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What Ozempic does to the gut-brain axis

psychologytoday.com

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Re: What Ozempic does to the gut-brain axis

#441

Post by PaulHoule »

tsimionescu wrote: post #379
faangguyindia wrote: post #368

Earlier quoted context omitted.

I posted this elsewhere too but i'll add it here: I've helped many people lose weight, become jacked, and go from underweight to a healthy weight. I regularly hear from overweight and obese people who come to me, “I’m genetically predisposed to being fat.” Yet after a few months, we often make significant progress. Many of them have also tried “deficit dieting,” and it didn’t work for them. But when I looked more dee…

I think you are ignoring the selection bias, when looking at people who seek out professional help for losing weight, even more so when it's about people who can then become jacked. Note that I'm not speaking as someone who has just accepted being overweight/obese. I was hovering around 105kg in my early 20s, then I gathered the motivation to go down to ~75kg over the course of a year, then maintained myself around 8…

A lot of us with mesomorphic physiques (I am not an ex-football player but my dad played for Syracuse in the The Express era) can be very physically active and muscular but still pretty fat. Lots of us have metabolic syndrome and heart trouble (my dad died in an accident, but all my uncles have received stent and stent, i'm hoping being proactive with medication et. al will head that off in my case)

Yeah I know bodybuilders manage to get jacked and many of them are doing nothing but maintain their body and are taking anabolic steroids and thyroid hormone and stimulants and who knows what.

Re: What Ozempic does to the gut-brain axis

#442

Post by estearum »

SoftTalker wrote: post #213
htk wrote: post #150

Earlier quoted context omitted.

No, the symptom is being treated, not the underlying issue. And that's ok, but treating the underlying issue, when possible, is better, as the problem ceases to exist.

But that's not what the pharma companies want. They want you on the lifetime prescriptions that don't actually address the underlying problem.

Pharma companies don't control the availability of calories

And anyway, demonstrably not true given that pharma companies are working on a number of drugs that are one-and-done treatments for things like Lp(a). We should figure out a way to make them fabulously wealthy for achieving breakthroughs like that even without a lifetime prescription.

Re: What Ozempic does to the gut-brain axis

#443

Post by estearum »

hack1312 wrote: post #220
nemomarx wrote: post #216

Earlier quoted context omitted.

Diets also don't stick when you discontinue them. It would be an incredible advancement if we figured out a reliable and replicatable way to just eat less food, but until then I think a drug that makes you do that is pretty decent.

> Diets also don’t stick when you discontinue them. Yes, obviously. Which is why sustainable weight loss takes a commitment to making a change in lifestyle. What’s more sustainable, changing your lifestyle to maintain the weight you lost, or being beholden to taking a drug to maintain that same lifestyle change for a hope at maintenance?

Why can't the commitment to a lifestyle change just be a commitment to take a daily or weekly drug?

Re: What Ozempic does to the gut-brain axis

#444

Post by estearum »

hack1312 wrote: post #266
ajross wrote: post #259

Earlier quoted context omitted.

> What’s more sustainable, changing your lifestyle to maintain the weight you lost, or being beholden to taking a drug to maintain that same lifestyle change for a hope at maintenance? That's some pretty... charged language. But even so: the drug, clearly. People take drugs reliably as a matter of empirical fact. People likewise emphatically don't "change their lifestyles" as a general rule. If they did we wouldn't b…

It’s reality. People take drugs if they can afford them; will GLP-1’s be available dirt-cheap to the masses or limited to those fortunate enough to have health insurance.

Yes, of course they will. Is this a serious question? It will take at most twenty years due to patent expiration.

Re: What Ozempic does to the gut-brain axis

#445

Post by s1artibartfast »

faangguyindia wrote: post #324
s1artibartfast wrote: post #319

Earlier quoted context omitted.

This has never been my problem. I can easily eat 5k calories of whole foods

What do you eat in those 5000kcal calories? Genuinely curious.

as an aexample, I once ate a 5lb tritip over an afternoon, and that isnt counting breakfast or sides

Re: What Ozempic does to the gut-brain axis

#446

Post by mapkkk »

Netcob wrote: post #405
mapkkk wrote: post #371

Earlier quoted context omitted.

I personally believe you are right to be weary about holding off on long term use before the long term efficacy and risk profile of a drug has been established, but GLP1 class drugs have been around for a long time now. GLP1 agonist type incretins have been available for over 20 years at this point. The first marketing approval was in 2005 for exenatide (Byetta), indicated for T2DM. Exenatide was the first in class f…

Are there any cases of people upregulating too much in response to those agonists?

