What I am seeing in the evidence (presented here and elsewhere) is that, in non-diabetic individuals, these drugs are effective for weight loss, with some potential for protective effects on the heart. Weight loss, in and of itself, will not save billions of dollars in healthcare costs. I would argue that these drugs are reaffirming weight-bias and stigma by essentially celebrating "getting rid of fat people" as opposed to shifting our focus to health behaviors and the social determinants of health, which are actually at the root of the health outcomes that are much, much too often attributed to "obesity" or body size. I would LOVE to see you dive in to the literature around weight-inclusivity and whether obesity is, in fact, a disease in and of itself or if we should be shifting our focus (and money) from trying to change a number on a scale towards encouraging healthy relationships with food, moving our bodies for pleasure, and creating environments in which all people have access to health promoting foods and environments, rather than weight loss drugs.
Yes, thanks for this clarification. Hopefully my overall point was clear - that what we know at this point is that (in non diabetic individuals) these drugs help people lose weight, but do not significantly improve health outcomes. But as a culture we subscribe to the (false) weight = health paradigm. This paradigm is incredibly harmful as it contributes to weight cycling, bias, weight based bullying and eating disorder development. Celebrating these drugs exacerbates all of this.
Having read the article, I didn't get the message that "weight equates to health." Obesity is a risk factor in many diseases and reducing it is a worthwhile goal, generally speaking. That doesn't mean that simply reducing your weight makes you healthy all by itself, of course. It has to be part of an overall change in one's approach to food.
That said, I don't doubt that companies in the weight loss biz are pushing that misconception.
Hi Doug. Actually, in general yes. Health has more to do with movement and nutrition than it does with weight. I encourage you to explore the research behind Health at Every Size (HAES). The Maintenance Phase podcast also has some great research-based information on this. I encourage you to do your due diligence in exploring their sources and biases. Furthermore, an average weight loss of 15lbs (or even 10%) will hardly impact the "obesity" epidemic since most people who fall into that category would still be considered obese after the weight loss (the faultiness of using BMI to measure health is a whole deep dive on it's own!).
THanks for your comment. Take 2 groups of people who both have the same average movement and nutrition for Americans. One obese and one group non obese. So you are saying the obese group will be just as healthy as the non-obese group? What about longevity? The obese group lives just as long as the non-obese group?
What is the average weight loss for obese people who use Ozempic who stay in the Obese category? Do they become more healthy despite the risk of negative side effects?
Hi Doug. Excellent questions. I know there is research out there on this stuff but I'm not an expert, and this why I'm hopeful this topic could be a worthwhile follow-up given it's propensity for misconceptions and misinterpretations of data.
To give you a super personal example, which understandably is just a single data point, my 31yo sister passed away about a year and a half ago after a short bout of really aggressive pneumonia. Her heart stopped when they tried to intubate her to help raise her oxygen levels. Because she was otherwise healthy, an autopsy was done. Even though her heart gave out due to the incredible stress it was under, the cause of death was listed as obesity. The coroner personally called us to tell us that reporting guidelines required her to list that as the cause of death but that she didn't believe her weight was the contributing factor - that the cause of death was obviously pneumonia.
Generally speaking, when it comes to medical issues, I always ask "what would you do/how would you treat this condition if obesity was not an option on the table?"
Your sister's death and the reporting guidelines about the cause reminds me of COVID. Hospitals reported a lot of COVID deaths that were not actually due to COVID because they got a financial reward for doing that. A person could get injuries from a car accident or gunshots, taken to the hospital and die for those reasons. But if the hospital found out they had COVID, then COVID caused the death. But when it came to somebody dying from a COVID shot, then the opposite applied. Anything but the COVID shot caused the death. Or there was no cause determined.
Just an FYI: Hospitals got a financial bonus for treating living Medicare and Medicaid patients. If they weren’t diagnosed and treated for Covid as a hospitalized patient, no bonus. Also it didn’t apply to private insurance.
IF they had things like high blood pressure and diabetes that often go along with obesity. I don't know if simply having a high BMI was a risk. (of course often folks with high BMI might have those things and not be diagnosed so there is that confounded any statistics too.
Thanks for sharing this information. My 80 year old diabetic mom was just prescribed Ozempic. She's one person I would consider it for. She's a very good eater, watches her carbs, eats well rounded but just can't get her A1C down or lose any weight. She also has heart disease. So she's a good candidate, but we have many concerns based on the stories we've heard. So I appreciate hearing your point of view.
