How long til we're all on Ozempic?

Statins are regularly given to people with high cholesterol. I would bet that most older people take or qualify to take a statin. If it happens with statins, therefore, it's not out of the realm to think that most people will eventually be prescribed GLP-1 to reduce weight which will improve overall health. It makes sense.

It's a pretty sad thought that everybody will be on a drug that keeps weight in check while most people will still eat a basically toxic diet. Weight is certainly an important factor but there is more to a healthy life.

There were several side effects related to pancreatic cancer associated with the precursors to GLP-1 drugs. The same companies promoting GLP-1s were responsible for driving up insulin prices. So I'm hedging my bets.

There's a really cool Modern MBA video [1] on this topic btw :)

[1]: https://www.youtube.com/watch?v=7sUoZVke_30

This compares Ozempic with past drugs, but sales of past drugs are almost always limited by demand. I'm not sure there's much to learn here for a drug that is limited by supply. Also, this part is silly:

"The announced investments across both companies total $32 billion. GLP-1s were 71% of Novo’s revenue in 2023, 16% of Lilly’s in 2023, and 26% of Lilly’s in 2024Q1. If these sales are proportional to the manufacturing capacity used to create those drugs, then about 40% of Novo and Lilly’s combined estimate of $45 billion in gross PP&E is for GLP-1s, for a total of $18 billion; $25 billion would then mean a 140% increase in GLP-1-relevant PP&E."

Manufacturing investment is not proportional to sales, because there's a fixed cost to making a certain drug regardless of how much you sell. If a rare-disease drug will have a few thousand patients ever - not uncommon! - you still need to figure out a synthesis path for that particular drug, run QC tests on the production line, get regulatory approval, etc. Economies of scale matter a lot (https://en.wikipedia.org/wiki/Experience_curve_effects).

I'd think it more likely that it'll be one of the next generation drugs, but I do agree with the premise that it will be really common.

A few weeks ago I started a low dose of tirzepatide (aka Mounjaro, aka Zepbound) and the side effects are interesting.

The biggest negative, which just takes adjustment, is drastically lower stomach capacity. Used to be that two eggs and two pieces of toast was breakfast. Now I better skip at least one of those pieces of toast or I'm going to feel overfull and might get reflux as punishment.

But there are some unexpected positives.

Obviously I am eating less. I have to log food not to keep it in check, but to make sure I'm eating enough and with the right nutrients. There's another possible negative here -- you get a lot of hydration from food, so if you start eating less you should carefully monitor your fluid intake to allow for that.

But I'm also more focused. Not nearly as distracted. I'm getting a lot of things done which I used to just procrastinate on until years had passed in some cases. Man, the garage is going to be clean and superbly organized in a few weeks.

And my emotions are quieter. Not just the food noise, that was expected, but I feel more relaxed. That's not what I expected, and I'm pleasantly surprised.

As an aside, what makes this all really noticeable is that it's a once-a-week injection, and the peaks and valleys are very obvious. Saturday is injection day, but Sunday is where it really becomes quite noticeable that I took it. Monday-Wednesday is cruising altitude and the effects are good but not over the top. Thursday I can feel it tapering, and today ... well, I'm looking forward to tomorrow's injection. I might switch to a twice-a-week split dose at some point to ease the peaks and valleys.

Edit: Before someone asks, yes I have considered there may be long term effects. This is a risk, which I've decided I'm okay with at my age. Nobody gets to live forever anyway, and I was going to end up in an early grave via another route if I didn't do this. "Just eat less and exercise more" is trite. If it were that easy, we'd all be in fantastic shape.

I do hope to taper off at some point if I can figure out an alternate strategy for staying lighter. Though I'll miss some of the positive side-effects.