• Welcome to the new Internet Infidels Discussion Board, formerly Talk Freethought.

Weight-Loss Drugs?

lpetrich

Contributor
Joined
Jul 27, 2000
Messages
25,600
Location
Eugene, OR
Gender
Male
Basic Beliefs
Atheist
What Is Ozempic and Why Is It Getting So Much Attention? - The New York Times - "More people are turning to a diabetes medication to induce weight loss — but experts say it’s not a miracle drug."
The Food and Drug Administration first approved the injectable medication for treating diabetes in 2017; the agency approved a drug with a higher dose of the active ingredient in Ozempic, called semaglutide, to treat obesity in 2021, under the brand name Wegovy.

... Demand is mounting for Mounjaro, a diabetes medication, as Eli Lilly, the company that manufactures it, touts dramatic weight loss results for people with obesity and diabetes in trials using tirzepatide, the active ingredient in Mounjaro. Other drugs that use a similar mechanism to Wegovy and Ozempic are being developed.
How do these drugs work?
Semaglutide lowers blood sugar levels and regulates insulin, which is crucial for people with Type 2 diabetes. The drug also imitates a hormone called glucagon-like peptide-1 that we naturally produce in our intestines, limiting appetite by signaling to our bodies that we feel full and prompting our stomachs to empty more slowly. As a result, people with obesity and accompanying health concerns have lost weight while taking it. People feel fuller faster, said Dr. Janice Jin Hwang, chief of the division of endocrinology and metabolism at the University of North Carolina School of Medicine. For patients taking the medication, “foods that used to be really exciting to them are no longer exciting,” she said. The medication has not been significantly studied in people without diabetes or excess weight.
 
New Obesity Drugs Come With a Side Effect of Shaming - The New York Times - "Wegovy and other drugs expose a social tension between a quest to medicate illness and a stigmatizing belief that obese people lack sufficient willpower to lose weight."
Wegovy and drugs like it make this “a very exciting time in the field,” said Dr. Susan Yanovski, co-director of the office of obesity research at the National Institute of Diabetes and Digestive and Kidney Diseases.

...
But there is still the taint.

“There’s a moral component to it,” Dr. Yanovski said. “People really believe that people with obesity just need to summon their willpower and they think that taking a medicine is the easy way out.”

Unlike other chronic diseases, obesity is on full public display, Dr. Yanovski said. “No one looks at you and knows you have high cholesterol or high blood pressure,” she said.

Obesity, she added, “is one of the most stigmatized conditions out there.”
Use for weight loss has led to huge demand for these drugs, demand that has caused shortages.
The drugs have arrived at a time when researchers have documented the risks of obesity and the futility of prescribing only diet and exercise as a treatment. Decades of studies have consistently shown that very few people can lose excess weight and keep it off with lifestyle changes alone.

People with obesity are at risk for a variety of serious medical conditions, including diabetes, hypertension, high cholesterol, sleep apnea and nonalcoholic fatty liver disease, a leading reason for liver transplants in the United States.

Losing weight can make some of these complications vanish.

Yet the belief persists — fed by diet gurus, influencers and an industry selling supplements and diet plans — that if people really really tried, they could shed pounds.

So those who take a drug like Wegovy often end up in uncomfortable situations that are influenced by the common view that obesity is a lifestyle choice.
 
What happened to someone who lost a lot of weight.
But she discovered an unintended social consequence to weight loss, as many longtime friends fell away.

“Only my genuine friends are left and that’s a very small number,” Ms. Ewing said.

Obesity medicine specialists say they are not surprised — they see the same thing after people lose weight with bariatric surgery.

Relationships shift because obesity is such a defining condition. People of normal weight may feel superior to a friend with obesity and that helps define a relationship — until the friend loses weight. Other friends who themselves have obesity may use the condition as a bonding factor in the relationship. Now that is gone.
 
From reporting one version inhibits appetite leading to eating less and weight loss.

The market is exploding. Kids are being given the drugs.
 
When covered by insurance. Other than that, it's a thousand dollars a month which has the added side effect of really cutting into the grocery budget.