I've also found myself a bit amused by the topic that last couple years. Here we have people jumping on board left and right for the "magic" weight loss pill. Without little information and science behind long term risks. Yet, when it came to covid vaccines or just the virus itself, everyone was a scientist and major skeptic! but for fast weight loss, so many take the leap without questioning the science. (insert eye roll lol)
My concerns with these drugs is folks thinking that weight loss is all you need for a healthy life. My mom being a prime example. She has been battling ovarian cancer and was already obese when she started treatment. Her doc ended up putting her on Ozempic and she experienced the weight loss a lot of folks experience. However, given her cancer treatments and already having been obese, she is still weak and has fallen often. She needs to exercise, too, because she needs that strength to keep her from falling and to help extend her life. Do you happen to know if part of the conversations docs have around prescribing Ozempic include discussions about working out and how it's not just weight loss that makes you healthy?
Also- just as an aside because this is part of the research I do as a PhD student looking at the commercial determinants of health- I'd be shocked if semaglutide ends up off patent any time soon. Many times these companies find a way to keep it on patent in order to continue that blockbuster status using strategies such as patent thickets or evergreening. I'd be curious to know, too, whether the prices of Wegovy, Ozempic, and Rybelus are substantially different from each other since they are all produced by Novo Nordisk. Different brands, same drug. It's very strategic and intentional.
Average is 10 years before we see generic meds of any kind. Generics only have to be 80% similar. Some work better for some people than others because of the other 20% that's different and we don't control what generics we can get. That's also a problem.
My understanding is that the 80% thing is a myth and it's more to do with the statistical requirements of how to show bioequivalence (the 10% confidence interval of the ratio must lie entirely between 80% and 125%, and all measurements must also be in that range). If a generic produced only 80% of blood levels of the drug, it's unlikely that all measurements and its 10% confidence interval would be entirely to the right of 80%. See this document, especially slides 18-19 (https://www.fda.gov/media/156312/download), or this post https://www.pharmacytimes.com/view/debunking-a-common-pharmacy-myth-the-80-125-bioequivalence-rule
I've been on Mounjaro since April of 2023. I've lost over 45 lbs. and dropped below diabetic level in my blood sugars. I no longer even count calories or steps; I simply plan sensible meals and exercise daily. At first, the weight loss was startling, but now it has slowed down to a more realistic 2–4 lbs. a week. In short, Mounjaro has transformed my life.
The first week of the injection I had pretty serious side effects, including one evening where I basically just stayed in the bathroom. I was so desperate to lose weight, I asked myself how long I could stand this if I really wanted to lose weight — I decided I could hack this for three weeks before calling my doctor. Thankfully, the side effects completely disappeared when I got to week 2.
Now, the only time I have a reaction is if I overeat; I don't get sick, but it can feel like a huge rock in your stomach overnight, sometimes for a day, and you don't want to eat anything. It has taught me portion control, and I never have seconds.
When you're seriously overweight, not only are you dealing with the health consequences, but also the sense that you are a failure. The worst part was feeling I was letting my kids down by shortening my life. Nothing like guilt to make a bad situation worse. I had honestly almost given up on myself. When I had my regular exam, I was in tears as I thanked my doctor.
I'm in my 60s, and I still have a long way to go. But now, I have one thing I've been missing since my 30s: Hope.
Am surprised there was no mention of the more severe possible side-effects like gastroparesis and pancreatitis. While rare, it is my understanding there is an association.
My mom already has gastroparesis which required her to be intubated for multiple procedures before she got on meds for it. She's not a candidate for these meds. A lot of people aren't for similar reasons.
After being put on a diet (unneeded) at age 12, and being told that my value was based on looking like Audrey Hepburn…. Unsurprisingly I yo-yo dieted all my life. My relationship with food has been very distorted, and a source of shame my whole life. I feel bad that I put my family, including 2 daughters, through that.
Enter Ozempic at age 69. Why? Because I wasn’t going to give up….it was a life hurdle that I was going to fix if I could. How overweight was I? 5 foot 6 high of 225, but 210 when I started O. I was very healthy….no diabetes, high blood pressure, blood tests good. Only weight-related problem was sleep apnea.
Now I weigh 145 with no effort. I weight-train twice a week and enjoy exercising. Insurance isn’t covering it. I’m not looking for a weight on a chart…I’ve stabilized here because it’s right for me.
You might say I’m a rich white woman who has bought society’s message to women on weight. You’re right…it’s just too instilled in me.
I am so relieved to not struggle any more. I don’t think about food very much at all. I eat what I feel like, but can’t overeat. I always wondered what it would feel like to react normally to food….and this feels like I’m finally normal.
