"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:There are so many drugs I plan to use for life. I’ll never get off Zyrtec. I don’t expect Advil taken for today’s headache to work on one next week. I’ll be on birth control until I’m on hormone replacement. I don’t see myself ever stopping using Tretinoin. Both my parents will be on cholesterol drugs for life, so I expect at some point I will be too.

Why is it that when it comes to weight loss medications people are clutching their pearls at the idea that people won’t eventually stop?

You didn't read the OP or the linked article did you? The problem is not the people who take it for life. The problem is the majority of people who take it temporarily.

But that’s a fake concern. People will take it for life. Cost is not a serious concern to cite: prices have already plummeted.

[Anonymous]

Anonymous wrote:There are so many drugs I plan to use for life. I’ll never get off Zyrtec. I don’t expect Advil taken for today’s headache to work on one next week. I’ll be on birth control until I’m on hormone replacement. I don’t see myself ever stopping using Tretinoin. Both my parents will be on cholesterol drugs for life, so I expect at some point I will be too.

Why is it that when it comes to weight loss medications people are clutching their pearls at the idea that people won’t eventually stop?

Because they want people to stop. And then gain the wait back. Because they hate fat people, because they need someone to feel superior to. This "People will gain it back if they stop!!" stuff is all about driving the narrative that it is somehow "cheating" to use medical intervention for obesity. It's similar to people a generation ago clutching their pearls at the idea that certain folks were "acting uppity."

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Similar with insulin. If you stop taking it you die, so is it really helping?

Being overweight doesn’t kill you unless you are morbidly obese, which is who the drugs are targeted for. If you are taking it to be slim from a healthy/slightly overweight start you will do more harm than good. This isn’t rocket science; it’s just normal logic a reasoning.

Being obese—which like 40% of Americans are—is horrible for you.

True. But most obese people are too poor to afford the drugs - statistically. It’s mainly UMC who want it for vanity who get the drugs.

It's mainly "UMC" who get the drugs, yes -- because they have the good insurance or can afford to pay for it. But it's mainly UMC folks who are obese -- which is a medical condition that causes other illness and injury and even death, let alone harms quality of life and causes misery -- not UMC folks "who want it for vanity."

The only people I know in my UMC circle weren’t overweight to begin with. Maybe they were the heavier die of the healthy range. I do agree that if you can’t keep weight off in any healthy way and cannot control your diet and exercise, then this is a viable (expensive) path.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There are so many drugs I plan to use for life. I’ll never get off Zyrtec. I don’t expect Advil taken for today’s headache to work on one next week. I’ll be on birth control until I’m on hormone replacement. I don’t see myself ever stopping using Tretinoin. Both my parents will be on cholesterol drugs for life, so I expect at some point I will be too.

Why is it that when it comes to weight loss medications people are clutching their pearls at the idea that people won’t eventually stop?

You didn't read the OP or the linked article did you? The problem is not the people who take it for life. The problem is the majority of people who take it temporarily.

This. It's especially problematic for people who are using these drugs to lose small amounts of weight, and who often are not obese to begin with.

It's the same problem with yo-yo dieting we've always had. Thee have always been ways to drop a lot of weight quickly, and there have always been people willing to do these things for a little while in order to achieve a short term goal -- looking a certain way in their wedding day, feeling good in a bikini, etc. But people have always given up on these methods and regained weight, because there is usually sacrifice and discomfort they can't tolerate long-term. GLP1s are no different -- the drugs are pricy, taking them is inconvenient, and many people experience cause effects.

This is the problem with widespread use. The vast majority of people don't actually need these drugs for health reasons, and thus will go off them when they no longer want to sacrifice the money and physical side effects, and those folks will regain the weight.

Gaining and losing substantial amounts of weight multiple times in your life has been shown to have a lot of negative health effects, even when the weight loss is achieved in a healthy way.

The problem is that people who use these meds for small amounts of weight is that if they instead were an entirely different patient population, who gained and re-lost substantial weight, they would have negative health effects?

That is such a silly argument I think you are blinded by bias instead of actually dumb.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Did this guy actually not realize these were lifetime meds? I know that and I’m not a doctor. My guess is that even with the patients who stop taking GLPs and regain the weight, on average they are much more effective than any other method the doctor can offer.

