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.
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?