It may be everywhere, but apparently NOT in local pharmacies for my Mom, with pre-diabetes, who still can't get it. She was correctly prescribed it and this mass marketing of it has made this and the other similar medications impossible to access. The downside with one of these "miracle cures" is that it becomes over prescribed and those for whom it is intended, can't actually get it. Incredibly frustrating and more evidence that our current healthcare system is complete trash.
it is disappointing to see YLE and Unbiased Science referring to OZEMPIC which is what is prescribed for T2 diabetes when the dosage for treatment of obesity is WEGOVY.
Hi! Appreciate the feedback. I've learned that scientific communication is an art between nuance and understandably. (Not to mention getting everything in under 1000 words is incredibly challenging). While we anchor the title and topic on Ozempic we explain that there a larger class of GLP's. I also think it's also important to recognize that off label prescriptions are happening at a high rate.
I appreciate your reply and would agree that some who cannot obtain Wegovy for obesity are turning to off label use of Ozempic - however it is incorrect to tie Ozempic to obesity since it is Wegovy that is approved for Obesity. While Ozempic has been used (incorrectly) by the media it does no one any good to continue to use this incorrectly and I would expect better and more careful treatment by both you and Unbiased Science. #wordsMatter
These drugs have some benefits, but we don't know the long-term risks. And if you have any of a number of issues like asthma or Afib you can't take these meds.
While anecdotal, a friend's uncle is slowly starving to death on this medication. The side effects and discomfort after eating are so bad he barely eats. But he won't stop taking the drug. That's not healthy. Nausea, vomiting, diarrhea, and constipation are common side effects experienced by almost e reyine whi takes these medications. Every time something like this comes out, I cringe because we are still just making 'magic pills' without addressing any of the root causes like horrible food and many other factors that never get addressed.
When will we learn that there is no magic pill and we need to better in so many other areas to end the obesity crisis we face. The average American diet is only 30% plant-based and highly processed (ultra-processed in most cases). Americans consume three times as much meat as any other developed nations (per person). Many of our agricultural practices are banned in the rest of the world. Were also the only country without a universal healthcare system. There's no real prevention in medicine here as a result because it's all about profit over people. If you're lucky enough to have insurance. It's still a nightmare to get care. And I have been uninsured for 18 years. If I ever got seriously injured or ill, I'd die. I can't afford treatment.
My brother is diabetic and asthmatic and has been taking an GLP 1 for several years, so I don't think asthma prohibits one from taking these drugs. He took it to get his A1C under control, the weight loss was just a bonus. Does that still make it a "magic pill"? These drugs are a useful tool in the battle against obesity. If they work, there is no virtue is doing it what some people believe to be "the hard way." In the end, it's going to take all of the changes- better food, the right medicine and a more supportive society.
And all indicators thus far say that people have to take these medications forever and we have no data on long-term effects. It's a crap shoot and it's dangerous. Thise who stop gain the weight back. It's not a solution, it's a band-aid at best and still doesn't fix that fact that we have the highest instances of preventable diseases like Type 2 diabetes in the developed world.
Unless you are an expert in this field, you can't say whether they are dangerous or not. My brother has been taking them for several years with no ill effects. It was the only thing that got his A1C to an acceptable level. You called it a "crap shoot and a band aid" -- well no, it's a cure and it's the only thing that worked to get it down in years. Go ahead an scowl and insist that he should have done it by eating less meat and less carbs and more plant based diet (and I'll throw in my own bias that everyone needs to move more) but the reality is THIS WORKED and it probably added several years to his life. Now he's walking more and might feel well enough to tackle the food end of things. I find it interesting you bemoan our high rates of T2D, then decide with very little evidence that one of the best possible preventative medicines to come along is in years is crap. I understand "waiting for more data." (That's kind of my stance, I wouldn't take it for weight loss alone right now. I might if I was pre-diabetic, which fortunately I am not.) I don't understand deciding upfront that they are dangerous and don't work.
The judgement coming from people who have never tried the meds is astounding on this thread. Change obesity to anxiety/depression and GLPs to SSRIs- no one would ever question someone using SSRIs now but in the 90s this was EXACTLY the type of conversations that were being had and sadly it prevents a lot of people who can greatly benefit from them from trying.
Very good point, Katie. It also galls me that people who have no expertise just lots of opinions feel free to push that as if it is equivalent to science. I have only my brother's (very positive) experience to go on, so I wait and watch the research. I do feel like we are FINALLY on the right track.
I am on Medicare which still does not cover Ozempic or Wegovy for weight loss. I do not have any other health issues (diabetes or cardiac issues) that would cause Medicare to cover the cost. However, there is a local compounding pharmacy which will prepare semaglutide and my cost per month is $160. It’s an oral prescription taken once daily and administered under the tongue. I just started my second week (.25 dose the first week; .50 the second; increased to. 1.0 the third and thereafter if tolerated). So far I have experienced no side effects and have lost five pounds.
