Semaglutide is one specific drug within the class of GLP-1 agonists. Other examples include Liraglutide (Victoza, Saxenda), Dulaglutide (Trulicity), and Tirzepatide (Mounjaro, though this is technically a dual GIP/GLP-1 agonist).
Semaglutide is available under several brand names for different uses: Ozempic (type 2 diabetes), Wegovy (weight management), and Rybelsus (oral form for type 2 diabetes).
The number of things it apparently just cures is staggering.
I have been reading obsessively about this drug since going on it. I have been fortunate enough not to suffer side effects on it, save for one -- frustration with the cynicism around it. A cynicism I shared prior to experiencing its effects.
I am convinced that, barring any life threatening long term side effects, this is the most important drug of our lifetime (from a first world perspective) or until a silver bullet cancer drug is found. The potential to be the tide that lifts so many boats and alleviates so much physical and emotional pain and suffering on a population level is almost overwhelming to think about.
There's the rub. We have not been prescribing semaglutide very long, and I won't trust it until we've had enough time to suss out long term side effects.
My father was on a long-term maintenance dose of immunosuppressant (I think prednisolone, but I could be misremembering) following his kidney transplant. When it was first prescribed to him, the long term side effects were either not known at all or not widely known. By the time these side effects were more widely known, it was too late, as he was already losing his vision (cataracts) and mobility (cartilage was being destroyed). He spent his last few years in pain.
I am very cautious about the potential for damaging long-term side effects.
It reminds me of the British reaction to the famine in Ireland - the good ministers were concerned about the moral health of the Irish. If they were provided with charity food, it would be a terrible tragedy if they became dependent. Just let them starve to death, with a clean soul.
Purchasing NN Would cost roughly 0.2 Iraq wars.
The EU loves to ransom US tech companies for budget money. It's very clear that this is an opportunity for the US to similarly damage a big EU company by threatening its patents in the US, or otherwise hitting Novo for tens of billions of dollars in ransom money. The US market is by a huge margin the most important drug market in the world, and especially for Novo.
Find an abusive excuse to invalidate their patents if all else fails. Let Europe learn a valuable lesson in trade wars.
- Higher rates of cardiovascular disease
- Type 2 diabetes
- Sleep apnea and breathing problems
- Osteoarthritis due to excess pressure on joints
- Multiple types of cancers (colon, breast, endometrial)
- Depression and anxiety from social stigma
- Reduced mobility and quality of life
- Higher medical costs (~$1,429 more annually per person)[1]
- Decreased workplace productivity
- Shorter life expectancy (can reduce by 5-10 years)
Oh no wait, sorry, those are the effects of obesity.
https://www.perplexity.ai/search/does-exenatide-lower-or-ext...
There is an enormous amount of biotech work to develop next-gen versions that have better half-lives, lower adverse events, and most importantly, have long patent lives. But it seems base GLP-1 are good enough that we should see massive societal change starting next decade.
We already know what can go wrong.
We already did that decades and decades ago. Sugar, for example. Aside from so many foods being laced with it, you can now simply walk into a store and buy a kilogram of sugar and eat it. So many other examples. That ship sailed a long long time ago. All we can do now is nudge the dial the other way.
It cures behavior, not directly disease. I see red flags. Firefly did a movie about a drug that interfered with people's motivations to do things.
Nothing is being healed, we are just helping people cope with excess
This drug in a nutshell partially paralyzes the stomach and upper intestine causing food to move through slowly. This has the effect of reducing food cravings as you literally stay full longer.
However slowing down the stomach muscles has many risks and many side effects.
Yes this drug is great for people who have struggled with weight loss and may not realistically be in a position to work on diet and exercise.
However this drug is not a substitute for the larger issue at hand. Many (possibly most) Americans are not living healthy lives in terms of mind, body (maybe spirit).
Improving physical activity leveled.. learning to eat less and to eat healthy should be a national priority. If anything the US government lack of addressing the elephant in the room and the underlying cause of many of these metabolic orders should outrage all Americans.
Just my two cents
No it isn't. Stop trying to make fetch happen.
