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FDA Approves Lilly's Zepbound (Tirzepatide) for Chronic Weight Management

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Re: FDA Approves Lilly's Zepbound (Tirzepatide) for Chronic Weight Management

#41

Post by aantix »

molsongolden wrote: post #36

With these drugs, is there any mechanism at work beyond "patients have a lower appetite and eat less food"? I've only read a few papers and articles but what I've seen is that all of the hormone triggering leads to 1) decreased appetite 2) slowed gastric emptying which also decreases appetite. Patients lose weight due to eating less but usually regain the weight when stopping the drug since they then go back to their…

- Tirzepatide may activate brown fat, which might be a metabolic advantage.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9396640/

- Another study - there was a 16% weight loss for those that received semaglutide/diet/exercise/counseling versus a loss of 5% for placebo those that received diet/exercise/counseling without semaglutide.

But they didn't control for calories, so it may just be proving that dietary adherence with the medication is better than without.

https://pubmed.ncbi.nlm.nih.gov/33625476/

https://classic.clinicaltrials.gov/ct2/show/NCT03611582

Re: FDA Approves Lilly's Zepbound (Tirzepatide) for Chronic Weight Management

#42

Post by quux »

molsongolden wrote: post #36

With these drugs, is there any mechanism at work beyond "patients have a lower appetite and eat less food"? I've only read a few papers and articles but what I've seen is that all of the hormone triggering leads to 1) decreased appetite 2) slowed gastric emptying which also decreases appetite. Patients lose weight due to eating less but usually regain the weight when stopping the drug since they then go back to their…

GLP-1 affects a lot of systems beyond just appetite and gastric emptying. For instance it acts in the pancreas to promote insulin secretion. GLP-1 receptors are also found in a lot of other tissues, including heart, tongue, adipose, muscles, bones, kidneys, liver and lungs. The effects of GLP-1 in these tissues are an area of intense research.

Re: FDA Approves Lilly's Zepbound (Tirzepatide) for Chronic Weight Management

#43

Post by nathanyz »

rs_rs_rs_rs_rs wrote: post #37
nathanyz wrote: post #16

Earlier quoted context omitted.

This cannot be understated. Obesity is being changed from a willpower problem to a chronic disease that is treatable. The follow-on effects of this are huge.

>Obesity is being changed from a willpower problem to a chronic disease that is treatable It's absolutely a willpower problem. These medications won't fix that for you. You stop taking them and you will gain weight again.

The amount of willpower required to maintain differs from person to person. So yes you can willpower your way to a healthy weight, but the amount of mental energy required is going to vary significantly between people. The drug proves it as it basically flips people with a high willpower requirement to feel more in the normal range where it is easier to eat less.

Re: FDA Approves Lilly's Zepbound (Tirzepatide) for Chronic Weight Management

#44

Post by xnx »

candiddevmike wrote: post #19
nathanyz wrote: post #16

Earlier quoted context omitted.

This cannot be understated. Obesity is being changed from a willpower problem to a chronic disease that is treatable. The follow-on effects of this are huge.

What are the side effects? There's never a free lunch with biological systems...

Possibly none. These drugs are bringing our appetite under control in an environmental that is full of readily available, appetizing, easy to digest, high-calorie foods.

Re: FDA Approves Lilly's Zepbound (Tirzepatide) for Chronic Weight Management

#45

Post by cowboyscott »

While personally I'd like to see a reduction in obesity rates by focusing on causes (e.g., "sugar taxes" and the like), it's hard to deny the positive impact of these drugs. Obesity is such a destructive epidemic in my country (US) that I see an argument for providing these drugs either for free or at substantially reduced costs via government subsidy. Despite vaccine skepticism, free COVID vaccinations might be a model worth following.

If the public sector doesn't help, I imagine that insurance companies are doing what they can to put downward price pressure on these drugs. If I can pay x now to avoid 10x in payout costs to medical providers for obesity complications (while keeping rates the same), I'm going to take that trade (subject to actuarial data and discount rates).

