New Weight Loss/Obesity Drugs Could Transform Economy

[audreyh1]

I didn't know that, thanks.

At some point with type 2 diabetes the pancreas can get worn out and reduce insulin production. That’s because it’s been overproducing insulin for decades. At that point the patient may need additional insulin.

 

[W2R]

I thought insulin was for Type I diabetes, not Type II? (speaking from one who has neither)

Here's what the American Diabetes Association has to say about it:

https://diabetes.org/health-wellness/medication/insulin-basics

My doctor (who is an M.D. who is fully qualified in internal medicine, and also a PhD endocrinologist whose patient load is almost 100% diabetics) agrees with the ADA on this.

Here's more reading material about insulin and type 2 diabetes, this time from the UK:
https://www.diabetes.org.uk/guide-t...reating-your-diabetes/insulin/type-2-diabetes

insulin and type 2 diabetes

Around one in four people with type 2 diabetes take insulin.* If you have type 2 diabetes and are prescribed insulin, it doesn’t mean you have type 1 diabetes. You still have type 2 diabetes but you’ve changed treatment.
Insulin is used as a treatment for type 2 diabetes because the insulin your body makes either is not working properly, which is called insulin resistance, or in some cases insulin resistance means the pancreas initially produces more and more insulin to help, but over time the pancreas can become worn out and start to produce less insulin. This may mean you need to use it as a treatment.

If you need insulin as a medication it isn’t your fault and it doesn’t mean you haven’t managed your diabetes well. It's simply another medication that can help to keep you as healthy as possible. And insulin may be the most appropriate treatment choice for you.

 

[W2R]

For those folks who have taken or are taking one of the subject drugs, do they suppress your desire for all foods, or just the less healthy ones?

When I was on Ozempic, I really didn't feel hungry for any type of food. Frank would bring my dinner over and I'd tell him to put it in the frig, that I'd eat it later (and then I'd forget to do that).

I have also noticed that on insulin I am not very hungry either. I have no explanation, but "I'll take it!". It's nice to not be ravenously hungry all the time.

 

[aja8888]

Here's what the American Diabetes Association has to say about it:

https://diabetes.org/health-wellness/medication/insulin-basics

My doctor (who is an M.D. who is fully qualified in internal medicine, and also a PhD endocrinologist whose patient load is almost 100% diabetics) agrees with the ADA on this.

Here's more reading material about insulin and type 2 diabetes, this time from the UK:
https://www.diabetes.org.uk/guide-t...reating-your-diabetes/insulin/type-2-diabetes

Thanks!

 

[badatmath]

When I was on Ozempic, I really didn't feel hungry for any type of food. Frank would bring my dinner over and I'd tell him to put it in the frig, that I'd eat it later (and then I'd forget to do that).

I have also noticed that on insulin I am not very hungry either. I have no explanation, but "I'll take it!". It's nice to not be ravenously hungry all the time.

Odd. My diabetic friend blames insulin for hunger and massive weight gain.

I found this too:
Insulin therapy or intensification of insulin therapy commonly results in weight gain in both type 1 and type 2 diabetes. This weight gain can be excessive, adversely affecting cardiovascular risk profile.

https://pubmed.ncbi.nlm.nih.gov/17924864/

 

[rittchard]

Obviously everyone is different but my experience with Ozempic over the last couple years has been:

- no significant side effects
- slight decrease in overall appetite
- NO weight loss, possibly some gain
- does seem to control blood sugar better than without it

 

[Bruizer]

I think it has a lot of potential.

One of the issues is that the drug is fda approved for the lowering of blood glucose levels in type 2 diabetics. To my knowledge, weight control is an off-label use. Physicians can still prescribe it, but it gives insurance companies grounds to refuse to cover an expensive medication.
.

I got a notice in December from my insurance company (BCBS) stating that Ozempic now requires pre-approval starting in 2024. My doctor had to indicate on a form that the drug is prescribed for Type II Diabetes.

 

[Bruizer]

For those folks who have taken or are taking one of the subject drugs, do they suppress your desire for all foods, or just the less healthy ones?

All foods. It also suppresses my desire for alcohol.

 

[rittchard]

I got a notice in December from my insurance company (BCBS) stating that Ozempic now requires pre-approval starting in 2024. My doctor had to indicate on a form that the drug is prescribed for Type II Diabetes.