Yes, he does realize this, but most people don't.

The benefits of these drugs cannot be denied when they are taken as intended -- meaning indefinitely. But what happens to the body and mind when these medications are discontinued? This is where the problem lies.

The truth is, most patients don't stay on anti-obesity medications -- I see it in my practice every day. Research shows that three-quarters of patients stop GLP-1 medications within 2 years, many within months. 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.

And he also knows exactly how this article will be read/taken. It's fear mongering and amplifying fat phobia rage. Anything for clicks and attention! The sentence you bold there is thrown in only for credibility with other clinicians to deflect criticism.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did this guy actually not realize these were lifetime meds? I know that and I’m not a doctor. My guess is that even with the patients who stop taking GLPs and regain the weight, on average they are much more effective than any other method the doctor can offer.

There are a lot of dumb doctors out there.

Even more dumb people who are too stupid to make it into med school.

Well, yeah, when one takes into account the population of the world, this isn't a hard conclusion to come to ...

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:His claim that people who use the drugs lose muscle and don’t gain it back when they stop the drug therapy is concerning.

Has only to do with the speed of weight loss, which can be managed with proper dosing and nutrient intake. The issue is not with the medication.

In theory, yes. In practice, no. I’ve never seen anyone not lose massive amounts of muscle. Sure, it’s possible but it’s just as hard as losing weight and building muscle in a lifelong way - so the old fashioned way is better/safer.

Everyone loses muscle when they lose weight. You can reduce muscle mass loss by lifting and losing at a 1-2 lb per week rate. Nothing to do with the GLP-1…

You are naive and will fight to the end. Continue on your path.

GLP has everything to do with rate, which is what causes the large muscle loss. Gradual lifestyle changes are far more sustainable and healthier on your body.

Sure come back and say they’re not. I really don’t care. Then again I don’t need GLPs. I’m an athlete with a long history of muscle building and lifestyle sustainability. So just like you think popping a pill is magic with no long term data - I think healthy diet and exercise is magic with long term data and sustainability.

Do you have any citations? Because I do. There’s no evidence that muscle mass loss in GLP-1s is any worse than muscle mass loss from other means.

“There's concern in the general public about how weight loss drugs affect muscle mass, but the presenters emphasize that the data doesn't show GLP-1 analogs have a unique, high level of lean body mass loss compared to other weight loss paradigms.”

https://advances.massgeneral.org/endocrinology/article.aspx?id=1601

I trust Mass General a lot more than I trust an unsubstantiated, anonymous claim on the internet.

Seriously?! You want citations for something so well known it dates back 100s of years of conventional wisdom? You are one of those “dumb” people PP mentioned.

Citations won’t convince me. We haven’t had these drugs long enough to even have the data. Remember the miracle drug fen-phen - this is the same. It’s a miracle until it’s not and we see the long term damage. The FDA approved fen-phen and the hype was the same as it is now. Maybe you are too young to remember that.

I should mention I’m in my 50s so I’ve seen the hype before. I’m also knowingly very bias. I’m 5’3” and 130 lbs - although I wear a size 0-2 - so I’m solid muscle, like really solid.

We have a couple decades of data but you don’t want to believe it because it makes you mad.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:His claim that people who use the drugs lose muscle and don’t gain it back when they stop the drug therapy is concerning.

Has only to do with the speed of weight loss, which can be managed with proper dosing and nutrient intake. The issue is not with the medication.

In theory, yes. In practice, no. I’ve never seen anyone not lose massive amounts of muscle. Sure, it’s possible but it’s just as hard as losing weight and building muscle in a lifelong way - so the old fashioned way is better/safer.

Everyone loses muscle when they lose weight. You can reduce muscle mass loss by lifting and losing at a 1-2 lb per week rate. Nothing to do with the GLP-1…

You are naive and will fight to the end. Continue on your path.

GLP has everything to do with rate, which is what causes the large muscle loss. Gradual lifestyle changes are far more sustainable and healthier on your body.

