GLP-1 drugs: An economic disruptor? (2024)
528 comments
·March 1, 2025cj
no_wizard
I’m not going to lie all this sounds like heaven to me.
I absolutely hate the way my appetite works. I have a genuine dysfunction with food. It goes back as far as I can remember. My cravings never stop, even after being satiated. It’s an endless cycle of weight gain then loss then gain as my willpower fluctuates for a variety of reasons.
My insurance only recently started to cover these weight loss drugs, and I have been looking into them over the last month because I think I’m an ideal candidate for it.
If it gives this kind of control over cravings and appetite I’m really looking forward to how this can genuinely make my life better
Henchman21
I'm a few months into this drug as well, and I have to say, it doesn't offer control. What it offers is a lack of cravings & appetite. That is different, remarkably so.
Control would mean I might still feel hungry. Ever. Or that I could decide to eat heavily at one meal, but I don't and as long as I take the drugs, I won't. That doesn't feel like control, it feels like I've had something removed. I guess it's a matter of perspective?
I don't know if its a common sentiment but this drug treatment is the hardest thing I've ever done for my health. I'm not sure I'll be able to continue though. It's like I've robbed myself of the one joy I had left and now I have none. Tread carefully.
no_wizard
The difference here may simply be in how our mental health relates to food.
It sounds to me like it brings you enjoyment you miss. I respect that.
Food for me isn’t that. The lack of cravings and appetite means I would be firmly in the drivers seat with it. It means I can eat exactly the amount I’m suppose to and not feel like I must have more
fragmede
Note that if you're doing this treatment at home (aka bought a vial and a syringe off the Internet and are injecting yourself), you can simply give yourself slightly less next injection. It's not a binary "hunger (y/n)" but more of a spectrum. (anecdotally)
relaxing
I don’t understand what’s missing. What was the joy?
For me, hunger is misery, and so is feeling over-full. I’d do anything to take that away (well, short of sacrificing my financial security to pay the market rate for the drug.)
petesergeant
Stop moving up the dosage so fast.
ta2234234242
I've been on them for over a year now. I was 320lbs at my peak. I'm down to 247 as of today. I have about another 27 pounds to lose, and then I think I'll be where my doctor wants me.
Here's my experience (n=1):
* Zepbound is better than Wegovy. Wegovy has more side effects than Zepbound. Also the Zepbound pen is better than Wegovy.
* If you're worried about needles, don't be. The injection feels more like a rubber band snapping at the skin. And you'll get used to it.
* I typically have moody days maybe 2 or 3 days after I inject. I attribute that to blood sugar changes.
* Food tastes differently to me now. Food I used to really like can sometimes now just be okay. I don't like french fries so much anymore like I used to (they're good, but not what I remember). The huge bowl of chips I got from the Mexican restaurants don't taste as good anymore. Potatoes aren't really as attractive anymore. I prefer protein.
* I had constipation, which is a side effect. There was a stool softener I took from costco that helped. Eventually that went away.
* I got a bike for exercise. It's nice in that I feel like I actually go places rather than sitting on a Peloton. I also get fresh air. I had to find something I wanted to do, and I hate walking frankly.
* As I lost weight my alcohol tolerance dropped, but it's to be expected but still surprising when one beer hits you harder than it used to.
Maybe some tips:
* Nausea might a be a side effect, more so with Wegovy than Zepbound according to my doctor. So I guess plan to take it easy if you can.
* Your relationship with food will change, so be prepared mentally for that. Food used to make you happy maybe, and now it won't. So figure out what activities and interests that make you happy which don't involve food.
* Sugar is the one thing that can still ruin your progress. So be careful with desserts/candies/sweets/sugared sodas/etc.