I agree with Deb's entry. The advent of GLP-1's to control weight is a giant benefit for the pharmaceutical industry and removes any need for countering our nation's ridiculous approach to public health. The fast food industry, the beverage industry, the snack industry, and the overall cultural denial of the impact of obesity on health are abetted by the strident voices against "fat-shaming." I agree that people should not be shamed for obesity...or for much of anything else except bad behavior, and then only with the intention of creating change for the better. And we can still face the fact that obesity is a major factor in multiple diseases. The cost of these drugs is unsupportable and does indeed contribute to socioeconomic splitting. Best of all, we have no idea of the long-term effects of regular dosing for years. Poverty, ACE's, and the other social determinants of health should be our chief focus in all areas. George Carlin was unfortunately correct about our corporate masters, who have been well-served by the dismantling of the public health system, and by the abandonment of any discussion of the roots of illness.
I gained 80 lbs between my pregnancies and could not lose more than 30 of it with diet and exercise over the 5 years I worked hard at it. I was devoting HOURS a day to thinking about food and my diet and exercising only to gain weight back when I allowed myself to focus on other priorities like my career or personal interests. I started GLPs 9 months ago and am back to my pre-pregnancy weight. I’ve also been lucky enough to have had my migraine and fibromyalgia symptoms just disappear. I’m no longer drinking more than 1 glass of wine here or there and overall feel like I finally have control on my life and can focus my mental and physical energy on things other than my health. This is a huge win for me.
I personally am very tired of hearing naysayers who have never tried the drugs or do not have obesity express unsolicited opinions about them. Much like it was en vogue to disparage the first round of SSRIs in the 90s, it seems like it’s hilarious for comedians to make fun of GLPs and therefore every arm chair health expert is allowed to have an opinion about the medical decisions patients have made in consultation with their physicians. From a patient to all those questioning this medicine: we don’t care what you think. To those siting the body positivity movement as a reason to not promote these drugs: my knees respectfully disagree with your rationale. All bodies are indeed beautiful, but not all bodies are healthy and those who are obese should have the ability to choose a medicine that helps them lose weight and feel better. The only person whose opinions matter in this regard are the patients and their physicians.
American never had as much obesity as it has now. How about addressing why this is happening? If you look at the evidenced based reasons for why American now has so much obesity, maybe you will find ways for people to avoid becoming obese without resorting to drugs with negative side effects. People take these drugs because it's' easy. There have been other appetite suppressant drugs, this is not the first. But there are also plenty of other ways to loose weight that can be done, and are done every day by people to reduce weight.
You could also discuss another side-effect. Ozempic face. That happens with this kind of weight loss drug.
If diets work, why isn't everyone thin? Weird correlation seems that the more diets that are out there, the more people are overweight. Maybe dieting doesn't work!?
Once again a judgmental comment from someone not taking the drug. Have you had 100 lbs to lose? How did you do it? Outside of a massive revolution, the US food system is not going to Change overnight. People with obesity who’ve tried everything to lose weight should not be denied meds that work to extend their live bc of a food system that doesn’t prioritize health.
What's judgmental about my comment? The U.S. food system is not going to change, but most people still have choices about what they eat. I never said these drugs should be denied to anybody. So there is actual evidence these drugs extend life? Or does simply losing weight extend life?
Let me put this another way, would you post a comment under a discussion of a groundbreaking treatment for asthma that we really should be devoting our efforts to improving air quality and other environmental risk factors for asthma vs creating new expensive drugs? No of course not bc even though we know air pollution plays a huge role in triggering and exacerbating asthma symptoms, it’s understood that asthma is a potentially deadly disease and we shouldn’t be denying the people treatment they need for a better quality of life. Somehow it’s okay to deny patients with obesity the same respect.
(Note: Thoughts are my own.) As a long-term subscriber, I appreciate this post on a high-interest topic. A couple notes. 1. Zepbound (tirzepatide) is also FDA-approved in the US as adjunct to reduced-calorie diet and increased physical activity in adults with overweight or obesity. 2. Both Mounjaro and Zepbound contain the active ingredient, tirzepatide, which actually has dual agonism of GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptors. Similar drug as the rest, but in fact, different.