Sure come back and say they’re not. I really don’t care. Then again I don’t need GLPs. I’m an athlete with a long history of muscle building and lifestyle sustainability. So just like you think popping a pill is magic with no long term data - I think healthy diet and exercise is magic with long term data and sustainability.

Do you have any citations? Because I do. There’s no evidence that muscle mass loss in GLP-1s is any worse than muscle mass loss from other means.

“There's concern in the general public about how weight loss drugs affect muscle mass, but the presenters emphasize that the data doesn't show GLP-1 analogs have a unique, high level of lean body mass loss compared to other weight loss paradigms.”

https://advances.massgeneral.org/endocrinology/article.aspx?id=1601

I trust Mass General a lot more than I trust an unsubstantiated, anonymous claim on the internet.

Seriously?! You want citations for something so well known it dates back 100s of years of conventional wisdom? You are one of those “dumb” people PP mentioned.

Citations won’t convince me. We haven’t had these drugs long enough to even have the data. Remember the miracle drug fen-phen - this is the same. It’s a miracle until it’s not and we see the long term damage. The FDA approved fen-phen and the hype was the same as it is now. Maybe you are too young to remember that.

I should mention I’m in my 50s so I’ve seen the hype before. I’m also knowingly very bias. I’m 5’3” and 130 lbs - although I wear a size 0-2 - so I’m solid muscle, like really solid.

Outrage and ad hominem -- the classic refuge of those who don't have citations to back anything up. Welcome to RFK's anti-science America. DP

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:His claim that people who use the drugs lose muscle and don’t gain it back when they stop the drug therapy is concerning.

Has only to do with the speed of weight loss, which can be managed with proper dosing and nutrient intake. The issue is not with the medication.

In theory, yes. In practice, no. I’ve never seen anyone not lose massive amounts of muscle. Sure, it’s possible but it’s just as hard as losing weight and building muscle in a lifelong way - so the old fashioned way is better/safer.

Everyone loses muscle when they lose weight. You can reduce muscle mass loss by lifting and losing at a 1-2 lb per week rate. Nothing to do with the GLP-1…

You are naive and will fight to the end. Continue on your path.

GLP has everything to do with rate, which is what causes the large muscle loss. Gradual lifestyle changes are far more sustainable and healthier on your body.

Sure come back and say they’re not. I really don’t care. Then again I don’t need GLPs. I’m an athlete with a long history of muscle building and lifestyle sustainability. So just like you think popping a pill is magic with no long term data - I think healthy diet and exercise is magic with long term data and sustainability.

Do you have any citations? Because I do. There’s no evidence that muscle mass loss in GLP-1s is any worse than muscle mass loss from other means.

“There's concern in the general public about how weight loss drugs affect muscle mass, but the presenters emphasize that the data doesn't show GLP-1 analogs have a unique, high level of lean body mass loss compared to other weight loss paradigms.”

https://advances.massgeneral.org/endocrinology/article.aspx?id=1601

I trust Mass General a lot more than I trust an unsubstantiated, anonymous claim on the internet.

+1 From a body builder athlete, no less, who literally is not the genetic market for this medicaion, and who likely believes that every body is exactly like theirs, and that their physical "superiority" is mental and moral, not genetic.

[Anonymous]

Anonymous wrote:

Anonymous wrote:There are so many drugs I plan to use for life. I’ll never get off Zyrtec. I don’t expect Advil taken for today’s headache to work on one next week. I’ll be on birth control until I’m on hormone replacement. I don’t see myself ever stopping using Tretinoin. Both my parents will be on cholesterol drugs for life, so I expect at some point I will be too.

Why is it that when it comes to weight loss medications people are clutching their pearls at the idea that people won’t eventually stop?

Because they want people to stop. And then gain the wait back. Because they hate fat people, because they need someone to feel superior to. This "People will gain it back if they stop!!" stuff is all about driving the narrative that it is somehow "cheating" to use medical intervention for obesity. It's similar to people a generation ago clutching their pearls at the idea that certain folks were "acting uppity."

