Reporting on these drugs is so bad. Most of the benefits AND downsides they keep reporting are the same for any major rapid weight loss. Be it hair shedding or sleep apnea resolving. They keep acting like these are novel drug specific side effects rather than weight-loss related side effects.
At this point it might legit be impossible for a side effect to be discovered that outweighs the immense health benefits of losing weight.
It feels like people want there to be some horrible side effect to these drugs. Idk if it’s some moral objection to weight loss without discipline, or just general mistrust of big pharma.
I feel like the opposite, it seems like people desperately want it to be a miracle drug and are irrationally hostile to discussion or research on side effects. Kind of the same thing happened with cannabis and the downplay on mental health disorders. Given how much money is at stake maybe there is also a big marketing push.
Edit: also regarding the moral/discipline thing, to many people me included the larger issue is absolutely not this, it’s obviously a good thing if people can improve their health. It’s that we are unhappy that the answer to food designed to be addictive and that is poisoning people is having to research a drug and having the whole population take it to protect themselves. I have a hard time celebrating such a waste of resource and a supposed market "innovation" hiding yet another government failure at regulation. When people were poisoning themselves with lead pipes, the answer was not having the whole population take a drug to manage the effects of lead poisoning. Even if there was absolutely 0 side effect I would be happy for the individuals losing weight, but unhappy with the larger picture.
It's absolutely the moral thing. Even on HN there are an endless number of people who treat the use of GLP-1s as a failure that must be publicly shamed.
I suspect a big part of that stems from the fact that many people treat being overweight as a moral failure in and of itself, and rather than repenting and doing the morally right and correct thing to lose the weight on your own, using a GLP-1 is "cheating".
Of course, all that ignores that people's bodies are different, and some people will be slim no matter what they do, while others are doomed to be heavier regardless what they do on their own (barring extremes like developing eating disorders), but I'm not sure it would matter even should everyone understand that -- a large proportion of people need someone they perceive as lesser whom they can look down upon, and physical appearance is a quick and easy means to categorize others.
and yes, using tools like GLP-1 is a moral failing. a proper christian would just be more disciplined. and be a straight up better human from that too.
but hey, i'm an atheist, and struggled with my weight all my life to varying degrees. The way fat people generally undersell the issue that theyre fat and keep wanting to be victiums / not responsible for their own actions is extremely dystopian however. and its flabbergasting our societies have degraded so far to no longer even be able to tell that.
> others are doomed to be heavier regardless what they do on their own
While this is true in individual cases, it is obviously not by any means common. Unless the human species has had some extreme mutations in the last 100 years (and only in the West). Yet this is brought up in every thread about obesity, because believing yourself to lack agency is more convenient.
There are three levels to this. One are individuals with bodies that gain weight regardless of what the person does.
The second is psychological, people whose bodies work normally and they do everything wrong on their own.
The third is structural. Countries in which a huge part of the population is obese while other similar countries don't have that problem, have systemic issues that cause that. In the US it's the fact policies all around favor food that cause obesity and make healthy food be extremely expensive, which is the opposite of what countries where obesity is uncommon do.
Fix this last issue, wait two to three generations, and you'll see obesity fall to normal levels, at which point, yes, bringing up the moral argument for some of the few remaining cases may even become valid.
"One are individuals with bodies that gain weight regardless of what the person does."
Physically, that's not possible. If calories consumed is less than calories burned, the body cannot add weight. It doesn't have access to zero-point energy.
That's because people are recommending them for long term use, and treating them like some miracle cure, when the only affect is appetite suppression. If you are malnourished for years, you're just going to die. These things are useful for a few months if you really, really have no willpower and don't want to develop any. For anyone else (most people), it's much healthier to learn how to do difficult things.
Yes, there absolutely is a sense of "it was hard for me, but I did it anyway, you should do the hard thing too". But that's not out of nowhere. Willpower is a muscle. If someone never exercises it, it's going to atrophy. It doesn't need to be shameful, but people who promote these things need to seriously consider the reality that most people's hunger is caused by something real, and just not being hungry does not solve any of those underlying problems.
My mother is a little bit overweight, which is a problem of calories OUT being too low. She doesn't exercise enough. She doesn't have energy to exercise. That's a problem of calories IN being too low. She's taking a GLP-1 now to lose weight. It very exactly does not solve either of those issues. She has less energy. Most of the weight being lost is muscle mass. I think it's despicable that these things were rushed through the medical system. I don't think it's the layman's fault for being manipulated into thinking it's medicine.
> For anyone else (most people), it's much healthier to learn how to do difficult things.
You don't know this.
> Willpower is a muscle.
I know you mean this in a figurative sense, but what exactly is "willpower"? There has to be a physical (and physiological) mechanism for "willpower", no?
Do you believe that can be aberrant physiological conditions?
I do. I also believe over-eating is a manifestation of some type of "aberrant" physiology.
That's common sense reasoning, which is to say, not based on anything scientific.
