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GLP-1 drugs: An economic disruptor? (2024)

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Re: GLP-1 drugs: An economic disruptor? (2024)

#521

Post by loeg »

SkyPuncher wrote: post #499
no_wizard wrote: post #276

Earlier quoted context omitted.

I’m not going to lie all this sounds like heaven to me. I absolutely hate the way my appetite works. I have a genuine dysfunction with food. It goes back as far as I can remember. My cravings never stop, even after being satiated. It’s an endless cycle of weight gain then loss then gain as my willpower fluctuates for a variety of reasons. My insurance only recently started to cover these weight loss drugs, and I have…

Don’t waste your time with insurance. Just go to one of the consumer facing companies that compound them directly. I’ve seen cases where these sites are 5x cheaper than insurance

FDA has determined the shortages of the non-compounded versions has been resolved (of zepbound/tizepatide in October 2024, and wegovy/semaglutide last week): https://www.fda.gov/drugs/drug-safety-and-availability/fda-c...

So compounders can no longer legally sell tirzepatide and will soon (April-May) be unable to legally sell semaglutide.

That said, the lowest doses direct from Lilly without insurance are $350-500/mo. And if you can do math, you can pay for a higher dose and spread it out over time to achieve a lower average price.

Re: GLP-1 drugs: An economic disruptor? (2024)

#522

Post by wakawaka28 »

TechDebtDevin wrote: post #461
wakawaka28 wrote: post #270

Earlier quoted context omitted.

It will probably fuck up your body in ways that we can hardly imagine. Ozempic has been linked to lots of horrible side effects.

Its saved or extended 1000 lives for every one person whos gotten some GI stress from it.

I doubt it's that high of a ratio. Even if it was, you need to break it down into weight loss versus diabetic cases. I'm sure the dosage is different along with the mechanism of action, even though the substance is the same.

Imagine saying that starches have extended more lives than they have cost, without breaking down the analysis any further. Clearly the health impact depends on the quantities and patterns of consumption. This is the kind of muddling that is now happening with GLP-1 drugs.

Re: GLP-1 drugs: An economic disruptor? (2024)

#523

Post by crazygringo »

PeterStuer wrote: post #488
crazygringo wrote: post #225

Earlier quoted context omitted.

I'm curious -- do you have any brain fog? Are you able to exercise? When you exercise, do you wind up eating more, i.e. the caloric amount that you exercised? I've never had any psychological difficulty with losing weight. I don't care if I'm hungry. But what happens when I eat less and lose weight is that I have trouble concentrating. The glucose my brain needs just isn't there. And if I do physical activity, forget…

Your muscle repair would come primarily from protein. I used to train quite intensely and this protocol worked for me (timings matter): - 45 mins before workout: small bowl of oatmeal with milk - 30-0 mins before workout start: 1 liter of water pre-hydration - During workout: 1/2 liter of water per half hour of intense cardio training, less so for resistance - Straight after workout: double black espresso coffee (hig…

> Your muscle repair would come primarily from protein.

This is a common misconception.

Yes, muscles are made from protein, and so you need additional protein to provide new "building blocks".

But the process of muscle repair uses a far greater amount of glucose to actually do the work of assembly. Estimates are generally that you need something like 10x as many calories from carbs/fats to build muscle, compared to the actual protein required.

So no -- muscle repair actually comes primarily from glucose, if you're measuring calories. But the point is that you need both. If you eat plenty of protein but your blood sugar is low, the muscle growth/repair will be extremely slow, or just not happen at all.

Also, your protocol is entirely about the workout. I'm talking about the 48h afterwards, when the growth actually occurs in response to the stresses incurred during the workout.

Re: GLP-1 drugs: An economic disruptor? (2024)

#524

Post by crazygringo »

lm28469 wrote: post #504
crazygringo wrote: post #286

Earlier quoted context omitted.

I'm very curious what one of your cake recipes is! Because sugar also greatly affects the texture of cake -- it retains moisture, prevents gluten formation, incorporates air... reducing sugar by 75% is going to make for a very dry, tough, and dense cake. I can't even imagine how you're going to make a cake recipe work with 75% less sugar. And it's not an American thing -- it's not like European cakes are any differen…

In that specific case it was a cheese cake. But I've made made fruit cakes with virtually no added sugar, just fruits, and sometimes even that is quite sweet I can't eat cakes from coffee shops &co because they taste waaaaay too sweet.

Ah, I see. Those aren't really cakes at all, despite the names. Thanks, that makes more sense.

You're just extremely sensitive to sugar. The average person is not.

But also, that's not necessarily an adaptation. I went for an entire year once without sugar. Once I went back (after finishing losing weight), nothing tasted overly sweet. It still tasted exactly as I remembered. I could (and can) still drink a Coke and it tastes great.