Consider that we want a healthy society where this type of behavior is not normalized. I want my kids to grow up surrounded by healthy diets and exercise - not people who can’t control themselves and try to take a short cut. There was zero obesity at the turn of the century. There’s no good reason for it now other than people cannot control themselves around junk food that is push through ever media possible - weak minds, weak impulse control, equates to weak society. I don’t want that for my kids to live in. I’m sure you blame your obesity on hormones or something out of your control, but it’s not that or we would see fat mammals in the wild and people would have been obese throughout history.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did this guy actually not realize these were lifetime meds? I know that and I’m not a doctor. My guess is that even with the patients who stop taking GLPs and regain the weight, on average they are much more effective than any other method the doctor can offer.

Yes, he does realize this, but most people don't.

The benefits of these drugs cannot be denied when they are taken as intended -- meaning indefinitely. But what happens to the body and mind when these medications are discontinued? This is where the problem lies.

The truth is, most patients don't stay on anti-obesity medications -- I see it in my practice every day. Research shows that three-quarters of patients stop GLP-1 medications within 2 years, many within months. 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.

And he also knows exactly how this article will be read/taken. It's fear mongering and amplifying fat phobia rage. Anything for clicks and attention! The sentence you bold there is thrown in only for credibility with other clinicians to deflect criticism.

Please feel free to quote the fatphobic part of the article. I must have missed it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There are so many drugs I plan to use for life. I’ll never get off Zyrtec. I don’t expect Advil taken for today’s headache to work on one next week. I’ll be on birth control until I’m on hormone replacement. I don’t see myself ever stopping using Tretinoin. Both my parents will be on cholesterol drugs for life, so I expect at some point I will be too.

Why is it that when it comes to weight loss medications people are clutching their pearls at the idea that people won’t eventually stop?

You didn't read the OP or the linked article did you? The problem is not the people who take it for life. The problem is the majority of people who take it temporarily.

This. It's especially problematic for people who are using these drugs to lose small amounts of weight, and who often are not obese to begin with.

It's the same problem with yo-yo dieting we've always had. Thee have always been ways to drop a lot of weight quickly, and there have always been people willing to do these things for a little while in order to achieve a short term goal -- looking a certain way in their wedding day, feeling good in a bikini, etc. But people have always given up on these methods and regained weight, because there is usually sacrifice and discomfort they can't tolerate long-term. GLP1s are no different -- the drugs are pricy, taking them is inconvenient, and many people experience cause effects.

This is the problem with widespread use. The vast majority of people don't actually need these drugs for health reasons, and thus will go off them when they no longer want to sacrifice the money and physical side effects, and those folks will regain the weight.

Gaining and losing substantial amounts of weight multiple times in your life has been shown to have a lot of negative health effects, even when the weight loss is achieved in a healthy way.

This is your argument: this drug a problem because someone who should not have been taking it in the first place stopped taking it. And the "problem" is that they will regain the small amount of bikini envy weight they lost, that they really didn't need to lose in the first place.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There are so many drugs I plan to use for life. I’ll never get off Zyrtec. I don’t expect Advil taken for today’s headache to work on one next week. I’ll be on birth control until I’m on hormone replacement. I don’t see myself ever stopping using Tretinoin. Both my parents will be on cholesterol drugs for life, so I expect at some point I will be too.

Why is it that when it comes to weight loss medications people are clutching their pearls at the idea that people won’t eventually stop?

Because they want people to stop. And then gain the wait back. Because they hate fat people, because they need someone to feel superior to. This "People will gain it back if they stop!!" stuff is all about driving the narrative that it is somehow "cheating" to use medical intervention for obesity. It's similar to people a generation ago clutching their pearls at the idea that certain folks were "acting uppity."

Consider that we want a healthy society where this type of behavior is not normalized. I want my kids to grow up surrounded by healthy diets and exercise - not people who can’t control themselves and try to take a short cut. There was zero obesity at the turn of the century. There’s no good reason for it now other than people cannot control themselves around junk food that is push through ever media possible - weak minds, weak impulse control, equates to weak society. I don’t want that for my kids to live in. I’m sure you blame your obesity on hormones or something out of your control, but it’s not that or we would see fat mammals in the wild and people would have been obese throughout history.