GLP-1 is produced by the body to regulate and balance food consumption. People whose bodies produce less than the correct amount eat more because they feel a lot more hunger than people whose bodies are normal. Taking in GLP-1 drugs, if following medical advice, brings their level back to what it should have been all along, in which case most wouldn't have become obese at all.
I'm such a case. Clinical exames never showed up any clear problem associated with weight gain, so for my entire life my obesity was linked by everyone, doctors included, to lack of willpower.
I only discovered what my issue was when I took a genetic test and discovered that my DNA came with these lovely traits:
* I feel more intense hunger than the average people, so I need to eat more than they do to feel satiated. If I eat the same amount a normal person does, I leave the table literally still hungry.
* My body accumulates more fat than the average person, so even if I eat the same amount they do and keep constantly hungry, I accumulate some fat.
* Caloric-reduction diets don't work for me. So the years and years I tried and tried them had little effect, and were mostly wasted effort.
* Fat-reduction diets also don't work for me. Good thing I didn't lose time with those since everyone recommended me the useless caloric-reduction ones.
* The only diet that has some effect for me is the Mediterranean one, which I didn't know about and no one had ever recommended.
* Physical exercise has little effect for me, as I gain less muscle mass from it than the average person. So the years of walking and the many attempts at going to the gym were also mostly wasted effort.
* And physical exercise causes more pain for me than it does for the average person, so all the time I was doing those, I was suffering more than most people while getting worse results then they do from it.
If your genetics is normal on all those fronts, then sure, a bit of willpower fixes that. With that combo though, and fully not knowing you have any of that? Not a chance.
There are a few things here. Developing willpower is a thing. Having depression or other mental health issue is another. It is easy to dismiss it as lack of willpower, but it is a bit more complicated.
I also don't think you understand how living with kcal deficiency works on the long run. Have a look at the Minnesota starvation experiment. When in deficit for long the mind constantly goes to "what/when are we going to eat?" and it only gets worse from there. It becomes an obsession. It takes over everything. My understanding is that glp-1 reduces that.
It also helps for people who have too much extra weight, or incapable (waiting for hip replacement, or the elderly) of exercising.
I have been on diet and managed to go back to the target weight (lost around ~16% of bodyweight) but the food noise was real and constant. It is not a one off "I am not going to eat anymore" that was a decision to be made every minute until next meal came around. I do cycle 10-12 hour a week and the occasional footbal game but finding the deficit that is not causing the food noise is different for everyone.
Yeah, no. Willpower is more like a well that replenish with sleep, friends, family and a secure environment and that you use to do anything difficult. The harsher your life, the deeper you need to go to get water back.
I lost now 42 kg from my heaviest (5 kg left to reach my ideal weight of 73 kg), the first 20 i absolutely needed eat less and to fight the hunger pangs (which are more painfull than ankle sprain due to my fucking grehlin receptor being whack), some medical help was needed anyway (i fasted for 5 days under medical supervision to reset my leptin levels, and stayed in ketosis for 3 month prior to that to reset my insulin resistance). 20 kg loss over 18 months. I thought exercise would be enough for the last 20, but i took 5 year to loose 5, and only a change in diet finally helped me go under 80.
NGL, all that is very difficult if you have issues at home or in your life. My family might have individual flaws but as a unit we've been doing great since like 2006, and my income in 2019 when i started my weight loss was comfortable enough for me to have a great apartment, private medial help and a good overall social life.
If people need GLP-1 to get back in track, they should absolutely go for it. I do think we should help them, once they are close to their optimal weight, to sever from GLP1 though, i've heard about the "rebound", imho it is way easier on the mind to eat as much as you use to than forcefully reduce your portions (your leptin/grehlin level were unfucked by GLP1, so your old eating habits are now only psychological, not hormonal)
> It feels like people want there to be some horrible side effect to these drugs.
Being able to lose weight is, in many minds, associated with self-discipline. A route to the same goal that elides self-discipline is consequently viewed as a cheat, a shortcut.
It's a product if the cultural pervasiveness of the Protestant work ethic and its relation to the health and wellness domains. That fine, in my opinion, if one is Protestant, but why carry the baggage for someone else's religion if you're not one, ya know?
Culture and religion are intertwined even if separate. Western civilization is "culturally Christian" even in secular countries like France. Many places in the US are thus "culturally Protestant" even if most of their current-day population don't follow that religion.
I'm a doxastic voluntarist, as in, we think ourselves to be less able to change our beliefs than we actually are. The idea that weight loss by means other than self-discipline seems, at least to me, quite easy to choose to not believe in.
Recently I've talked to someone who said she is worried about those drugs as they will create 2 tier society because only people with money will get thin. This also increases already bad fat phobia in our society according to her.
She has a PhD in biotechnology and works in a lab. She is also quite thin (always was).
It's crab mentality disguised as moral position. It's especially obvious when the same people advocate for free access to drugs, alcohol or gambling. You should have freedom you do anything as long as it doesn't improve your life or move you to in social hierarchy.
I would give you the name but that wouldn't be ok.
Other than that what else can I do? I've spent time writing about an encounter I can with someone I know for 20 years and you just called me a lier because the story sounds improbable to you.
