New diabetes drug helped obese people without the disease lose incredible amounts of weight

It looks like it costs about $8,000 a month.

Not so many people will be lining up to shell that out.

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High weight loss for a drug meant for diabetes management does not strike me as particularly safe. Blood sugar management for diabetics is an every day/rest of your life thing. A drug which causes major metabolic shifts does not sound like a great long term treatment for the condition.

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It sounds just amazing, and obesity is the underlying cause of huge amounts of America’s, and the world’s, health problems. However, the list of failed weight loss drugs (Fen-Phen, Ayds, too many others to list) is so long, I’m skeptical until real long-term results come in from a larger set of patients.

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I believe this is another similar formulation to Saxenda and Wegovy (liraglutide), which I was on pretty recently. It was a huge fucking help. It didn’t just magically make you lose weight, it just stopped the constant hunger feelings I’ve had forever.

I had to go off it because my new job doesn’t cover it.

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I’m not sure how it would be abused? The desired effect is one of the things it’s designed for. It’s a prescription injection, so it’s not like there will be a black market for it. And overdosing does not increase the weight-loss effect.

I’m actually pretty excited about this. It uses a somewhat new approach to treat diabetes, and apparently one of the side effects is that it addresses metabolic syndrome, or at least most of the symptoms of it, and improves lipid metabolism as well. This is a big change from older type 2 diabetes medications, like metformin and glipizide. Some of the newer diabetes meds, called SGLT-2 inhibitors (Jardiance and Farxiga are two of them) have shown similar, though much lesser, weight loss effects.

You’ve met my brother. He’s a poorly-controlled diabetic and quite overweight. If this works as advertised, it’ll be a great thing for him. I’d really like for him to live as long as I intend to!

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I’ve lost a couple inches off my waist since starting on the Ozempic. It’s also making the difference between watching every carb and gram of sugar versus just trying to eat relatively decently.

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So, with insurance, that’s somewhere between $3 and $14,000 depending on provider, pharmacy, plan tier, coinsurance, and conjunction of Saturn.

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Yeah, it’s not a stimulant. Stimulants definitely work for weight loss. The problem is, they are addictive, the more you take the more it works, and it has tons of side effects. This thing has none of those issues. It doesn’t make anyone feel high, taking more than the recommended dose doesn’t do more, and the side effects are minor.

Seems like this drug, if it really works out, is going to benefit a lot of people.

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And it’s an injectible, weekly injection. Not sure if that means it’s a depot that time-releases the med over a week, or something else.

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I feel like we need to drop the implicit and explicit moralizing around this topic. People want to be healthier, but a staggering proportion of people are not able to reach and maintain a healthy weight long-term through diet and exercise alone, in the current society and food environment. If the drug is relatively safe and effective, then this is a good thing, and should be welcomed.

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I was looking for reassurances but, hey…

Do You Yes GIF by Rosanna Pansino

BTW, thanks @shuck and @RatMan for breaking it down…

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I know that medical insurers have a reputation for a combination of cold-blooded ruthlessness and incomprehensible procedural errors to maintain; but I’m still a bit shocked that they’d outright say ‘vanity’ rather than just going with the old standby of ‘experimental or investigational’ or at least ‘cosmetic’.

‘Vanity’, while it was probably enjoyable to revel in moral condemnation of the fatty, is just so blunt that you could hang a readily upsetting article(like, not at all hypothetically, that one) from it; while something more opaque would have just made everyone’s eyes glaze over; and, when you win the game until someone actually forces you to pay out, esoteric but not immediately understandable, much less immediately falsifiable, without subject area knowledge works at least as well.

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Typically super long half life.
Semaglutide is an already out once weekly injection that is working well for diabetes and weight loss.
There was a head to head comparison, also in the NEJM, that showed this new one is more effective

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There’s an argument to be made that ‘drug abuse’ has a cogent non-moralistic definition: a situation where someone is using a drug despite its downsides outweighing its benefits(most especially if they know that this is the case and are unable to stop; less so if they are following advice that turns out to be incorrect; that’s not a good situation but lumping poor medical advice or ill-understood conditions in with addictions and dependency doesn’t really advance the cause of drawing useful distinctions); but unless the side effects turn out to be a lot worse(either in the medium-long term or for a subset of people) than described getting weight loss at the cost of some gastrointestinal upset sounds like medicine just working to me.

