JohnMakin
> Suboxone is a compound of two drugs that decreases one’s cravings for opioids while blocking their effects. It is safer and less cumbersome than methadone, which requires daily or weekly visits to a clinic, and more effective than any abstinence-based treatment, which requires people to withstand cravings and suppress physical discomfort.

This highlights one of the issues I have with articles like this about Ozempic at this current moment - this glosses over something major with these two particular drugs. With methadone, yes, it will keep you off of heroin, but you'll also likely never, ever get off of methadone because the withdrawal is 1) just as horrible and severe as heroin and 2) can last months. To the point where you'd almost be better off just kicking the heroin the "old fashioned" way. suboxone is similar - the drug isn't without side effects either. Of course, that isn't to say these things aren't useful - to have a methadone/suboxone dependency is way preferable to heroin addiction.

My only real point is that we should wait to see what long term side effects these drugs have before calling them miracles and glossing over their down sides, because I think the end effect of that is counterproductive to medicine. I'm always immediately skeptical as to what drugs pharmaceutical companies are pushing out, due to the history I've witnessed so far in my lifetime.

That all said Ozempic probably would've saved a relative of mine's life. In the end, they'd likely not care about the side effects all that much.

akavi
> We also had initial results from the FLOW trial, suggesting that Ozempic prevents diabetics with kidney disease from needing dialysis.

Between this and the 2nd order decrease in renal disease from the reduction in diabetes and high blood pressure, Ozempic would have to end up having some truly awful long term effects to net out negative in utilitarian terms.

The US spends 130 G$/yr (0.5% of the _entire_ GDP) on dialysis, and that undercounts just how awful being on dialysis is in subjective terms.

Animats
The cost problem will decline over time, as patents run out. The underlying drug is old.

The food industry is worried.[1] "One big concern for the industry is the importance of so-called “super consumers”, who drive an outsized share of spend. For instance, consider this recent estimate: 9% of adults drive 34% of candy consumption. Assume that one-third of those adults successfully adopt Ozempic or another GLP-1, and that’s a roughly 10% hit to category sales."

The snack industry needs "whales".

[1] https://foodinstitute.com/focus/analysis-ozempic-likely-to-i...

themadturk
I take 3mg of Rybelsus, the pill form of Ozempic, every day for diabetes. This is about half the recommended dosage, but the major side effect for me has been gastric distress...on the full 7mg daily dose I was frequently nauseous, to the point where it rendered me unable to work some days. 3mg is supposedly the dosage you start out with for a month before moving up to 7mg, but 3mg has relieved most of my stomach distress, kept my daily blood sugar numbers down, and probably helped with weight loss (I'm down 15 pounds since February, a steady reduction that started a good 3 or 4 months before starting Rybelsus). The weight loss is a bonus for me; I'm in it for the diabetes benefits. When I was on the full dose, I often felt full. The half dose has the same effect, just not as much.

Fortunately my insurance covers most of the cost; at $25 a month, it's over 2.5x higher than any of my other prescriptions, but well within my budget. We'll see how long that lasts, especially since I plan to retire at the end of 2025 and go onto Medicare.

riffraff
> Ozempic seems to be something of a miracle. It’s a very effective treatment for diabetes as well as high blood pressure, heart failure, and kidney disease. New evidence suggests that it improves depression and reduces suicidality, and it also seems, unexpectedly, to reduce non-food-related addictive behaviors, like gambling. Studies are underway to see if it prevents cancer and Alzheimer’s disease.

reminds me of cortisone, which was also hailed (and partially is) a sort of panacea. Turned out not to be a cure for everything, and with some significant downsides, while still being a very valuable drug.

bl4ckm0r3
This approach will definitely save someone's life (and probably already is) but there's no golden pill that will, long term, give a healthy, in shape, body to people without effort.

Eating disorders are a thing and often have to do with the mind or genetics, but there are so many people just letting go to cravings and having terrible habits when it comes to eating, don't want to do any sacrifice and just let themselves go for so long than it becomes a serious health issues for them.

I see plenty of parents feeding the kids like they are going to do foie gras out of them... People eating pastries like it's chewing gum, bagels like it's a snack... some of my American colleagues have never drunk just plain water...only sodas...and a lot of it.

I really feel like this is just the trick the food (and healthcare) industry was waiting for to allow those people to eat as much as they want and don't get fat (and possibly get ill later), and the fashion industry to push for a "cheap way" to reach beauty standards (which is why this practice has mostly became popular thanks to famous people using it).

Plus there are pretty common side effects (1 out of 10 experiences them) and it fundamentally creates a dependency to a drug, because without changing habits, if a patient stops using the drug, they'll regain the weight in a short time...

Most people think they have a condition but in reality it's just them not trying to solve the problem and complaining about it.

leshokunin
I've been on semaglutife for a month now. My food cravings haven't disappeared, but their "volume" in my head went from a 10 to a 2.

I no longer agonize over thinking about yummy unhealthy foods. I no longer want to treat myself outside of lunch and dinner. I no longer want portions beyond being full.

Even if the weight loss aspects didn't work, the upside in clear headedness and not dedicating energy to thinking about food has been worth it.

ghostcluster
It's not just weight loss that Ozempic and the other GLP-1 drugs encourage. They also help people stop drinking to excess, and help lower pangs for other harmful drugs like heroin.