The same exact drug is marketed/labelled as Wegovy for weight loss. Interestingly during the shortage last year insurance wouldn’t approve me for it even though I was type 2 diabetic. Edit: I am also “morbidly” obese but they didn’t care.

 

[ERhoosier]

WAAAAAY too early to say if these drugs given for weight loss per se might decrease overall health care costs. History shows that with new drugs/treatments real world results (including short & long-term complications) can be quite different from results published in controlled studies.

 

[PaunchyPirate]

I am somewhere between pre-diabetic and diabetic. I have been on Metformin for several years and added Trulicity (lowest dose) about 3 years ago. Between those, I keep my A1C between 5.5 and 6.5.

With recent supply shortages of Trulicity (my order was on its 10th day at CVS and still not filled due to high demand from adding weight loss dosages across all brands), I spoke to my Doctor about it at my recent checkup. He suggested we switch to Mounjaro because he had not heard it was having as bad of issues with supply. However, he said that could change, as it too had just been approved for weight loss. Plus, if it helped me drop some weight, that would be an added bonus. So I decided to make the switch. My BC/BS insurance did require pre-approval. I can’t recall if Trulicity did when I started. It took almost a week to get that approval as they kept asking my Dr. for more information.

Then my local CVS did not have it in stock for 2 days. I took my first dose 5 days ago. I will take this dose for a month and if no issues my Dr. will bump up the dosage. After 5 days, I can’t tell if it’s decreasing my appetite or not. Maybe a little.

This year, I am on an high deductible insurance plan for the first time. My deductible is $1700. The insurance discounted price for Mounjaro is $1019. There is a manufacturer coupon that you can download fro Lilly that took $150 off the cost. So I paid $869 for my first dose. Since I have a couple other claims in process that are adding to my deductible, my next Mounjaro purchase will probably be closer to the $500 range. After meeting my deductible, it should drop to $25 (just like my Trulicity was). I still use the coupon to get it that low.

Time will tell if it also helps me lose weight. I hope so, but it’s not the primary driver in using it.

 

[Romer]

Obviously everyone is different but my experience with Ozempic over the last couple years has been:

- no significant side effects
- slight decrease in overall appetite
- NO weight loss, possibly some gain
- does seem to control blood sugar better than without it

I see in your other post you are taking it for Diabetes

Ozempic and Wegovy are the same drug, But Wegovy after the first dose regime iterates to a much higher dose. I had weight loss at .25, but many others didn't until a higher dose.

You typically do .25 for 4 weeks, .5 4 weeks, 1.0 4 weeks, 1.7 4 weeks, and then either stay on 1.7 or go to 2.4 if you need a higher dose

Have you talked to your DR about a higher dose?

 

[Retired Expat]

A new class of weight loss/obesity drugs called semaglutides, a diabetes drug that also has weight loss effects, could be responsible for transforming the economy in many sectors, analysts say. Ozempic is one of the major brand names, and works by mimicking a naturally occurring hormone. As those hormone levels rise, the molecules go to your brain, telling it you're full. It also slows digestion by increasing the time it takes for food to leave the body. This is similar to the effect of bariatric surgery.

https://www.businessinsider.com/semaglutide-wegovy-ozempic-weight-loss-healthcare-airlines-economy-productivity-2023-11



Insurance companies haven't been lining up to cover the drugs, which costs somewhere between $900 and $1200 per month. Medicare does not cover them at all.

Thoughts?

Having lost about 40 lbs on Ozempic I can testify that I am spending much less on food and much less on dining out. Being outside the US mostly allows me to get a monthly supply for around $200 and I am saving that in food alone but the impact on my health is sure to be even greater. Able to cut back on other diabetes meds recently although they are super cheap in comparison to Ozempic. Cost of the drug at $200-$300 a month is probably a wash currently.

If only they priced clothing by the size would be a nice savings there. For the first time in 20+ years my BMI is considered a healthy weight although too close to overweight still.

Considering they say it is discrimination to charge more to cut long hair than short I don’t see airlines charging less for lighter weight passengers but maybe they should? They charge us for overweight bags don’t they? But it is true that you can choose to not bring 12 pairs of shoes on your trip but you can’t decide to leave your excess weight at home and weight is a complicated issue….. lord knows! But if these drugs come way down and could be given to all who needed them? It could change the world! No more supersizing of meals, much less food and packaging waste


Emotionally and intellectually there is much less food noise going on and food and eating is no longer the most important thing in my day. That has opened up at least a few hours a week free time for me. Less cooking, eating, ironing smaller clothes.