> Improving physical activity leveled
It doesn't appear that this is the issue. You can't explain a recent trend (obesity) using something that hasn't changed recently. And exercise is not very effective for weight loss compared to diet (it's something like 20%/80%).
* Blood sugar levels (or whatever this is a proxy for)
* Weight
* The changes the GLP-1 Agonists make to the body itself.
While it is simple to say if you reduce the weight, you reduce the blood sugar levels, and so the GLP-1 is unnecessary, you can look at many accounts of using Ozempic where it talks about reducing the "food noise."
That is, Ozempic makes it easier to eat the right things. I'm a "normal weight" through grit, but I don't think my life is better through said grit - in fact, I'd say it's significantly worse. In my earlier life, I was naturally thin, and I can say that my weight increase wasn't a significant change to my diet, nor was my weight loss: I just had to be hungry and irritable more.
So, fundamentally, the cause and effect doesn't matter, because the drug makes it easier to be a more healthy weight and to control the blood sugar.
Yes! I keep trying to explain to folks that this is the benefit of these drugs, they let you keep a healthy relationship with food, maintain "intuitive eating" where you aren't constantly fighting and discarding your hunger signals, and aren't (as) miserable doing it.
I did it the hard way, I wouldn't wish it on anyone.
Obviously we need some more double blind studies dedicated to this class of drugs and Alzheimer's, but this informs the direction researchers and drug companies will likely map out.
Losing weight is still a hard endeavor.
Plenty of people find their appetite capped at a level where the caloric intake will make them skinny. If they don't eat right and exercise, though, it won't necessarily bring them to great health. Like all caloric restriction, you will lose muscle mass if you don't ingest enough protein and perform resistance training, so you could still end up with a suboptimal lean body mass:fat ratio.
>IIRC it increases the effects of a healthy lifestyle change by 15%,
I'm not sure what this means. In the clinical trials for weight loss, semaglutide patients lost 10-15% of their body weight over the trial period, which might be what you mean? The trials don't indicate that this is the maximum, however - people have seen sustained weight loss for periods longer than the trials. Nor did it require people follow a specific diet or exercise plan. Plenty of people lose weight just eating less of what they were already eating - though this is generally not the best way to approach it.
>effect which is lost if you leave it.
Some number of people regain some or all of the weight they lost when going off the medication, but not all. However, the current indication is that people should be allowed to remain on the drug to maintain (generally at a lower dose) indefinitely if they need to. If the safety profile changes, this recommendation might also change.
>The life style change (activity and nutrition) alone is more important, cheaper, and as permanent as you want it to be.
Agreed. I'm someone who was quite fit when younger and let a variety of factors cause nutrition and exercise to fall farther and farther back on my priority list, and so far, tirzepatide has made it much easier for me to prioritize these things and enjoy them. I'm fairly confident once I have spent some time back at a healthier weight and developed long term habits around these things I'll be able to go off of it.
All we need to do is just tell a few million people to lose weight.
If it’s the drug and not the weight loss that lowers Alzheimers risk, then even people who are not overweight might benefit from the drug.
Those choices become easier when you have assistance.
https://www.nbcnews.com/science/science-news/alzheimers-theo...
This publication is bogus. It is too soon to know if there is any benefit at all from Semaglutide.
If you are expert in this space: Is such a dataset available publicly? If so, are there examples of other studies that have used this? Where does one go to read more about the mechanism of this study? Thanks!
This deduplicates patients and lets them find specific details like which medications they are on without knowing any PII.
It's very common for researchers within health systems to want to collaborate and combine populations to perform retroactive data analysis.
(The Trust Me Bro™ security aspect is the "It's secure because people will go to jail" and "We so totes won't use this easily subpoenaed data against you" security, when it would be best if the data stayed on a RAID in my doctor's office and an offsite VPN-linked backup instead. This goes 20x for psychs.)
Given that, I'd want to see more reproductions.
Also, I'm very annoyed by our American culture which tries to fix problems with drugs, rather than preventing them from happening in the first place with good diet, exercise, sleep and stress management.
The problem is these are individual solutions. We have a societal-wide problem. These solutions are therefore useless. You can't solve societal problems with individual solutions.
