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There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

arstechnica.com

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Re: There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

#81

Post by apple4ever »

tyleo wrote: post #4

Interesting. Saying, "there may not be a safe off-ramp," doesn’t feel quite right. The article describes people losing weight while on the drugs and then regaining weight after stopping them. That's not ideal, but it does imply an off-ramp, just with regressions. Compare that to something with no real off-ramp: testosterone replacement therapy. Once you're on TRT, you can permanently suppress your body's own testoste…

Plus if you look at the numbers (found in the comments of that story):

17.5% maintained 75+% of their weight loss. 25% maintained 50-75% of their weight loss. 23% maintained 25-50% of their weight loss. 24% maintained 0-25% of their weight loss.

I mean that's pretty good!

Re: There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

#82

Post by SpicyLemonZest »

stalfie wrote: post #66
SpicyLemonZest wrote: post #52

Earlier quoted context omitted.

What don't we understand about the obesity epidemic? The story seems pretty clear to me at this point: * Almost everyone has access to a wide variety of delicious food, which we on average enjoy eating more of than is required to maintain a healthy weight. * We don't want the government to forcibly restrict people's food access. * Research consistently shows that voluntary portion control works occasionally in the sh…

I would argue that your argument is simplistic and does not account for observed geographical variations. Japan does not have an obesity epidemic. The US has an extreme obesity epidemic. There does not seem to be any good genetical explanation, there might be cultural based behavioral explanations, but Japanese communities in the US are also more obese than ones in Japan (although less obese than the general US popul…

I’m not sure cross-cultural comparisons are useful here. One big difference is that friends and family will aggressively police your weight and the amount you eat, with the ideal set far below health standards for normal weight. It’s not clear how you could operationalize that into an intervention, even if you wanted to.

Re: There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

#83

Post by m463 »

sReinwald wrote: post #30
tyleo wrote: post #4

Interesting. Saying, "there may not be a safe off-ramp," doesn’t feel quite right. The article describes people losing weight while on the drugs and then regaining weight after stopping them. That's not ideal, but it does imply an off-ramp, just with regressions. Compare that to something with no real off-ramp: testosterone replacement therapy. Once you're on TRT, you can permanently suppress your body's own testoste…

Strange framing, isn't it? Bariatric surgery shows 25-65% significant regain rates depending on definition and timeframe. And regular dieting is even worse. Nobody would frame that as a safety issue. That's... just how weight loss works, not a unique GLP-1 problem. Calling a return of symptoms (obesity) a "safety issue" is like saying insulin has "no safe off-ramp" because diabetics get hyperglycemic when they stop t…

well, it could also be from a "do no harm" standpoint.

(although looking into it, it seems many oaths never actually say "first do no harm")

Re: There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

#84

Post by apple4ever »

apple4ever wrote: post #81
tyleo wrote: post #4

Interesting. Saying, "there may not be a safe off-ramp," doesn’t feel quite right. The article describes people losing weight while on the drugs and then regaining weight after stopping them. That's not ideal, but it does imply an off-ramp, just with regressions. Compare that to something with no real off-ramp: testosterone replacement therapy. Once you're on TRT, you can permanently suppress your body's own testoste…

Plus if you look at the numbers (found in the comments of that story): 17.5% maintained 75+% of their weight loss. 25% maintained 50-75% of their weight loss. 23% maintained 25-50% of their weight loss. 24% maintained 0-25% of their weight loss. I mean that's pretty good!

(Formatted better)

* 17.5% maintained 75+% of their weight loss

* 25% maintained 50-75% of their weight loss

* 23% maintained 25-50% of their weight loss

* 24% maintained 0-25% of their weight loss.

Re: There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

#85

Post by K0balt »

jstummbillig wrote: post #75
Aurornis wrote: post #48

Earlier quoted context omitted.

I do not. I’m typing on my phone from a waiting room. I’d probably have fewer incorrect words and awkward sentences if I did.

I see. I got curious because of the correct usage of ’ (instead of the common ')

Argh. It’s so strange to be ridiculed and have your ideas devalued just because you know how to use punctuation marks. I have 20 year old blog posts with hundreds of comments accusing me of using AI. I understand people being suspicious, but it’s beyond annoying when it becomes an entire personality online, as it has for many persons.

How about we go back to valuing ideas, regardless of their origins, if they deliver insight, value, or joy? I don’t care if someone writes something good or if the idea was stolen from something they read, or if a machine made it for them, unless the value proposition is their personal capacity for original prose.

