New Weight Loss/Obesity Drugs Could Transform Economy

[Closet_Gamer]

DD works in a pharmacy and is on the front line of lots of the drug wars.

She's young and prone to be cautious but has two strong views on this:

1 - She is livid about how often she has to tell diabetic patients they can't get the drug because of the demand of off-label weight loss use. She not judgemental about the weight loss use, but feels like until the diabetic need is met there needs to be a hard shutdown on weight loss use.

2 - She's concerned people are under-estimating the side effects and potential long term side effects among a larger population.

Personally, I think science and industry have brought us a lot of the changes that surround us in calories so its almost certain we need science and industry to counteract that. I do worry about people reaching for this before they do other things, particularly once its cheap. But there are other reasons people have trouble losing weight -- mental health drugs can cause weight gain for example -- so I won't judge from the outside.

All that said, if I were king-for-a-day, there are many other societal options available before we start putting another drug in everyone's body. Here's my suggestion: make it illegal to advertise a meal with over 1,000 calories as a meal for one person. It is ludicrous that companies can put 1700+ calories on a plate and call it a meal. Its funny when you're 17 to eat a burger with three patties and six strips of bacon. Yay for being young. But overall, some regulatory constraints on this jet engine of calories we produce would be wise. And WAY cheaper.

 

[athena53]

1 - She is livid about how often she has to tell diabetic patients they can't get the drug because of the demand of off-label weight loss use. She not judgemental about the weight loss use, but feels like until the diabetic need is met there needs to be a hard shutdown on weight loss use.

2 - She's concerned people are under-estimating the side effects and potential long term side effects among a larger population.

Totally agree with both of these. I also agree with your assessment of Big Food- the processors and the fast food chains. I shudder at the stuff you can buy off the shelf- edible "cookie dough", microwavable French fries, canned frosting- things that used to take time to prepare so they were rare treats. Panera at least had the grace to show calorie counts on the giant, tempting cookies by the register. When I told them I burned that many calories in a sprint triathlon back when I could do them a clerk said they were "for sharing". Uh-huh. There's money in bigger portions- you charge more but they don't require any more people, rent, etc.

 

[audreyh1]

Sugar cravings are real.

 

[Aerides]

I can't find the link, but I recently read a long personal piece buy a reporter, probably in his late 50's, on taking on of these drugs. He'd lost about 65 lbs in 4 months or so.

He wrote about his lifelong struggles with weight. His many attempts - some briefly slightly successful - at old school fat loss. It had clearly plagued him his whole life. He was big. (think probably 5'10", 280 lbs?).

He wrote about the constant noise he had lived with in his head, describing it as always searching and screaming for food. Almost sounded like an anxiety or depression of its own? That even when he was losing weight and doing well, the voices and the noise were there, now even louder.

With Ozempic (or Wegovy, I don't recall which), he said the voice, the noise, was silenced. That the desire for food was almost completely gone. He could munch on broccoli, or not, who cared. In some ways this was sad to read - one of life's great joys is a fabulous meal, that was going to be a trade off for him.

This was not someone who had never heard "eat less, move more, duh.... discipline, I can do it why can't you?" - which is clearly not the solution for those with real issues.

 

[audreyh1]

For folks dealing with muscle loss on these drugs - will exercising such as strength training help mitigate that?

AFAIK weight loss reducing sugar and carbs is generally fat loss. By getting insulin level way down fat stores are released and you burn that, less hungry, reduces cravings, etc.

With Ozempic (or Wegovy, I don't recall which), he said the voice, the noise, was silenced. That the desire for food was almost completely gone. He could munch on broccoli, or not, who cared. In some ways this was sad to read - one of life's great joys is a fabulous meal, that was going to be a trade off for him.

This was not someone who had never heard "eat less, move more, duh.... discipline, I can do it why can't you?" - which is clearly not the solution for those with real issues.

Obviously powerful hormones drive this stuff even beyond mental health issues. Hormones is what these drugs are targeting.

 

[Romer]

For folks dealing with muscle loss on these drugs - will exercising such as strength training help mitigate that?

I do 15-20 minutes of weights most days (at least 5 days a week). I haven't noticed any muscle loss. If you eat plenty of protein and do weights then this really mitigates it.

I tried eat less move more and it worked for me in a yo yo fashion even though I was pretty fit into my early 40's before I gained the weight. I understand for those that works it is hard to understand it doesn't for everyone.

Like I said earlier. On this drug I don't deprive myself of anything and I do enjoy a good meal. I just eat less.

 

[RetiredHappy]

Carb addiction is real. If I eat alot of junky carb for a day or two, I would want to keep eating carbs all the time. Once I cut back on high carb stuff for even a day, the voice in my head to keep eating carbs is alot quieter. I believe that it takes willpower to reduce carb intake, and when that happens, the cravings become reduced. It is a vicious cycle. Eat more carbs, you will want to eat more and more carbs and put on weight. Once you cut out the carbs, the cravings are much reduced and you will lose wieght.

