The drug, semaglutide, works by hijacking the body's own appetite regulating system in the brain leading to reduced hunger and calorie intake.
Three quarters (75%) of people who received semaglutide 2.4mg lost more than 10% of their body weight and more than one-third lost more than 20%. No other drug has come close to producing this level of weight loss -- this really is a gamechanger.
The drug possesses a compound structurally similar to (and mimics) the human glucagon-like peptide-1 (GLP-1) hormone, which is released into the blood from the gut after meals.
Imagine you walk around with a 30 lbs bag of flour on your back all the time. Then, all of a sudden, you are able to put that bag down.
The faster you lose weight (this is all anecdotal) the more it is like putting that bag down all at once.
Now, can they keep the weight of after losing it? Because I can gain those 30 lbs back very, very quickly.
I can feel the fat pushing and creating pressure points, which contributes to both conditions. The crazy thing, is I'm not like super fat or anything. 6'2" 245lbs was my max, and I'm at 235lbs now... I felt perfectly fine at 225 when I worked out. Seems like such a small difference, but I've gotten virtually no exercise with covid, so it's not a fair comparison.
That's enough for obesity, but the crazy thing is it's not considered fat at all in the USA, if you're a guy. You just "aren't in your early 20s anymore", or have a "dad bod", or you're a loveable jolly rascal that loves life (eg. Chris Pratt in P&R). We act like it's practically inevitable and not a horrific medical condition that's causing me to be eaten from the inside out by my own acid.
I know some of this is just luck, but I wonder what truly fat people have to deal with. I couldn't imagine my reflux being better if I was say 275-300+.
But just look at reproductive hormone treatments (the pill) to see how things like this can go wrong (serious mental side effects; my sister struggled with seasonal depression for half her life, turns out it was just the pill. My girlfriend developed suicidal ideation from the Mirena coil. They stopped a research in male anticonception medication because of the mood swings).
All known drugs that actually trick the body into burning more fat are kind of dangerous, some are lethally dangerous from a single overdose. And they would reduce the appetite, oppositely some cause monstrous appetite.
I'm 80-85kg 173cm man. Months of strenuous exercise doesn't barely make me reach 78-79. Though they do make me feel much better, and energetic.
A therapy needs to do both, somehow make the body consume more energy from fat specifically, and not cause excess appetite. This can be one leg of that.
Any way to achieve a calorie deficit will accomplish this. There doesn't have to be a second drug to make your body use fat as energy once you've already given it no other choice.
One problem it highlights is that modern armies and military tactics are incredibly inefficient. The amount of fuel, munitions and calories they use for every kill is staggering. Also much of modern military tactics are based around putting on a massive show of force up front and hoping the enemy surrenders or retreats. That is not a problem if you only have to kill a few thousand people who's spirit to fight can be broken, and you're backed up by a fully functional logistics network. Remove the logistics network and face off against an 'army' of hunderds of thousands of enemies that will never retreat then those tactics will quickly see your fuel and munition stores depleted.
Towards the end of the book the Army has reinvented the infantry square and equipped all their soldiers with bolt action rifles to stop them wasting ammo.
If you want to see how a zombie horde would fare on a battlefield, look at how infantry and cavalary charges did against ww1 machineguns. It would be like that, but 10x worse.
Besides, there is the whole issue of zombies rotting and concervation of energy - after a few months they should turn to rotten goo, or motionless husks.
Machine guns lack the accuracy to stop a zombie completely, and have a limited capacity relative to millions of attackers. Tanks would be able to run over zombies, but eventually would be swamped or simply run out of fuel. All the strategies relied on fighting an enemy with human emotions and a survival instinct, the two things zombies lack.
Oh absolutely and I think the book agrees. I recall them describing battles where the piles of dead zombies where so high the soldiers couldn't see the next wave approaching. The hard part was never killing zombies but making sure you killed all the zombies before you ran out of fuel and bullets.
None of those predicted the hoarding of toilet paper though.
Bupropion is also used as an antidepressant and antismoking drug.
I am taking Bupropion to treat my depression and it helps me - at least I think it does. I also think it helped me to loose a little bit of weight.
I have observed myself and with Bupropion I simply want to do stuff, go out for a walk, meet friends etc. Instead of being in bed all day. I think this is how it helps me do both: improve my depression and lose weight at the same time.
I might be totally wrong though since I have no idea regarding the actual mechanics of Bupropion and I may simply experience the "placebo-effect".
And ADHD meds were used previously for loosing weight. I think it will be the same with Bupropion.
I can only imagine the fight people will have with their insurance. One of the many reasons we can't have nice things.
The article explains that the substitutions increase the half-life of the substance in the body, so I understand that as an advantage of the drug over the naturally occuring peptide. This would be important with an injection. But the skeptic in me wonders if, the drug now is available in an oral form, if the real reason for pushing the drug over GLP-1 is because the drug can be patented and GLP-1 cannot.
Here are Swiss prices (German/French only): https://compendium.ch/search?q=Semaglutid
While injections are still quite expensive (~$130 per 3mg), pills are available for as little as $4 per 14mg dose (and judging from the dosage information, those pills are splittable).
