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Discontinuation and reinitiation of dual-labeled GLP-1 receptor agonists

nautil.us

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Re: Discontinuation and reinitiation of dual-labeled GLP-1 receptor agonists

#41

Post by gpt5 »

TaupeRanger wrote: post #3

Kind of a useless analysis if it doesn't compare the risk after stopping GLP-1s to the risk of NEVER taking GLP-1s in the first place. We probably don't know the numbers yet, but one can easily envision a scenario like: risk of CE without GLP-1 weight loss: 20%. Risk after taking GLP-1s for 2 years: 10%. Risk after stopping GLP-1s: 12%. "Your heart attack chance goes up 20% after stopping GLP-1s!!!"

Especially since every GLP-1 study shows almost complete regain to original weight after stopping.

It’s like stopping a blood pressure medicine and then being surprised that people have more heart attacks afterwards.

Re: Discontinuation and reinitiation of dual-labeled GLP-1 receptor agonists

#43

Post by rootusrootus »

Teknoman117 wrote: post #26

I’m always kind of envious of the people who were able to lose weight on GLP-1 drugs. I lost a bunch of weight a few years ago, and still need to lose a lot more (430 lb -> 330, goal 240), but I fell out of the good habits for, well, no good reasons… Decided to try Ozempic and was on it for about 6 months. Didn’t do a single thing for my appetite unfortunately, even on the max dose. Sample size of one here, but if yo…

You missed out on both of the weight suppression tricks, which really does suck. Appetite suppression (or reduction of food noise) is pretty useful, but GLP1s also tend to punish you mightily if you overeat. For me, even if I were hungry, overeating will make me hurt for hours. I could not gain weight on this even if I wanted to.

There are some difference, too, between the various drugs. I never tried ozempic, I went directly to tirzepatide (zepbound). And then to retatrutide. I will say that reta is in some ways the most interesting, because it has less appetite suppressing activity than tirzepatide (this is common, not just me), but it still cuts my stomach capacity quite a lot, and ramps up my metabolism. I had stalled at about 90 pounds down with tirzepatide, and reta immediately knocked off another 15. I track calories, and I had changed nothing. Felt more hungry, still lost more weight. Wild.

From one rando to another, I recommend trying tirzepatide. Or try semaglutide again but stacked with cagrilintide -- some people get pretty great results with that, similar to tirz.

Re: Discontinuation and reinitiation of dual-labeled GLP-1 receptor agonists

#44

Post by rootusrootus »

nisegami wrote: post #14

This makes it even more fantastic that the supply of GLP1s from my country's only legal importer is spotty and I've been suddenly cut off twice already

One benefit of going gray is that you can stock up. If I could not get any more, it would be a number of years before I ran out.

Re: Discontinuation and reinitiation of dual-labeled GLP-1 receptor agonists

#45

Post by rootusrootus »

amazingamazing wrote: post #37

Honestly don’t understand it. Feels like a lack of discipline. I was 250. Plugged in a bunch of numbers into an app and it gave me a calorie count per day. I brought a scale with me everywhere, used ChatGPT to guesstimate calories, I added 50% for good measure. A year later I’m 175. You can’t do this even with drugs you’re gonna get fat anyway. I’m most curious about someone like me vs someone who lost the same amoun…

We know that GLP1s have benefits that are disproportionate with just weight loss, so someone who is otherwise like you in terms of weight loss would probably have better cardiovascular markers.

Probably the biggest difference, though, is that an average "you" will be back at original weight, plus a little, in about a year, while the average GLP1 user will (assuming they keep taking it) be the same weight, or even a bit lighter.

Re: Discontinuation and reinitiation of dual-labeled GLP-1 receptor agonists

#46

Post by rootusrootus »

ErroneousBosh wrote: post #16
Robotbeat wrote: post #2

Kind of makes sense that stopping taking a drug that reduces heart attack and stroke risk leads to a return to the higher risk of before.

It doesn't reduce heart attack and stroke. It reduces appetite, kind of, and gives you a sore stomach while making you shit yourself inside out. All this can, with care, help contribute to weight loss. Weight loss can reduce heart attack and stroke, but GLP-1 does not. You could also reduce heart attack and stroke risks by not eating crap and going for a walk every so often.