Isn't the whole point to read about what others think or experienced to learn about things you personally hasn't?
Yes, it does look superficially like the kind of thing that happens with nutrient deficiencies. Many of these people eat extremely unhealthily and continue to, but now in significantly lower quantities.
“Millions of people live longer healthier lives by reducing cardiovascular and diabetes risk, but their fingernails might be more brittle!” Doesn’t hit the same does it?
I lost 170 lbs natty (100lbs the first year) and my hair and nails only got better. If your generative follices are dying off you are not losing weight healthily.
if you're losing it as a weight loss drug and that's a side effect of the rapid weight loss that otherwise wouldn't occur it's a side effect of the drug in any practical sense, or are you trying to establish the 'guns don't kill people' for pharmaceuticals?
It's a side effect of the treatment regimen that many people in all likelihood aren't even aware of so it's good to report it like this
Idk, i think its important to distinguish between side effects that would also happen via diet and exercise vs side effects that do not happen when losing weight via other means.
malnutrition and starvation is technically a diet change.
That said, based on googling telogen effluvium seems to have lots of causes not related to malnutrition, even if insufficient protein is one of the causes.
If you shoot someone in the face, generally speaking that person will die. Not everyone who takes GLP-1s actually lose weight. A decent fraction of people are non-responders. Those people also tend to not lose their hair or have their sleep apnea and knee problems go away. Your analogy isn't as clever as you might think.
no listed side effect on every drug, or effect for that matter applies to all people. Anti-Depressants don't work for a fairly large amount of users, that doesn't mean we don't list those effects.
it feels like you are being deliberately obtuse so I may be wasting my time, but I'll attempt to assume the best and try one more time. This is very basic correlation vs causation stuff. The side effect is related to rapid weightless of any kind. Weightloss is a "side effect" of the drug. Hairloss is a side effect of rapid weight loss. There is a chain of effects there but it's not X causes Z, it's X might cause Y, which causes Z. This distinction matters less for negatives - still good to tell people but for positives it is disingenuous. If you don't lose weight, your sleep apnea doesn't go away. Your joint pain doesn't get better. Your blood pressure doesn't go down - because the drug doesn't cause those things, the weight loss does.
FDA trials follow this approach. If something bad happens it’s logged as an adverse event; if they croak it’s a serious adverse event (SAE).
So if you have a treatment for moles, and a patient (trial participant) has a mole on their back treated and then falls down the stairs or is run over by a trolley the agency wants you to do an analysis to see if the treatment might have had something to do with getting run over or not taking the lift.
Note: this is not an exaggeration. I have written phase I and phase II clinical trial protocols earlier in my career.
GLP1s do seem like incredible science but I will admit to being a little floored when I saw how far they spread and how quickly. I really hope small numbers of hair loss and nail issues are the biggest issues we face.
Very large studies already exist. They’re safe. Fearmongering about side effects is actually harmful at this point, because skepticism could keep someone from getting safe, effective treatment.
Not only that but the weight loss is often a side effect of fixing other issues, for me I’ve been taking a low dose for autoimmune related ME/CFS for about 4 years now.
Could these be signs of malnutrition? I see a lot of people who take them but don't also adjust their diet or exercise to make sure they're getting solid nutrition and start looking sickly.
That was actually my thought. When I started controlling my diet a lot more I was surprised about the (positive) change in my nails. I had heard it was a thing but had never experienced it before.
I feel like waaay more than people think depends on nutrition. You literally are what you eat. Like for example, sometimes my skin oils get messed up somehow to where everything starts sticking to it, and then I eat some food and it's fixed. I have no idea what this is or how to make it stop happening between every meal, but it doesn't seem related to whether I touch the food while eating, so it's probably something about nutrition.
> Though these issues aren’t necessarily too serious, both patients and doctors should be aware of the potential risk, the researchers say.
> “For people taking or considering GLP-1 receptor agonists, the main takeaway is: do not panic, and do not stop an effective treatment on your own because of your hair or nails—but do mention these symptoms to your doctor,” study author Charles Taïeb, a clinical dermatologist at Necker University Hospital in Paris, told Gizmodo.
Wow. Sounds pretty fuckin serious. Can't believe people are taking these highly dangerous drugs instead of mustering up a mass of eternal self-discipline they clearly already don't have and never will. Shame on them and the doctors! Side-effects are very serious even if the people taking about them are like "uhhh yeah not a huge deal, but like, be aware and talk to your doctor about it", why not just try being a perfect human being like me! Try not being fat! I am very smart!!!!
> Can't believe people are taking these highly dangerous drugs instead of mustering up a mass of eternal self-discipline they clearly already don't have and never will. Shame on them and the doctors!
That take does have some merit actually. The easier it is for people with low self-discipline to reproduce, the less self-disciplined future generations will be, and they might simply be unfit to handle future cataclysms.
Case in point: imagine teleporting to America in year 1000 and telling locals that they should go through a few plagues in order to build immunity. They'd call you crazy and then rip your heart out, and centuries later die from diseases brought by the Spanish.