 

[athena53]

Emotionally and intellectually there is much less food noise going on and food and eating is no longer the most important thing in my day. That has opened up at least a few hours a week free time for me. Less cooking, eating, ironing smaller clothes.

This is similar to what I read in a WSJ editorial by a writer who started on these meds to lose weight. I'm beginning to realize that some people have cravings that I just don't have. I still need to exercise and watch what I eat to keep my weight at a healthy level, but eating has never been "the most important thing in my day". It's helped me understand how hard it is for some people to "eat less, move more" when apparently their body chemistry is telling them the opposite.

 

[RetiredHappy]

This is similar to what I read in a WSJ editorial by a writer who started on these meds to lose weight. I'm beginning to realize that some people have cravings that I just don't have. I still need to exercise and watch what I eat to keep my weight at a healthy level, but eating has never been "the most important thing in my day". It's helped me understand how hard it is for some people to "eat less, move more" when apparently their body chemistry is telling them the opposite.

I love food and actually think about eating all day. However, I am in the normal weight range, having a BMI of 22 and would like to get it back down to about 19. My will power fights my food cravings pretty much every day for the past 20 years. Before than, I could eat all that I wanted and still be pretty trim. I do find that when I control carbs, the food cravings drop somewhat. Hence the term carb addiction.

 

[Lee94joyce]

Personal experience....I am type II diabetic. Have been successful in losing weight over the last 6 years since retirement. But it has been painfully slow and some yo yo. 287 down to about 247. For the last 6 months I have been on Ozempic. I have been able4 to loose about 35 pounds in the last 6 months with the only change to my diet and exercising routine being eating much much smaller portions. I do believe a substantial amount of the weight was muscle mass. I just took my last dose Monday. I am going to try to continue weight loss without the Ozempic, hoping I have developed better eating habits. I am discontinuing mostly due to cost. About $750 for three month supply. Fingers crossed.

 

[PaunchyPirate]

Personal experience....I am type II diabetic. Have been successful in losing weight over the last 6 years since retirement. But it has been painfully slow and some yo yo. 287 down to about 247. For the last 6 months I have been on Ozempic. I have been able4 to loose about 35 pounds in the last 6 months with the only change to my diet and exercising routine being eating much much smaller portions. I do believe a substantial amount of the weight was muscle mass. I just took my last dose Monday. I am going to try to continue weight loss without the Ozempic, hoping I have developed better eating habits. I am discontinuing mostly due to cost. About $750 for three month supply. Fingers crossed.

Great progress! Keep it up.

 

[Happyras]

I've been on the Mounjaro clinical trial for cardiac risk patients for 1 year now. My check up with the trial doc's was yesterday. No weight loss on a 15mg dose, no side effects, and no improvement in any metric. So as suspected, I have been jabbing myself weekly with saline.....pretty sure. They loaded me up with another 3 month supply of jabs.

The benefit is really in getting to actually see a real doctor every few months who does a full review with blood tests of your health. Not so sure I will continue for the 5 yr study though.

My sister is 81 and on Ozempic she has lost a ton of weight. She has been large all her life and now, skinny and very judgmental of what everyone else is eating.

 

[Vacation4us]

I have been on Wegovy 6 months, minimal side effects, have lost 52 lbs. I consider this drug medically necessary for me. I had hypertension (HAD) , Hashimotos, high cholesterol, pre diabetic, and am at moderate riskfor a heart attack or stroke based on my blood work from my Endocrinologist. Per Endo I am a type 2 diabetic but since only the continuous glucose monitor showed this not my A1C or fasting BS. Insurance will deny diagnosis. I run 160 BS while sleeping unrelated to food intake. Definitely insulin resistant.

My father, mother, and brother are all Type 2. My mother’s family has a strong history of strokes. My paternal grandfather was dead by 48 of heart disease. My father had open heart surgery at 51, died of cancer by 59.

Wegovy has proven to decrease a person’s risk of heart disease and stroke by 20%. Since no one on dad’s side of family has lived past 65, I consider Wegovy my chance for a longer life. I never plan on stopping. My insurance co pay is $40/ 3 month supply. I’m 57, hoping by the time we have to switch to Medicare it will be cheaper and covered.

Every country outside of the US pays far less than we do. In Denmark where Novo Nordisk is located it’s $100/ month out of pocket and about 200 pounds in the UK. I would definitely pay that to save my life.

