I was capable of. I've even been able to build up a weight lifting plan that actually works for me and I feel good after the day.

There are lots of problems with drug reliance still to be worked out, but I'm excited for the chance to rebuild my habits into something good and work my way off to something normal.

Related, exercise is awesome but has little impact on long term weight loss! Check this out: https://www.youtube.com/watch?v=vSSkDos2hzo

Re: GLP-1 pills are coming, and they could revolutionize weight-loss treatment

#66

Post by unshavedyak »

JumpCrisscross wrote: post #43
unshavedyak wrote: post #40

Earlier quoted context omitted.

Sidenote, my SO recently started a generic GLP-1 shot. It has far more side effects, at least during ramp up - than just reward center. Notably a wide array of food either make them sick to their stomach or have colon related issues (diarrhea or constipation). I suspect i do observe reward changes as well, but especially in the first few weeks it felt like i was observing weight loss strictly because they struggled t…

> many of the foods they still wanted would just make them sick immediately or hours later Can you name some of the foods? Never been on GLP-1 drugs. But a good amount of fast food leaves me feeling lethargic and, if I eat it too quickly, nauseated afterwards.

Their doctor suggested that they would drop a lot of weight fast, and they wanted to make sure they focused on eating lots of protein. So that's one restriction, medically prescribed meal types.

On top of that, fatty meals, larger meals, and iirc fast carb heavy meals would all cause either nausea or diarrhea. Interestingly their mother is on the identical same generic GLP-1 shot, and has mostly the same side effects. It's kinda difficult to enumerate all the foods that went poorly, and it doesn't always feel logical. We eat a lot (entirely?) home cooked meals, so it's not like i'm even talking fast food here.

Off the top of my head a lot of dark green vegs have been working well. Brassicas and the like.

I should note that they're still quite happy on the drug. They still eat normally enough that it's not like they're only eating broccoli or something. We just have to plan meals very purposefully. It's also a lot of trial and error to find the subset that works.

Re: GLP-1 pills are coming, and they could revolutionize weight-loss treatment

#67

Post by JumpCrisscross »

bossyTeacher wrote: post #51
toomuchtodo wrote: post #42

Earlier quoted context omitted.

There are side effects, but the risk profile is known (is my understanding). It is (at this time) believed to be a forever drug, just like diet and exercise stop working if you stop them. A longer term fix is likely gene therapy (Fractyl Health has a clinical trial in progress, REMAIN-1) vs chronic maintenance. GLP-1s allow us to poke at the human to see what happens. Gene therapy will, hopefully, allow us to impleme…

Diet and exercise don't have negative side effects and they are free. Exercise is social too and has lots of side effect benefits beyond the obvious fitness ones

> Diet and exercise don't have negative side effects and they are free

They're absolutely not free. They fail at a high rate, which incurs medical costs. And when they work, they require--in practice--a lot of follow-up and coaching.

It's fairy-tale level mindblowing that we can look at the status quo where nearly half of the industrialised world is obese and get haughty about a drug that medically, demonstrably improves patient outcomes.

Re: GLP-1 pills are coming, and they could revolutionize weight-loss treatment

#68

Post by nkohari »

bossyTeacher wrote: post #46
toomuchtodo wrote: post #9

Earlier quoted context omitted.

It patches a reward center in your brain, reducing appetite, but also patching addiction reward center activity. https://recursiveadaptation.com/p/the-growing-scientific-cas... > The consistency that I'm hearing from all across patient groups is gain of control, whereas previously, there was a loss of control… All of a sudden they're able to step back and say, 'oh, well I had this shopping phenomenon that was going o…

Sounds worrying to me as it means this is essentially a lifetime drug. As soon as you stop taking it, your appetite returns and so does your old weight. The better option seems to be face the appetite head on rather than putting it on a temporal cage

> Sounds worrying to me as it means this is essentially a lifetime drug. As soon as you stop taking it, your appetite returns and so does your old weight.

I see this said all the time about GLP-1 agonists, and it's a mischaracterization. It is true that when you stop taking the drug, your appetite is no longer suppressed, but you can still keep the weight off by eating a sustainable amount of calories.

Usually, the biggest challenge with weight loss is sticking with it, since it's normally miserable and takes a very long time. Taking a GLP-1 agonist speeds the process and makes it much more tolerable. I lost ~45 lbs. (~205 to ~160) in 6 months by taking tirzepatide (Mounjaro), and if I had done it without the drug it would have taken at least twice as long and been much more difficult.

Re: GLP-1 pills are coming, and they could revolutionize weight-loss treatment

#69

Post by AmericanChopper »

rickbutton wrote: post #59
AmericanChopper wrote: post #32

Earlier quoted context omitted.

Health care costs is how individual people’s terrible lifestyle decisions end up impacting everybody else. If somebody wants to live some awful unhealthy lifestyle it really should be their own choice to do so. Except for the fact that it drives up everybody’s insurance premiums, and in countries where the government either partially or entirely subsidises healthcare costs, it gives the government an outright moral m…

Do you think addicts should receive treatment? Do you think that people who make bad decisions deserve to live? Do you extract the exact amount of value from society relative to the amount you put in, or do you take more than you give? Are you sure? Please explain. Your perspective is frankly disgusting. I hope you don't have any vices. The point of a society is to pool resources together to improve the collective. D…

I don’t think being addicted to laziness and having a glutinous appetite is exactly comparable to say, being addicted to heroin. But yes, I do think addicts should receive treatment, just as I think obese patients should (and do) receive treatment for all the diseases they end up with. But addicts, like the obese, impose many of the costs of their own bad life decisions onto others. It’s what you’d call a negative externality, and if some magic treatment came along to fix drug addiction, I would also be very happy to see that negative externality addressed.

Re: GLP-1 pills are coming, and they could revolutionize weight-loss treatment

#70

Post by rickbutton »

JumpCrisscross wrote: post #56
crmd wrote: post #49

Earlier quoted context omitted.

In my view, the sole focus of the healthcare system should be maximizing human wellbeing. Humanity’s GDP is around $100 trillion per year . There is plenty of money for healthcare with many orders of magnitude to spare for other endeavors. Bean counting here feels like Google in the early ‘00s proposing to make office supply expense reduction a business priority.

> is plenty of money with many orders of magnitude to spare Putting infinite value on anything is a great way to incentivise a system that delivers little to none of it.

There should certainly be measurements taken, costs considered, alternatives approached when building our healthcare system. No one has ever implied otherwise, ever. To imply that there is some level of healthy after which it doesn't make sense to seek improvement is the dehumanizing and anti-social part. What is the point of building an economy at all if not to improve the lives of the population? Opinions in this thread already seem to be that "people are healthy enough, and if not, it is due to their own choices" rather than "we should carefully consider how to optimize this system for efficiency" while focusing on the actual goal of improving lives for the average person as well as those who need more healthcare.
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