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GLP-1s are breaking life insurance

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Re: GLP-1s are breaking life insurance

#541

Post by darkwizard42 »

aqme28 wrote: post #9
arn3n wrote: post #4

Obesity is highly correlated with other medical conditions, from cancer to diabetes to heart disease. I wonder if there is a point at which it is cheaper for health insurance companies to offer subsidized or even free GLP-1s to patients than pay out for other specialized medications. For example, my insurance covers flu shots in my community every year because it's presumably less expensive to pay for the shots compa…

You’re thinking too highly about the incentives of the US healthcare system. Since insurance is tied to your employer (and therefore changing every few years), and most people die on Medicare, there’s not much incentive for insurance companies to pay for preventative care that won’t actually help you for several decades.

Actually from what I have heard, GLP-1 are maybe the first category of drugs which have impact within the median tenure of people on a medical plan (~2 years). It is so significant that you can see ROI within that window which justifies in subsidizing/encouraging patients to use it.

Doesn't disagree with your original claim that there is low incentive for any private insurance to care regarding longevity, but figured I could add some color

Re: GLP-1s are breaking life insurance

#542

Post by fn-mote »

coredog64 wrote: post #489
aqme28 wrote: post #9

Earlier quoted context omitted.

You’re thinking too highly about the incentives of the US healthcare system. Since insurance is tied to your employer (and therefore changing every few years), and most people die on Medicare, there’s not much incentive for insurance companies to pay for preventative care that won’t actually help you for several decades.

This misunderstands how employer-provided insurance works for most people. Large employers sign up with a company like Cigna to provide a network and administrative process. But the actual healthcare is covered by the employer. So really, Cigna or BCBS don't really give a rip if you're taking a bunch of money out of the pool.

USA: That’s the case if your company is “self-insured”. Some are, some aren’t. I imagine there are financial requirements to self-insure but I’ve never looked.

Re: GLP-1s are breaking life insurance

#543

Post by jtrn »

xattt wrote: post #501
jtrn wrote: post #204

Clinical psychologist here in Norway, and just my subjective experience: People stop GLP1 agonists for the following reasons, in descending order: - They want to enjoy eating again. - Medications are a hassle. - Worry about long-term effects, even if there is no alarming evidence for now. - Price (we are a spoiled/rich country). - Other (like hating needles, feeling bad for taking medications that others need more, b…

Can you talk about people who discontinue for GI side-effects? I understand they are present for a short duration, but have heard anectdata that they persist for months for some people. Have you observed persistent GI side-effects in your own practice, and if so, do you believe these are legitimate? Or… are they a social cover for individuals to get back to eating for psychological coping?

It's not just GI side effects. Semaglutide is genuinely GI TOXICITY. That's why it's EXTREMELY important to ramp slowly. So yeah, it's a thing. But for basically everybody, it's manageable with slow and controlled ramping of dosage. There has been hard to find any lasting danger if you ramp slowly.

There has been almost a hysteria, it seems, regarding "Pancreatitis." And when I see multiple diagnoses, medications, and reports associated with Pancreatitis, I recognize a pattern I have seen many times before. Both the mental health and medical fields have periodic fixations on certain symptoms or diffuse diagnosis, and when it has the "wave-like" pattern like this, I am willing to bet it's just the latest version of "Fatigue," "Whiplash," "Repetitive Strain Injury", "lactose intolerance" or the dental amalgam controversy. Don't get me wrong. These are real things. But sometimes they just balloon beyond anything reasonable, and an unreasonable amount of people suddenly get diagnosed with it or suspect they have it. Pancreatitis is giving me that vibe over the last year or so. Copy paste this for "Stomach Paralysis".

But let's say the social benefit of alcohol has a value of 100 and a health risk score of 100. I would say that GLP-1 agonists have a health value of 500 and a risk score of 20. Nothing is without risk, but mathematically speaking, if you are overweight, I would be 25x more positive about injecting myself with Ozempic than alcohol... mathematically at least.

And to answer your question, I personally haven't seen many people stop early due to GI symptoms. And if they did stop early, I would think it was because they genuinely had a physical negative response that was horrible for them. Anecdotally, I feel the people that stop so they can get back to eating usually last at least 6 months, and probably more. I am 100% in agreement with the studies that many stop at around 1 year. So if someone stopped at 2 months, I would belive them when they said it was due to GI symptoms. But if they stopped at 1 year and CLAIMED it was due to GI symptoms, I would doubt; and guess that it was driven by missing food.