I don't understand the "shaming" aspect of it. Why does anyone need to know you're taking Wegovy in the first place? Secondly, if a friendship is defined mainly by a feeling of superiority over a fat friend, is that not a friendship better lost? This all seems pretty obvious to me.
 
My FIL was noting that he was trying to lose weight (he's been overweight for a LONG time) after the diabetes diagnosis, but it was slow going. He noted that the weight loss with the Ozempic was irrationally successful for him. It isn't pleasant for a couple days after the shot, but otherwise, it is working... ie the side effect of the drug, it also does help with the blood sugar for him as well (the drugs actual purpose).
 
When covered by insurance. Other than that, it's a thousand dollars a month which has the added side effect of really cutting into the grocery budget.

I don't understand the "shaming" aspect of it. Why does anyone need to know you're taking Wegovy in the first place? Secondly, if a friendship is defined mainly by a feeling of superiority over a fat friend, is that not a friendship better lost? This all seems pretty obvious to me.
That struck me as well. I guess I could see some catty school girls acting that way. But grown-ass adults? :picardfacepalm:
 
Most adults behave socially like a bunch of teens, with all the superficiality and cattiness that comes from that.

Their circles of friends are more static and stable, but no less weak, and are generally held together by a terror of being cast out from the clique, to be alone and friendless forever.

Of course, that's a foolish and unlikely fear, and even if it happened, would probably be better than being stuck with "friends" who are increasingly divergent from you in attitudes and opinions, and who don't even like you or care about you, other than as a bulwark against their own similar fears.

But that's how it is. We're a social species, and so we fear the rejection of our social groups, however irrational, or even harmful, that fear might be.
 
Where I live, most people are obese. I have many obese friends and I have the opposite problem. I have a hard time gaining weight. My daughter in law is very obese too. I don't understand the fat shaming thing either. I do know that severe obesity has many risk factors, including diabetes, hypertension, heart disease and some types of cancer, so my heart goes out to those who suffer with this medical condition. I worry about my obese friends. One was diagnosed with type II diabetes earlier this year. She is 30 years younger then me. She's done a good job of changing some of her habits, but I know how easy it is for people to go back to their old habits. I have another obese friend who I think of as a sister. She has taken some sort of weight loss drug, an older one. I don't think it's helped her. She has had some health problems, including hypertension. She is 20 years younger than me. Another obese friend has suffered from RA since she was 17. We met about 10 years ago. She is dirt poor and her dear little granddaughter is also obese. I've never met a sweeter child.

Obesity is a disease and should be thought like that. It's mean and ignorant to fat shame. Don't get me wrong. I've wondered why a very obese person might go to a pizza buffet and eat enough for 3 or 4 people, but I also understand that food addiction is a thing and we are all different when it comes to that, so I would never not like someone or condemn such an individual. It's just sometimes hard to understand someone who is so different from yourself. I was obsessed with not gaining too much weight since I was a teenager growing up just outside of New York City, during the days when it was a sin not to be thin. Like my mom, I was slightly overweight in middle age and then freaked out and changed my habits. My mom was exactly the same way. I think there is a genetic component to all of this.

One of my sisters had successful weight loss surgery about 10 years ago and has kept off all of the weight, but to be honest, I sometimes think she feels a little superior to those who haven't been able to keep off the weight. It's supposedly rare to be able to keep off the weight after most types of weight loss surgery. My other sister successfully lost over 100 lbs, via Weight Watchers, but sadly, she developed kidney cancer about 4 years ago, which can sometimes be due to obesity. Now, she is on hospice. Our paternal grandmother was obese, although not to the extent some people are these days. I guess my sisters probably had some of her genetic tendencies in them.

I am hoping that some of these new drugs will be successful for those who need and want help losing weight. I don't think it's a good idea to normalize obesity since it is a risk factor for so many serious diseases, and puts a big strain on our healthcare system. Plus, it's now considered a diagnosis with its own ICD-10 medical code. Some doctors fat shame and that is disgusting. One did that to my sister once many years ago. Obesity is a disease and I've read recently that some people who don't eat much, can suffer from obesity too. I do wonder if that's because of gaining and losing weight repeatedly. That might impact one's metabolism to the point where they can't eat much.