But there's lots of lunches with such a huge benefit and such a minimal cost, that it's virtually a free lunch, that's most of medicine, you just take penicilin and it kills lots of infections, wash your hands and avoid diarrhea, etc...
In an economic sense the cost that you'd associate with those is research, which you would have already paid when choosing to use a drug with a net positive effect.
i've visited many subreddits, telegram and discord groups i see this common pattern:
People import it from China from suppliers and do not know how to properly dose it. Many are using it in knee jerk fashion with no proper dosing protocol.
Why they do it? it's because it's cheaper this way and they have to answer or explaining the use to no one.
Others have this strange idea, "if i am using GLPs, exercise and dieting is no longer needed".
I feel like you're misunderstanding something here. Nearly every obese adult has unsuccessfully tried a number of other strategies to lose weight. What GLP-1s immediately illustrate to most people who try them is that there's a real, physical problem with their appetite that only GLP-1s successfully correct. A few weeks after I started taking GLP-1s, I started to feel full again for the first time since college. Everyone should work out daily and maintain a varied, healthy diet, but I did and they never made me feel that way alone.
I do encourage anyone who can remotely afford the name-brand drugs to buy them, but even with price cuts they're still quite expensive. So while I'm never going to encourage buying pharmaceuticals from sketchy grey market producers, I find it very hard to tell the people who can't afford GLP-1s that they have to just deal. It'd be like not being able to buy painkillers.
>Nearly every obese adult has unsuccessfully tried a number of other strategies to lose weight.
What's the source of this info?
The market is filled with "Eat X for weight loss, eat Y for weight gain."
The average person actually does not choose the right strategy for weight loss which is "Calorie Deficit"
But implementing it is not "EASY" until you understand how expenditure, calorie intake, and weight movement work, which is too much work to understand for an average Joe.
OKAY, vasty majority of people on HackerNews can probably wrap their head around these concepts if they find the right resource, but average Joe can't.
Let's take something as simple as "calorie deficit."
Being at a calorie deficit itself requires knowing two things:
1. How much you burn in a day (total daily energy expenditure or TDEE)
2. How much your intake is for the day
Deficit = TDEE - Intake
You can do calorie counting for #2. But what can you do for #1?
The average guy does not know how to calculate these properly, let alone judge weight movement, which can move a lot in the opposite direction due to water weight fluctuations that can exceed 1 kg+ of movement a day.
We've 17,000+ users why? because #1 is a difficult problem for many.
>What GLP-1s immediately illustrate to most people who try them is that there's a real, physical problem with their appetite that only GLP-1s successfully correct.
That doesn't mean every guy who is overweight by 5-10kg needs GLPs.
>A few weeks after I started taking GLP-1s, I started to feel full again for the first time since college. Everyone should work out daily and maintain a varied, healthy diet, but I did and they never made me feel that way alone.
Sorry but most people diet poorly, dieting well requires training and education.
Have you actually worked on this problem? or you just make bunch of assumption and accept them as "truth"?
At the end, I am not a GLP “hater.” If you fail to stay at a deficit for several weeks (deficit 300-400kcal) due to poor appetite regulation, you feel insanely hungry even after volume eating methods, improving physical activity by walking more and lifting 1x a week etc..., you are perhaps a valid candidate for GLP, so you can reach out to doctors.
Eating whole foods, lifting 1x a week, and walking 10k steps (at zone 2 pace) are something everyone should do, regardless of whether they are fat or not!
But saying all fat people need GLPs is something I am not going to agree with.
Reporting on these drugs is so bad. Most of the benefits AND downsides they keep reporting are the same for any major rapid weight loss. Be it hair shedding or sleep apnea resolving. They keep acting like these are novel drug specific side effects rather than weight-loss related side effects.
At this point it might legit be impossible for a side effect to be discovered that outweighs the immense health benefits of losing weight.
It feels like people want there to be some horrible side effect to these drugs. Idk if it’s some moral objection to weight loss without discipline, or just general mistrust of big pharma.
I feel like the opposite, it seems like people desperately want it to be a miracle drug and are irrationally hostile to discussion or research on side effects. Kind of the same thing happened with cannabis and the downplay on mental health disorders. Given how much money is at stake maybe there is also a big marketing push.
Edit: also regarding the moral/discipline thing, to many people me included the larger issue is absolutely not this, it’s obviously a good thing if people can improve their health. It’s that we are unhappy that the answer to food designed to be addictive and that is poisoning people is having to research a drug and having the whole population take it to protect themselves. I have a hard time celebrating such a waste of resource and a supposed market "innovation" hiding yet another government failure at regulation. When people were poisoning themselves with lead pipes, the answer was not having the whole population take a drug to manage the effects of lead poisoning. Even if there was absolutely 0 side effect I would be happy for the individuals losing weight, but unhappy with the larger picture.
It's absolutely the moral thing. Even on HN there are an endless number of people who treat the use of GLP-1s as a failure that must be publicly shamed.
