"I No Longer Think GLP-1s Are the Answer — The drugs "work" but may be working against us long-term"

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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Anonymous wrote:After being a size 4 from teens into my late 40s,I was on a strict whole 30 and weight watchers diet simultaneously and was still gaining 20-30 lbs a year after i went through menopause and had some other metabolic issues almost reaching 200 lbs - glp-1s have been great for me and I am very open about being on them to try to counter the judgement on this thread. If diet and exercise alone work for you great - but mind your own business re: others

I have no judgement for anyone that uses a GLP-1 but I do not want to spend tax dollars or pay increased premiums to enrich big pharma when it doesn't improve health for three quarters of people that use the drugs.

And I don’t want tax dollars to be spent on quadruple bypass surgery for obese people, or chemo for smokers with lung cancer. It’s. Slippery slope

The majority of people do not stay on GLP-1 drugs, so the majority of the time these drugs confer no health benefit.

Then we should focus on keeping people on the drugs including by reducing costs. Problem solved!

Not really since cost is not the only reason people don't stay on the drugs. I do see the cost reduction as a potential part of the solution, but it seems like the reason for stopping the drug is that people just don't want to be on it forever.

No, it's the cost. People don't want to pay $300/month forever.

[Anonymous]

Anonymous wrote: So it is this awful cycle of you gain weight, you move less, you then spend more time eating to comfort yourself, by gaining weight you have more aches and pains like knee pain so you end up moving even less. You think about food all day and what you will have for your next meal. It really becomes a constant thought. Once you get used to eating more and moving less it just becomes ingrained that is your destiny.

GLP-1's break this cycle. It quiets the "food noise" that overweight /obese people have often ALL day. You eat and suddenly you feel full much sooner, you don't feel the need as often as before so instead of eating breakfast at 8, a snack at 10, lunch at 12 and a snack at 2, you eat skip breakfast/ eat tiny bit for breakfast and eat lunch at 12 and are fine until dinner. Once you start loosing weight you can try to exercise and it becomes easier as you loose weight.

Long-term the more practice you have with eating less and exercising more is only going to help a person.

It is hilarious "a practicing obesity medicine specialist" is against GLP-1's, cynically I think this is because he probably realizes that because so many people are successful on GLP-1's he is getting pushed out of his speciality.

If you are eating to comfort yourself you need to solve THAT problem. It’s a mental health problem and GLPs will help ONE symptom but it won’t cure you and you will always comfort eat

[Anonymous]

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Anonymous wrote:It seems like he likes GLP-1s and his objections are not hard to overcome:

"Reasons for discontinuation include cost, side effects, and supply shortages. But one of the most common reasons is that patients simply don't want to take a weight loss medication indefinitely. Many believe they can "beat the system," use them briefly, change their lifestyle, and stop taking them without regaining weight."

So why not educate patients so they understand the importance to stick with the GLP-1s? There are many reasonable cost options out there. The support group I am in has a wide spectrum of income. With cost going down and the ease of newer pill meds, all the objections (aside from side effects, and a switch to a different specific med can help with that) for staying on meds go away.

It sounds like his experience is patients don't stay on the drugs. I assume he is warning them they need to stay on them, but people don't want to do that. And since the majority are not staying on them and instead are cycling on and off the drugs they are just spending a lot of money for no health benefits.

Most people (no matter how they lost weight) regain the weight eventually. The benefit of weight loss is still there for the patient though: the ability to move around in the world as a normal weight person, being able to hike, sit easily on an airplane, physically be more active with kids and grandkids, having fewer health issues while on the med, not feeling addicted to food...Personally I think this is absolutely priceless even if it is fleeting because it is such better quality of life. But do I think staying on the med is best? Yes. I think that should be the takeaway rather than "don't start it because you'll stop it" which is fatalistic and not solution-oriented especially when the main objection is cost.

Weight yo-yoing (weight cycling) is generally considered bad for you, linked to increased risks for heart disease, type 2 diabetes, higher body fat, slower metabolism, and poorer mental health due to repeated stress, muscle loss, and metabolic disruption, making future weight loss harder and increasing health problems.

It is bad for you. But you're not going to find many doctors advising their patients to stay fat and not try and lose weight, despite knowing that they are likely to regain the weight (again, regardless of how they did it).