I read an article yesterday that gave evidence that obesity is often due to eating too many overly processed foods, which according to the article causes people to eat a lot more than they should to maintain a healthy weight. I eat too many overly processed foods, but I don't have that problem so as with most things, we are all different when it comes to this issue. Still, I eat more than most people my size but I don't over eat and until recently, I exercised a lot. Obese people can benefit from exercise even if they don't lose weight. I exercised with quite a few obese people and was always happy to have them join our group.

Anyway, I do hope we can find effective, safe treatment for those who want help. I recently read that one of the drug companies had to stop the development of a weight loss drug as early trials showed too much of a risk of liver damage. When I worked as an RN caring for older adults, only a few were obese. Sadly, it often shortens life expectancy, although not for everyone. My husband's sweet grandmother was obese and she lived to be about 94. She ate lots of nuts and had a positive outlook.

Maybe nuts would help instead of soft drinks. Many of the young women I worked with were obese. They asked me how to lose weight. My first question was, "How many soft drinks do you have a day". It was sometimes as much as 2 liters or more. One died in her 40s of heart disease. It's a tragic disease that has become an epidemic, especially in the American South. Those are some of my thoughts about a disease that has impacted many of the people I love.
 
When covered by insurance. Other than that, it's a thousand dollars a month which has the added side effect of really cutting into the grocery budget.

I don't understand the "shaming" aspect of it. Why does anyone need to know you're taking Wegovy in the first place? Secondly, if a friendship is defined mainly by a feeling of superiority over a fat friend, is that not a friendship better lost? This all seems pretty obvious to me.
That struck me as well. I guess I could see some catty school girls acting that way. But grown-ass adults? :picardfacepalm:
You’re not wrong but I’ve read about people reacting negatively towards those taking weight loss drugs for ‘taking the easy way out.’

There is a perception that overweight people are lazy and/or self indulgent and lack willpower. If they just tried harder, they’d lose the extra weight—easy. Or maybe not easy but not that hard.

If only that were true!
 
Not much different that mental health medication. People get self-conscious about needing to take medication as being some sort of weakness.
 
I'm "gifting" an article about some promising pill forms of the newer weight loss drugs. You can read the entire article is interested.

https://www.nytimes.com/2023/06/25/...8r10jkpcBiQuOarSb7CeklUZCnF-7p&smid=url-share

The next iteration of Ozempic and Wegovy — the much-discussed, hard-to-obtain injectable medications known for their ability to induce weight loss — may come in pill form.

Researchers presented data in two studies on Sunday at the American Diabetes Association Scientific Sessions conference, one of which showed that 50 milligrams of semaglutide — the active compound in Ozempic and Wegovy — taken orally each day is roughly as effective as weekly Wegovy shots in reducing weight in people who are overweight or obese. Wegovy injections contain 2.4 milligrams of semaglutide.

That trial, also published Sunday in The Lancet, tracked 667 people over 68 weeks. Eighty-five percent of those who took semaglutide lost at least 5 percent of their body weight over the course of the study, compared to just 26 percent of those who received the placebo. Those who took semaglutide lost, on average, around 15 percent of their body weight — roughly six times that of the placebo group.

A separate study, also presented Sunday and published in The Lancet, focused on oral semaglutide for people with Type 2 diabetes. Just over 1,600 participants were divided into three groups and given 14-milligram, 25-milligram or 50-milligram daily doses. Those who took the 25- and 50-milligram doses lost more weight, and had greater reductions in blood sugar, than those who took the lowest dose.

Hopefully, there will be new ways of helping those who suffer from obesity that are safe and effective. People who insult people who are obese are ignorant and mean, including insulting them because they are seeking help. Come to think of it, my sister who had weight loss surgery told me that some people online said that those who had weight loss surgery were taking the easy way out. Different things work for different people. That's true of just about everything when it comes to health. I just hope that these new drugs will be covered by insurance and also be available for those who lack insurance or good insurance.
 
some people online said that those who had weight loss surgery were taking the easy way out.
Taking the easy way out is a major virtue.