I don't know the reasoning behind studying the effects of injections vs oral admission.
>The international trial was funded by the pharmaceutical company Novo Nordisk.
From the Ozempic website:
> Cornerstones4Care®, NovoFine®, and Ozempic® are registered trademarks of Novo Nordisk A/S.
Follow the money.
Realy good results and only one aplication per week, which is great.
We are from Slovenia. Drug is free of charge with normal insurance.
The EU cannot do anything against that, so why bother.
Blocking the site is something I do not understand
It looks like for two doses.
But there's this thing that when people get some sort of diagnosis they'll act like it's something you have absolutely influence on and the only way is to have some sort of external intervention or declare "that's just the way I am". You just have to look at how many patients gain back large amounts of weight after getting their stomachs stapled.
Exercise has a positive correlation with controlling hunger, eating differently can also greatly increase fullness and reduce hunger, cutting alcohol from the diet does absolute wonders. Maybe it won't get you to a 'beach lean' physique, but it will for sure make you more healthy.
If this drug is truly effective it will only save the patient from the direct effects of obesity, not the effects of sustaining a poor diet, a lack of exercise, or overconsumption of alcohol.
Do you have any good source on that?
Genetics have not rapidly changed in this time period.
The claim is: in a given group of a thousand people, eating the same food and having the same execesise, some will be obese and some will not due to genetics. That distribution is very wide, and well studied.
Thus, when you encounter a random obese person in the wild you cant conclude this is just because they eat bigmacs all day
Lastly, I do dislike comments that pick a random statement from OP and ask "where is the proof" and do not actually engage with the crux of the message. They just sidetrack discourse.
This was not the same claim.
Yes, it is well understood that individuals are different. some people have a harder time and some have an easier time, for sure. This does not negate that personal choice plays a much greater role than genetics.
>> hunger and fullness are very much genetically determined and that that dictates to a large degree how fat you'll be
Genentech influences are only significant if you intentionally exclude dietary choice providing the "same food and exercise" to each person.
>Thus, when you encounter a random obese person in the wild you cant conclude this is just because they eat bigmacs all day
Im not sure when or why I would need to make conclusions about a specific random obese person in the wild. I'm fine with the understanding that 90+% of obesity is personal diet. This is sufficient for talking in generalities about obesity in society. If for some weird reason, I need to do a root cause assessment on a random individual's obesity, yes, this is not sufficient.
If I encounter another random obese person in the wild, I have no reason to care if the reason IS their bigmac consumption. It is their life and their choice. Lots of people value food consumption over their weight.
Lastly, I totally agree that the genetics was a footnote to the original point, but think there is value in correcting incorrect facts. If someone else wants to engage with the crux of the message, they are still free to do so. What I don't like is when people erroneously claiming that science backs up their position when it doesn't.
People can loose weight, but pretty often do it in an unhealthy way that is not sustainable. Keeping that weight in sustainable way is what issue is. We dont have intervention that would actually worked long term for that.
This is a big commitment and people have a tendency to quit when one single thing fails. The key is not willpower, it is persistence. It took me years to get to a point where I felt in control of my weight. It wasn't easy and I did many stupid things but I just kept on going on.
A big part of it is not seeing a lack of progress in scale weight or body composition as a personal failure but as valuable feedback or just an "oopsie".
When you get older, you body is not as good at regulating itself. Think sumo wrestler - they can beat your ass and survive in a tundra, but they don't look like a model.
If they could wave a magic wand and loose 10 kg, they would.
He lost 125kg.
In my experience IF is an easy way to cut out excess calories, and EF gives me amazing energy and mental clarity, while helping me have a healthier relationship with food.
My simplistic view on fasting is that my body stored all that excess energy as fat for the purpose of being used when food is not so readily available, a situation that may have been common in the not-too-distant past but just doesn't happen for me or most Americans today; therefore it's incumbent on me to restrict food occasionally and let the body use these stores, while performing other maintenance that is limited when digestion is occurring (notably autophagy).
Note: when I refer to fasting I mean water-only (also non-caloric drinks like tea and coffee), with electrolyte supplementation for extended fasts.
Our natural instincts tell us to eat as much as we can whenever food is available. This is because we evolved without any guarantee of frequent meals. Post food-scarcity society seems basically against our natural instincts.
Compounding the problem, we've identified what activates these instincts (fat and sugar), and hyper-optimized food to target the reward centers and cause people to eat _even more_ food that they don't need. Then we use what we've learned about psychology to trigger people's desire for food even when they're not eating.
Then we invent expensive drugs (see TFA) to help people lose the weight (and throw commercials at them for _those_)...
No single factor seems to line up with increasing obesity rates well enough to be blamed as The Cause. I think it may be a combination of small nudges that form strongly obesity-promoting environments.
Granted, those turn offs are for people without diabetes. People with it already have to follow that routine in their life.
All that said, it is better to have more tools than less given US population increased obesity rates.
Someone that frequently has low blood sugar should probably adjust their diet, but that's anyway going to be part of a weight loss regimen.