I suspect a big part of that stems from the fact that many people treat being overweight as a moral failure in and of itself, and rather than repenting and doing the morally right and correct thing to lose the weight on your own, using a GLP-1 is "cheating".
Of course, all that ignores that people's bodies are different, and some people will be slim no matter what they do, while others are doomed to be heavier regardless what they do on their own (barring extremes like developing eating disorders), but I'm not sure it would matter even should everyone understand that -- a large proportion of people need someone they perceive as lesser whom they can look down upon, and physical appearance is a quick and easy means to categorize others.
> people treat being overweight as a moral failure in and of itself
the thing is though, at least as far as our society is concerned: thats a fact not a missrepresentation
https://en.wikipedia.org/wiki/Gluttony
and yes, using tools like GLP-1 is a moral failing. a proper christian would just be more disciplined. and be a straight up better human from that too.
but hey, i'm an atheist, and struggled with my weight all my life to varying degrees. The way fat people generally undersell the issue that theyre fat and keep wanting to be victiums / not responsible for their own actions is extremely dystopian however. and its flabbergasting our societies have degraded so far to no longer even be able to tell that.
> others are doomed to be heavier regardless what they do on their own
While this is true in individual cases, it is obviously not by any means common. Unless the human species has had some extreme mutations in the last 100 years (and only in the West). Yet this is brought up in every thread about obesity, because believing yourself to lack agency is more convenient.
There are three levels to this. One are individuals with bodies that gain weight regardless of what the person does.
The second is psychological, people whose bodies work normally and they do everything wrong on their own.
The third is structural. Countries in which a huge part of the population is obese while other similar countries don't have that problem, have systemic issues that cause that. In the US it's the fact policies all around favor food that cause obesity and make healthy food be extremely expensive, which is the opposite of what countries where obesity is uncommon do.
Fix this last issue, wait two to three generations, and you'll see obesity fall to normal levels, at which point, yes, bringing up the moral argument for some of the few remaining cases may even become valid.
"One are individuals with bodies that gain weight regardless of what the person does."
Physically, that's not possible. If calories consumed is less than calories burned, the body cannot add weight. It doesn't have access to zero-point energy.
That's because people are recommending them for long term use, and treating them like some miracle cure, when the only affect is appetite suppression. If you are malnourished for years, you're just going to die. These things are useful for a few months if you really, really have no willpower and don't want to develop any. For anyone else (most people), it's much healthier to learn how to do difficult things.
Yes, there absolutely is a sense of "it was hard for me, but I did it anyway, you should do the hard thing too". But that's not out of nowhere. Willpower is a muscle. If someone never exercises it, it's going to atrophy. It doesn't need to be shameful, but people who promote these things need to seriously consider the reality that most people's hunger is caused by something real, and just not being hungry does not solve any of those underlying problems.
My mother is a little bit overweight, which is a problem of calories OUT being too low. She doesn't exercise enough. She doesn't have energy to exercise. That's a problem of calories IN being too low. She's taking a GLP-1 now to lose weight. It very exactly does not solve either of those issues. She has less energy. Most of the weight being lost is muscle mass. I think it's despicable that these things were rushed through the medical system. I don't think it's the layman's fault for being manipulated into thinking it's medicine.
> when the only affect is appetite suppression
You don't know this.
> These things are useful for a few months
You don't know this.
> For anyone else (most people), it's much healthier to learn how to do difficult things.
You don't know this.
> Willpower is a muscle.
I know you mean this in a figurative sense, but what exactly is "willpower"? There has to be a physical (and physiological) mechanism for "willpower", no?
Do you believe that can be aberrant physiological conditions?
I do. I also believe over-eating is a manifestation of some type of "aberrant" physiology.
That's common sense reasoning, which is to say, not based on anything scientific.
GLP-1 is produced by the body to regulate and balance food consumption. People whose bodies produce less than the correct amount eat more because they feel a lot more hunger than people whose bodies are normal. Taking in GLP-1 drugs, if following medical advice, brings their level back to what it should have been all along, in which case most wouldn't have become obese at all.
I'm such a case. Clinical exames never showed up any clear problem associated with weight gain, so for my entire life my obesity was linked by everyone, doctors included, to lack of willpower.
I only discovered what my issue was when I took a genetic test and discovered that my DNA came with these lovely traits:
* I feel more intense hunger than the average people, so I need to eat more than they do to feel satiated. If I eat the same amount a normal person does, I leave the table literally still hungry.
* My body accumulates more fat than the average person, so even if I eat the same amount they do and keep constantly hungry, I accumulate some fat.
* Caloric-reduction diets don't work for me. So the years and years I tried and tried them had little effect, and were mostly wasted effort.
* Fat-reduction diets also don't work for me. Good thing I didn't lose time with those since everyone recommended me the useless caloric-reduction ones.
* The only diet that has some effect for me is the Mediterranean one, which I didn't know about and no one had ever recommended.
* Physical exercise has little effect for me, as I gain less muscle mass from it than the average person. So the years of walking and the many attempts at going to the gym were also mostly wasted effort.