What is it about GLP1s that bring out the kooks who suddenly think diet and exercise are the only valid medical treatment? Is it a moral issue?

Re: Discontinuation and reinitiation of dual-labeled GLP-1 receptor agonists

#47

Post by renewiltord »

amazingamazing wrote: post #37

Honestly don’t understand it. Feels like a lack of discipline. I was 250. Plugged in a bunch of numbers into an app and it gave me a calorie count per day. I brought a scale with me everywhere, used ChatGPT to guesstimate calories, I added 50% for good measure. A year later I’m 175. You can’t do this even with drugs you’re gonna get fat anyway. I’m most curious about someone like me vs someone who lost the same amoun…

Everything is discipline. If you just always do the thing you’re supposed to you will win at life. People can’t always do the thing they’re supposed to so they supplement with drugs that help them do it: caffeine, amphetamine, SSRIs, GLP-1RAs and related drugs.

In fact, everything is discipline. If you were disciplined enough to always put the basketball in the net from anywhere on the court you’d be Steph Curry. The thing is most people don’t have that kind of discipline. Someone runs up to them and puts their hand up in the air? They shoot wide or balk. Curry shoots true. Discipline.

Just always do the right thing and never do the wrong thing and you’ll be fine at literally everything.

Re: Discontinuation and reinitiation of dual-labeled GLP-1 receptor agonists

#48

Post by amazingamazing »

renewiltord wrote: post #47
amazingamazing wrote: post #37

Honestly don’t understand it. Feels like a lack of discipline. I was 250. Plugged in a bunch of numbers into an app and it gave me a calorie count per day. I brought a scale with me everywhere, used ChatGPT to guesstimate calories, I added 50% for good measure. A year later I’m 175. You can’t do this even with drugs you’re gonna get fat anyway. I’m most curious about someone like me vs someone who lost the same amoun…

Everything is discipline. If you just always do the thing you’re supposed to you will win at life. People can’t always do the thing they’re supposed to so they supplement with drugs that help them do it: caffeine, amphetamine, SSRIs, GLP-1RAs and related drugs. In fact, everything is discipline. If you were disciplined enough to always put the basketball in the net from anywhere on the court you’d be Steph Curry. The…

Some things require talent like your examples, weight loss does not imho. The disparities in obesity and culture within country says it all.

Re: Discontinuation and reinitiation of dual-labeled GLP-1 receptor agonists

#49

Post by bitwize »

01100011 wrote: post #36
Teknoman117 wrote: post #26

I’m always kind of envious of the people who were able to lose weight on GLP-1 drugs. I lost a bunch of weight a few years ago, and still need to lose a lot more (430 lb -> 330, goal 240), but I fell out of the good habits for, well, no good reasons… Decided to try Ozempic and was on it for about 6 months. Didn’t do a single thing for my appetite unfortunately, even on the max dose. Sample size of one here, but if yo…

It lets me more or less skip a meal but holy hell I am craving sugar more than ever. On the whole I'm cutting calories and have lost a lot of weight, I just wish I didn't want sugar this much.

Try allulose-sweetened stuff. Allulose is a sugar your body doesn't metabolize like sucrose. It has zero calories and does not increase your blood sugar. It's a component of maple syrup and so does taste a bit maple-y, but better than most artificial sweeteners and even stevia leaf extract (stevia and aspartame have a "tang" to them I dislike).

Re: Discontinuation and reinitiation of dual-labeled GLP-1 receptor agonists

#50

Post by embedding-shape »

post-it wrote: post #11
IAmGraydon wrote: post #7

Earlier quoted context omitted.

>This is a very odd phrasing that makes it seem like heart attack and stroke risk are higher for those who stop taking the drug than those who never took the drug. That does appear to be the case, according to the study.

It certainly does not. To make that claim, the study would need a control group of people who had never taken the drug. They didn't have that: > Participants Veterans Affairs users with type 2 diabetes who started treatment with GLP-1RAs (n=132 551) or sulfonylureas (n=201 136), followed up for three years. Veterans Affairs users were defined as having at least two visits to Veterans Affairs and having used the Veter…

> They didn't have that

So, why not? Seems very obvious to everyone here on HN that it's "kind of useless" unless they did have that, yet they didn't. What reason would there be for ignoring that?

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