GLP-1s are costing employers and taxpayers a.lot of money. That's fine if it has a health benefit. But if there is no added health benefit then it is a net negative for health and society.

There is a cost benefit to society in having fewer obese people. Not all employer plans cover it depending on specifics, and many people go out of pocket and get compounds anyway on their own dime.

Our public school system is millions of dollars in the hole due to GLP-1s. I am all for spending money to reduce obesity sustainably but not for medication assisted yo yo dieting.

There is no proven way to lose weight without a very high likelihood of yoyo weight.

So let's choose the option that's free and has the same result.

Go for it! I’m choosing the option that cost me 25 dollars a month and actually works , whereas the last 20 years of dirt and exercise and thinking of food constantly has not. For me. We both win!

Kind of. . . Your insurance won’t cover it for $25/mo to you once you lose enough weight that you are not at high risk. Then you yo yo and . . . well, you lose (not weight).

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It seems like he likes GLP-1s and his objections are not hard to overcome:

"Reasons for discontinuation include cost, side effects, and supply shortages. But one of the most common reasons is that patients simply don't want to take a weight loss medication indefinitely. Many believe they can "beat the system," use them briefly, change their lifestyle, and stop taking them without regaining weight."

So why not educate patients so they understand the importance to stick with the GLP-1s? There are many reasonable cost options out there. The support group I am in has a wide spectrum of income. With cost going down and the ease of newer pill meds, all the objections (aside from side effects, and a switch to a different specific med can help with that) for staying on meds go away.

It sounds like his experience is patients don't stay on the drugs. I assume he is warning them they need to stay on them, but people don't want to do that. And since the majority are not staying on them and instead are cycling on and off the drugs they are just spending a lot of money for no health benefits.

Most people (no matter how they lost weight) regain the weight eventually. The benefit of weight loss is still there for the patient though: the ability to move around in the world as a normal weight person, being able to hike, sit easily on an airplane, physically be more active with kids and grandkids, having fewer health issues while on the med, not feeling addicted to food...Personally I think this is absolutely priceless even if it is fleeting because it is such better quality of life. But do I think staying on the med is best? Yes. I think that should be the takeaway rather than "don't start it because you'll stop it" which is fatalistic and not solution-oriented especially when the main objection is cost.

Weight yo-yoing (weight cycling) is generally considered bad for you, linked to increased risks for heart disease, type 2 diabetes, higher body fat, slower metabolism, and poorer mental health due to repeated stress, muscle loss, and metabolic disruption, making future weight loss harder and increasing health problems.

It is bad for you. But you're not going to find many doctors advising their patients to stay fat and not try and lose weight, despite knowing that they are likely to regain the weight (again, regardless of how they did it).

GLP-1s are costing employers and taxpayers a.lot of money. That's fine if it has a health benefit. But if there is no added health benefit then it is a net negative for health and society.

There is a cost benefit to society in having fewer obese people. Not all employer plans cover it depending on specifics, and many people go out of pocket and get compounds anyway on their own dime.

Our public school system is millions of dollars in the hole due to GLP-1s. I am all for spending money to reduce obesity sustainably but not for medication assisted yo yo dieting.

There is no proven way to lose weight without a very high likelihood of yoyo weight.

So let's choose the option that's free and has the same result.

Go for it! I’m choosing the option that cost me 25 dollars a month and actually works , whereas the last 20 years of dirt and exercise and thinking of food constantly has not. For me. We both win!

Kind of. . . Your insurance won’t cover it for $25/mo to you once you lose enough weight that you are not at high risk. Then you yo yo and . . . well, you lose (not weight).

This isn't accurate. I've been on two different insurance and they both cover maintenance at my healthy BMI. I spoke with the prior auth team, and they explained that for those in maintenance, you complete the form with your original weight, not your current weight. Many insurance companies (and PBMs) understand this to be a lifetime drug.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It seems like he likes GLP-1s and his objections are not hard to overcome:

"Reasons for discontinuation include cost, side effects, and supply shortages. But one of the most common reasons is that patients simply don't want to take a weight loss medication indefinitely. Many believe they can "beat the system," use them briefly, change their lifestyle, and stop taking them without regaining weight."

