Semaglutide & Tirzepatide - Ozempic, Wegovy, Rybelsus, Mounjaro. Are they "miracle" weight loss drugs at last?

[Monkey Pink]

https://my-bmi.co.uk/advice-medical-therapy-how-does-semaglutide-work/

What is Semaglutide?
Semaglutide is a drug that is currently licensed for the treatment of type 2 diabetes, either via a subcutaneous injection (Wegovy), or as a daily tablet (Rybelsus).

However, during clinical trials, it was discovered that Semaglutide can also help with weight loss in adults with a BMI of over 30.

It is currently going through more clinical trials with a view to being approved as a drug for obesity as well as for type 2 diabetes.

GLP-1
Before we talk about how Semaglutide can help with weight loss, we first need to understand what GLP-1 is.

GLP-1 is a hormone that’s naturally produced by our bodies in the small intestine when we’ve eaten a meal and it plays a part in helping us to feel satisfied after eating.

However, natural human GLP-1 doesn’t last that long, which is why we often feel hungry or peckish a couple of hours after a meal.

GLP-1 is an incretin, which is a type of hormone that helps to reduce blood glucose levels and stimulate the secretion of insulin.

In people with diabetes, the GLP-1 produced by the body isn’t enough to control glucose and insulin levels, so drugs that mimic the hormone, such as Semaglutide, are used to boost the body’s natural response.

As Semaglutide is a synthetic version of this hormone, it’s usually called a GLP-1 receptor agonist, or alternatively, an incretin mimetic.

This means that it mimics the hormone we produce naturally, but with a few alterations, which explain why weight loss is a common side effect of Semaglutide.
_____________

Has anyone on the Farms tried this? I'm very curious about it, but currently there is a shortage of these medications due to their newfound popularity. Could this be a huge step in fixing the Obesity crisis? It only fixes hormones and not diet, but you tend to not want to eat much on Semaglutide anyways. But for those with Cushing's, PCOS, etc who struggle with weight loss, it looks like a potential breakthrough.

 

[Blasterisk]

The "huge step" in the fatass "crisis" is not eating everything you can all the time all day!


Calories in, calories out. That's all.

 

[Monkey Pink]

The "huge step" in the fatass "crisis" is not eating everything you can all the time all day!


Calories in, calories out. That's all.

Well of course. The law of thermodynamics and CICO is still as valid as it ever was. Ozempic isn't just an appetite suppressant, it changes how the body processes insulin which does directly affect fat storage.

Will someone who loses weight with Ozempic gain it all back if they eat like shit? Yes. It's not a magic syringe.

Side effects can include nausea for months. It's not an easy choice to make for anyone but TikTok had to make it a fucking trend and cause a shortage and now actual diabetics are pissed.

I follow this girl on YouTube but I'm a little peeved that she isn't diabetic or morbidly obese. However, she documents her "journey" pretty well and doesn't sugar coat the bad sides of it.

 

[Manul Otocolobus]

It is a bad idea, pharma's dream, and a solid pathway to cancer. Once you start taking it you can't stop taking it otherwise the weight comes right back, so you are a permanent pharma customer, which they love, of course. Also, all GLP-1 agonists are a cancer risk. A paper just published a few days ago showed that at the dose for treatment of Type-2 diabetes, which is substantially lower than the one for weight loss, raises the absolute risk of endocrine cancer by 35%, and thyroid cancer specifically by 60%. The risk is dose and time dependent. So, the higher the dose, the more likely and the sooner it is likely to happen. Furthermore, the longer you take it the greater your risk of eventually developing endocrine cancer. Taking something to lose weight, that you must continue to take forever, that will probably give you cancer at some point is beyond retarded.

 

[AgendaPoster]

There are many medications that can result in weight loss, and all of them have often severe side effects. In fact, even a harsh diet, or a very hardcore cardio weight loss program on a beginner can have nasty side effects, and if you will rebound and gain the weight back in just a few months if you stop.
Now I cannot give medical advice online and things depend A LOT on your personal circumstances (for example a 40 yrs old dude that has been sedentary since his 20s and has a 30 BMI is not the same as a 45 yrs old former athlete that let himself go the last 10 years at same BMI), but in general the best way to lose weight is by SLOWLY reducing calory intake coupled with exercise, and from working with athletes for 15 years, running seems to be the most potent weight loss exercise, followed closely by biking/spinning, rowing etc.
You have to slowly train your body to a different metabolism, and you need to do it over a long enough period so that the adaptations are long lasting.
Don't try shortcuts, they are risky and they don't work.
It's only hard when you start, after you start to see results you'll likely keep going out of a desire to improve further.