It seems especially innocuous given how unpleasant some of the current weight loss mechanisms are: some people do succeed on lifestyle changes alone; some others get a lifetime of somewhat disordered relationship with food and little to show for it; while on the pharmacological side you’ve got some reasonably effective but not desperately safe stimulants; and some rather effective but definitely not safe metabolic poisons(Absolutely not recommended; since it’s not entirely nontoxic and sufficiently good at tanking metabolic efficiency that you can drive yourself into lethal hyperthermia; but it’s pretty cool that there is a metabolic poison that directly scuttles the proton gradient across the mitochondrial membrane and pushes you toward anaerobic levels of efficiency, which are far too low to sustain an obligate aerobe and so drive the body to throw massive resources at the problem to try to compensate, most of which go straight to heat).

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A tricky call with a finite lifetime. I am 14 and a half stone, and I fell would be happier back at my college weight of 12 and a half, and not having to carry this extra stuff around. Not vanity, though I expect it is in there too, somewhere. I thought liposuction might be a solution, if it could suck out the fat storing cells once and for all, but apparently they grow back, so that’s not worth it. I wondered whether to go for surgical eye correction, but I waited so long with that to see if there were side effects, that I got cataracts and I now have new lenses for a different reason. I were to take this stuff, I would want to do it before I got much older and the side effects might pose a risk.

I won’t, of course.

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Fair enough. The drug appears to work by making people less interested in eating, and more satisfied when they do eat. So if the sort of abuse you had in mind was people wanting to stuff their faces and never get fat, I don’t think that is an issue - it doesn’t increase the amount you can eat.

I actually don’t know if anyone has investigated what its effects are on the eating behaviour of healthy weight individuals who have never been overweight, so whether it is open to abuse by people wanting to get unhealthily thin for aesthetic reasons, I don’t know.

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It wasn’t all due to the drug, presumably, though it appears that the drug made a huge difference in weight loss. Here’s a quote from the article:

“People in the study also received counseling sessions to help them stay on a healthy diet with a daily 500-calorie deficit, as well as at least 150 minutes of physical activity each week. While that certainly helped, it does not explain the magnitude of the weight loss seen in the study, Gabbay said.”

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“side effects were primarily gastrointestinal, and included nausea, vomiting and diarrhea…”

I got the same effect from catastrophic food poisoning, and I didn’t need to take any drugs. I shed 40 lbs in 3 days!

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Did you use these drugs primarily to lose weight?

Ok. Unique outlook and anecdote following.

Me: diagnosed type 2 diabetic last year. Initially on one metformin tablet a day, now on two metformin tablets and one jardiance a day. Horrific side effects (sorry in advance: this is graphic); liquid diarrhoea, no warning. I don’t know what’s causing it and haven’t yet been back to the doctor (my GP - Australian equivalent of primary care physician) to discuss but feel like I’m poisoning myself. Also extremely pissed off that despite making changes, cutting out full-fat Coke and stopping smoking, I haven’t lost any fucking weight.

Sister 1: ‘obese’ because of poly-cystic ovary disease. Has recently started the new injectable drug. Doctor recommended against it because of the rapid but unsustainable weightloss. She’s dropped a little weight but mainly because she’s nauseous to the point of vomiting multiple times a day and is only able to stomach minimal amounts of everything. She became aware of the drug because it has ‘gone viral’ on tik tok and is.being used by ‘influencers’ for fast substantial weight loss (even when there’s clearly no need for them to lose weight :roll_eyes:).

Sister 2: works for a pharmaceutical wholesaler. Massive shortages of the drug everywhere because of demand being so increased because of the off-label use. Being rationed to pharmacies so diabetics can get it first. The new injectable is available through Australia’s Pharmaceutical Benefits Scheme which reduces the cost. The PBS is a federal government program.

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