What I am seeing in the evidence (presented here and elsewhere) is that, in non-diabetic individuals, these drugs are effective for weight loss, with some potential for protective effects on the heart. Weight loss, in and of itself, will not save billions of dollars in healthcare costs. I would argue that these drugs are reaffirming weight-bias and stigma by essentially celebrating "getting rid of fat people" as opposed to shifting our focus to health behaviors and the social determinants of health, which are actually at the root of the health outcomes that are much, much too often attributed to "obesity" or body size. I would LOVE to see you dive in to the literature around weight-inclusivity and whether obesity is, in fact, a disease in and of itself or if we should be shifting our focus (and money) from trying to change a number on a scale towards encouraging healthy relationships with food, moving our bodies for pleasure, and creating environments in which all people have access to health promoting foods and environments, rather than weight loss drugs.
Wegovy is the only one thar seems to offer any cardiovascular benefits.
Yes, thanks for this clarification. Hopefully my overall point was clear - that what we know at this point is that (in non diabetic individuals) these drugs help people lose weight, but do not significantly improve health outcomes. But as a culture we subscribe to the (false) weight = health paradigm. This paradigm is incredibly harmful as it contributes to weight cycling, bias, weight based bullying and eating disorder development. Celebrating these drugs exacerbates all of this.
Please consider a follow up where you address the misconception that weight equates to health.
YES. My thoughts exactly.
Having read the article, I didn't get the message that "weight equates to health." Obesity is a risk factor in many diseases and reducing it is a worthwhile goal, generally speaking. That doesn't mean that simply reducing your weight makes you healthy all by itself, of course. It has to be part of an overall change in one's approach to food.
That said, I don't doubt that companies in the weight loss biz are pushing that misconception.
So you think that obese people are just as healthy as non-obese people in general?
Hi Doug. Actually, in general yes. Health has more to do with movement and nutrition than it does with weight. I encourage you to explore the research behind Health at Every Size (HAES). The Maintenance Phase podcast also has some great research-based information on this. I encourage you to do your due diligence in exploring their sources and biases. Furthermore, an average weight loss of 15lbs (or even 10%) will hardly impact the "obesity" epidemic since most people who fall into that category would still be considered obese after the weight loss (the faultiness of using BMI to measure health is a whole deep dive on it's own!).
THanks for your comment. Take 2 groups of people who both have the same average movement and nutrition for Americans. One obese and one group non obese. So you are saying the obese group will be just as healthy as the non-obese group? What about longevity? The obese group lives just as long as the non-obese group?
What is the average weight loss for obese people who use Ozempic who stay in the Obese category? Do they become more healthy despite the risk of negative side effects?
Hi Doug. Excellent questions. I know there is research out there on this stuff but I'm not an expert, and this why I'm hopeful this topic could be a worthwhile follow-up given it's propensity for misconceptions and misinterpretations of data.
To give you a super personal example, which understandably is just a single data point, my 31yo sister passed away about a year and a half ago after a short bout of really aggressive pneumonia. Her heart stopped when they tried to intubate her to help raise her oxygen levels. Because she was otherwise healthy, an autopsy was done. Even though her heart gave out due to the incredible stress it was under, the cause of death was listed as obesity. The coroner personally called us to tell us that reporting guidelines required her to list that as the cause of death but that she didn't believe her weight was the contributing factor - that the cause of death was obviously pneumonia.
Generally speaking, when it comes to medical issues, I always ask "what would you do/how would you treat this condition if obesity was not an option on the table?"
Your sister's death and the reporting guidelines about the cause reminds me of COVID. Hospitals reported a lot of COVID deaths that were not actually due to COVID because they got a financial reward for doing that. A person could get injuries from a car accident or gunshots, taken to the hospital and die for those reasons. But if the hospital found out they had COVID, then COVID caused the death. But when it came to somebody dying from a COVID shot, then the opposite applied. Anything but the COVID shot caused the death. Or there was no cause determined.
Just an FYI: Hospitals got a financial bonus for treating living Medicare and Medicaid patients. If they weren’t diagnosed and treated for Covid as a hospitalized patient, no bonus. Also it didn’t apply to private insurance.
Don’t obese people die at disproportionately higher rates from Covid?
IF they had things like high blood pressure and diabetes that often go along with obesity. I don't know if simply having a high BMI was a risk. (of course often folks with high BMI might have those things and not be diagnosed so there is that confounded any statistics too.
Thanks for sharing this information. My 80 year old diabetic mom was just prescribed Ozempic. She's one person I would consider it for. She's a very good eater, watches her carbs, eats well rounded but just can't get her A1C down or lose any weight. She also has heart disease. So she's a good candidate, but we have many concerns based on the stories we've heard. So I appreciate hearing your point of view.