AI gotchaism is becoming as least as tiring as the droll, tone deaf creations of LLMs.

Re: There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

#86

Post by apple4ever »

chimeracoder wrote: post #59
Aurornis wrote: post #57

Earlier quoted context omitted.

If someone shows up with a testosterone level of 700 you can (and should) explain that low testosterone is not the explanation for whatever they’re suffering from. The TRT clinics are ignoring levels or even not testing at all. They’ll find an excuse to prescribe to someone even who has clinically high levels because they want the monthly recurring revenue from keeping that customer for life.

> If someone shows up with a testosterone level of 700 you can (and should) explain that low testosterone is not the explanation for whatever they’re suffering from. I'm not going to say TRT clinics are the best actors here, but to an actual endocrinologist, diagnosing hormone issues isn't so simple as looking at single point-in-time measurement of total testosterone. Testosterone levels naturally vary even for a giv…

Yup that's right. I had multiple low (Now I am worried about the long term effects, but it's been so long that if I am on it for the rest of my life and it does help me, that's good enough.

Re: There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

#87

Post by apple4ever »

BizarroLand wrote: post #74
observationist wrote: post #47

Earlier quoted context omitted.

"Those poor people have no agency and their behaviors are outside their control!" Well, I guess we have no choice but to affirm and reinforce their lack of agency and ensure we put them on drugs for the rest of their lives! It's ironic that one of the effects of this drug seems to be reducing the impact of impulsive behaviors, reducing cravings from other drugs and alcohol and cigarette addictions. The hat trick for…

I think your opinion is valid from your point of view but missing an important part of the bigger picture. Obese people typically do not try to become obese. Most obese people have tried to lose weight and find that they lack the tools and skills needed to succeed, and many of the ones that do succeed only do so temporarily. Why is that? It's a question with no simple answer, and no single answer. Evolutionary biolog…

Bingo. The attitude that people have failed just because they didn't will it enough is ridiculous to me. Plenty of people have tried hard to lose weight. But plenty of them have failed not because of will, but other factors. This is decades long! Having something that can help them is great!

Re: There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

#88

Post by apple4ever »

financltravsty wrote: post #42
tyleo wrote: post #4

Interesting. Saying, "there may not be a safe off-ramp," doesn’t feel quite right. The article describes people losing weight while on the drugs and then regaining weight after stopping them. That's not ideal, but it does imply an off-ramp, just with regressions. Compare that to something with no real off-ramp: testosterone replacement therapy. Once you're on TRT, you can permanently suppress your body's own testoste…

As an experienced polysubstance researcher, that's not exactly accurate. TRT cessation does not inherently cause men to have suppressed hormone levels after. With precautions and extra steps like HCG to maintain leydig cell/testicular function, preventing atrophy, one may safeguard against that risk. Coming off TRT, yes you will have lower levels as your HPTA has been suppressed by exogenous hormones. One may speed u…

Thank you for the info on the TRT, I was getting a little worried reading some of the other comments. I'm getting on it due to years of low testosterone. I'm also getting on Zepbound due to years of obesity. The two may be linked, but I need help controlling my appetite and reducing my fatigue.

Re: There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

#89

Post by apple4ever »

axxto wrote: post #77
glp1guide wrote: post #14

> Of the 308 who benefited from tirzepatide, 254 (82 percent) regained at least 25 percent of the weight they had lost on the drug by week 88. Further, 177 (57 percent) regained at least 50 percent, and 74 (24 percent) regained at least 75 percent. Generally, the more weight people regained, the more their cardiovascular and metabolic health improvements reversed. So weight loss was actually maintained for most peopl…

> So weight loss was actually maintained for most people Unless I'm mistaken, how can you interpret that from an article that claims that 57-82% of participants regained 25%-50% of their weight loss, with 24% regaining at least 75% of it? In just a bit more than a year and a half, too.

They still lost weight from their original amount right?

That's the key. They may have come up from their lowest, but they still better off.

Re: There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests

#90

Post by apple4ever »

orwin wrote: post #58

Each time an article on glp-1 is out, I will comment: Yes, you can loose weight without it, I did, I'm even in the healthy range now. No, you don't have to, if you need medicine help, take it. When I lost weight, I had my first real job that I liked so much, it didn't felt like one, 11 weeks of vacation per year, a nice enough apartment I couldn't be evicted of, great emotional support and advices and support from a…

Really really thoughtful reply, and a great counter point to the "just will it and you'll be fine!" arguments
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