So why not educate patients so they understand the importance to stick with the GLP-1s? There are many reasonable cost options out there. The support group I am in has a wide spectrum of income. With cost going down and the ease of newer pill meds, all the objections (aside from side effects, and a switch to a different specific med can help with that) for staying on meds go away.

It sounds like his experience is patients don't stay on the drugs. I assume he is warning them they need to stay on them, but people don't want to do that. And since the majority are not staying on them and instead are cycling on and off the drugs they are just spending a lot of money for no health benefits.

Most people (no matter how they lost weight) regain the weight eventually. The benefit of weight loss is still there for the patient though: the ability to move around in the world as a normal weight person, being able to hike, sit easily on an airplane, physically be more active with kids and grandkids, having fewer health issues while on the med, not feeling addicted to food...Personally I think this is absolutely priceless even if it is fleeting because it is such better quality of life. But do I think staying on the med is best? Yes. I think that should be the takeaway rather than "don't start it because you'll stop it" which is fatalistic and not solution-oriented especially when the main objection is cost.

Weight yo-yoing (weight cycling) is generally considered bad for you, linked to increased risks for heart disease, type 2 diabetes, higher body fat, slower metabolism, and poorer mental health due to repeated stress, muscle loss, and metabolic disruption, making future weight loss harder and increasing health problems.

It is bad for you. But you're not going to find many doctors advising their patients to stay fat and not try and lose weight, despite knowing that they are likely to regain the weight (again, regardless of how they did it).

GLP-1s are costing employers and taxpayers a.lot of money. That's fine if it has a health benefit. But if there is no added health benefit then it is a net negative for health and society.

There is a cost benefit to society in having fewer obese people. Not all employer plans cover it depending on specifics, and many people go out of pocket and get compounds anyway on their own dime.

Our public school system is millions of dollars in the hole due to GLP-1s. I am all for spending money to reduce obesity sustainably but not for medication assisted yo yo dieting.

Public school system? Hows that?

Because they provide health insurance for their employees and are self-insured which means they just pay the cost of all the claims themselves.

So teachers are obese but you don't want them to get the meds needed to lose weight because it costs too much? Maybe the issue is with manufacturers and drug prices, but we all pay for very costly meds for all sorts of people including meds that are needed due to lifestyle issues.

DP
This is so true. And I actually don’t think non-obese people should be taking these and I don’t believe in supporting GLPs for overweight people who cannot control themselves. For the people that really need them for health reasons - they should have access at reasonable prices. I once had a medication that cost $350 for a few pills in the US and that same medication in the UK was £6, because the government negotiated better drug prices than our insurance companies do.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:After being a size 4 from teens into my late 40s,I was on a strict whole 30 and weight watchers diet simultaneously and was still gaining 20-30 lbs a year after i went through menopause and had some other metabolic issues almost reaching 200 lbs - glp-1s have been great for me and I am very open about being on them to try to counter the judgement on this thread. If diet and exercise alone work for you great - but mind your own business re: others

I have no judgement for anyone that uses a GLP-1 but I do not want to spend tax dollars or pay increased premiums to enrich big pharma when it doesn't improve health for three quarters of people that use the drugs.

And I don’t want tax dollars to be spent on quadruple bypass surgery for obese people, or chemo for smokers with lung cancer. It’s. Slippery slope

Wow! So you don’t want universal healthcare. Got it!

And I’d add (as a mountain climber) I don’t think we should be paying for accidents from extreme sports!

[Anonymous]

Anonymous wrote:Seems like there is this undercurrent of anger and/ jealousy that “fat” people now have an easy button allowing them to dramatically improve the quality of their lives and improve their body composition with any hard work. That they were somehow lazy and sedentary before which lead them to be a massive burden on society because of how much all the weigh related heath problems cost. And that now these “fat” lazy people are getting access to a cheat code they don’t have to work for. I’m not fat but still was above where I needed to be. Even with weekly workouts and cardio life, work, kids, supporting elderly parents and just getting old meant I was on track for potential heath problems down the road. If you plan to take this until you die and commit to weigh bearing exercises any hypothetical downside risks would be more than outweighed by real risks like type 2 diabetes, fatty liver disease, high blood pressure, heart diseases plus need for cpap machines to counter sleep apnea, mobility devices etc. in the long run heath costs should drop simply
Precisely because all the fatties have access to to these drugs

There is no undercurrent of anger/jealousy - although you thinking this is very telling about you. Most people who have massive weight problems have equally massive mental/emotional problems. I can’t feel anger or jealousy towards people like that. I actually feel sad that they are looking for a shortcut that will not solve their problems.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I am happy for people who are losing weight on meds.