What kind of idiot would deliberately choose to do something difficult in a way that is harder than it needs to be?

I don't think that surgery is ever a particularly easy option; But if it's the least difficult for a given individual's situation, then to eschew it for something more difficult would be truly perverse.
 
I'm "gifting" an article about some promising pill forms of the newer weight loss drugs. You can read the entire article is interested.

https://www.nytimes.com/2023/06/25/...8r10jkpcBiQuOarSb7CeklUZCnF-7p&smid=url-share
I’m curious if thr post-weight-loss phase, or maintenance phase, is easier, harder or the same as other forms of weight loss, including basic calorie-reduction from diets.
I've wondered that myself, but I don't think we have the answers yet.I don't know enough about the weight loss drugs to know if you have to take them for the rest of your life or just while you're losing weight. For the most part, they were originally for diabetics. It's not something I've read very much about yet, although living in an area, where obesity often looks like the norm, and having had two very obese sisters, and an obese grandmother, has made me very interested in weight related issues.

The following is unrelated to the drugs, so excuse me for that. Unless you are as interested in obesity and its causes like I am, skip the rest of my long post.


I've mentioned that one of my sisters had weight loss surgery, which was called "the sleeve". If you're not familiar with it, they remove most of your stomach, leaving just a narrow part of it that resembles a sleeve. For about the first year, you lose your appetite as the enzyme that causes us to be hungry isn't secreted, but then it returns. She lost about 100 lbs and kept it off, due to her strong determination never to be overweight again. But, imo, her diet isn't very healthy. She is supposed to eat a very high amount of protein, so she almost lives on yogurt, since she prefers it to most meat. She rarely eats any fiber or vegetables so she's usually very constipated.

I don't know if most people who've had that surgery eat like her. She has told me that most people gain all of the weight back, once they regain their appetite. Chris Christie had that belly band surgery, if you recall, and he gained all of his weight back. I have known two women who had the more complicated, risky, colon bypass surgery, where I think they remove a large part of your colon, so a lot of calories aren't absorbed. The two women I know or knew that had that done, kept the weight off. One of them was a former neighbor who had the surgery over 40 years ago. She went from 400 lbs. to 200 lb.s She was still rather overweight but she was thrilled to be less overweight than previously. The other one is a niece by marriage.

My mother and I were both slightly overweight in middle age and we both lost the weight and remained thin in old age. I believe that's at least partly due to genetics. She also had a very thin father, who ate very little but did have a problem with ETOH, which neither of us have hd. She used something similar to Weight Watchers to lose the weight. I simply counted calories and increased my activity by walking several miles a few times a week. I think that might have been a combination of genetics and environmental influences as growing up in the NYC area put a lot of pressure on women to be thin. Nobody on my mom's side of the family was ever overweight.


My other sister who lost over 100 lbs on Weight Watchers, gave up after she was diagnosed with cancer. She cut me out of her life shortly before that, but according to my other sister, she gained back most of the weight. I now worry about my estranged niece who looked to be about 400 lbs the last time I saw her. I know that when her mother used to pack her lunch, she put lots of unhealthy carbs in it. Prior to her 20s, both of these family members were thin. Was the weight gain partly genetic from our late paternal grandmother and partly due to eating too much overly processed foods?

I just like trying to figure out what has changed to make obesity an epidemic when it was rare during my childhood. I only remember two overweight students in school. One might have been 10 lbs over weight and yet he was stigmatized by some of the other children. The other was a girl who ended up with anorexia, after going from slightly obese to ultra thin. We did eat junk food when we were kids but we were extremely active compared to most children today. Of course, it might have been very different in the South, where fried foods and lots of bread before meals has been a very common part of the culture.