I mean, especially when I work out, I wind up ingesting a lot of glucose. It's just what my body needs to fuel itself, to keep my blood sugar from getting too low.

Re: GLP-1 drugs: An economic disruptor? (2024)

#525

Post by hollerith »

crazygringo wrote: post #524
lm28469 wrote: post #504

Earlier quoted context omitted.

In that specific case it was a cheese cake. But I've made made fruit cakes with virtually no added sugar, just fruits, and sometimes even that is quite sweet I can't eat cakes from coffee shops &co because they taste waaaaay too sweet.

Ah, I see. Those aren't really cakes at all, despite the names. Thanks, that makes more sense. You're just extremely sensitive to sugar. The average person is not. But also, that's not necessarily an adaptation. I went for an entire year once without sugar. Once I went back (after finishing losing weight), nothing tasted overly sweet. It still tasted exactly as I remembered. I could (and can) still drink a Coke and i…

>You're just extremely sensitive to sugar.

Then I must be extremely sensitive to sugar, too.

Re: GLP-1 drugs: An economic disruptor? (2024)

#526

Post by timr »

cj wrote: post #186
timr wrote: post #145

Earlier quoted context omitted.

They might be branded that way, but that's not what they are. They have dramatic effects on the metabolic pathway and insulin response that need to be carefully considered if you're not actually diabetic. I recommend that you listen to the most recent Peter Attia podcast, which is a 2+ hour interview with Ralph DeFronzo (diabetes expert) where he goes deep into the effects of GLP-1 agonists on insulin response and ot…

I’ll have to rewatch that video. Saw it a couple days ago and walked away with the opposite take. DeFronzo spent a whole lot of time heavily praising the generation of drugs (including the next generation in phase 2 trials) If there’s a specific part you remember talking about the negatives I’d be interested to hear. I legitimately have a difficult time finding anything negative when researching the drug, other than…

He's praising them for people with clear metabolic syndrome, and I'm reading between the lines as someone with prior knowledge. As a simple example, while it's probably good to inhibit gluconeogenesis in people with elevated A1c, doing so in a healthy person could lead to hypoglycemia.

I don't have a list of exact timestamps, but there are multiple places where he discusses the impacts of the GLP-1 agonists (of various generations) on insulin signaling, glucose transport etc., and the conversation is generally complex, nuanced, and wide-ranging. We don't understand everything these drugs are doing, but they're clearly banging around a complicated metabolic/hormonal system with a big, blunt hammer.

Re: GLP-1 drugs: An economic disruptor? (2024)

#527

Post by timr »

cj wrote: post #435
timr wrote: post #145

Earlier quoted context omitted.

They might be branded that way, but that's not what they are. They have dramatic effects on the metabolic pathway and insulin response that need to be carefully considered if you're not actually diabetic. I recommend that you listen to the most recent Peter Attia podcast, which is a 2+ hour interview with Ralph DeFronzo (diabetes expert) where he goes deep into the effects of GLP-1 agonists on insulin response and ot…

Specific part of the interview that talks about GLP-1 safety with DeFronzo and Attia: https://www.youtube.com/watch?v=QGIFdakceHM

Yeeeeah, he says that "they're quite safe", but it's in the context of a wider conversation focused on people with metabolic syndrome. I wouldn't be eager to extrapolate from that comment to "let's put this in the water supply" (exaggerating for the sake of argument).

Re: GLP-1 drugs: An economic disruptor? (2024)

#528

Post by thefz »

cj wrote: post #517
thefz wrote: post #513

Earlier quoted context omitted.

> After a few weeks on the drug, I'm 100% convinced that once this drug is widely available and cheap... being overweight will be a choice It already is.

Yes. In the same way addiction is a choice.

Stopping opioids or alcohol cold turkey can kill you; stopping food will not, for a very long time depending on how much fuel you carry around.

Re: GLP-1 drugs: An economic disruptor? (2024)

#529

Post by cyberax »

abirch wrote: post #510
cyberax wrote: post #355

Earlier quoted context omitted.

It looks like it's mostly caused by having too high doses of GLP-1 too soon.

I’m not about the root cause. I’m on a GLP-1 and while doing a premortem on my medication I saw that this, vomiting, and burps were common.

I've been using GLP-1 agonists since before Ozempic, and by now I have no side effects from them.

My doctor said that she now titrates the dose up slower than the recommended monthly increments and the side effects are less frequent.

Another problem is that GLP-1 drugs seem to synergize with other drugs that can cause GI issues.

Re: GLP-1 drugs: An economic disruptor? (2024)

#530

Post by belter »

belter wrote: post #94
luketheobscure wrote: post #23

Is there a term for this style of writing? It's like a longform linkedin post. I don't mean this as a criticism, it just seems like written language is evolving to better capture our diminishing attention spans.

TLDR: Dont eat so much, you wont be so fat.

TLDR: A slight appetite curtailment might add a dash of elegance
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