I presume you're referring to receptor upregulation in response to the drugs. Bear in mind as you read my comment that this isn't my primary area, and it's been a while since I last studied cell biology and signalling around G-protein coupled receptors. I also have not gone out of my way to read papers about the cell signalling pertaining to these drugs, only papers around clinical outcomes for these class of drugs.

After discontinuation, most patients regain around 60-80% of the weight they've lost with the medication - but this figure is limited to the study duration, so the weight regain might have continued beyond that. A good starting point for dipping your toes into outcomes would be the STEP and SURMOUNT trials, these were the trials they did for marketing approval. (They did multiple rounds of these, I believe STEP4 and SURMOUNT4 specifically had groups that stopped therapy mid-way).

We see this rebound effect with weight loss mediated solely via lifestyle modification as well, however. Still no idea why. Very broadly speaking, only a small proportion of obese/overweight patients will manage to keep the weight off, and the rest of the patient population tends to be divided into two groups: those who regain most of it (usually around half of the lost weight will be regained within 2 years, and 80% by follow up year 5), and those who regain more weight than they had lost. There hasn't been a way to tell preemptively which group the patient will land in at the time of beginning of lifestyle modification.

On top of this, yoyo-ing is also a phenomenon we tend to see. Obese and overweight patients who've managed to lose weight once will regain, lose again and so on. This phenomenon is associated with worse outcomes than being obese alone, so it is important to do long-horizon thinking when initiating therapy (be it lifestyle or pharmacotherapy) e.g. is the patient willing to stay on pharmacotherapy indefinitely? what about an indefinite maintenance dose if the patient succeeds with lifestyle modification alone? has the patient had lost and regained significant amount of wt prior? etc.

Re: What Ozempic does to the gut-brain axis

#447

Post by PotatoPrime »

applfanboysbgon wrote: post #296
dghlsakjg wrote: post #202

Earlier quoted context omitted.

Look up what percentage of people take statins long term at some point in their life. For people in certain age brackets it's more than the 40% of people taking GLP-1s that you are so concerned with. Why don't they just lower their cholesterol via other means? Look up what percentage of people take antidepressants. Why don't they just try being happy? Look up what percentage of people regularly take OTC pain killers,…

> Look up what percentage of people take antidepressants. Why don't they just try being happy? If there's a genuine chemical imbalance that needs correcting, whether that's causing obesity or depression it certainly warrants medical intervention. That should only account for a couple of % of people, however. If 40% of your population is on antidepressants, in other words 40% of your population is chronically depresse…

> What happens when 50% of the population is on some cocktail of GLPs, stimulants, painkillers, sleep meds, and antidepressants simultaneously because it was deemed easier and more instantly gratifying to prescribe chronic medication for everything than addressing any actual causes?

Don't you then start trying to figure out how you can reduce the uses of those precriptions, while maintaining the health figures they're helping to produce? Isn't the answer to do something better than doing nothing? Work with the problem in front of you? etc.

Re: What Ozempic does to the gut-brain axis

#448

Post by microgpt »

Aaargh20318 wrote: post #416
microgpt wrote: post #414

Earlier quoted context omitted.

You should get in touch with a therapist to help you find meaning in life that isn't just eating food. Or get a girlfriend - i heard that helps most people.

Ah yes, a therapist. One of those people who will try to gaslight you into thinking spending 40 hours a week in dayprison is a meaningful life.

What do you do with the other 128 hours?

Re: What Ozempic does to the gut-brain axis

#449

Post by s1artibartfast »

grey-area wrote: post #395
rnewme wrote: post #363

Earlier quoted context omitted.

Eating disorders are mental health condition. Just because there are a lot of visible "false" cases, it doesn't mean that someone else is not living it for real. Your comment is insensitive

> Eating disorders are mental health condition. Agreed, and often the root cause is something else in a person’s life (stress, feelings of losing control etc ). Adding new labels related to food doesn’t do anything to fix the underlying conditions and if anything distracts from them and points the blame at food and physiology, which is not often the root cause of over or under eating.

yes, and many of those root causes are not addressable.

Re: What Ozempic does to the gut-brain axis

#450

Post by StefanBatory »

faangguyindia wrote: post #352
solumunus wrote: post #290

Earlier quoted context omitted.

Specifically for me it makes junk food unpleasant. My diet is now impeccable. I hardly ever have a takeaway and if I do it needs to be something that is not greasy and is good clean food. I also find drinking alcohol much less pleasant. I still drink sometimes but after a few beers or glasses of wine it starts to become very unappealing and I stop. I do bodybuilding and I’m still getting my 150g of protein in. I’m ba…

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