I couldn't find the article that I wanted to post in this thread that mentioned that eating overly processed foods leads to eating too many calories. That may be true, but almost everything was considered overly processed in that article. My mom and I both eat/ate too many sweets, while remaining thin.I had a desk job and ate out in restaurants almost every meal when I gained weight in middle age. But later, we both became very active and I guess we didn't eat as much as those who seem to become addicted to those foods. I eat lots of salads and vegetables, and small portions of lean meat, fish etc. I eat vegan at least a couple of days per week. I just love sweets and over the past few years, I've needed to eat extra calories or I lose weight. I never expected that. Again, apparently nothing is the same for everyone, but perhaps a lot of people do get addicted to processed foods and eat an amount that causes them to gain weight. I think that eating in restaurants has also been a reason for increased obesity. I've seen people eat enormous amounts of foos at buffets etc. I tend to think that food addiction is similar to any other addiction, but we all must eat to survive, so it can be much harder to lose weight than to stop other addictive habits. I'm not saying that all obese people are addicted to food, but it does seem common these days.

My daughter in law appears to weight over 300 lbs or more, but I'm proud of her for how she has raised my grandkids. They rarely get sweet snacks and almost always drink water at meals or when they are thirsty. I noticed that my 12 year old granddaughter stops eating when she feels full. I now do that too. She is healthy and thin and more active than most children I've known. Same with the grandson. I think my dil doesn't want her children to have her obesity problems. She does over eat a lot, but she is trying to be more active and sometimes I think she is trying to stop eating when full. I totally understand how hard it is to change habits for most people. If we need a separate thread about what causes obesity and what helps cure it, I have no objection to removing my lengthy posts.
 
Bariatric Surgery Procedures | ASMBS - it's small-intestine bypass that's sometimes done, not large-intestine (colon) bypass.


More broadly, these weight-loss drugs seem like a medical revolution, one comparable to the discovery that many stomach ulcers are caused by the bacterium Helicobacter pylori. Before that discovery, stomach ulcers required rather arduous treatment, but after it, treatment was a simple matter of attacking those bacteria.  Timeline of peptic ulcer disease and Helicobacter pylori and  Peptic ulcer disease and  Helicobacter pylori
 
I think you have to be wary of big pharma marketing sources. The industry smells big profits making people dependent on more drugs.

Don't forget how oxy was pushed by drug companies. You can bet doctors are being pushed to prescribe them.

I wonder if part of it s the placebo effect. People believe they will eat less so they will eat less

I'd like to see imdependent placebo test results.
 
https://www.mayoclinic.org/healthy-lifestyle/weight-loss/in-depth/weight-loss-drugs/art-20044832

I found this piece about the weight loss drugs. It appears that if they are working for you, you may have to take them long term. But, then, that's true about drugs for all types of diseases from diabetes to seizure disorders etc. I don't think we know enough yet to understand if they work for most people or if most people can tolerate them without side effects.

How long you take a weight-loss drug depends on whether the drug helps you lose weight. If you've lost enough weight to improve your health and you haven't had serious side effects, your health care provider may suggest that you take the drug long term.

If you haven't lost at least 5% of your body weight after taking the full dose of a drug for 3 to 6 months, your health care provider will probably change your treatment. They may switch you to a different weight-loss drug.


What drugs are approved for weight loss?​


Six weight-loss drugs have been approved by the U.S. Food and Drug Administration (FDA) for long-term use:

  • Bupropion-naltrexone (Contrave)
  • Liraglutide (Saxenda)
  • Orlistat (Xenical, Alli)
  • Phentermine-topiramate (Qsymia)
  • Semaglutide (Wegovy)
  • Setmelanotide (Imcivree)

Most prescription weight-loss drugs work by making you feel less hungry or fuller. Some do both. The exception is orlistat. It affects the way your body absorbs fat.
 
Bariatric Surgery Procedures | ASMBS - it's small-intestine bypass that's sometimes done, not large-intestine (colon) bypass.


More broadly, these weight-loss drugs seem like a medical revolution, one comparable to the discovery that many stomach ulcers are caused by the bacterium Helicobacter pylori. Before that discovery, stomach ulcers required rather arduous treatment, but after it, treatment was a simple matter of attacking those bacteria.  Timeline of peptic ulcer disease and Helicobacter pylori and  Peptic ulcer disease and  Helicobacter pylori
Thanks Loren. I wasn't thinking when I said part of the colon, instead of part of the small intestine.

I didn't realize that some of the weight loss drugs could be used to treat stomach ulcers etc.
 
Back
Top Bottom