Live data from Hacker News

There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

arstechnica.com

11–20 of 106 posts

Re: There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

#11

There doesn’t need to be an off-ramp they just have to take it for life. Why would someone think they would keep the weight off? If they could they would have before Ozempic.

I could see it building habits that persist even when no longer using the drugs. They've found other things to fill their time instead of eating, and things which would previously trigger them to start eating now trigger them to do other things.

There's of course a risk that when they stop the drugs that hunger will drive them to re-establish those habits, but now that they have new habits that fight that hunger they are in a much better position to resist it than they were when they'd initially established their eating patterns.

Re: There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

#12
post #4

Interesting. Saying, "there may not be a safe off-ramp," doesn’t feel quite right. The article describes people losing weight while on the drugs and then regaining weight after stopping them. That's not ideal, but it does imply an off-ramp, just with regressions. Compare that to something with no real off-ramp: testosterone replacement therapy. Once you're on TRT, you can permanently suppress your body's own testoste…

If you're on TRT, you are already not producing enough on your own.

Re: There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

#13
post #4

Interesting. Saying, "there may not be a safe off-ramp," doesn’t feel quite right. The article describes people losing weight while on the drugs and then regaining weight after stopping them. That's not ideal, but it does imply an off-ramp, just with regressions. Compare that to something with no real off-ramp: testosterone replacement therapy. Once you're on TRT, you can permanently suppress your body's own testoste…

If you're on TRT, you are already not producing enough on your own.

Unless you went on when you weren't really low because the men's vitality clinic pushed you into a treatment protocol*

* not me but I see it with men in my age range

Re: There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

#14
> Of the 308 who benefited from tirzepatide, 254 (82 percent) regained at least 25 percent of the weight they had lost on the drug by week 88. Further, 177 (57 percent) regained at least 50 percent, and 74 (24 percent) regained at least 75 percent. Generally, the more weight people regained, the more their cardiovascular and metabolic health improvements reversed.

So weight loss was actually maintained for most people -- the hard part is finding a healthy daily lifestyle which can maintain the drastic effects of GLP1s.

This information isn't new -- weight regain has been studied before and I've written about it before:

https://glp1.guide/content/do-people-regain-all-the-weight-l...

The missing piece to this article is just how bad the alternative is -- never having the cardiovascular and metabolic benefits is clearly not the best strategy (and if simply changing patterns was so easy, people would have done it already).

GLP1s don't work for everyone but they're pretty close to miraculous in effect given the balance of positive and negative side effects. Making GLP1s cheaper & more tolerable then figuring out how to actually deal with the complex web of how to keep the weight off sustainably for most people seems like the right way forward here, not avoiding potentially life-saving medication because you may not be able to get off of it as fast as you want (if you can afford it).

BTW, there is already generic Liraglutide, and legal workarounds for getting compounded Semaglutide that already mean no one pays the $1000 that was in the zeitgeist a while ago. Even Lilly Direct and similar outfits from Novo sell for $500/month, with the $150/month pricing coming soon[0].

[0]: https://glp1guide.substack.com/p/negotiations-are-underway-f...

Re: There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

#15
post #5

There doesn’t need to be an off-ramp they just have to take it for life. Why would someone think they would keep the weight off? If they could they would have before Ozempic.

> take it for life That's literally the implication of these findings. But one can always hope for a miracle drug that you can take for a bit, then stop, and have its effects last. Now we know that Ozempic is not that drug.

I think it would almost need to be some sort of genetic modifier, which may not be that far off.

Re: There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

#17

"Generally, the more weight people regained, the more their cardiovascular and metabolic health improvements reversed." You don't say ;-) I lost 50 lbs and have kept it off for the past year while maintaining great BP. But I'm under no illusions GLP-1 medications don't have dangers and cause problems for many. It should be handled on an individual basis like any serious medication. That said, is someone losing a lot…

> losing a lot of weight then gaining half of it back

The trick, of course, is to repeat the process as you asymptotically approach your goal.

Zeno's paradox of mass.

Re: There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

#18

Earlier quoted context omitted.

If you're on TRT, you are already not producing enough on your own.

Unless you went on when you weren't really low because the men's vitality clinic pushed you into a treatment protocol* * not me but I see it with men in my age range

I am a big fan of Dr Rohin Francis, and this landed on my youtube's front-page recently

https://www.youtube.com/watch?v=FPsKTfFQFqc

Re: There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

#20

The headline doesn't seem to match the article? 20% of participants did keep the weight off and 40% kept half the weight off after stopping. So there appears to be an off-ramp, we just don't know what it is.

> we just don't know what it is.

calories_in < calories_out seems to be a pretty good formula.

Post reply on HN