 

[Monkey Pink]

It is a bad idea, pharma's dream, and a solid pathway to cancer. Once you start taking it you can't stop taking it otherwise the weight comes right back, so you are a permanent pharma customer, which they love, of course. Also, all GLP-1 agonists are a cancer risk. A paper just published a few days ago showed that at the dose for treatment of Type-2 diabetes, which is substantially lower than the one for weight loss, raises the absolute risk of endocrine cancer by 35%, and thyroid cancer specifically by 60%. The risk is dose and time dependent. So, the higher the dose, the more likely and the sooner it is likely to happen. Furthermore, the longer you take it the greater your risk of eventually developing endocrine cancer. Taking something to lose weight, that you must continue to take forever, that will probably give you cancer at some point is beyond retarded.

Now, the thyroid risks I *HAVE* heard of and want to do some unbiased research. If you have any links to share I'll give them a read for sure. I know they won't give it to anyone with a family history of (one of two different types of) thyroid cancer.

You have to slowly train your body to a different metabolism, and you need to do it over a long enough period so that the adaptations are long lasting.
Don't try shortcuts, they are risky and they don't work.
It's only hard when you start, after you start to see results you'll likely keep going out of a desire to improve further.

Semaglutide was essentially "invented" in 2018. Have we even had the time to study the long-term weight loss effects? I've heard mixed stories about keeping the weight off, but the ones who gained it back tended to have shitty diets.

 

[Manul Otocolobus]

Now, the thyroid risks I *HAVE* heard of and want to do some unbiased research. If you have any links to share I'll give them a read for sure. I know they won't give it to anyone with a family history of (one of two different types of) thyroid cancer.

Semaglutide was essentially "invented" in 2018. Have we even had the time to study the long-term weight loss effects? I've heard mixed stories about keeping the weight off, but the ones who gained it back tended to have shitty diets.

Here is the latest study of the GLP-1 agonists and thyroid cancer risk:

GLP-1 Receptor Agonists and the Risk of Thyroid Cancer

OBJECTIVE. To determine whether use of glucagon-like peptide 1 (GLP-1) receptor agonists (RA) is associated with increased risk of thyroid cancer.RESEARCH DESIG

diabetesjournals.org

For anyone who wants to read the article but isn't familiar with how to read the outcomes, a Hazard Ratio is essentially the averaged risk as a % divided by 100. As such, an HR of 1.00 = 100%, which means exactly no impact as 100% is the baseline. An HR of 0.54 = 54% which means it reduced the likelihood of the outcome by 46%. An HR of 1.48 = 148%, which means it increased the likelihood of the outcome by 48%.

Put another way, an HR of 1.00 would mean what they are evaluating is neither protective nor provokes the condition they were looking at. An HR of less than 1.00 means that whatever they were evaluating was protective against the condition they were looking at . An HR of more than 1.00 meant that whatever they were evaluating provoked the condition they were looking at.

As you can see in the article, GLP-1 agonists were associated with a substantial increase in the risk of all types of thyroid cancer.

 

[Otterly]

I’m kind of in two minds about these. If someone is morbidly obese, their chances of dying from it are fairly high. What’s the risk of remaining 300lb vs 160lb and a higher risk of a rarer cancer? 300lb is an almost certain beetus future and that’s death if it’s not fixed.
I think they might be used for a short period of time to help patients lose that initial weight and then (hopefully) learn better food habits.
Obesity is simultaneously simple and complex. Just eat less. But at the same time it’s obvious that a lot of people find that almost impossible to do.
I know a few American expats here and every single one has lost weight after coming to the Uk - now I don’t think we have a particularly healthy national diet but I’ve spent enough time in the states to see how different it is to the American one. Your portion sizes are insane.
And again yes, you can buy ‘clean’ food in the states just like you can here, but I remember trying to find simple things like milk in Walmart even back in the early 2000s and being faced with a whole aisle of ‘stuff that’s allegedly milk’ and not finding just actual milk. Ditto cereal. I wanted some porridge, and there was a whole aisle of sugary crap but no porridge oats. They were in the baking aisle. In a ten pound bag
We have sugary crap too, but yours is on a higher level. Also long hours working, poor sleep, and stress fuck you up. It’s not an excuse but we do live in an environment that’s not easy for a lot of people

I’m no fan of big pharma and I’m very wary of pharma solutions to psychological and social issues. Having said that, if someone is committed to losing weight, and they can get a whole load off in a year or two then maintain then perhaps that’s the lesser evil?

 

[Tablet County]

I follow this girl on YouTube but I'm a little peeved that she isn't diabetic or morbidly obese.

So is Null.

 

[Slick]

The "huge step" in the fatass "crisis" is not eating everything you can all the time all day!


Calories in, calories out. That's all.

Yeah basically. Diet is 80% of all weight loss. The other basic redpill is Muscle growth, gaining muscle increases your metabolic rate because you have more contractile tissue to support so keeping weight off is easier. fatties should still do cardio so reduce cardiovascular disease risk though.

