Cheap, effective interventions like this are incredible for our future populace.
I want to point out, I disagree with the HAES people, you are not healthy at every size.. you're going to have some people who are more healthy than others regardless of some amount of weight... But not obesity, not that size.
It's absolutely a willpower problem. These medications won't fix that for you. You stop taking them and you will gain weight again.
What we need is a radical change in the food we eat and how we live our lives. It's easier than ever to not move all day. Sugar in one form or another is our primary diet. These problems won't go away.
The issue with that thinking is it's super black and white, that willpower alone is the cure to weight loss.
So let's do a little thought experiment , what about all those naturally thin people, like really thin.. they can eat what they want and remain thin, find it hard to put on muscle. If it's really really hard for them to gain weight... Then isn't the inverse also true? Aren't there also people who are trying to do everything they can but for similar get inverted reasons just cannot lose weight?
The problem with relying on willpower alone is there's a finite amount of it.
Yes, for some people they have terrible willpower, they have terrible diets, and they do not work out. But they aren't the only ones. There's definitely others who are trying but failing... And you can only fail for so long before you give up.
So going back to my first point. I hope these drugs enable a new option, to get them past a certain point where they can lose weight without the failure... Begin to make better choices... Gain more confidence and willpower.
That for sure would obviate the need for such pharmaceutical countermeasures, but achieving such radical change would be very difficult and time consuming. I'm glad we have some options to improve the quality and quantity of peoples lives while we work on that.
Dieting makes you hungry, truly revolutionary research.
Ever try working on a tricky coding project while starving? Take a math test when all you can think about is finding something, anything, to eat?
Losing significant amounts of weight the natural way isn’t so much a test of willpower as a test of how well you can function under a constant sense of hunger (or, how good you are at tricking your way out of it).
Bonus tip: when you are so hungry you can’t sleep and don’t want to drink a bunch of water right before bed, sugar-free jell-o has only 10 calories and can silence the feeling long enough to fall asleep.
And oh, by the way, we also happen to be introducing a very very very slightly different molecule that qualifies for a brand new patent. No side effects this time, we promise, and see you in 20 years.
Who is they?
> And oh, by the way, we also happen to be introducing a very very very slightly different molecule that qualifies for a brand new patent
Presuming “we” is the companies that own the current patent, what does this have to do with the older molecule’s patent that is expiring?
There's much less oversight over the production of compounded drugs, and people who purchase them may not be getting what they expect, with no way to tell the difference.
https://www.fda.gov/drugs/postmarket-drug-safety-information...
https://medicalxpress.com/news/2023-10-links-popular-weight-...
But its still pretty exciting.
I've lost 60+lbs with Mounjaro and never experienced any of the side effects listed.
I lost cravings for alcohol, sugars.
I was tired once jumping from 2.5->5, but we also have four kids, so..
These are my most recent blood work numbers. My A1C was 4.7
Remember to eat, and you don't get gastroparesis.
It is a GLP-1 agonist as well and is considered a well-tolerated, long-term weight loss agent.
I've only read a few papers and articles but what I've seen is that all of the hormone triggering leads to 1) decreased appetite 2) slowed gastric emptying which also decreases appetite.
Patients lose weight due to eating less but usually regain the weight when stopping the drug since they then go back to their normal level of eating.
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Are these drugs fixing/replacing a system failure where people don't feel satiated normally?
Can the same effect be replicated by eating a higher fiber and higher fat diet with more whole foods to feel full longer and slow gastric emptying?
Those are definitely the key routes, but I suspect from my experience (and so the do the drug companies!) that there's some kind of mediation of reward system going on there too. Simply put: I no longer get a massive dopamine hit from sugary food. A candy bar still tastes great, but I don't immediately want to eat another one like I used to, even if I'm genuinely hungry. My addictive response to food is gone.
My favourite foods still taste great, I just no longer have to expend all of my energy in not having three portions.
> Can the same effect be replicated by eating a higher fiber and higher fat diet with more whole foods to feel full longer and slow gastric emptying?
No. Like many people who've been on a perpetual diet, I have tried -- at length -- virtually every style of eating known to man. The food noise always comes back. Even before I started, I was eating very healthily as a base-line, mostly vegetables, mostly vegan, mostly whole foods, tracking my fiber to make sure it was high. But I've also tried and sustained for many months keto, paleo, "slow carb", all sorts.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9396640/
- Another study - there was a 16% weight loss for those that received semaglutide/diet/exercise/counseling versus a loss of 5% for placebo those that received diet/exercise/counseling without semaglutide.
But they didn't control for calories, so it may just be proving that dietary adherence with the medication is better than without.
I think it simply takes a long time for your body to adjust back to where it should be after a period of extended binging and these drugs make it happen much faster. The only time I consistently lost weight in my life was when I lived in a food desert and had no car and not much money, so I was forced to only buy the cheapest vegetables and meats (usually chicken) and make what I could out of that and make it last for the week. Even then it took more than 6 months before I felt normal eating that way.
Of course, it's extremely easy to fall off the wagon when your body works this way too. Even a day can wipe out weeks of gains and you can always 'relapse' even after months of doing the right thing, and end up stagnating or completely reversing any progress you've made. In a way it seems that food is the most addictive drug of all. You can easily quit alcohol, cigarettes, hard drugs with a couple weeks of willpower (and I have multiple times). You can't ever stop eating food if you want to be around to experience life.
The weight loss number surpass that of semaglutide alone. https://www.nejm.org/doi/full/10.1056/nejmoa2107519
From: https://www.nytimes.com/2023/11/08/well/zepbound-mounjaro-we...
I've seen great success stories, but I'm kind of nervous of the long-term effects of taking a drug like this for your whole lifetime (i.e. what's implied by the "chronic" in "chronic weight management").
It seems like it might be a great off-ramp from obesity to a body weight where the risk of injury in exercise is greatly diminished and the degree of enjoyment in exercise goes way up. If you could go off the drug and then use exercise to maintain the caloric deficit (instead of under-eating, as the drug induces you to do), that sounds like it would be kind of miraculous.
Exercise is great for dozens of reasons, but weight loss is probably at the bottom of the list (if it's on the list at all). The asymmetry between the ease of consuming calories and the effort of exhaling calories during exercise is too great.
I, and many many other overweight people, have successfully lost a lot of weight in the past. There's no off-ramp when you look at the data, you always gain it back.
Mounjaro is no different from any other way of losing weight in that respect, except it doesn't rely on willpower, so you can keep taking it, and keep the weight off.
https://www.reuters.com/business/healthcare-pharmaceuticals/...
https://www.nejm.org/doi/full/10.1056/nejmoa2107519
I think retatrutide might be the current leader for weight loss from clinical trials.
If I remember correctly, you lost the same amount of weight on retatrutide vs tirzepatide, but over a shorter time span.
If the public sector doesn't help, I imagine that insurance companies are doing what they can to put downward price pressure on these drugs. If I can pay x now to avoid 10x in payout costs to medical providers for obesity complications (while keeping rates the same), I'm going to take that trade (subject to actuarial data and discount rates).
The insurance companies basically think 1 year at a time for drug coverage and only care about keeping you alive for that 1 year at the cheapest possible price. Long term care and planning is something medicare/medicaid may better be able to utilize in their economic model to justify coverage.