However, although they are now thin, IMO they don’t look good. Their skin is gaunt and they look sickly. I understand it’s better than being overweight.

I also think there will be some bad side effects that are yet to be discovered.

Just because you think your friends/acquaintances who have lost a lot of weight look different does NOT mean they look gaunt and sickly. That's just your opinion because they look different.

Your nastiness doesn't look good on you, sweetie.

Well, your gaunt sickly face doesn’t look good on you, sweetie.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:After being a size 4 from teens into my late 40s,I was on a strict whole 30 and weight watchers diet simultaneously and was still gaining 20-30 lbs a year after i went through menopause and had some other metabolic issues almost reaching 200 lbs - glp-1s have been great for me and I am very open about being on them to try to counter the judgement on this thread. If diet and exercise alone work for you great - but mind your own business re: others

I have no judgement for anyone that uses a GLP-1 but I do not want to spend tax dollars or pay increased premiums to enrich big pharma when it doesn't improve health for three quarters of people that use the drugs.

And I don’t want tax dollars to be spent on quadruple bypass surgery for obese people, or chemo for smokers with lung cancer. It’s. Slippery slope

The majority of people do not stay on GLP-1 drugs, so the majority of the time these drugs confer no health benefit.

Then we should focus on keeping people on the drugs including by reducing costs. Problem solved!

Not really since cost is not the only reason people don't stay on the drugs. I do see the cost reduction as a potential part of the solution, but it seems like the reason for stopping the drug is that people just don't want to be on it forever.

No, it's the cost. People don't want to pay $300/month forever.

+1
300/mo x 12mo/yr x 20yrs is 72k. If you instead invested that money with average returns in the S&P you’d have over $200k. Unless you are going to die without it; it’s not a good investment

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:After being a size 4 from teens into my late 40s,I was on a strict whole 30 and weight watchers diet simultaneously and was still gaining 20-30 lbs a year after i went through menopause and had some other metabolic issues almost reaching 200 lbs - glp-1s have been great for me and I am very open about being on them to try to counter the judgement on this thread. If diet and exercise alone work for you great - but mind your own business re: others

I have no judgement for anyone that uses a GLP-1 but I do not want to spend tax dollars or pay increased premiums to enrich big pharma when it doesn't improve health for three quarters of people that use the drugs.

And I don’t want tax dollars to be spent on quadruple bypass surgery for obese people, or chemo for smokers with lung cancer. It’s. Slippery slope

The majority of people do not stay on GLP-1 drugs, so the majority of the time these drugs confer no health benefit.

Then we should focus on keeping people on the drugs including by reducing costs. Problem solved!

Not really since cost is not the only reason people don't stay on the drugs. I do see the cost reduction as a potential part of the solution, but it seems like the reason for stopping the drug is that people just don't want to be on it forever.

No, it's the cost. People don't want to pay $300/month forever.

+1
300/mo x 12mo/yr x 20yrs is 72k. If you instead invested that money with average returns in the S&P you’d have over $200k. Unless you are going to die without it; it’s not a good investment

Prices will continue to drop due to increased competition. Plus going generic in 2032. Then prices will be a few dollars.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:After being a size 4 from teens into my late 40s,I was on a strict whole 30 and weight watchers diet simultaneously and was still gaining 20-30 lbs a year after i went through menopause and had some other metabolic issues almost reaching 200 lbs - glp-1s have been great for me and I am very open about being on them to try to counter the judgement on this thread. If diet and exercise alone work for you great - but mind your own business re: others

I have no judgement for anyone that uses a GLP-1 but I do not want to spend tax dollars or pay increased premiums to enrich big pharma when it doesn't improve health for three quarters of people that use the drugs.

And I don’t want tax dollars to be spent on quadruple bypass surgery for obese people, or chemo for smokers with lung cancer. It’s. Slippery slope

The majority of people do not stay on GLP-1 drugs, so the majority of the time these drugs confer no health benefit.

