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How long til we're all on Ozempic?

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Re: How long til we're all on Ozempic?

#711
post #588

Earlier quoted context omitted.

Personally, I've never seen obesity as a failure of character or willpower, at least as long as I can remember having any particular views on it at all. I see it as a failure of information and choices. Obesity was rare until the United States officially decided in 1977 that saturated fats were considered harmful. A few years later, it started rising to the current epidemic level. We've come a long way since the Amer…

Do you view a chronic smoker as a failure of character or willpower?

I wouldn't say inherently. Trying and failing to quit is plainly a failure of willpower on some level, albeit an understandable one given varying levels of nicotine addiction. Perhaps it could also be a failure of information (helpful techniques, etc.), although I'm not familiar enough to comment in detail on what quitting smoking is like.

On the other hand, is picking up the habit in the first place, or choosing not to attempt to quit, a failure of character? I'm not sure that's for anyone other than the individual to decide. I personally feel it's unwise given that in 2024 smoking tobacco is pretty much universally known and accepted to be wildly unhealthy, but if someone weighs the tradeoffs and decides that maybe it has social and/or professional and/or mental benefits for them that outweigh the downsides, I wouldn't call that a character flaw so much as a decision that I'd highly disagree with. I'd say the same whether we were discussing tobacco or meth.

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Edit: More to the point I now see you were probably getting at, there's a pretty big difference in the knowledge and time/resource investment required to stop buying cigarettes (which costs nothing) and to adopt a low-carb or ketogenic diet that a particular individual would be happy with long-term. I've been keto for over 12 years, and I have a routine that I enjoy, know my way around a kitchen, know what foods I like, and know all the right ingredients and recipes to use to create any food I might want to eat in a keto-friendly form that's as good as or better than what I could otherwise buy at a store or restaurant. For example, I make some of the best ice cream I've had anywhere (sometimes in flavors that I've never seen commercially available), and the one time I cheated for a New York slice I was disappointed because it didn't hold up to the pizza I'd already been making at home.

Maintaining my diet takes zero willpower, because I enjoy it even more than my diet from when I was fat, and I never had to starve myself or give up my sweet tooth. The problem is that for that to work it required not just the inclination to research and adopt keto in the first place (a major hurdle in itself), but turning it into a dedicated hobby with development of knowledge and skills that I wouldn't expect the average person to casually pick up. That may work for me, but isn't a scalable solution for the population at large. On the other hand, if I could magically reformulate every food product in the world based on what I know from experience works, no one would struggle to eat a high-fat diet because that would just be the default instead of high-carb.

Re: How long til we're all on Ozempic?

#712

Earlier quoted context omitted.

> "Just eat less and exercise more" is trite. If it were that easy, we'd all be in fantastic shape. Studies show it just doesn't work. There was a massive (18,000,000 people) cohort analysis published in 2023 that showed the likelihood of someone losing 5% of their body weight in any given year was 1 in 11 and the likelihood of going from severely obese to normal weight is 1 in 1667. https://www.ncbi.nlm.nih.gov/pmc/…

People need to understand what activity / exercise really is. The desperation of the medical establishment to get people to do ANY exercise meant the general advice is watered down. It's the doom of the statistical distribution. Good outcomes are defined in relative terms on the bell curve, not on absolute performance which exercise is actually suited for. In days of manual labor jobs and lots of walking, people like…

Finally someone posting something that makes sense. I have hormonal issues that make me predisposed to being overweight. When I lived in New York, I was able to keep the pounds off by walking 20 miles per day. That's how evil my body is. That I would literally have to draw green polygons over Manhattan for five hours a day to not be overweight. I stopped doing that when I moved to the Bay Area because it's not as much fun to walk around here. So I'm very excited about Ozempic since it'd be nice to be able to be able to keep the weight off and get most of those five hours back.

Re: How long til we're all on Ozempic?

#713
post #129

I'd think it more likely that it'll be one of the next generation drugs, but I do agree with the premise that it will be really common. A few weeks ago I started a low dose of tirzepatide (aka Mounjaro, aka Zepbound) and the side effects are interesting. The biggest negative, which just takes adjustment, is drastically lower stomach capacity. Used to be that two eggs and two pieces of toast was breakfast. Now I bette…

> Saturday is injection day, but Sunday is where it really becomes quite noticeable that I took it. Monday-Wednesday is cruising altitude and the effects are good but not over the top. Thursday I can feel it tapering, and today ... well, I'm looking forward to tomorrow's injection. I might switch to a twice-a-week split dose at some point to ease the peaks and valleys. Perhaps coincidentally, this is similar to my ex…

You could have food allergies that take a couple days to clear up.

Re: How long til we're all on Ozempic?

#714

I've been on tirzepatide (Mounjaro) for 4 months now. I'm down 13% of my body weight. I realized that frequent cannabis consumption interferes with the weight loss, so I've kicked the habit from daily to occasionally on weekends. I've started walking 2-3 miles a day, 2-3 days a week regularly, in addition to eating less and being more motivated to calorie count. All this to say, this drug has been life changing for m…

Have you been recommended an exercise regimen, or taken one up yourself? The one the great things about GLP-1s is that with the weight loss, it's easier to be more active once you've lost some of the weight. The negatives is that the current breed promote a loss in muscle mass as well as fat loss, so it is very important to do your best to maintain if not increase muscle while on them.

The next generation of drugs are including 2nd molecule...I'm blanking on the name, and a search isn't bringing it to me...which maintains or potentially increases muscle mass.

But curious what your experience with exercise has been.

I also didn't know there was a planned reduction in dosage, but the expectation is that you'll be on some type of GLP1 for life, is that not right?