If I was you (op) I wouldn't hop on the semaglutide bandwagon until the effects are a little better understood.

 

[Mayhem]

I have a great endocrinologist who absolutely refuses to write a prescription for these for me unless my insurance will cover it. Which it won’t: I have no significant risk factors that would warrant a prescription for it, like type 2 diabetes, and an insurance that does not approve any medication used for the treatment of obesity. In a sense, I’m extremely lucky that I don’t have type 2 diabetes, but also kind of frustrated.

I have a lot of friends on these medications and they have lost a lot of weight. These are people who have yo-yo dieted for years on end and seen few results. While the side effects can be unpleasant, they think the results they are getting of 40 pounds or more gone worth it. I have no doubt a lot of them could have lose weight on a hardcore diet, but dieting is exhausting when you have to do it for years on end and do major cuts in calories to see the same results it seems others can get effortlessly. It’s not necessarily so simple as eat less, move more; as my doctor has told me, a lot of weight loss depends on age, stress level, the state of your endocrine system, and genetics.

If you do make the decision to go on these meds, you will need to go on them long-term. They are extremely expensive. If insurance will pay, they tend to cover them for a short period of time, like three months, and if you stop them, the weight will come back. As stated earlier, they are a dream for big pharma, but they are also making a huge difference for a lot of very fortunate people who can afford them or have insurance access to them.

Spoiler: Personal stuff

I have PCOS, but my real issues with weight have come about as a result of long-term SSRI usage. It is an open secret in psychopharmacology that psychiatric medications of all kinds can cause patients to gain enormous amounts of weight; the doctors don’t inform patients of these risks because these patients often need these medications to function. I try to keep active and maintain a good diet, but I’ve also struggled with an eating disorder for more than a decade. I eat less than pretty much everyone I know and I actually have vitamin deficiencies and anemia from not eating enough, but yet I still have obesity and the risks associating with that are rising. I was just told flat-out by my endocrinologist that I should completely ditch the SSRI and see how my weight loss goes. So, if you are battling obesity, go to an endocrinologist and have some detailed bloodwork drawn, then have a serious conversation with your doctor before you make any decisions about weight loss medications.

 

[XYZpdq Jr.]

ain't got nothing on the good ol' ECA stack

 

[CoolFool]

I was against these but tbh I have obese friends that are taking Mounjoro/Tizepatide and the results are pretty damn impressive. One of my childhood friends is normal sized for the first time ever. Like I've never seen her skinny in all the years that I've known her, and she doesn't have ozempic face or whatever. She seems really happy and she was actually able to keep up with me when we went on an outing, usually we had to take frequent breaks whenever we went to the mall or out walking, now she can walk the entire time and not have to rest.

Obviously, if you don't make diet changes, then this won't help you stay slim and healthy or get the core of your eating problems, but if used in conjuction to life style changes, I think it's a net positive.

That said, I cannot believe how expensive it is, one of my friend's insurance does not cover it and she's paying $1,000 a month. The other friend I have takes some offbrand one but it's still like $500. Insane.

 

[Barry Williams]

I'm considering starting one of these drugs. I'm still in the preliminary stages of discussing it with my new doctor though.

Add me to the list of people who were on SSRI's and it completely fucking ruined my body. I gained almost 50 pounds. My former psych doctor didn't warn me in the slightest that this could've happened. I struggled with the antidepressants because I felt as a whole they did not work and now I was grossly overweight and this ruined my self esteem and made me feel even worse than before I went to see the doctor. I've been off the SSRI's for about 18 months now but losing the weight has been extremely hard.

I have a subtle physical deformity that makes walking for prolonged periods hard and eventually painful. Jogging/running is the most efficient way to burn calories via cardio but it's something I cannot do because of my sorta-disability. I'm able to eat healthier and watch my carbs but since I can't do a lot of physical activity it makes losing weight difficult. I'm hoping I can get into all of this with my doctor and find a possible solution. I'm still very upset over what the antidepressants did and I'd like to get my life back on track.

 

[Mayhem]

I have a subtle physical deformity that makes walking for prolonged periods hard and eventually painful. Jogging/running is the most efficient way to burn calories via cardio but it's something I cannot do because of my sorta-disability. I'm able to eat healthier and watch my carbs but since I can't do a lot of physical activity it makes losing weight difficult. I'm hoping I can get into all of this with my doctor and find a possible solution. I'm still very upset over what the antidepressants did and I'd like to get my life back on track.