Then we should focus on keeping people on the drugs including by reducing costs. Problem solved!

Not really since cost is not the only reason people don't stay on the drugs. I do see the cost reduction as a potential part of the solution, but it seems like the reason for stopping the drug is that people just don't want to be on it forever.

No, it's the cost. People don't want to pay $300/month forever.

I’m already paying less than this for compounded version. Cost will not be a reason to get off the drug for long.

[Anonymous]

I don't understand why people double down on these common misconceptions about weight.

Skinny woman at 20 = has control
Exact same woman and diet in perimenopause = no control

When will we ever admit biology plays a HUGE role in weight.

You'd never dare say that same skinny woman could be built and play tennis like Serena Williams if only she were more dedicated to tennis because that's not true.

So why do you say that about weight?

Fwiw I've been the larger girl my entire life in a home where my Mom, eating the same food, never weighed more than 100 lbs most of her life. I was build like my football player Dad and not my tennis-playing Mom.

GLP 1 might be the first time in my life I ever hit below my plateau. Not for trying either. I spent my entire life dieting and exercising. Division one athlete with an eating disorder and still was never skinny.

[Anonymous]

Anonymous wrote:

Anonymous wrote: So it is this awful cycle of you gain weight, you move less, you then spend more time eating to comfort yourself, by gaining weight you have more aches and pains like knee pain so you end up moving even less. You think about food all day and what you will have for your next meal. It really becomes a constant thought. Once you get used to eating more and moving less it just becomes ingrained that is your destiny.

GLP-1's break this cycle. It quiets the "food noise" that overweight /obese people have often ALL day. You eat and suddenly you feel full much sooner, you don't feel the need as often as before so instead of eating breakfast at 8, a snack at 10, lunch at 12 and a snack at 2, you eat skip breakfast/ eat tiny bit for breakfast and eat lunch at 12 and are fine until dinner. Once you start loosing weight you can try to exercise and it becomes easier as you loose weight.

Long-term the more practice you have with eating less and exercising more is only going to help a person.

It is hilarious "a practicing obesity medicine specialist" is against GLP-1's, cynically I think this is because he probably realizes that because so many people are successful on GLP-1's he is getting pushed out of his speciality.

If you are eating to comfort yourself you need to solve THAT problem. It’s a mental health problem and GLPs will help ONE symptom but it won’t cure you and you will always comfort eat

Nope that is the miracle of GLP-1's. You feel awful you constantly crave food and have no self-control so end up eating even more, hence the comfort eating. Then you take GLP-1's and realize - wait a second this is what it is like not to think about food or overeat. You realize it isn't a moral flaw, you are just wired differently. It isn't a mental health problem at all.

[Anonymous]

Anonymous wrote:I don't understand why people double down on these common misconceptions about weight.

Skinny woman at 20 = has control
Exact same woman and diet in perimenopause = no control

When will we ever admit biology plays a HUGE role in weight.

You'd never dare say that same skinny woman could be built and play tennis like Serena Williams if only she were more dedicated to tennis because that's not true.

So why do you say that about weight?

Fwiw I've been the larger girl my entire life in a home where my Mom, eating the same food, never weighed more than 100 lbs most of her life. I was build like my football player Dad and not my tennis-playing Mom.

GLP 1 might be the first time in my life I ever hit below my plateau. Not for trying either. I spent my entire life dieting and exercising. Division one athlete with an eating disorder and still was never skinny.

Maybe your body was never meant to be skinny. And now you are taking a drug to force your body into a physique it never wanted. How is this good?

[Anonymous]

Anonymous wrote:

Anonymous wrote:I am happy for people who are losing weight on meds.

However, although they are now thin, IMO they don’t look good. Their skin is gaunt and they look sickly. I understand it’s better than being overweight.

I also think there will be some bad side effects that are yet to be discovered.

Just because you think your friends/acquaintances who have lost a lot of weight look different does NOT mean they look gaunt and sickly. That's just your opinion because they look different.

Your nastiness doesn't look good on you, sweetie.

DP. I’ve always been thin but have not been pretty. I would have always chosen to pretty over thin. The amount of people picking their body over their face is baffling to me.