My friend who is on Ozempic for weight loss said that he is just no longer hungry or even enjoying his food. He had lost 35 lbs the last time we spoke. My husband who is on Trulicity for his diabetes also has dropped about 20 lbs and he is eating smaller portions.

 

[ElizabethT]

He wrote about the constant noise he had lived with in his head, describing it as always searching and screaming for food. Almost sounded like an anxiety or depression of its own? That even when he was losing weight and doing well, the voices and the noise were there, now even louder.

With Ozempic (or Wegovy, I don't recall which), he said the voice, the noise, was silenced. That the desire for food was almost completely gone. He could munch on broccoli, or not, who cared. In some ways this was sad to read - one of life's great joys is a fabulous meal, that was going to be a trade off for him.

This was not someone who had never heard "eat less, move more, duh.... discipline, I can do it why can't you?" - which is clearly not the solution for those with real issues.

Reading that this drug might alleviate the compulsion to overeat is very encouraging. Anecdotally, though I have never been more than 25 lbs up from my current weight, and am considered 'skinny' by pretty much everyone around me at my current weight (115), it is still a daily battle to quiet the voices in my head telling me to eat when I know I am not hungry.

I've always understood the science of weight loss (eat less than your body burns) and for sure get frustrated by those who appear to want to deny that it's for some other reason that they cannot lose weight. Conversely, I also understand and can empathize that the 'how' of accomplishing that can very, very hard for a lot of people. Brutal even.

Back on thread- at my new, lower weight I spend much less on items like candy, cookies, and the like. However, I spend considerably more on items like coffee and sparkling water. More on clothing as it's much more fun to go shopping these days. More on personal services like hair, nails, and facials for the same reason. More on sporting apparel and events.

No impact on medical expenditures, as I have never been overweight from a medical standpoint, so no personal anecdotes there.

As is usually the case, if the propensity of weight loss drugs shrink some segments of the economy, opportunities will most certainly arise to see it grow elsewhere. I don't see it growing per se, just shifting. So same size pie, just different array of slices.

 

[PatrickA5]

I've been overweight most of my adult life. I've done many diets and have kept track of my calories for years (currently on day 2,008 on MyFitnessPal). I'm still down 50lbs from my high, but have gained over the last couple of years. For me, losing weight (and keeping it off) is extremely difficult. Just having "willpower" isn't enough for many people.

I might have to look into these drugs. Just had my annual checkup with my PCP, but he didn't mention the possibility of these drugs. He probably wouldn't prescribed them for me anyway since I don't have diabetes.

And for those of you that think fat people are lazy...well...I think I'll keep it civil and not respond any further.

 

[athena53]

I can't find the link, but I recently read a long personal piece by a reporter, probably in his late 50's, on taking on of these drugs. He'd lost about 65 lbs in 4 months or so.
<snip>
With Ozempic (or Wegovy, I don't recall which), he said the voice, the noise, was silenced. That the desire for food was almost completely gone. He could munch on broccoli, or not, who cared. In some ways this was sad to read - one of life's great joys is a fabulous meal, that was going to be a trade off for him.

It may be the WSJ article I read earlier. It's "A Weight-Loss Drug Changed My Life. Will It Solve My Problem?" by Bradley Olson.

Carb addiction is real. If I eat a lot of junky carb for a day or two, I would want to keep eating carbs all the time.

When I was in my 20s I once bought a bag of red licorice bites at the grocery store and ate the whole bag on the way home. That kind of scared me. Mom always said that candy "spearmint leaves" were her downfall. Being single, it's easy for me to just keep some things out of the house.

My indulgence is a pack of 4 Nutter Butters after I donate blood, plasma or platelets. Then I back away from the table and go home.

 

[Sunset]

Restaurants really push high calories.

We eat at Cracker Barrel when traveling, they had a desert sort of like a mini apple pie with ice cream. We would share it after lunch, and on about our third time there, we looked at the calories from the desert.
It was ~ 1,200 calories just for that desert !!! That's half of a day's worth for a man !!

Now we no longer order desert there, but I still miss it.

 

[aja8888]

Restaurants really push high calories.

We eat at Cracker Barrel when traveling, they had a desert sort of like a mini apple pie with ice cream. We would share it after lunch, and on about our third time there, we looked at the calories from the desert.
It was ~ 1,200 calories just for that desert !!! That's half of a day's worth for a man !!

Now we no longer order desert there, but I still miss it.

We used to eat the lunch special after golf. Ever notice the extra large entry/exit size doors there?