Re: How long til we're all on Ozempic?

#716
post #229
post #170

Instead of a system that makes these drug available for purchase, I'd rather live in a system that promotes healthy food and active behavior. Unfortunately, I have to drive everywhere, work too many hours to have free time for recreation and have no idea which government subsidy is going to help big ag likely at the expense of my health. All things being equal, I'd prefer to spend less money on prescriptions and have…

If you have an open mind, I'd like to assign you some homework if you like. Take a look around r/zepbound and count the following: 1. Posts from folks who diet+exercise, or who have tried diet/exercise and nothing's worked so they then turned to Zepbound ("excited to hit the gym," "my diet is finally starting to work with Zepbound" and similar) 2. Posts from folks who haven't tried diet/exercise and turned to Zepboun…

> Perhaps it's necessary to have self-control to lose weight > it's not so simple.

Presumably people who have good self control and are not prone to developing addictions (due genetic or various semi-immutable cause) do not become obese in the first place. It might be fairly easy easy for them to lose weight they just don't need.

Re: How long til we're all on Ozempic?

#717
post #428

Earlier quoted context omitted.

And apparently the pure manufacturing cost for Ozempic is relatively low: > the active drug in Ozempic can be produced for about 29 cents for a month’s supply, or 7.2 cents for a typical weekly dose, the research found. It’s not cheap to make — semaglutide costs over $70,000 per kilogram. But only a tiny quantity of the drug is used in each weekly dose. > https://fortune.com/europe/2024/03/28/ozempic-maker-novo-nor..…

By chance I just talked to someone with deeper knowledge on this and they said the current constraint is actually ramping up supply of the delivery mechanism, not the drug. I have zero expertise on this, but would be curious if anyone knows what's special about Ozempic delivery that can't be served by a commodity syringe.

> By chance I just talked to someone with deeper knowledge on this and they said the current constraint is actually ramping up supply of the delivery mechanism, not the drug.

The article says this:

> Surprisingly, the study found that the biggest cost in producing Ozempic is not the active medicine, called semaglutide, but the disposable pens used to inject it. They can be made for no more than $2.83 per month’s supply, the authors concluded, based on interviews with former employees and consultants to injection device manufacturers. One Ozempic pen is used weekly and lasts a month.

So while the injection pens are significantly more expensive than manufacturing the drug itself, they are still relatively cheap. So it seems to be not a major problem to strongly ramp up production here as well.

Which suggests any supply shortage will be resolved relatively quickly. Perhaps in less than a year? Then the limiting factor will not be the supply but the market price.

Re: How long til we're all on Ozempic?

#718
post #457

Earlier quoted context omitted.

Sounds like a miracle drug that helps with all afflictions that come with our modern life/sedentary living.

The problem with this (and all diet plans/drugs) is the lifestyle that led to problem in the first place. If you do not change your lifestyle, for real and not just superficially, then you will relapse with a vengeance. That is to say, be careful with using a drug as a crutch. Sure, it can artificially make you much more interested in not consuming so many calories and/or perhaps being more active than before - but y…

I'm someone that has spent many years of my life eating well and exercising regularly, including weightlifting. I'm also someone who has spent the past decade doing neither of those things, with one attempt in the middle to correct my behavior interrupted by a knee injury.

I'm currently on tirzepatide and have also started to resume exercise, and I'm enjoying it like I did when I was younger - I expect I'll be able to go off of it when I get to my goal weight.

But at the same time, there's not any real reason that people would need to go off the drugs, outside of cost. So far we don't see any adverse reactions in the vast majority of people. Some people have reactions from rapid weight loss - gallstones, hair loss, etc. but these are also risks in crash diets, etc.

We accept that people will need lifelong medication (often with worse side effects) for other illnesses that have less risk to all cause mortality, etc., than obesity. Why would we be unwilling to do it for obesity?

The fact of the matter is that despite the risks and downsides of obesity being well known in America, 42% of American adults are obese. No amount of education or knowledge that has gotten us on the whole to eat better or exercise more. Plainly, being on these GLP1 medications is preferable to being obese based on all current knowledge.

Re: How long til we're all on Ozempic?

#719

I've been on tirzepatide (Mounjaro) for 4 months now. I'm down 13% of my body weight. I realized that frequent cannabis consumption interferes with the weight loss, so I've kicked the habit from daily to occasionally on weekends. I've started walking 2-3 miles a day, 2-3 days a week regularly, in addition to eating less and being more motivated to calorie count. All this to say, this drug has been life changing for m…

Have you been recommended an exercise regimen, or taken one up yourself? The one the great things about GLP-1s is that with the weight loss, it's easier to be more active once you've lost some of the weight. The negatives is that the current breed promote a loss in muscle mass as well as fat loss, so it is very important to do your best to maintain if not increase muscle while on them. The next generation of drugs ar…

Cagrilintide (paired with semaglutide) and retatrutide are the next wave, though I'm not aware of any research for either indicating an increase in muscle mass.

My understanding of the literature is that there's nothing special about semaglutide or tirzepatide that promote muscle loss - it's just people who lose weight based purely on diet tend to also lose muscle mass. Even bodybuilders lose some muscle mass when cutting.

It's up to the individual to increase their protein intake and exercise, the same way they would in any caloric deficit.

Re: How long til we're all on Ozempic?

#720

I think we desperately need to answer the question of why GLP-1 agonists are so effective, and particularly whether it's counteracting something in the environment that has been acting to reduce GLP-1 (or other glucagon-related pathway) activity without us realizing it. The obesity data practically screams that something happened in North America ca. 1980 that messed up our metabolisms, and it may have spread to Euro…

Glyphosate was introduced around that timeline.
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