Re: FDA Approves Lilly's Zepbound (Tirzepatide) for Chronic Weight Management

#46

Post by dearsaturn »

n8cpdx wrote: post #39
ng12 wrote: post #17

> Research now shows that the body may respond to a calorie-deficit diet by increasing hunger and reducing feelings of fullness Dieting makes you hungry, truly revolutionary research.

It seems obvious but the “just eat less” crowd needs to hear it. Ever try working on a tricky coding project while starving? Take a math test when all you can think about is finding something, anything, to eat? Losing significant amounts of weight the natural way isn’t so much a test of willpower as a test of how well you can function under a constant sense of hunger (or, how good you are at tricking your way out of…

To fight off hunger while dieting, you eat lower calorie density, fiber-rich vegetables and unsaturated fats. Potatoes, avocados, legumes, there are a lot of options. They just don't fulfill the same psychological need that less healthy food does.

Re: FDA Approves Lilly's Zepbound (Tirzepatide) for Chronic Weight Management

#47

Post by quux »

Obscurity4340 wrote: post #38
aantix wrote: post #30

Earlier quoted context omitted.

Of FDA approved medications for weight loss, tirzepatide would be the current gold standard. https://www.nejm.org/doi/full/10.1056/nejmoa2107519 I think retatrutide might be the current leader for weight loss from clinical trials. If I remember correctly, you lost the same amount of weight on retatrutide vs tirzepatide, but over a shorter time span.

You're saying this NEW medication is already currently the gold standard? What was it prior?

The active ingredient, tirzepatide, isn't what's new here. It was patented in 2016 and has been on the market for treating type 2 diabetes since 2021.

What's new is that tirzepatide is now FDA approved for treatment of obesity, which will make it possible for insurance to cover it without a type 2 diabetes diagnosis.

Re: FDA Approves Lilly's Zepbound (Tirzepatide) for Chronic Weight Management

#48

Post by nathanyz »

cowboyscott wrote: post #45

While personally I'd like to see a reduction in obesity rates by focusing on causes (e.g., "sugar taxes" and the like), it's hard to deny the positive impact of these drugs. Obesity is such a destructive epidemic in my country (US) that I see an argument for providing these drugs either for free or at substantially reduced costs via government subsidy. Despite vaccine skepticism, free COVID vaccinations might be a mo…

While I agree on your points of the benefits, the one place who is not advocating for them is insurance. People switch insurance frequently, so there is no benefit to help this year what causes a significant disease to their customer in 10 years as that benefit will likely acrue to some other insurance company.

The insurance companies basically think 1 year at a time for drug coverage and only care about keeping you alive for that 1 year at the cheapest possible price. Long term care and planning is something medicare/medicaid may better be able to utilize in their economic model to justify coverage.

Re: FDA Approves Lilly's Zepbound (Tirzepatide) for Chronic Weight Management

#49

Post by xnx »

gen220 wrote: post #35

Has anybody here taken this category of drug, lost significant weight, and kept it off after dropping the drug? I've seen great success stories, but I'm kind of nervous of the long-term effects of taking a drug like this for your whole lifetime (i.e. what's implied by the "chronic" in "chronic weight management"). It seems like it might be a great off-ramp from obesity to a body weight where the risk of injury in exe…

> exercise to maintain the caloric deficit

Exercise is great for dozens of reasons, but weight loss is probably at the bottom of the list (if it's on the list at all). The asymmetry between the ease of consuming calories and the effort of exhaling calories during exercise is too great.

Re: FDA Approves Lilly's Zepbound (Tirzepatide) for Chronic Weight Management

#50

Post by nexus7556 »

gen220 wrote: post #35

Has anybody here taken this category of drug, lost significant weight, and kept it off after dropping the drug? I've seen great success stories, but I'm kind of nervous of the long-term effects of taking a drug like this for your whole lifetime (i.e. what's implied by the "chronic" in "chronic weight management"). It seems like it might be a great off-ramp from obesity to a body weight where the risk of injury in exe…

There are lots of success stories on the Mounjaro subreddit.
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