 

[Koolau]

DD works in a pharmacy and is on the front line of lots of the drug wars.

She's young and prone to be cautious but has two strong views on this:

1 - She is livid about how often she has to tell diabetic patients they can't get the drug because of the demand of off-label weight loss use. She not judgemental about the weight loss use, but feels like until the diabetic need is met there needs to be a hard shutdown on weight loss use.

2 - She's concerned people are under-estimating the side effects and potential long term side effects among a larger population.

Personally, I think science and industry have brought us a lot of the changes that surround us in calories so its almost certain we need science and industry to counteract that. I do worry about people reaching for this before they do other things, particularly once its cheap. But there are other reasons people have trouble losing weight -- mental health drugs can cause weight gain for example -- so I won't judge from the outside.

All that said, if I were king-for-a-day, there are many other societal options available before we start putting another drug in everyone's body. Here's my suggestion: make it illegal to advertise a meal with over 1,000 calories as a meal for one person. It is ludicrous that companies can put 1700+ calories on a plate and call it a meal. Its funny when you're 17 to eat a burger with three patties and six strips of bacon. Yay for being young. But overall, some regulatory constraints on this jet engine of calories we produce would be wise. And WAY cheaper.

What an interesting dynamic. No more "Evil drug companies and their obscene profits." Now it's "Those evil drug companies won't make enough of that drug to meet demand." The "poor" drug companies just can't seem to win.

Time to buy their stock??

 

[badatmath]

.. .
That has opened up at least a few hours a week free time for me. Less cooking, eating, ironing smaller clothes.

I just quit ironing.

 

[Closet_Gamer]

What an interesting dynamic. No more "Evil drug companies and their obscene profits." Now it's "Those evil drug companies won't make enough of that drug to meet demand." The "poor" drug companies just can't seem to win.

Time to buy their stock??

No vote on the stock purchase but, yes, it it humorous.

A lot of big infrastructure, long cycle businesses carry those same societal scars. I hate you when you're making money but I hate you even more when you're not provided what I want when I want it.

 

[Koolau]

I just quit ironing.

DW quit ironing the day we were married 50+ years ago. If it needed ironing, she gave it to Salvation Army.

 

[sengsational]

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

I agree, but I'm not sure what about what I said was judgemental. My position for a long time is that you didn't pick your genes, and that explains most of what's going on. Adipose tissue is an active "organ" and it can call for nourishment when the body is in a fed state. I do not agree that legislating food calories would be helpful. I do not think it's a willpower thing. You got your genes and perhaps your microbiome and that gets you in an easier or harder place to keep at a healthy weight. To suggest that if we all applied the same willpower as the leaner of us then there would be no obesity seems absurd to me. If a drug can extend healthspan for overweight condition, then it should be leveraged. The issue with any new drug, and new can be pretty old, because the time scale to measure is a human life span, is unintended consequences. There are some things we already know to watch out for, like body composition issues I mentioned, but there's more, like understanding if the cardio benefits are simply from less weight or through another mechanism. If it were me that matched the population studied, I'd do it, but I'd watch side effects closely and I would hold-off if I didn't match the study population.

 

[brett]

A health professional made a comment to us about the increasing amount of obesity and diabetes in North Americans and how it is reaching down to youngsters and adolescents.

The gist of his comment was to look down any suburban thoroughfare and count the number of fast food outlets and donut shops. Or walk into a 7-11 or gas mart and see the shelf space dedicated to sugary drinks, and snack food.

Ditto for supermarkets...just walk in and see the shelf space and prime in store locations dedicated to snack foods, highly processed foods, cakes/cookies, and sugar laden drinks.

They tell a story.

 

[ElizabethT]

A health professional made a comment to us about the increasing amount of obesity in North Americans and how it is reaching down to youngsters and adolescents.

The gist of his comment was to look down any suburban thoroughfare and count the number of fast food outlets and donut shops. Or walk into a 7-11 or gas mart and see the shelf space dedicated to sugary drinks and snacks.

Ditto for supermarkets...just walk in and see the shelf space and prime in store locations dedicated to snack foods, highly processed foods, cakes/cookies, and sugar laden drinks.

These tell the story.

No, I strongly disagree and I think the health professional is being disingenuous.

Does he think we of the 60's and 70's ate wholesome, chemical free food? We of the Ding Dong, Hamburger Helper, Twinkies, Coke/Pepsi, Lays Potato Chips, Velveeta Cheese, Spam, and the like generation?

No. We were thinner because we were kicked out of the house after breakfast, and told to not come back until dinnertime. And we spent that time bicycling, skating, swimming, running, and causing general mayhem with our friends.

Prior generations engaged in much more physical work than exists today for most of us.

We are becoming heavier as a nation because we spend most of our day being sedentary, even if through no fault of our own.