What do you think people on Ozempic eat?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There are so many drugs I plan to use for life. I’ll never get off Zyrtec. I don’t expect Advil taken for today’s headache to work on one next week. I’ll be on birth control until I’m on hormone replacement. I don’t see myself ever stopping using Tretinoin. Both my parents will be on cholesterol drugs for life, so I expect at some point I will be too.

Why is it that when it comes to weight loss medications people are clutching their pearls at the idea that people won’t eventually stop?

You didn't read the OP or the linked article did you? The problem is not the people who take it for life. The problem is the majority of people who take it temporarily.

This. It's especially problematic for people who are using these drugs to lose small amounts of weight, and who often are not obese to begin with.

It's the same problem with yo-yo dieting we've always had. Thee have always been ways to drop a lot of weight quickly, and there have always been people willing to do these things for a little while in order to achieve a short term goal -- looking a certain way in their wedding day, feeling good in a bikini, etc. But people have always given up on these methods and regained weight, because there is usually sacrifice and discomfort they can't tolerate long-term. GLP1s are no different -- the drugs are pricy, taking them is inconvenient, and many people experience cause effects.

This is the problem with widespread use. The vast majority of people don't actually need these drugs for health reasons, and thus will go off them when they no longer want to sacrifice the money and physical side effects, and those folks will regain the weight.

Gaining and losing substantial amounts of weight multiple times in your life has been shown to have a lot of negative health effects, even when the weight loss is achieved in a healthy way.

This is your argument: this drug a problem because someone who should not have been taking it in the first place stopped taking it. And the "problem" is that they will regain the small amount of bikini envy weight they lost, that they really didn't need to lose in the first place.

I think this poster might not be eating enough for proper brain function.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:His claim that people who use the drugs lose muscle and don’t gain it back when they stop the drug therapy is concerning.

Has only to do with the speed of weight loss, which can be managed with proper dosing and nutrient intake. The issue is not with the medication.

In theory, yes. In practice, no. I’ve never seen anyone not lose massive amounts of muscle. Sure, it’s possible but it’s just as hard as losing weight and building muscle in a lifelong way - so the old fashioned way is better/safer.

Everyone loses muscle when they lose weight. You can reduce muscle mass loss by lifting and losing at a 1-2 lb per week rate. Nothing to do with the GLP-1…

You are naive and will fight to the end. Continue on your path.

GLP has everything to do with rate, which is what causes the large muscle loss. Gradual lifestyle changes are far more sustainable and healthier on your body.

Sure come back and say they’re not. I really don’t care. Then again I don’t need GLPs. I’m an athlete with a long history of muscle building and lifestyle sustainability. So just like you think popping a pill is magic with no long term data - I think healthy diet and exercise is magic with long term data and sustainability.

Do you have any citations? Because I do. There’s no evidence that muscle mass loss in GLP-1s is any worse than muscle mass loss from other means.

“There's concern in the general public about how weight loss drugs affect muscle mass, but the presenters emphasize that the data doesn't show GLP-1 analogs have a unique, high level of lean body mass loss compared to other weight loss paradigms.”

https://advances.massgeneral.org/endocrinology/article.aspx?id=1601

I trust Mass General a lot more than I trust an unsubstantiated, anonymous claim on the internet.

Seriously?! You want citations for something so well known it dates back 100s of years of conventional wisdom? You are one of those “dumb” people PP mentioned.

Citations won’t convince me. We haven’t had these drugs long enough to even have the data. Remember the miracle drug fen-phen - this is the same. It’s a miracle until it’s not and we see the long term damage. The FDA approved fen-phen and the hype was the same as it is now. Maybe you are too young to remember that.

I should mention I’m in my 50s so I’ve seen the hype before. I’m also knowingly very bias. I’m 5’3” and 130 lbs - although I wear a size 0-2 - so I’m solid muscle, like really solid.

We have a couple decades of data but you don’t want to believe it because it makes you mad.

Same with fen-phen. And as I said - I don’t care what you do to your individual body. You could take prescription Adderall or non prescription speed and get the same effect - I also don’t want those normalized in society, just as this drug shouldn’t be normalized. I also don’t believe in normalizing pot, lsd, oxy, coke, fentanyl - most of which were legal at some point in history - and there is a reason they are no longer legal.