>If you do not change your lifestyle, for real and not just superficially, then you will relapse with a vengeance.
Longterm glp-1 agonist research doesn't agree with this.
> but you have to continue that lifestyle after stopping the drug.
Why stop the drug?
>Will Ozempic users have developed the personal discipline to prevent themselves from relapse without the drug - or will they forever be on a the yo-yo of weight gain/loss?
A small % of people are able to achieve significant weight loss with diet and exercise. And an even smaller % of that group are able to maintain it for the long term. We've been trying to solve obesity this way for a 50 years and have bubkis to show for it. If someone has high cholesterol we give them a statin, if they have high blood sugar we give them diabetes. Now if they're overweight we give them ozempic.
"For the two in every five patients who discontinue the treatments within a year, according to a 2024 JAMA study, this means that they are likely to rebound to their original weight with less muscle and a higher body fat percentage."
The other issue is the muscle loss on being on these drugs as "Clinical data shows that 25 per cent of weight loss from Eli Lilly’s shot resulted from a reduction in lean body mass, including muscle, while 40 per cent of Novo Nordisk’s jab was due to a drop in lean body mass."
Via https://www.ft.com/content/094cbf1f-c5a8-4bb3-a43c-988bd8e2d...
Right, so we doom some portion of the population to forever take a pill from big pharma? How is that acceptable with anyone?
The goal should be to use Ozempic until you are in a better place to manage things yourself. The goal should not be to get people hooked on Ozempic for their entire lives.
Perhaps Ozempic prescriptions should come with prescribed exercise with check-in and monitoring, or something.
I guess young people don't always know this, but there are plenty of medications a lot of people take for the rest of their lives. Blood pressure and cholesterol pills are maybe the most common.
This gives a vast number of people 5-10 years longer lives, and I think this is great thing, even if some pharma executives end up getting rich.
Or insulin. I’ve been shortsighted since childhood and will need to wear glasses for the rest of my life (unless I get laser corrective surgery, I guess).
Many people in my wife’s family have thyroid gland dysfunction and have to take thyroid hormones their whole lives.
Not just young people. High blood pressure runs in our family. A cousin, despite being healthy in most indicators, developed high blood pressure at 23. She's still going in her 50s just fine but has had to take blood pressure meds for the last 27 years.
This thread has multiple people relating their personal stories of using ozempic to start building those healthy habits. Also, it doesn't just magically get rid of fat so you can eat more, its supposed to make you feel full longer (as I understand it, someone feel free to correct me on that).
Plus, even if it did magically get rid of fat temporarily, I'd rather encourage people to do something rather than simply shaming them for giving into a very human addiction.
Your biggest concern around glp-1 drugs shouldn't be the overweight people successfully slimming down, it should be people who are already a healthy enough weight who think they need to be even skinnier (something I've encountered plenty of).
> its supposed to make you feel full longer (as I understand it, someone feel free to correct me on that).
It's complicated. This is commonly reported by people taking it, but it's not the only mechanism. Also commonly reported are that it reduces hunger levels flat out across the board, makes you feel full after eating less food, and that as you get used to eating less food your stomach physically gets smaller and you can't even eat as much food at all even if you tried to force yourself to (e.g. at a big holiday meal full of delicious food where you want to eat everything so long as physically able to, well past the point of hunger).
Yes, it is within the realm of human power for every individual to not be obese.
But the fact of the matter is... a huge chunk of people don't succeed. 42% of American adults are obese. "Eat better and exercise" has not resolved the issue.
I spent a good chunk of my adult life eating well, doing cardio, lifting weights and loving it. Then I got busy with life and stopped. And it has been incredibly difficult to get back to that and gets harder as I get older. I don't think I'm some paragon of willpower - if so, I wouldn't have fallen off the wagon. But I think it would also be silly to think that if someone who has a proven track record of maintaining that for years can struggle with maintaining it for a lifetime, there's probably a lot of people who have never even had that much success who are going to have even worse of a time.
Are we going to moralize over bp meds and statins too? If people can't adapt, fuck 'em, let 'em die young?
We don't get pissed that elephants don't climb trees. What value is it to characterize people's obesity entirely as slovenness and gluttony? While there are certainly some slobs and glutton, dismissive judgmentality of everyone doesn't make sense.
For this reason, I believe your comment is lacking in empathy for people who may struggle differently than you, yet struggle all the same.
Sure of the almost 8 billion people in the world there are plenty who have successfully lost and kept off weight.
But if you want to see if there is a reproduceable lifestyle intervention that treats obesity successfully in the long term you can look here. After a few hours of searching you will probably find the same thing I and almost all obesity researchers have concluded. There isn't one.
There are two ways to lower weight. Eat less, and Ozempic. I don't think it's any of my business which one people pick. The important thing is that they become healthy.
I've realized people are very different. Some can just decide to eat less by applying a little willpower. For others, that's incredibly hard. If you're in group 1, it's easy to think everyone is and be appalled how others can't even put in that little bit of effort.