I've also found myself a bit amused by the topic that last couple years. Here we have people jumping on board left and right for the "magic" weight loss pill. Without little information and science behind long term risks. Yet, when it came to covid vaccines or just the virus itself, everyone was a scientist and major skeptic! but for fast weight loss, so many take the leap without questioning the science. (insert eye roll lol)
My concerns with these drugs is folks thinking that weight loss is all you need for a healthy life. My mom being a prime example. She has been battling ovarian cancer and was already obese when she started treatment. Her doc ended up putting her on Ozempic and she experienced the weight loss a lot of folks experience. However, given her cancer treatments and already having been obese, she is still weak and has fallen often. She needs to exercise, too, because she needs that strength to keep her from falling and to help extend her life. Do you happen to know if part of the conversations docs have around prescribing Ozempic include discussions about working out and how it's not just weight loss that makes you healthy?
Also- just as an aside because this is part of the research I do as a PhD student looking at the commercial determinants of health- I'd be shocked if semaglutide ends up off patent any time soon. Many times these companies find a way to keep it on patent in order to continue that blockbuster status using strategies such as patent thickets or evergreening. I'd be curious to know, too, whether the prices of Wegovy, Ozempic, and Rybelus are substantially different from each other since they are all produced by Novo Nordisk. Different brands, same drug. It's very strategic and intentional.
Average is 10 years before we see generic meds of any kind. Generics only have to be 80% similar. Some work better for some people than others because of the other 20% that's different and we don't control what generics we can get. That's also a problem.
My understanding is that the 80% thing is a myth and it's more to do with the statistical requirements of how to show bioequivalence (the 10% confidence interval of the ratio must lie entirely between 80% and 125%, and all measurements must also be in that range). If a generic produced only 80% of blood levels of the drug, it's unlikely that all measurements and its 10% confidence interval would be entirely to the right of 80%. See this document, especially slides 18-19 (https://www.fda.gov/media/156312/download), or this post https://www.pharmacytimes.com/view/debunking-a-common-pharmacy-myth-the-80-125-bioequivalence-rule
I've been on Mounjaro since April of 2023. I've lost over 45 lbs. and dropped below diabetic level in my blood sugars. I no longer even count calories or steps; I simply plan sensible meals and exercise daily. At first, the weight loss was startling, but now it has slowed down to a more realistic 2–4 lbs. a week. In short, Mounjaro has transformed my life.
The first week of the injection I had pretty serious side effects, including one evening where I basically just stayed in the bathroom. I was so desperate to lose weight, I asked myself how long I could stand this if I really wanted to lose weight — I decided I could hack this for three weeks before calling my doctor. Thankfully, the side effects completely disappeared when I got to week 2.
Now, the only time I have a reaction is if I overeat; I don't get sick, but it can feel like a huge rock in your stomach overnight, sometimes for a day, and you don't want to eat anything. It has taught me portion control, and I never have seconds.
When you're seriously overweight, not only are you dealing with the health consequences, but also the sense that you are a failure. The worst part was feeling I was letting my kids down by shortening my life. Nothing like guilt to make a bad situation worse. I had honestly almost given up on myself. When I had my regular exam, I was in tears as I thanked my doctor.
I'm in my 60s, and I still have a long way to go. But now, I have one thing I've been missing since my 30s: Hope.
Oh, I guess I should mention I'm very lucky my insurance covers most of the cost. I only have a $60 co-pay every 90 days.
Am surprised there was no mention of the more severe possible side-effects like gastroparesis and pancreatitis. While rare, it is my understanding there is an association.
My mom already has gastroparesis which required her to be intubated for multiple procedures before she got on meds for it. She's not a candidate for these meds. A lot of people aren't for similar reasons.
This is the side effect I keep hearing about that scares me long term for people
After being put on a diet (unneeded) at age 12, and being told that my value was based on looking like Audrey Hepburn…. Unsurprisingly I yo-yo dieted all my life. My relationship with food has been very distorted, and a source of shame my whole life. I feel bad that I put my family, including 2 daughters, through that.
Enter Ozempic at age 69. Why? Because I wasn’t going to give up….it was a life hurdle that I was going to fix if I could. How overweight was I? 5 foot 6 high of 225, but 210 when I started O. I was very healthy….no diabetes, high blood pressure, blood tests good. Only weight-related problem was sleep apnea.
Now I weigh 145 with no effort. I weight-train twice a week and enjoy exercising. Insurance isn’t covering it. I’m not looking for a weight on a chart…I’ve stabilized here because it’s right for me.
You might say I’m a rich white woman who has bought society’s message to women on weight. You’re right…it’s just too instilled in me.
I am so relieved to not struggle any more. I don’t think about food very much at all. I eat what I feel like, but can’t overeat. I always wondered what it would feel like to react normally to food….and this feels like I’m finally normal.