I believe that these attributes are so promising, that the idea of government subsidized Ozempic just seems like great domestic policy to me. I believe that whichever politician pitches this idea first will get a ton of support from the public and the press.

thrownawaysz
I'm on liraglutide (Saxenda) for 2 months, can't get semaglutide (Ozempic) in my country without being diagnosed with diabetes

Anyway. Food cravings gone, I was eating like 10 times a day before that. At least, but sometimes even more. Now I'm on intermittent fasting/OMAD and has 0 problems. No hunger, no cravings. Feeling significantly better.

Lost 30 pounds so far.

xkcd-sucks
> What If Ozempic Is Just a Good Thing?

Then I will gladly suffer FOMO while other people test this hypothesis over the next decade or so

hnburnsy
A study says these drugs could prevent 1.5 million cardiac events over 10 years, add in a reduction in alcoholism and governments should be giving away these drugs to save on healthcare costs...

----- We identified 3999 US adults weighted to an estimated population size of 93.0 million [M] (38% of US adults) who fit STEP 1 eligibility criteria. Applying STEP 1 treatment effects on weight loss resulted in an estimated 69.1% (64.3 M) and 50.5% (47.0 M) showing ≥ 10% and ≥ 15% weight reductions, respectively, translating to a 46.1% (43.0 M) reduction in obesity (BMI ≥ 30 kg/m2) prevalence. Among those without CVD, estimated 10-year CVD risks were 10.15% “before” and 8.34% “after” semaglutide “treatment” reflecting a 1.81% absolute (and 17.8% relative) risk reduction translating to 1.50 million preventable CVD events over 10 years.

https://news.ycombinator.com/item?id=37166206

fnfjfk
How do these drugs affect cardiovascular health compared to exercising?

Basically if you run/bike a lot you’ll burn more calories and lose weight if you eat at a deficit. But you’ll also improve your heart health, lower your resting heart rate, etc.

Do these drugs help in that way at all or just with losing the weight? It would be amazing if we had a drug that improved people’s heart health.

idontwantthis
I don’t understand what body positivity has to do with Ozempic. You should accept the things you cannot or have chosen not to change. If you opt to change them then why should acceptance matter anymore? Once a fat person becomes healthy, there’s still plenty for them to hate or accept about their body. But now they get to do that while also not burdened with health problems.
petesergeant
There appear to be a lot of people who derive a significant amount of their self-confidence and self-image from not being fat, and looking down on people who are. They seem to get pretty upset when people who they've been able to dismiss as fat become not fat, and hate that these drugs allow the users of them to take away that moral superiority -- various GLP1 subreddits are full of stories about them.

I'd never encountered anyone like that in real life, but they show up over and over again on any discussion of these drugs. It's very strange to me.

monkpit
The submitted title is wild compared to the article.
johnea
Like all short term weight loss solutions, when the user stops taking these meds, the weight is regained.

Not sure how that is a good thing...

zamalek
As far as I understand it, the one major issue is that it can make a temporary problem (overweight) a chronic one.

As a counter-example, most people experience depression at least once in their life and most of these take antidepressants on a temporary basis (the exception being those who are genetically/developmentally depressed - i.e. chronic/lifelong). Once the underlying issue has been addressed with therapy or what-have-you, these people can cease use of the drug.

This is not the case with Ozempic. If you take it to lose weight then cessation will cause rapid weight gain. You'll be stuck with it for the rest of your life, for something that can [again] usually be permanently solved with other forms of treatment.

I think this is morally fine. However, it does mean that these people will suffer even more harm if they are ever find themselves unable to afford/obtain Ozempic. We would effectively be duplicating the current issue that we have with insulin.

1970-01-01
I'm just glad something this effective is available. Obesity is a novel epidemic. Being very fat is supposed to be the exception to the rule, and not the default.
iwsk
Free lunch good
4b11b4
It's not
optimalsolver
[flagged]
hypertele-Xii
Imagine taking drugs instead of working out.
throwanem
Participate in a Phase IV trial at your peril.

But I wonder whether I'd say the same if I hadn't learned to lose and keep off all the weight I needed to, before it came along.

(If the downvotes are because I sound like I'm bragging, that's fair but also not my intent. What I mean to say is, I suspect I'd view this class of drug and indication less dispassionately and with more of an appetite for risk, if I weren't so lucky as to have no pressing need for the benefit.)

thefz
> What If Ozempic Is Just a Good Thing?

Has there ever been a point in human history in which we basically started taking a drug daily for the rest of our lives with no side effect whatsoever?

l33tbro
The article steps around the fact that Ozempic encourages poor nutrition and entrenches body dysmorphia. Working out and eating responsibly not only creates far more longevity, but it mentally empowers you to be the custodian of your own wellness.
slowmovintarget
Wasn't this the drug that also had the occasional effect of stopping people's digestive tract cold so they could no longer eat? Or am I thinking of something else.

That's not listed here: https://www.drugs.com/sfx/ozempic-side-effects.html?form=sub...

imwillofficial
The problem with Ozempic isn't the drug. It's that we have to take a drug to counter the literal poison that's been fed to us, with full subsidization from our government.

We allow poison in food, but not led in our water, radioactive waste in our backyards. Why?

renewiltord
It's just the same old thing. If someone worked hard to get somewhere, they hate it when someone else gets that for free. Oh, but you didn't really make that art, you used a brush, you used a diffusion model, blah blah. Oh but you didn't really work out. Oh but you didn't really write that Python program in 100 lines, it actually relies on these million lines of stdlib + firmware. If it works, it works. If it doesn't, it doesn't. That's how it is.

I have a personal bias to small effect consistent medication over high effect rare medication, but I have at least one friend who has seen great results with Ozempic. So I'm glad to see more people can access this drug.

After all, I can't really see. I use glasses or contact lenses.