For example, I can't say "people shouldn't steal because it's immoral". It's true, and for me or you that might be enough to keep us from stealing. This is an individual solution.
The societal solution is how do you demotivate people from stealing? Now we're not talking about morals. We're talking about economics, poverty, crime prevention, the criminal-industrial complex, etc.
If you're waiting around for the day that American "culture" magically reverses itself and everyone wants to be healthy by their own accord, it will never come.
If you want an example of changing "culture", look at smoking. Hint: it has nothing to do with "being healthier". The changes we made were not about that.
I like bottom-up way to approach it, rather than only top-down via policy.
Be healthy yourself and hopefully that bleeds out to your family and friends. If enough people do it, you have a different culture. Certainly possible given all the cultures that do prioritize these things.
Realistically, ozempic is a miracle and it seems to be a solution to numerous issues of our world.
It would be nice if it wasn’t so, but apart from the 10% of people who can control themselves (which also causes psychological issues btw), most people just can’t.
It's the food industrial complex's fault, along with many others (politicians, individuals without self control, etc)
I lived in rural Colombia for 4 years. People had access to the junk food, but it wasn't consumed very much because the veggies and meat are all produced locally and super tasty and cheap. And the local dishes were extremely meat and veggie based.
Oh, and most people know how to cook there.
It's not a fact of human nature to be unhealthy. It's a fact of modern culture.
The biggest difference was seen when comparing patients who took semaglutide to those who took insulin: Semaglutide patients had a 70% lower risk of Alzheimer’s, the study found.
Full link to the study itself: https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz...
So far, I haven't seen much evidence that GLP-1s have a positive effect on people who aren't overweight. And while I'll be the first to admit that the proportion of people who could benefit from these drugs is quite large, it's pretty far from everyone.
So while it's an amazing drug / new class of drugs, it probably will not lower risk of Alzheimer's in metabolically healthy people.
If it's purely around the weight loss, etc., then it won't.
I don't think the comment was meant to minimize the impact of losing weight on health.
https://en.wikipedia.org/wiki/Health_at_Every_Size
And good riddance I say!
Disgusting.
But genuinely, aren’t you just paying money to… not spend the money on food instead?
If we compare the efficacy of "telling people to lose weight" vs taking ozempic, there is a stark contrast. Pooled results show that education and counselling[sic] did not significantly reduce weight (SMD –0.73, 95% CI –1.89 to 0.42, n = 3 studies; I 2 = 98%)[1]. The mean change in body weight from baseline to week 68 was −14.9% in the semaglutide group as compared with −2.4% with placebo[2].
Telling people to just lose weight is not an evidence-backed intervention to affect weight loss. Continuing to practice it is equivalent to practicing folk medicine or alternative medicine. Despite us wanting it to work, it does not. Like all interventions, pharmaceutical interventions have the possibility of side effects, and it's up to the patient and doctor to weight risk vs reward. There is variation in both for each case, but we have to keep in mind that the mere existence of side effects is not typically a reason for categorically deciding against using a drug.
Definitely lacking in compassion. Whether it be obesity or anorexia, these are almost always symptoms of something deeper underlying. I shouldn’t be so flippant.
I think I still have to stand by my belief that semaglutide won’t truly solve people’s relationship with food though. That requires going deeper than the temporary solution drugs might provide.
Yes, it is possible for every obese person on this planet to eat less and stop being fat. 100%.
But for some people, this is actually really difficult to do! And the more fat you put on, the more feedback loops there are in your body that push you towards eating more. Insulin and ghrelin response are big ones, but it wrecks your sex hormones, too - you're almost certain to see massive testosterone drops in men, which further stimulates your body to deposit more fat and build less muscle.
Being told to lose weight by diet and exercise is probably the most prescribed treatment on the planet, and one with one of the absolute lowest success rates.
Because it requires willpower and discipline, this just a pill/injection doing all the heavy work for you. Hence the success in USA. There are countries where this drug is semi unknown.
If you're so convinced that obesity is a moral failing, then just put 'no fatties and no fake skinny glp-1 users' in your tinder profile, and all of the rest of us can move on with our days.
