Weight loss drugs?

I'm just catching up on the specifics, but am getting the impression there is a wave of weight loss drugs being pedaled to consumers. My basic understanding is that they are prescribed for diabetes, but they have been so effective in helping people with weight loss that they are becoming widespread solely for that. Not a bad strategy for one of the most overweight countries in the world. They say they also reduce the risk of heart attack and stroke, which probably goes along with weight loss but may go beyond that. Down side seems to be that once you stop taking them the weight comes back so it's something like a semi-permanent arrangement?

I have a couple of friends that this could be a great boon for. People who have been grossly overweight for decades and have not been able to control their weight with diet and or exercise. I know we've had discussions here about drugs being pushed on the public by "big pharma". I've basically defended the medical industry, but I'm starting to wonder about this one. It just seems like an opportunity for abuse, but great for the right people. It's not something I would need or consider. It just seems odd.

Yes, there are a couple of drugs on the market, in the class known as GLP-1's. They curb hunger by slowing the food through the intestine. I've heard that people just don't have the appetite they used to. I have a couple of friends who went on one and lost a tremendous amount of weight. There are 9 of them on the market now--some are indicated for diabetes and some are indicated for weight loss. They're not cheap, that's for sure, and insurance companies do not easily pay for drugs that are "just" for weight loss.

So far they seem to be safe--I haven't heard of any crazy safety signals. I think for people who have had a lifelong issue with weight they're a godsend, but I also feel that they aren't the best answer. I look at GLP-1s as methodone for overeaters.

my sister-in-law has been on one for a year and lost a ton of weight. I’m skeptical of their overall safety long-term .

I need to drop pounds but I’m not ready to try that yet. I suppose I might do that if I dropped weight and then hit a plateau, still needing to drop more.

Let's fill our food full of things that make America fat, then fix them with drugs that they have to keep buying. Let's put the consume, in consumer.

Or as of yesterday (idiot announced retirement without any intention of helping figure out how not to run a place designed for two people with one, when I used to be the third/backup_)

Gain 40lbs in 40 days, eat nothing but our pizza!!!

I suppose I may answer my questions eventually, but if they lower blood sugar, which is probably a cause of inflammation and which can be a precursor to a number of ailments, whether you are overweight or not, would they ever be advocated for other uses. And since maintaining weight loss could be a long term drug arrangement, are there long term studies on their safety.

The first GLP-1 was Byetta, which I think was approved about 20 years ago. I remember working on it when I was still in corporate.

I remain leery of this class of drugs. No one really knows what long term effects might be...until they do.

The people taking the drugs are the guinea pigs. As mentioned above, we'll see what the long term effects are. They could start many years from now when no one associates them with the drugs.

Late last year I started researching a different way of eating. I've been eating the SAD (Standard American Diet) of mostly lean meats, vegetables and fruits, "healthy" whole grains. And I've been gaining weight, experienced brain fog, aching joints, constant hunger. In January I started the Carnivore diet and it's been life changing. Starting weight was 124 (I know, not overweight but the most I've ever weighed), and am now holding steady at 107. No more needing to grab something when getting up from the floor, tons of energy, gained muscle/lost fat. I'm 58 and feel 25 again. Nothing but fatty beef, butter, bacon and eggs.

If people stick to unprocessed foods that our ancestors ate, it would change their lives.

I am totally confused about what to eat after a recent blood test showing my A1C and cholesterol are pre-diabetic (glucose still below 100). I have been eating a modified Mediterranean diet for many years with no issues, avoid sugar, sweets, processed food and don't eat a lot of bread or other carbs. I am not overweight. Scratching my head about how to proceed. Maybe it's just getting older? Doc wasn't much help with advice since I am already eating what they recommend.

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Originally Posted by pinkytoe

I am totally confused about what to eat after a recent blood test showing my A1C and cholesterol are pre-diabetic (glucose still below 100). I have been eating a modified Mediterranean diet for many years with no issues, avoid sugar, sweets, processed food and don't eat a lot of bread or other carbs. I am not overweight. Scratching my head about how to proceed. Maybe it's just getting older? Doc wasn't much help with advice since I am already eating what they recommend.

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Do you exercise? While most diabetes interventions are rightfully focused on diet, exercise plays a role in prevention.

https://www.ncbi.nlm.nih.gov/books/NBK549946/

My own theory, backed up with some evidence, is that stress contributes to diabetes. Are you experiencing stress at all?

https://pubmed.ncbi.nlm.nih.gov/1425110/

I walk about two miles a day, climb a lot of stairs daily and spend a lot of time in the garden. I stress a whole lot about where to live. I know that our emotions heavily affect our health.