* And physical exercise causes more pain for me than it does for the average person, so all the time I was doing those, I was suffering more than most people while getting worse results then they do from it.
If your genetics is normal on all those fronts, then sure, a bit of willpower fixes that. With that combo though, and fully not knowing you have any of that? Not a chance.
There are a few things here. Developing willpower is a thing. Having depression or other mental health issue is another. It is easy to dismiss it as lack of willpower, but it is a bit more complicated.
I also don't think you understand how living with kcal deficiency works on the long run. Have a look at the Minnesota starvation experiment. When in deficit for long the mind constantly goes to "what/when are we going to eat?" and it only gets worse from there. It becomes an obsession. It takes over everything. My understanding is that glp-1 reduces that.
It also helps for people who have too much extra weight, or incapable (waiting for hip replacement, or the elderly) of exercising.
I have been on diet and managed to go back to the target weight (lost around ~16% of bodyweight) but the food noise was real and constant. It is not a one off "I am not going to eat anymore" that was a decision to be made every minute until next meal came around. I do cycle 10-12 hour a week and the occasional footbal game but finding the deficit that is not causing the food noise is different for everyone.
Yeah, no. Willpower is more like a well that replenish with sleep, friends, family and a secure environment and that you use to do anything difficult. The harsher your life, the deeper you need to go to get water back.
I lost now 42 kg from my heaviest (5 kg left to reach my ideal weight of 73 kg), the first 20 i absolutely needed eat less and to fight the hunger pangs (which are more painfull than ankle sprain due to my fucking grehlin receptor being whack), some medical help was needed anyway (i fasted for 5 days under medical supervision to reset my leptin levels, and stayed in ketosis for 3 month prior to that to reset my insulin resistance). 20 kg loss over 18 months. I thought exercise would be enough for the last 20, but i took 5 year to loose 5, and only a change in diet finally helped me go under 80.
NGL, all that is very difficult if you have issues at home or in your life. My family might have individual flaws but as a unit we've been doing great since like 2006, and my income in 2019 when i started my weight loss was comfortable enough for me to have a great apartment, private medial help and a good overall social life.
If people need GLP-1 to get back in track, they should absolutely go for it. I do think we should help them, once they are close to their optimal weight, to sever from GLP1 though, i've heard about the "rebound", imho it is way easier on the mind to eat as much as you use to than forcefully reduce your portions (your leptin/grehlin level were unfucked by GLP1, so your old eating habits are now only psychological, not hormonal)
> It feels like people want there to be some horrible side effect to these drugs.
Being able to lose weight is, in many minds, associated with self-discipline. A route to the same goal that elides self-discipline is consequently viewed as a cheat, a shortcut.
It's a product if the cultural pervasiveness of the Protestant work ethic and its relation to the health and wellness domains. That fine, in my opinion, if one is Protestant, but why carry the baggage for someone else's religion if you're not one, ya know?
Culture and religion are intertwined even if separate. Western civilization is "culturally Christian" even in secular countries like France. Many places in the US are thus "culturally Protestant" even if most of their current-day population don't follow that religion.
I'm a doxastic voluntarist, as in, we think ourselves to be less able to change our beliefs than we actually are. The idea that weight loss by means other than self-discipline seems, at least to me, quite easy to choose to not believe in.
Recently I've talked to someone who said she is worried about those drugs as they will create 2 tier society because only people with money will get thin. This also increases already bad fat phobia in our society according to her.
She has a PhD in biotechnology and works in a lab. She is also quite thin (always was).
It's crab mentality disguised as moral position. It's especially obvious when the same people advocate for free access to drugs, alcohol or gambling. You should have freedom you do anything as long as it doesn't improve your life or move you to in social hierarchy.
Generics sell in India for $15/mo so it’s not gonna be too bad, long term.
Who are these mythical people that are
- Concerned about fatphobia
- Worried Ozempic might create a two tier society
- Believe we should have unrestricted access to gambling and drugs
This sounds like a goomba to me.
I would give you the name but that wouldn't be ok. Other than that what else can I do? I've spent time writing about an encounter I can with someone I know for 20 years and you just called me a lier because the story sounds improbable to you.
Isn't the whole point to read about what others think or experienced to learn about things you personally hasn't?
Yes, it does look superficially like the kind of thing that happens with nutrient deficiencies. Many of these people eat extremely unhealthily and continue to, but now in significantly lower quantities.
I know with the famous 382 day fast guy they fed him vitamins, but I don't believe they do that with GLP-1/Ozempic prescriptions? https://en.wikipedia.org/wiki/Angus_Barbieri%27s_fast
“Millions of people live longer healthier lives by reducing cardiovascular and diabetes risk, but their fingernails might be more brittle!” Doesn’t hit the same does it?
No, most people will not be able to sustain the kind of deficit needed for rapid weight loss long-term, so it's a self-regulating thing.
Anyone can take a lot of GLP and crash diet very easily.
If any person is capable of rapid weight loss naturally with no drugs, they already have enough willpower and ability to diet sustainably.