 

[aja8888]

No, I strongly disagree and I think the health professional is being disingenuous.

Does he think we of the 60's and 70's ate wholesome, chemical free food? We of the Ding Dong, Hamburger Helper, Twinkies, Coke/Pepsi, Lays Potato Chips, Velveeta Cheese, Spam, and the like generation?

No. We were thinner because we were kicked out of the house after breakfast, and told to not come back until dinnertime. And we spent that time bicycling, skating, swimming, running, and causing general mayhem with our friends.

Prior generations engaged in much more physical work than exists today for most of us.

We are becoming heavier as a nation because we spend most of our day being sedentary, even if through no fault of our own.

Excellent points. I recall my mom telling me to go out and play with your friends (they were all outside too) and be home when the streetlights are on. And when I got home, dinner was ready and it was cooked, not something out of a preprocessed container.

I recall Ding Dongs and if I had the money to buy one, I ate it outside after playing ball all day.

 

[Sunset]

No, I strongly disagree and I think the health professional is being disingenuous.

Does he think we of the 60's and 70's ate wholesome, chemical free food? We of the Ding Dong, Hamburger Helper, Twinkies, Coke/Pepsi, Lays Potato Chips, Velveeta Cheese, Spam, and the like generation?

No. We were thinner because we were kicked out of the house after breakfast, and told to not come back until dinnertime. And we spent that time bicycling, skating, swimming, running, and causing general mayhem with our friends.

Prior generations engaged in much more physical work than exists today for most of us.

We are becoming heavier as a nation because we spend most of our day being sedentary, even if through no fault of our own.

Not everyone was skinny, even back then while I was skinny, my sister was fat.

She had the same amount (little) money I did, and same parents for us (both adopted which might be key) and the same home cooked meals every day. Both were sent out to play all day, no sitting around the house.

We as a family might have gone to a restaurant 1 -> 5 times per year. It had to be a special event as $$ was tight.

She must have been biologically driven to eat more, as once my cousin found bread slices under her pillow. Plain bread is hardly appetizing..

 

[EastWest Gal]

Since the key to maintaining the weight loss on these drugs is lifestyle changes, it seems important to make the lifestyle changes as soon as possible.

It is very helpful to redefine yourself, have a purpose, and have goals that are not just a number. I've lost 34 lbs since starting weight loss in earnest, but my main goal was to get in shape for the Hawaii trip as well as enjoy skiing at Whistler-Blackcomb in March. I haven't skied in 5 years until two days ago. It was fantastic-I fit into my old ski bib that I haven't worn in at least 10 years.

I've also used a little Orlistat (Alli) to get over my plateaus. It is safer than semaglutides, and has a similar GI side effect profile that can be managed by using it less or more. It's over the counter, and the prescription dose is merely 2 pills instead of 1. The weight loss and lipid improvements are not that different than with semaglutides. Bariatric surgery can have significant GI side effects as well. I was taking it a couple of weeks before my lipid and fasting glucose labs in the fall. My fasting glucose was 80 instead of 100 and my cholesterol which had been hovering around 166 instead of 200.

https://www.ncbi.nlm.nih.gov/pmc/ar...showed a larger,≥10% weight loss respectively.

I have a friend who had bariatric surgery 6 months ago, and she has not gone to the gym nor has she changed her attitude toward food. Yet she brags about her weight loss constantly.

 

[brett]

I was about 40lbs overweight when I retired. Lots of eating out, customer entertainment, travel, etc. I was never able to loose the weight.

Right after retirement we spent 7 months traveling in Europe and Central America. Followed it up with six snowbird winters in Thailand, Vietnam, Malaysia and two months each fall in southern Europe.

Lost the excess weight and kept it off. It was not about dieting so much as it was the travel experience changing our eating habits. Our tastes and our preferences changed so much, as did how we prepared food.

The other plus was we both felt so much better after the changes in our diet. And according our GP's it shows up in our blood results.

 

[athena53]

I have a friend who had bariatric surgery 6 months ago, and she has not gone to the gym nor has she changed her attitude toward food. Yet she brags about her weight loss constantly.

In a way, she HAS made changes. From what I've heard/read about bariatric surgery you can gain the weight right back if you don't stay away form ice cream, sugary drinks, alcohol and other foods that get digested easily in a shrunken stomach but are loaded with calories, and you have to be very careful about getting enough protein or other nutrients or you'll end up malnourished. So, she is exercising some discipline she didn't before.

Interesting observations about Alii, though. Maybe more people could try that first.

 

[Koolau]

Both of my parents went through periods of their lives (think 1920s and 1930s) when they literally did not have enough to eat. What an interesting time we inhabit where weight LOSS is important to us - not where our next meal will come from. I think I prefer the issues I face rather than at least some of the issues my parents faced.

Returning you now...