I modified my diet a year ago April due to my then new diagnosis of pre-diabetes to take the carbs out of breakfast and lunch, adding in more protein and fat to make up the calories. I feel better, have lost weight (wasn’t really overweight but I’m now back to my college weight of 15 lbs lighter). And I’m taking the lowest possible dose of metformin. This past April my annual blood work up had improved. A1c and foot the first time in years, normal lipids across the board. I’d worried that the extra fat in my diet would cause the lipids to move in the opposite direction.

Regarding the use of diabetes drugs for weight loss I have mixed opinions. I’m glad it works for that for some people. But on the flip side SO was not able to get monjaro, which he is prescribed for full blown diabetes, for four months due to lack of availability.

Back to my pre-diabetes situation Dexcom was recently approved to sell continuous glucose monitors over the counter. I’ve ordered one with a month of sensors because I’m curious how various foods affect my glucose levels. I don’t plan to do it for more than a month but that should give me enough insight into what, if anything, makes my blood sugar spike so that I will know what I can enjoy and what I need to avoid. My sister, who is also pre-diabetic, recently did the same thing but by doing a thousand finger sticks and found that her blood sugar never spikes, it just never gets down below 100.

An interesting article for those so inclined.

https://www.nytimes.com/2024/09/16/o...f-disease.html

"It’s easy to attribute this to the dramatic weight loss provided by Ozempic and other drugs in its class, known as GLP-1 receptor agonists. But that isn’t the whole story. Rather, the drugs’ numerous benefits are pointing to an emerging cause of so much human disease: inflammation."

Inflammation might be why statins work too.

I had my annual physical recently and mostly out of curiosity asked a few questions about GLI-1. His story was that the popular injections cost $500-1000 dollars a month and insurance companies are reluctant to cover the cost. He said in some foreign countries the cost is a fraction of that for some reason. And he wasn't too sure if the injections would have to continue forever. He said he had a dozen or so patients who were paying out of pocket without insurance help to get the injections. I didn't ask about Medicare.

He thought the reduction in coronary events was mostly due to the weight loss rather than some other unexplained interaction, but didn't think anyone really knows for sure, so far.

The internet probably has loads of information to page through, but the real life perspective was interesting. Doctor is a pretty down to earth traditionalist when it comes to medications. It seems like there are a lot of unknowns. I guess the drug companies have found a way to pay for their endless Ozempic TV commercials.

I tried a month of it. It made me so ill I could not continue. This was after trying Metformin, which also made me ill. Insurance would not pay for it.

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Originally Posted by Tybee

I tried a month of it. It made me so ill I could not continue. This was after trying Metformin, which also made me ill. Insurance would not pay for it.

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Yikes, that is unfortunate. What were your symptoms of it making you sick? I suppose that in itself would be a weight loss control because if you’re sick, you can’t eat, but that’s not exactly what we’re going for.

how much was it costing and how did you take it, pill or shot?

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Originally Posted by iris lilies

Yikes, that is unfortunate. What were your symptoms of it making you sick? I suppose that in itself would be a weight loss control because if you’re sick, you can’t eat, but that’s not exactly what we’re going for.

how much was it costing and how did you take it, pill or shot?

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The way she prescribed it, it was a shot but it was going to last about 3 months and it cost 1000 dollars. Symptoms were feeling like I was walking on a rolling ship, nausea, tremendous fatigue, and headache. I could not stay upright on it.

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Originally Posted by Tybee

The way she prescribed it, it was a shot but it was going to last about 3 months and it cost 1000 dollars. Symptoms were feeling like I was walking on a rolling ship, nausea, tremendous fatigue, and headache. I could not stay upright on it.

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Oh that is miserable. Being seasick for 3 months, awful!

Yikes. That sounds terrible. I was concerned when doc prescribed metformin since I’d heard a lot of people have terrible side effects. Thankfully I have none.

An aside, I mentioned before (at least I think I did) that I had purchased one of those continuous glucose monitors now that you can buy them over the counter. It’s been fascinating and informative. I’ll put together my thoughts and start a new thread. Very short version, I’d recommend anyone in the pre-diabetes stage of the disease get one for just a month. They’re only $99 for the month and the insights as to what will lower your glucose are incredible.

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Originally Posted by jp1

Yikes. That sounds terrible. I was concerned when doc prescribed metformin since I’d heard a lot of people have terrible side effects. Thankfully I have none.

An aside, I mentioned before (at least I think I did) that I had purchased one of those continuous glucose monitors now that you can buy them over the counter. It’s been fascinating and informative. I’ll put together my thoughts and start a new thread. Very short version, I’d recommend anyone in the pre-diabetes stage of the disease get one for just a month. They’re only $99 for the month and the insights as to what will lower your glucose are incredible.

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Please do put together the thread, I am very interested in trying it.

These are going to be in short supply due to the port strike. Manufacturers sends them all via ocean. Switching to air. Linked article in the port strike thread.