Please note that I am speculating wildly, and this is just PURELY anecdotal and stream of consciousness.

Re: GLP-1s are breaking life insurance

#544

Post by _9ptr »

mschuster91 wrote: post #368
_9ptr wrote: post #155

Earlier quoted context omitted.

I would have thought the "traditional way" would simply be eat less, move more (by changing your habits of course).

The problem is, most people aim way too high in their weight-loss target and sending their bodies into starvation mode, which will lead the body to reacquire the lost body fat as soon as possible - aka when people are happy with their body weight and scale up their food intake to caloric neutral again.

There is no such thing as starvation mode. If you consistently don't overeat, you won't gain your weight back.

Re: GLP-1s are breaking life insurance

#545

Post by Gothmog69 »

almosthere wrote: post #25

so surreal reading comments... a month after non-stop threads about glp causing a billion issues, everyone is talking about how wonderful they are again. humanity

That's interesting I keep reading about a billion issues glp1 help like addiction, alzheimers and more

Re: GLP-1s are breaking life insurance

#546

Post by geye1234 »

jtrn wrote: post #536
joncrane wrote: post #459

Earlier quoted context omitted.

I believe you 100%. I have a history of substance abuse with bad consequences. I quit alcohol and now my drug is food. People tell me I'm a "supertaster." I can taste many of the ingredients in my food that others can't. I also have BPD and am in therapy for it, but man. Food is the drug that always works. When I get into a certain mode, it's like I don't care that I'm overweight and have high blood pressure. I just…

Reminds me of a client I had once. He said that the only thing that made him reset was to "pig out" with a carb-overdose, then just sit in front of the TV with a sugar high. Incidentally, I had been nagging him about trying ANYTHING (in addition to the therapy we were doing to find a life goal he believes in) that might help him get SOME help. Be it Adderall or Ozempic. But people are complex, and at best, a person i…

Do you have any thoughts on GLP-1s for ADHD? I have tried the stimulants (legally) without success, and am reluctant to try the non-stimulants since their success rate seems pretty poor and side effects seem worse.

Re: GLP-1s are breaking life insurance

#547

Post by jtrn »

gibagger wrote: post #437
jtrn wrote: post #204

Clinical psychologist here in Norway, and just my subjective experience: People stop GLP1 agonists for the following reasons, in descending order: - They want to enjoy eating again. - Medications are a hassle. - Worry about long-term effects, even if there is no alarming evidence for now. - Price (we are a spoiled/rich country). - Other (like hating needles, feeling bad for taking medications that others need more, b…

Having ADHD myself, and a bunch of friends who also have it, I have noticed that the people with this condition rarely have a healthy relationship with food. There is either a tendency to overeat indulgent foods, or a tendency to not think about food that much. I have also heard about people with ADHD being on GLP1 agonists that it does a lot for their reward seeking behavior and impulse control. This makes me wonder…

As I wrote to another person here: Yes. Not as much as with ADHD medication, but there is an obvious subset of addictive personalities that find relief from addictive behaviors (beyond eating addiction) with semaglutide.

But to add to this, I feel like there are different kinds of addictive behaviors at play that are more susceptible to one medication or the other and are based on different systems.

For instance, the food-craving reduction in GLP-1 is almost certainly not just related to reward and goal-seeking behavior. It literally affects hormone signaling for satiety, and slows down the movement of food through the stomach, and affects, globally in the body, responses to metabolic signals. And it probably has a global effect on the way every cell in the body works, which might be why there are positive health effects beyond just the weight loss.

ADHD medication, on the other hand, targets the goal-directed activity system directly. It seems much more likely to me that reduced appetite is just as much driven by the focus and "let's get shit done" mode that is artificially increased with dopamine. Both result in reduced eating but through massively different pathways. Basically, you pay attention to the biggest wave in the pond (the waves in the pond being a metaphor for all the things your brain COULD pay attention to). So when the goal-stuff gets increased in size, the food-seeking is automatically smaller by comparison, and less likely to drive your behavior and thinking.