I lost 170 lbs natty (100lbs the first year) and my hair and nails only got better. If your generative follices are dying off you are not losing weight healthily.
if you're losing it as a weight loss drug and that's a side effect of the rapid weight loss that otherwise wouldn't occur it's a side effect of the drug in any practical sense, or are you trying to establish the 'guns don't kill people' for pharmaceuticals?
It's a side effect of the treatment regimen that many people in all likelihood aren't even aware of so it's good to report it like this
Idk, i think its important to distinguish between side effects that would also happen via diet and exercise vs side effects that do not happen when losing weight via other means.
Diet and exercise have not caused any of that ever.
It sounds more like malnutrition and starvation.
I'll concede it may still be better than being fat, though.
malnutrition and starvation is technically a diet change.
That said, based on googling telogen effluvium seems to have lots of causes not related to malnutrition, even if insufficient protein is one of the causes.
People losing hair through "exercise" are using supplements.
If you shoot someone in the face, generally speaking that person will die. Not everyone who takes GLP-1s actually lose weight. A decent fraction of people are non-responders. Those people also tend to not lose their hair or have their sleep apnea and knee problems go away. Your analogy isn't as clever as you might think.
no listed side effect on every drug, or effect for that matter applies to all people. Anti-Depressants don't work for a fairly large amount of users, that doesn't mean we don't list those effects.
it feels like you are being deliberately obtuse so I may be wasting my time, but I'll attempt to assume the best and try one more time. This is very basic correlation vs causation stuff. The side effect is related to rapid weightless of any kind. Weightloss is a "side effect" of the drug. Hairloss is a side effect of rapid weight loss. There is a chain of effects there but it's not X causes Z, it's X might cause Y, which causes Z. This distinction matters less for negatives - still good to tell people but for positives it is disingenuous. If you don't lose weight, your sleep apnea doesn't go away. Your joint pain doesn't get better. Your blood pressure doesn't go down - because the drug doesn't cause those things, the weight loss does.
If you’re drunk and bump your head into a lantern, would you say that haematomas are a side-effect of alcohol consumption?
FDA trials follow this approach. If something bad happens it’s logged as an adverse event; if they croak it’s a serious adverse event (SAE).
So if you have a treatment for moles, and a patient (trial participant) has a mole on their back treated and then falls down the stairs or is run over by a trolley the agency wants you to do an analysis to see if the treatment might have had something to do with getting run over or not taking the lift.
Note: this is not an exaggeration. I have written phase I and phase II clinical trial protocols earlier in my career.
GLP1s do seem like incredible science but I will admit to being a little floored when I saw how far they spread and how quickly. I really hope small numbers of hair loss and nail issues are the biggest issues we face.
No, there are many more issues, like bile related issues and an increased risk of developing gallbladder stones.
Which are also commonly linked to rapid weight loss of any kind
Very large studies already exist. They’re safe. Fearmongering about side effects is actually harmful at this point, because skepticism could keep someone from getting safe, effective treatment.
Not only that but the weight loss is often a side effect of fixing other issues, for me I’ve been taking a low dose for autoimmune related ME/CFS for about 4 years now.
It definitely kept me from starting on one for 2 years. It was stupid. I lost 70 pounds and feel better than ever, with very little side effects.
I read the article, but my understanding that rapid weight loss is what is causing the alopecia. This is a pretty well understood process
Could these be signs of malnutrition? I see a lot of people who take them but don't also adjust their diet or exercise to make sure they're getting solid nutrition and start looking sickly.
That was actually my thought. When I started controlling my diet a lot more I was surprised about the (positive) change in my nails. I had heard it was a thing but had never experienced it before.
I feel like waaay more than people think depends on nutrition. You literally are what you eat. Like for example, sometimes my skin oils get messed up somehow to where everything starts sticking to it, and then I eat some food and it's fixed. I have no idea what this is or how to make it stop happening between every meal, but it doesn't seem related to whether I touch the food while eating, so it's probably something about nutrition.
I'm bald already so woohooooo
Hair and nails are both made of keratin, so .... expected ?
> Though these issues aren’t necessarily too serious, both patients and doctors should be aware of the potential risk, the researchers say.
> “For people taking or considering GLP-1 receptor agonists, the main takeaway is: do not panic, and do not stop an effective treatment on your own because of your hair or nails—but do mention these symptoms to your doctor,” study author Charles Taïeb, a clinical dermatologist at Necker University Hospital in Paris, told Gizmodo.
Wow. Sounds pretty fuckin serious. Can't believe people are taking these highly dangerous drugs instead of mustering up a mass of eternal self-discipline they clearly already don't have and never will. Shame on them and the doctors! Side-effects are very serious even if the people taking about them are like "uhhh yeah not a huge deal, but like, be aware and talk to your doctor about it", why not just try being a perfect human being like me! Try not being fat! I am very smart!!!!
What's the law about the challenge of differentiating extreme sarcasm from an honestly held extremist viewpoint?
Poe's
> Can't believe people are taking these highly dangerous drugs instead of mustering up a mass of eternal self-discipline they clearly already don't have and never will. Shame on them and the doctors!