Can you provide evidence that a statistically significant portion of the population have managed to maintain weight loss in the manner you describe?
The evidence I see does not support your claim. Obesity rates have only gone up during my lifetime and the folks I know in the medical field have consistently mentioned how diet and exercise simply does not have any sort of patient compliance. The folks who successfully do it are outliers.
I will go for the harm reduction principle on this one. The molecules themselves are trivially mass produced for less than $10 a dose and are already being sourced for that cost by folks who are willing to take a bit more risk to do so. Cost seems to be about the only major side effect so far.
> doom some portion of the population to forever take a pill from big pharma
That is temporary. The effects are real. The fact that you don't think big pharma should profit handsomely for making it happen is not the only alternative. Before too long semaglutide, as one example, will be out of patent and available as a generic. It won't cost a thousand bucks a month to big pharma, it'll be practically free. Cheap enough that most insurance plans will likely subsidize it all the way to zero out-of-pocket cost just because the ROI is so good.
How my decisions will affect some company's bottom line is way behind "will this help me live a better, longer life" in my list of priorities, but I'm already on other medications that are generic for the rest of my life for other genetic defects I've been blessed with, though I'm not on Ozempic.
Why not? What would you rather be: Fat to your death, or healthy and dependent on modern technological society in yet another way? How is it any different to diabetes treatment?
I take a statin as something in my body produces high levels of cholesterol even on a low fat diet. I will always take a statin. It works well and there are few side effects.
My spouse must take a thyroid medicine every day for life.
Not taking these pills is life threatening. How is taking them not acceptable?
Why would you want to continue using a drug for the rest of your life?
> Longterm glp-1 agonist research doesn't agree with this.
Please explain. If you stop using the drug, because you've achieved your goals, what stops you from relapsing other than your own personal habits and lifestyle?
> A small % of people are able to achieve significant weight loss with diet and exercise. And an even smaller % of that group are able to maintain it for the long term. We've been trying to solve obesity this way for a 50 years and have bubkis to show for it. If someone has high cholesterol we give them a statin, if they have high blood sugar we give them diabetes. Now if they're overweight we give them ozempic.
Yes, a pill for this, a pill for that... and there's no chance we'll discover these drugs have negative effects when used by a person for 50 years.
> Why would you want to continue using a drug for the rest of your life?
It's better than being obese. This is true of most drugs for chronic conditions. very few of them are curative, almost all of them treat the condition.
> Longterm glp-1 agonist research doesn't agree with this.
Sorry I wasn't clear, I meant with continued treatment you don't rebound.
> Yes, a pill for this, a pill for that... and there's no chance we'll discover these drugs have negative effects when used by a person for 50 years.
They might have negative side effects but obesity has very large negative side effects. I would be incredibly surprised if any of these drugs that have been used in diabetes treatment for a long time have anywhere close to the negative side effects of obesity.
Hot take: "choice" is a myth when it comes to long-term executive processing, one doesn't choose to be obese/not, drug addicted/not, etc, the same way one chooses whether they want chicken or beef ramen for lunch. It's an unending grind of executive functioning against more basal impulses, that is heavily influenced by the blend of nature and nurture and life events.
False. (All) People crave for food. Some people have stronger craving than others. In healthy people you call it "hunger". In obese people it is more like an addiction. Do you know people can be addictes to sex and to work, too?
If you insist on the choice argument, the only way an addict can stop consuming is locking himself in a room and throwing away the key. Other than that, much help is needed, many changes are needed, and even chemicals are needed.
All you're saying is the it's harder to make some choices depending on situation. They are still 100% choices. Choices don't have to be trivially easy.
It doesn't work. I keep trying to get off the diabetes and I just relapse after a few weeks. It doesn't help that my body tries to hide the glucose everywhere, like attached to hemoglobin or in my liver in the form of glycogen so it can share a hit with me first thing every morning.
Nope, not going back to the doctor that gave me diabetes. That was a mistake.
> A small % of people are able to achieve significant weight loss with diet and exercise. And an even smaller % of that group are able to maintain it for the long term.
Ozempic is only fighting symptoms of that, not the root of the problem which is the stigma around weightgain, being a big person, just fatphobia being extremly generalized and a lot of shame surrounding weight. While it's amazing for people who have medical conditions making them gain a lot of weight, just saying that they should take ozempic will not change people gaining too much weight. It's not anything like high cholesterol or high blood sugar in most cases.
Longterm glp-1 agonist research doesn't agree with this.
> but you have to continue that lifestyle after stopping the drug.
Why stop the drug?
>Will Ozempic users have developed the personal discipline to prevent themselves from relapse without the drug - or will they forever be on a the yo-yo of weight gain/loss?
A small % of people are able to achieve significant weight loss with diet and exercise. And an even smaller % of that group are able to maintain it for the long term. We've been trying to solve obesity this way for a 50 years and have bubkis to show for it. If someone has high cholesterol we give them a statin, if they have high blood sugar we give them diabetes. Now if they're overweight we give them ozempic.