It may be everywhere, but apparently NOT in local pharmacies for my Mom, with pre-diabetes, who still can't get it. She was correctly prescribed it and this mass marketing of it has made this and the other similar medications impossible to access. The downside with one of these "miracle cures" is that it becomes over prescribed and those for whom it is intended, can't actually get it. Incredibly frustrating and more evidence that our current healthcare system is complete trash.
it is disappointing to see YLE and Unbiased Science referring to OZEMPIC which is what is prescribed for T2 diabetes when the dosage for treatment of obesity is WEGOVY.
Hi! Appreciate the feedback. I've learned that scientific communication is an art between nuance and understandably. (Not to mention getting everything in under 1000 words is incredibly challenging). While we anchor the title and topic on Ozempic we explain that there a larger class of GLP's. I also think it's also important to recognize that off label prescriptions are happening at a high rate.
I appreciate your reply and would agree that some who cannot obtain Wegovy for obesity are turning to off label use of Ozempic - however it is incorrect to tie Ozempic to obesity since it is Wegovy that is approved for Obesity. While Ozempic has been used (incorrectly) by the media it does no one any good to continue to use this incorrectly and I would expect better and more careful treatment by both you and Unbiased Science. #wordsMatter
These drugs have some benefits, but we don't know the long-term risks. And if you have any of a number of issues like asthma or Afib you can't take these meds.
While anecdotal, a friend's uncle is slowly starving to death on this medication. The side effects and discomfort after eating are so bad he barely eats. But he won't stop taking the drug. That's not healthy. Nausea, vomiting, diarrhea, and constipation are common side effects experienced by almost e reyine whi takes these medications. Every time something like this comes out, I cringe because we are still just making 'magic pills' without addressing any of the root causes like horrible food and many other factors that never get addressed.
When will we learn that there is no magic pill and we need to better in so many other areas to end the obesity crisis we face. The average American diet is only 30% plant-based and highly processed (ultra-processed in most cases). Americans consume three times as much meat as any other developed nations (per person). Many of our agricultural practices are banned in the rest of the world. Were also the only country without a universal healthcare system. There's no real prevention in medicine here as a result because it's all about profit over people. If you're lucky enough to have insurance. It's still a nightmare to get care. And I have been uninsured for 18 years. If I ever got seriously injured or ill, I'd die. I can't afford treatment.
My brother is diabetic and asthmatic and has been taking an GLP 1 for several years, so I don't think asthma prohibits one from taking these drugs. He took it to get his A1C under control, the weight loss was just a bonus. Does that still make it a "magic pill"? These drugs are a useful tool in the battle against obesity. If they work, there is no virtue is doing it what some people believe to be "the hard way." In the end, it's going to take all of the changes- better food, the right medicine and a more supportive society.
And all indicators thus far say that people have to take these medications forever and we have no data on long-term effects. It's a crap shoot and it's dangerous. Thise who stop gain the weight back. It's not a solution, it's a band-aid at best and still doesn't fix that fact that we have the highest instances of preventable diseases like Type 2 diabetes in the developed world.
Unless you are an expert in this field, you can't say whether they are dangerous or not. My brother has been taking them for several years with no ill effects. It was the only thing that got his A1C to an acceptable level. You called it a "crap shoot and a band aid" -- well no, it's a cure and it's the only thing that worked to get it down in years. Go ahead an scowl and insist that he should have done it by eating less meat and less carbs and more plant based diet (and I'll throw in my own bias that everyone needs to move more) but the reality is THIS WORKED and it probably added several years to his life. Now he's walking more and might feel well enough to tackle the food end of things. I find it interesting you bemoan our high rates of T2D, then decide with very little evidence that one of the best possible preventative medicines to come along is in years is crap. I understand "waiting for more data." (That's kind of my stance, I wouldn't take it for weight loss alone right now. I might if I was pre-diabetic, which fortunately I am not.) I don't understand deciding upfront that they are dangerous and don't work.
The judgement coming from people who have never tried the meds is astounding on this thread. Change obesity to anxiety/depression and GLPs to SSRIs- no one would ever question someone using SSRIs now but in the 90s this was EXACTLY the type of conversations that were being had and sadly it prevents a lot of people who can greatly benefit from them from trying.
Very good point, Katie. It also galls me that people who have no expertise just lots of opinions feel free to push that as if it is equivalent to science. I have only my brother's (very positive) experience to go on, so I wait and watch the research. I do feel like we are FINALLY on the right track.
I am on Medicare which still does not cover Ozempic or Wegovy for weight loss. I do not have any other health issues (diabetes or cardiac issues) that would cause Medicare to cover the cost. However, there is a local compounding pharmacy which will prepare semaglutide and my cost per month is $160. It’s an oral prescription taken once daily and administered under the tongue. I just started my second week (.25 dose the first week; .50 the second; increased to. 1.0 the third and thereafter if tolerated). So far I have experienced no side effects and have lost five pounds.