That take does have some merit actually. The easier it is for people with low self-discipline to reproduce, the less self-disciplined future generations will be, and they might simply be unfit to handle future cataclysms.
Case in point: imagine teleporting to America in year 1000 and telling locals that they should go through a few plagues in order to build immunity. They'd call you crazy and then rip your heart out, and centuries later die from diseases brought by the Spanish.
Well, thank goodness I was too lazy to deal with my insurance provider and stuck with dieting and exercise.
TANSTAAFL, my dudes. TANSTAAFL.
But there's lots of lunches with such a huge benefit and such a minimal cost, that it's virtually a free lunch, that's most of medicine, you just take penicilin and it kills lots of infections, wash your hands and avoid diarrhea, etc...
In an economic sense the cost that you'd associate with those is research, which you would have already paid when choosing to use a drug with a net positive effect.
i've visited many subreddits, telegram and discord groups i see this common pattern:
People import it from China from suppliers and do not know how to properly dose it. Many are using it in knee jerk fashion with no proper dosing protocol.
Why they do it? it's because it's cheaper this way and they have to answer or explaining the use to no one.
Others have this strange idea, "if i am using GLPs, exercise and dieting is no longer needed".
When long term experienced GLP users say, you still need a dieting and workout protocol, https://www.reddit.com/r/tirzepatidecompound/comments/1omfgx...
GLPs are very useful but they are not needed by vast majority of people who use it.
And key questions
1. Do you really need GLPs? how did you figure this out?
2. How much do you need?
3. What's your dieting and workout strategy?
Very few GLP users actually run through these questions.
People should stop pushing it as a “miracle” and instead see it as a “tool” used in specific cases.
Those people often also fail to ask "is this stuff even made right?!"
I feel like you're misunderstanding something here. Nearly every obese adult has unsuccessfully tried a number of other strategies to lose weight. What GLP-1s immediately illustrate to most people who try them is that there's a real, physical problem with their appetite that only GLP-1s successfully correct. A few weeks after I started taking GLP-1s, I started to feel full again for the first time since college. Everyone should work out daily and maintain a varied, healthy diet, but I did and they never made me feel that way alone.
I do encourage anyone who can remotely afford the name-brand drugs to buy them, but even with price cuts they're still quite expensive. So while I'm never going to encourage buying pharmaceuticals from sketchy grey market producers, I find it very hard to tell the people who can't afford GLP-1s that they have to just deal. It'd be like not being able to buy painkillers.
>Nearly every obese adult has unsuccessfully tried a number of other strategies to lose weight.
What's the source of this info?
The market is filled with "Eat X for weight loss, eat Y for weight gain."
The average person actually does not choose the right strategy for weight loss which is "Calorie Deficit"
But implementing it is not "EASY" until you understand how expenditure, calorie intake, and weight movement work, which is too much work to understand for an average Joe.
OKAY, vasty majority of people on HackerNews can probably wrap their head around these concepts if they find the right resource, but average Joe can't.
Let's take something as simple as "calorie deficit."
Being at a calorie deficit itself requires knowing two things:
1. How much you burn in a day (total daily energy expenditure or TDEE)
2. How much your intake is for the day
Deficit = TDEE - Intake
You can do calorie counting for #2. But what can you do for #1?
The average guy does not know how to calculate these properly, let alone judge weight movement, which can move a lot in the opposite direction due to water weight fluctuations that can exceed 1 kg+ of movement a day.
Have you seen the math required for figuring out "Maintenance Calories?, see this: https://macrocodex.app/knowledge/rethink/adaptive-tdee/
And all the factors that go into this? see this: https://macrocodex.app/knowledge/macrocodex/smart-calorie-bu...
We've 17,000+ users why? because #1 is a difficult problem for many.
>What GLP-1s immediately illustrate to most people who try them is that there's a real, physical problem with their appetite that only GLP-1s successfully correct.
That doesn't mean every guy who is overweight by 5-10kg needs GLPs.
>A few weeks after I started taking GLP-1s, I started to feel full again for the first time since college. Everyone should work out daily and maintain a varied, healthy diet, but I did and they never made me feel that way alone.
Sorry but most people diet poorly, dieting well requires training and education.
GLP users themselves say this, https://www.reddit.com/r/tirzepatidecompound/comments/1omfgx...
Have you actually worked on this problem? or you just make bunch of assumption and accept them as "truth"?
At the end, I am not a GLP “hater.” If you fail to stay at a deficit for several weeks (deficit 300-400kcal) due to poor appetite regulation, you feel insanely hungry even after volume eating methods, improving physical activity by walking more and lifting 1x a week etc..., you are perhaps a valid candidate for GLP, so you can reach out to doctors.
Eating whole foods, lifting 1x a week, and walking 10k steps (at zone 2 pace) are something everyone should do, regardless of whether they are fat or not!
But saying all fat people need GLPs is something I am not going to agree with.
If you spend $300 on GLP-1s, but then don't spend $300 on garbage food, the math is easy.