I lost around 5% of my body weight by not being so hungry any more. I think this is due to a reduction of my suspect candidosa which was making me always crave for sugar.
As a plus I am also less humoral, and don't have mental fog any more.
I think of the human microbioma like a patch to human biology system, while DNA is the blueprint.
That said please bear in mind that I am no doctor, I have no medical or biological education... so take it for what it is, a very personal experience with also no statistical value
This seems like an incredible difference. And 94% of participants made it through the whole study. What are the downsides here, or what am I missing? It’s an already approved medication that’s normally used in smaller doses, so only the safety in larger doses needs to be validated?
Potential side effects include thyroid cancer, kidney problems, blindness, allergic reactions, low blood sugar, and pancreatitis
I'm not saying it's all bad :) but patients on this medicine need to make diet [and to a lesser extent exercise] changes as well. I'm sure this is already considered.
I’d wager that it would lead to a massive increase in consumption instead of allowing people to get healthy and then stay that way.
I'd rather try to eat less really good food, than have 'enough' of something I quit caring about?
There is so much more to life than tasting food, and a lot more exciting things in life become more accessible when you're physically-fit.
I'm relatively young, and not that overweight, but the last 40 pounds or so are going to be the hardest, and the most fulfilling to lose.
Oh, and modify the scenario slightly: you have to smoke a little to live. And while smoking is making one person sick with cancer, other people have different genes and can smoke as much as they want with no side effects.
That is what it’s like trying to “just make good food choices” today, especially if you are genetically insulin resistant, in which case you not only need to eat “good food,” you need to eat less of it than other people or you’ll still gain weight. Oh and don’t get me started on stress and cortisol.
“Just eat healthy,” is the ignorant remark of someone blessed with good genetics.
> Oh, and modify the scenario slightly: you have to smoke a little to live. And while smoking is making one person sick with cancer, other people have different genes and can smoke as much as they want with no side effects.
> That is what it’s like trying to “just make good food choices” today, especially if you are genetically insulin resistant, in which case you not only need to eat “good food,” you need to eat less of it than other people or you’ll still gain weight. Oh and don’t get me started on stress and cortisol.
> “Just eat healthy,” is the ignorant remark of someone blessed with good genetics.
Yeah it's like the mentally healthy telling the depressed to cheer up. It's not that simple.
It’s very, very difficult to overcome genetics.
It's not as easy as "this food is good" or "that food is bad", you need to educate yourself first; calories in and out, then macronutrients, then micronutrients, in that order.
All the diets, diet trends, and things labeled "good" and "bad" food are handwavey things, and research has shown that the common factor they all have is calorie intake reduction.
But you could change your food and eat tons of it. I am a pretty slim person and i eat a lot compared to my friends. I also don't do much sport and as a developer is sit a huge part of the day.
So for me it comes down to WHAT i eat and it's serving me pretty well. You don't need to fight your appetite, you can serve it and still loose weight.
I've lost over 150lbs and kept most of it off for the better part of a decade, so I will tell you from experience that you are full of shit.
Congratulations on your weight loss, does your experience compare to what I've described?
Is there? The study you quoted suggests the opposite. The drug doesn't directly cause fat to melt off. The fat is lost by eating less. Why is the control group eating more? lack of....
Shame on you and your lack of willpower!
Biological urges are powerful, don't be so quick to judge.
Because they aren't taking an appetite suppressing drug. It's easier to not eat when you aren't hungry, so it's easier to lose weight with the same amount of willpower compared to people that aren't taking an appetite suppressing drug. Willpower has no part in the study, it doesn't "suggest the opposite".
The drug does not remove fat. It removes the feeling of hunger. Assume both groups have little willpower (they are fat after all). The control group feels hunger and continues satisfying that hunger with food as they have no will power. The group with suppressed hunger from the drug also have no willpower, but since they feel no hunger they eat normal amounts.
Crime is solved by just not commiting crimes. BAM I just solved crime.
Drug problems is solved by just doing less drugs. BAM I just won the drug war.
What I am trying to say is that someone might not be able to control their appetite, but they do have at least some control over the food they put in their body. I think that education on nutrition can go a much longer way for overall human health than appetite pills.
I am hardly unique in this. I would argue that to lose and keep off this kind of weight without chemical assistance (good fucking luck getting a doctor to help there) pretty much necessitates the development of an eating disorder. It takes over a significant portion of your life and is no fucking fun at all.
Give me an apatite pill any day.
 this is without even mentioning how difficult it is to find information on nutrition that isn't complete bullshit pushed by people selling fads.
That being said, as a person who struggles with weight I can attest to how much better my life was before gaining the weight and being obese compounds the problem in a sort of vicious circle. I'm ashamed of my body so don't participate in fun healthy activities like swimming and dancing, my weight makes it risky to run or skate due to my ankles and knees being strained.
I used to be thin and thought along the same lines of your comment but when I gained the weight I also gained empathy and perspective.
can you elaborate on this? The terms toxic/toxins have been so overused when it comes to diet and alternative medicine that it's basically meaningless.
Yeah, of course we do!
And that is perfectly rational.