I am in the same situation with Medicare and have been wondering about compounding.
There are facebook and reddit groups for people who buy compounded semaglutide and tirzepatide. You can get leads on reliable pharmacies there.
I agree with Deb's entry. The advent of GLP-1's to control weight is a giant benefit for the pharmaceutical industry and removes any need for countering our nation's ridiculous approach to public health. The fast food industry, the beverage industry, the snack industry, and the overall cultural denial of the impact of obesity on health are abetted by the strident voices against "fat-shaming." I agree that people should not be shamed for obesity...or for much of anything else except bad behavior, and then only with the intention of creating change for the better. And we can still face the fact that obesity is a major factor in multiple diseases. The cost of these drugs is unsupportable and does indeed contribute to socioeconomic splitting. Best of all, we have no idea of the long-term effects of regular dosing for years. Poverty, ACE's, and the other social determinants of health should be our chief focus in all areas. George Carlin was unfortunately correct about our corporate masters, who have been well-served by the dismantling of the public health system, and by the abandonment of any discussion of the roots of illness.
I gained 80 lbs between my pregnancies and could not lose more than 30 of it with diet and exercise over the 5 years I worked hard at it. I was devoting HOURS a day to thinking about food and my diet and exercising only to gain weight back when I allowed myself to focus on other priorities like my career or personal interests. I started GLPs 9 months ago and am back to my pre-pregnancy weight. I’ve also been lucky enough to have had my migraine and fibromyalgia symptoms just disappear. I’m no longer drinking more than 1 glass of wine here or there and overall feel like I finally have control on my life and can focus my mental and physical energy on things other than my health. This is a huge win for me.
I personally am very tired of hearing naysayers who have never tried the drugs or do not have obesity express unsolicited opinions about them. Much like it was en vogue to disparage the first round of SSRIs in the 90s, it seems like it’s hilarious for comedians to make fun of GLPs and therefore every arm chair health expert is allowed to have an opinion about the medical decisions patients have made in consultation with their physicians. From a patient to all those questioning this medicine: we don’t care what you think. To those siting the body positivity movement as a reason to not promote these drugs: my knees respectfully disagree with your rationale. All bodies are indeed beautiful, but not all bodies are healthy and those who are obese should have the ability to choose a medicine that helps them lose weight and feel better. The only person whose opinions matter in this regard are the patients and their physicians.
Am I just cynical, or does this read like an advertisement?
American never had as much obesity as it has now. How about addressing why this is happening? If you look at the evidenced based reasons for why American now has so much obesity, maybe you will find ways for people to avoid becoming obese without resorting to drugs with negative side effects. People take these drugs because it's' easy. There have been other appetite suppressant drugs, this is not the first. But there are also plenty of other ways to loose weight that can be done, and are done every day by people to reduce weight.
You could also discuss another side-effect. Ozempic face. That happens with this kind of weight loss drug.
If diets work, why isn't everyone thin? Weird correlation seems that the more diets that are out there, the more people are overweight. Maybe dieting doesn't work!?
Once again a judgmental comment from someone not taking the drug. Have you had 100 lbs to lose? How did you do it? Outside of a massive revolution, the US food system is not going to Change overnight. People with obesity who’ve tried everything to lose weight should not be denied meds that work to extend their live bc of a food system that doesn’t prioritize health.
What's judgmental about my comment? The U.S. food system is not going to change, but most people still have choices about what they eat. I never said these drugs should be denied to anybody. So there is actual evidence these drugs extend life? Or does simply losing weight extend life?
Let me put this another way, would you post a comment under a discussion of a groundbreaking treatment for asthma that we really should be devoting our efforts to improving air quality and other environmental risk factors for asthma vs creating new expensive drugs? No of course not bc even though we know air pollution plays a huge role in triggering and exacerbating asthma symptoms, it’s understood that asthma is a potentially deadly disease and we shouldn’t be denying the people treatment they need for a better quality of life. Somehow it’s okay to deny patients with obesity the same respect.
(Note: Thoughts are my own.) As a long-term subscriber, I appreciate this post on a high-interest topic. A couple notes. 1. Zepbound (tirzepatide) is also FDA-approved in the US as adjunct to reduced-calorie diet and increased physical activity in adults with overweight or obesity. 2. Both Mounjaro and Zepbound contain the active ingredient, tirzepatide, which actually has dual agonism of GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptors. Similar drug as the rest, but in fact, different.