People make judgements on zero knowledge and experience. I don’t care. It’s my health and I am pretty sure my endocrinologist knows more about these meds than every single person passing judgment on this thread. I want to tell everyone I meet how life changing these drugs are but that doesn’t happen when someone’s immediate response is have some willpower. Sometimes willpower doesn’t work.

 

[Retired Expat]

These drugs might change body composition (reduce muscle mass), so as much hype as has gone into these compounds, there are negative side effects that might "transform the economy" in the other direction, at least a little bit. Of course it's not wise to let perfect be the enemy of good, and these compounds have proven themselves in obese populations, at least in the relatively short term studies published so far in this specific population.

Seems like a lot of comments from people who haven’t tried it and sound pretty judgemental about those who do

As I discovered there was something amazingly liberating in pushing away a plate full of food for the first time! And not thinking about what to make for dinner while having lunch. And I was in the gym 4 days a week and moving a lot. But the cravings and brain chemistry is very powerful. My wife who has always been thin simply thinks about food differently than I did. Now I think more like her.


I have gone off Ozempic for a few months and did not gain back the weight but had to up my exercise to where it was impacting my life and struggle to avoid snacking and keep portion sizes down. But is am a diabetic and this is my life we are talking about

 

[cyber888]

I don't know about these drugs, but keeping weight off is a lifestyle change.
I lost 28 lbs. - 1) drastically cut Sugar 2) cut a lot of carb, especially at night, 3) Walk and exercise, 4) Eat a lot of protein. Works for me.

 

[hopefullyoneday]

I believe that many people are lazy and they expect instant change.

Instead....many might want to think about eating a proper diet in moderation. Cutting out the fast food, the cakes, chips, and soft drinks, etc.

Plus a little exercise. Maybe try walking a little further than just from the car to house. Some do not even walk from the car to the fast food joint.....they use drive up.

Too many people make excuses for themselves. The MLM industry is getting rich selling these phony weight reduction pills and drinks.

We had some friends from Europe visit the US. The first thing they noticed was how many obese people there were...especially young people. Sad really.

I could not agree more. I told the wife if you want to get rich then invent something that makes people lazier than they are now. Btw she is on one of those drugs i forget which one but she went from 165 to 115 and is keeping it off so far. She has never been one to work out and probably will never start. The savings in groceries and eating out has offset the cost of the drug so no additional cost in the end.

 

[Sunset]

I appreciate everyone's stories about losing weight and the costs of the drugs, etc.

I need to talk to a relative about these drugs as I'm worried, regardless of all the times going to the gym that is claimed, this person is morbidly obese, and in denial in some ways.
It would be a shame to die young, or turn diabetic.

 

[athena53]

As I discovered there was something amazingly liberating in pushing away a plate full of food for the first time! And not thinking about what to make for dinner while having lunch. And I was in the gym 4 days a week and moving a lot. But the cravings and brain chemistry is very powerful. My wife who has always been thin simply thinks about food differently than I did. Now I think more like her.

This observation is another data point that makes me think it's more than will power, although will power plays a role. I come from a family of 5 kids. Mom and Dad were thin. All of us still are. All 13 grandchildren are thin; one was borderline obese in her 20s and decided to work on losing the weight- she's now as lean as the rest of us. Her Dad, my BIL, probably not coincidentally, has fought obesity all his life but recently dropped some of it through "eat less, move more". Great-grandchildren all thin but the oldest is 19 and I know weight problems can occur in adulthood. You let a pound creep on every year and it adds up.

We're not any more virtuous than anyone else. We all have exercise routines but nothing crazy, we all minimize processed food and exercise portion control. An exception is my skinny-as-a-rail brother who's running 5 miles a day at age 69 but is a meat-and-potatoes-and processed foods guy. When I stay with them I have to watch my pretzel consumption.

There have to be biological factors at work here; I'm guessing it's partly gut biomes, partly what our mothers ate during pregnancy, and who knows what else. Sometimes you can fight biology, sometimes you need help.

Given the terrible costs of obesity-diabetes, heart problems, joint problems, high BP.... I can see why these meds are a good idea for some and may save us in healthcare costs in the long run.

 

[twirler]

However, if you don't retrain your eating and activity habits nothing will change. Morover I've been hearing reports that these same drugs damage your muscle mass as well. Simply put just reduce calories and move. It's healthier.