I don't think I can say that there is much of a pattern between ADHD and overeating, just based on how easily I can predict if someone is overeating or not if I know they have ADHD. That is, it would be a coin toss.

The simplistic answer would be: Semaglutide reduces addictive behavior if it's driven by emotional regulation needs, and ADHD medication reduces pure drug-like craving. As seen in studies where people that start lisdexamfetamine (ADHD medication common in the EU) have a huge reduction in actual amphetamine abuse.

Case in point: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/... Findings In this Swedish nationwide cohort study of 13 965 individuals, lisdexamphetamine was significantly associated with a decrease in risk of hospitalization due to substance use disorder, any hospitalization or death, and all-cause mortality.

Re: GLP-1s are breaking life insurance

#548

Post by jtrn »

thewebguyd wrote: post #519
cik wrote: post #517

Earlier quoted context omitted.

As someone with diagnosed ADHD. I fully agree. There's some background thread that says "you, now, eat". It's almost impossible to shut off. That being the case, the same behaviours have led me to a compulsive need to plan meals. Doing so has helped me lessen (not eliminate) food noise. Anecdotally, I've noticed with others as well, that this is the way. Prep - be fine. Don't prep - eat a small village.

Also ADHD here, and same thing for me. Hyperfixating on meal planning and strength training has pretty much saved me. It's hard, and I still have to fight food noise daily, but having everything pre-prepped means I have easy, friction free healthy choices instead of reaching for a bag of chips and downing the entire thing while sitting at my desk, or not having the executive function necessary to cook an un-prepped,…

I am a strong believer that the biggest "thing" in ADHD is the challenge with sustained goal-focused behavior. And that is in large part due to how fucking hard it is to stay on task when you have ADHD. It's not uncommon to hear people like you who are able to keep control by focusing on the few things that make the most sense and are the most motivating. And even with a perfect target for behavior, it's a battle to keep at it. That is why I think a lot of people get adult-onset ADHD diagnoses—because they are burned out from spending 2x the energy to keep their life and behavior on track.

Re: GLP-1s are breaking life insurance

#549

Post by wil421 »

theshrike79 wrote: post #420
eru wrote: post #398

Earlier quoted context omitted.

Appropriately enough, (most) ADHD medications also tend to suppress appetites. So much so that weight loss is perhaps the most serious side effect for ADHD meds in children.

Yea, it's specifically warned against. Kids will just plain forget to eat on ADHD meds, which is kinda bad.

I could never eat lunch or sometimes dinner if I took it. I gained like 30 healthy pounds after stopping it at the end of my teens.

Re: GLP-1s are breaking life insurance

#550

Post by gbcbooks »

lumost wrote: post #42
paul7986 wrote: post #17

I believe AI along with smart glasses that shows and calculates your daily caloric intake will be a SUBSTITUTE (another option) to the Ozempics. With AI glasses doing this automatically for you upon seeing what your eating without u having to do anything some people may be shocked to learn how many calories they consume daily. Currently, it's too time consuming now for the majority to do (i use GPT via texting it or…

You're being downvoted as many people who try to count calories fail to achieve meaningful results. From my own experience, weight gain follows a simple progression. 1. Expected high stress work day -> Coffee w/ food item in the morning 2. Stress during the day -> No exercise + large lunch. 3. Post-day -> door dash due to not feeling up for cooking. 4. Sleep -> Get 6 hours of sleep due to not having the energy to mai…

In 2013, my weight was around 48kg, and I increased it to 55kg through fitness and dietary control. In 2016, my body shape reached its peak at 60kg, with a body fat percentage of 12%. In 2022, my weight was 63kg, but my body fat percentage was around 22%. I still managed to regain a weight of around 57kg and a body fat percentage of 18% through fitness and dietary control. I just want to emphasize that controlling diet is very important for shaping the body, and the method of controlling diet is to calculate the calories of food. Only then will you realize what foods you should consume. For example, when you are thirsty but don't want to drink pure water, you want to drink a beverage with a taste like coffee or tea. If you understand the calorie percentage of these foods, you can know that if you choose coffee, it's best to drink an Americano, and if you prefer tea, you can drink almost all types of tea. Even tea is considered beneficial for weight loss. Find tea here,https://teayucafe.com/ The reason why many people fail to achieve their weight change goals by calculating calories is that they cannot persist. Remember, this is a long process.
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