I’m not sure about accessibility where you live, but swimming is an excellent form of cardio and very good for people with limited mobility. Many gyms have pools with water aerobics classes, or you can do mild to moderate lap swimming. I’m an avid swimmer and the exercise definitely helps with my back, knees, and shoulders. If you’re concerned about how your body looks, take a water aerobics class with old people - guaranteed, they do not care how you look. A gym often will have machines that you can use even if you have limited mobility, too, like rowing machines. There are also modified bikes that are made for paraplegics that can be controlled with just your arms or a combination of arms and legs. I’ve personally never been a huge fan of running as exercise because it can be very stressful on your feet, knees, and hips. I know loads of people that got into running but had to quit due to injuries.

 

[Magicicada_septendecula]

A friend of my mom's went on one of those medications for weight loss. She did lose the weight, but it fucked up her insides so much, she has to go to the doctor every month to have fluids removed from her body. Apparently they work by paralyzing the digestive tract or something like that. I don't remember all the details, but it sounds horrifying. I think I'll just stick to a good diet and exercise.

 

[Xolanite]

Saw this article recently.

https://www.nbcnews.com/health/health-news/ozempic-may-linked-condition-causes-blindness-research-needed-rcna159991

https://archive.md/voocC

 

[Mary Lee Harvey osWalsh]

So one of my pet peeves is people considering Ozempic and its similar drugs as "miracle weight loss" drugs. Having been on Ozempic for a while, yes, it absolutely does reduce my hunger immensely. It helps my insulin resistance. However, it's not a miracle.

Spoiler: Major powerleveling

I have suffered from binge eating disorder for a very long time. If I get into a bingeing phase, of course the Ozempic isn't going to help. Of course I still gain weight. I mean, duh. It doesn't prevent me from bingeing or from stretching my stomach out over the course of weeks from gradually-increasing binges. And it certainly doesn't prevent hunger from my stomach now being used to having more food in it - at least not at first. (My stomach does adjust back to normal after a bit, but still. Starting an eating program is the hardest part. I'm writing this on Day 1 of "stop eating junk you asshole" and I want to eat chocolate so bad.)

For stuff like this, all the hunger-suppression drugs in the world aren't going to help. I mean, they'll help somewhat, of course, but that doesn't help the psychological component. I'm lucky in that I know how to eat well and I have exercised 5-6 days a week (strength training and cardio) for at least eight years now. Imagine how much worse off I would be if I didn't.

A lot of you say that the person needs to learn how to eat well, and I get that. I'm sure that's true for a lot of people with obesity, especially in America. But if you have an eating disorder like I do, all the knowledge in the world still won't fix it. All the Ozempic in the world won't fix it.

Further powerlevel but yes I did attend an outpatient program for binge eating disorder. Unfortunately this was when the pandemic started so it was all over Zoom. It did not help me at all. Also it was full of genderspecials and nutritionists ranting about "privilege." I challenged them frequently. They kept emphasizing not to be afraid of junk food and candy and such and that dieting was bad. I asked them, "Would you tell an alcoholic then that it's okay if he has a drink?" The person was silent for a moment and then admitted, "No."

I agree that many "diets" are bad. Diet culture is bad - not for the weight loss - but for the fact that most diets are short-term crash diets that do nothing for the long term and you will gain the weight right back. And I get that this program was trying to get you to have a "healthy" or "normal" relationship with food, but it still just didn't work. Some people have an addiction and should avoid certain foods.

America especially has a nutrition problem. When the government programs are still pushing seed oils as being healthier than butter, you know you have a problem. When they said fat is worse for you than sugar, you have a serious problem. When these huge companies have giant labs invested in trying to make their junk food as addictive as possible, YOU HAVE A PROBLEM. All the Ozempic in the world won't fix that.

 

[Day of the Cope]

America especially has a nutrition problem. When the government programs are still pushing seed oils as being healthier than butter, you know you have a problem. When they said fat is worse for you than sugar, you have a serious problem. When these huge companies have giant labs invested in trying to make their junk food as addictive as possible, YOU HAVE A PROBLEM. All the Ozempic in the world won't fix that.

Being someone who makes an effort to avoid seed oils, added sugars, and high carb items, I can not begin to tell you have fatiguing it is. If I didn't have a Costco membership, I legit think I would actually go crazy with trying to find the most basic of things.

 

[InternetDramaFillsTheVoid]

I’m torn on whether this is worth trying for me.

I lost a lot of my stomach/some of my intestine due to Steven’s-Johnson Syndrome a few years back (fucking gnarly illness that has high mortality rate), and whilst I’ve recovered, I don’t eat all that much compared to a standard adult. Yeah, it could be healthier, but I probably eat about half what a standard adult does in a day.

My main weightloss/exercise problem stems from the severe fatigue I deal with as an after effect of the illness I had. (If ANYONE has ANY tips/recommendations, please share, because I’m at my wits end with this bullshit)

What’s everyone’s opinion - would it still be beneficial? Or would it ultimately be a waste of money/it’s better to look at something to boost physical energy?