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

arstechnica.com

71–80 of 106 posts

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

#71
post #44

Earlier quoted context omitted.

Unfortunately that’s not true any more. TRT over prescribing is a major problem right now. Studies of TRT patients have even shown that 1/4 of TRT patients may not have had their testosterone levels measured before being prescribed TRT: (Source https://pmc.ncbi.nlm.nih.gov/articles/PMC6406807/ ) Completely unacceptable given how cheap testosterone testing is, but its happening. TRT clinics have also become a big busi…

>>The trick the clinics are using now is “diagnosing by symptoms”. You can't really diagnose by levels, though, unless you knew what that person's previous levels were. Setting an average across a population is not really realistic - you can't say Shaq should work to the same levels as, say, Emo Phillips. TRT is normally used due to aging, though, so you are unlikely to have your testosterone levels spontaneously rec…

>You can't really diagnose by levels, though, unless you knew what that person's previous levels were.

Exactly. Before suggesting it. my doctor had more than a year's worth of data. (I have some blood tests done quarterly; so, he added one for testosterone.) Even then, he sent the results to my urologist.

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

#72
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.

Isn't there TRT that doesn't impact your endogenous production? (HCG, SERMs)

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

#73
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…

Strange framing, isn't it? Bariatric surgery shows 25-65% significant regain rates depending on definition and timeframe. And regular dieting is even worse. Nobody would frame that as a safety issue. That's... just how weight loss works, not a unique GLP-1 problem. Calling a return of symptoms (obesity) a "safety issue" is like saying insulin has "no safe off-ramp" because diabetics get hyperglycemic when they stop t…

It's also very strange because more than 75% had some level of sustained weight loss after several years.

That's way better than any other weight loss program. Nothing else even comes close.

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

#74
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…

"Those poor people have no agency and their behaviors are outside their control!" Well, I guess we have no choice but to affirm and reinforce their lack of agency and ensure we put them on drugs for the rest of their lives! It's ironic that one of the effects of this drug seems to be reducing the impact of impulsive behaviors, reducing cravings from other drugs and alcohol and cigarette addictions. The hat trick for…

I think your opinion is valid from your point of view but missing an important part of the bigger picture.

Obese people typically do not try to become obese. Most obese people have tried to lose weight and find that they lack the tools and skills needed to succeed, and many of the ones that do succeed only do so temporarily.

Why is that?

It's a question with no simple answer, and no single answer.

Evolutionary biological drive to acquire calories.

Psychological dependency on food.

Inability to differentiate satisfaction from "being stuffed", likely due to environmental factors like negative education as a child or poverty mindset in parents.

The perceived difficulty of altering diets for longevity.

Self-hate.

I'm sure there are scores more reasons for this, and no single concept or mindset is large enough to fully accurately embody the breadth of reasons why people remain obese in a world that actively disincentivizes obesity in every measure of life satisfaction.

People outside of that fail to empathize with the plight of obese people. They blame them for living a life that is generally unintentionally thrust upon them.

They do not see obesity as a disease but as a choice and then mock or dismiss them for being obese, even though by all metrics it is a disease.

People tell obese people to diet like they tell alcoholics to quit drinking or drug addicts to quit using drugs and honestly believe their words have contributed value to humanity, but unlike drug addicts or alcohol, there is no cold turkey for obesity other than death.

People must eat. That includes obese people.

If you can figure out a way for a crackhead to smoke crack 3 times a day until they feel satisfied with how much crack they have smoked without remaining a crackhead, then you might be able to figure out how to get an obese person to eat 3 meals a day until they feel satisfied without remaining obese.

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

#75

Earlier quoted context omitted.

Did you use a LLM to write these comments?

I do not. I’m typing on my phone from a waiting room. I’d probably have fewer incorrect words and awkward sentences if I did.

I see. I got curious because of the correct usage of ’ (instead of the common ')

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

#76

Earlier quoted context omitted.

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

> Unless you went on when you weren't really low because the men's vitality clinic pushed you into a treatment protocol Saying that the men's vitality clinic "pushed you" into a treatment protocol is like saying that a fertility clinic pushed you into getting pregnant. Sure, it's a common outcome, but you had an idea of what you wanted out of it before you walked in the door.

> Saying that the men's vitality clinic "pushed you" into a treatment protocol is like saying that a fertility clinic pushed you into getting pregnant.

No, it isn't. “Men’s vitality” doesn’t mean “getting pumped with testosterone regardless of indications” the way “fertility” means “getting pregnant” in either literal denotation of words or the understanding of the general population.

> Sure, it's a common outcome, but you had an idea of what you wanted out of it before you walked in the door.

Yes, but in the case of fertility clinics, getting pregnant aas definitely the outcome beinf sought. Being pumped with testosterone isn’t the outcome being sought from a men’s vitality clinic, it is (even for the people who are actively thinking about it) a mechanism (and not an appropriate one for every patient) for atteempting to acheive the desired outcome.

If you go to a fertility clinic and they don't attempt to identify the source of your fertility issues and just pump you with hormones not indicated for your specific issue, that would be wrong, too.

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

#77

> 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 peopl…

  > So weight loss was actually maintained for most people
Unless I'm mistaken, how can you interpret that from an article that claims that 57-82% of participants regained 25%-50% of their weight loss, with 24% regaining at least 75% of it? In just a bit more than a year and a half, too.

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

#80

Earlier quoted context omitted.

> Unless you went on when you weren't really low because the men's vitality clinic pushed you into a treatment protocol Saying that the men's vitality clinic "pushed you" into a treatment protocol is like saying that a fertility clinic pushed you into getting pregnant. Sure, it's a common outcome, but you had an idea of what you wanted out of it before you walked in the door.

> Saying that the men's vitality clinic "pushed you" into a treatment protocol is like saying that a fertility clinic pushed you into getting pregnant. No, it isn't. “Men’s vitality” doesn’t mean “getting pumped with testosterone regardless of indications” the way “fertility” means “getting pregnant” in either literal denotation of words or the understanding of the general population. > Sure, it's a common outcome, b…

> No, it isn't. “Men’s vitality” doesn’t mean “getting pumped with testosterone regardless of indications”

When I Google "men's vitality clinic", the top result I see is titled "Your experts for testosterone replacement therapy...". TRT is front and center.

> Being pumped with testosterone isn’t the outcome being sought from a men’s vitality clinic, it is (even for the people who are actively thinking about it) a mechanism (and not an appropriate one for every patient) for atteempting to acheive the desired outcome.

This is such a weird distinction to try and make.

I frequently see ads for these services, and even when they're not so explicit as that one is about what they're selling, it's extremely clear what demographic they're going after and what the hook is.

Testosterone being a Schedule III substance, "men's vitality" is the way that they can legally advertise an service that prescribes AAS. It's no more of a secret that men's vitality clinics prescribe testosterone than it is that fertility clinics are prescribing estradiol. Both of these are sex hormones that induce a specific effect on the body which the patient is looking for.

Can I imagine someone walking into a men's vitality clinic and being surprised that they're getting offered testosterone? Sure, and there's also that German couple who went to a fertility clinic because they weren't having a baby, and were surprised to learn that they needed to start having sex.

Clueless people exist. That doesn't mean that it's not readily obvious to anyone who's paying attention what these clinics exist to do, and how they do it.

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