* There's some debate about whether diet sodas spike your insulin levels or not. I would recommend going to black coffee to get your caffeine if you haven't already, and black coffee will also help to stimulate your bowels as well. That said, diet sodas are still better than sugared sodas.
codingrightnow
I'm a major snacker in my 40s, have been most of my adult life. When I don't have my daughter I would fill myself up with cookies, cereal, and chocolate candy. I've been a few months off of all of that shit, accidentally didn't really plan it, I just haven't had any cravings whatsoever. I'm sure it could come back easily but it's not here and I don't miss it. I've lost a lot of fat. I'm not just eating fruit and vegetables, but I'm finding meals alone are enough.
SkyPuncher
Don’t waste your time with insurance. Just go to one of the consumer facing companies that compound them directly.
I’ve seen cases where these sites are 5x cheaper than insurance
loeg
FDA has determined the shortages of the non-compounded versions has been resolved (of zepbound/tizepatide in October 2024, and wegovy/semaglutide last week): https://www.fda.gov/drugs/drug-safety-and-availability/fda-c...
So compounders can no longer legally sell tirzepatide and will soon (April-May) be unable to legally sell semaglutide.
That said, the lowest doses direct from Lilly without insurance are $350-500/mo. And if you can do math, you can pay for a higher dose and spread it out over time to achieve a lower average price.
aorloff
Try reading Gary Taubes and seriously monitoring your carb intake
Your body has 2 separate engines that work completely differently
aenis
Awesome stuff. Envious, here (NL) its impossible to get a prescription.
For an alternative approach for comparison: My wife and I eat low carb and fast every other day for a year now. Around the 2nd month mark we got the exactly same outcome: food became a chore. We sometimes dont eat for 2-3 days when travelling or busy. I dont remember feeling hungry in about a year. We do sports - I sure have less peak power, but can sustain moderate efforts for longer (I use a power meter and Hr strap - my vo2max dropped). I feel significantly sharper mentally and managed to learn a new language (Dutch, from zero to B2) in a year - while working a cto job. Not eating easily gives 3hr extra a day, incl. what I get from waking up early.
Saves us a ton on groceries and eating out. The only thing we do watch out is carbs - I can eat a kebab or two tacos but dont eat any sweets, eat bread or drink beer/soda. Weight stabilized at my high school level. Not sure if I can recommend it as it is a bit tricky to practice, especially while having a job that requires routine socializing, but - it does work. The only really difficult thing is to start and endure the first two weeks or so.
wert7886
That sounds very intriguing, are you a bit concerned about the dropping vo2max ? Do you eat a lot more meat than before?
aenis
No, I eat a lot less in general and a whole lot of veggies.
I followed the same routine 4 years ago, then I stopped and when I started eating carbs my vo2max recovered overnight. I think one cant have it all - either you run on stored energy which caps the power to weight ratio - or on readily available glucose and glycogen. Its fine, I am not an athlete, I do sports to feel good. I dont see an impact on raw strength - just on anaerobic performance.
ctrlp
I've heard similar accounts and it sounds pretty wild. I'm not overweight and don't take anything but I do enjoy food. It would be horrible to me to lose the enjoyment of such a primal pleasure. If the choice is between being overweight and giving up the pleasure of eating altogether, I can imagine plenty of gourmands who would rather carry the extra weight for the physical and social pleasures of food. I've heard anecdotal reports of people losing their enjoyment of food permanently, even when discontinuing the drug. Canot confirm but that would be a high cost to pay, imho.
dghlsakjg
Counter-anecdote.
I have not lost my appreciation for good food, I just eat less of it. I used to be unable to leave any food on my plate regardless of how good or bad it was, now I’m perfectly happy to leave something uneaten if it isn’t to my taste.
alabastervlog
Same, I'm on one of them and I still love and enjoy eating and am perfectly capable of eating my beloved junk food. I'm just highly likely to feel done after a few bites instead of... dozens and dozens of bites.
Losing the pleasure of food was one of my main concerns starting it, and it hasn't been an issue whatsoever.
Meanwhile, I'm back down to my healthy weight range, which I haven't seen since 2021, which was about the third time I'd been at that weight and then ballooned up. I was just about at the top of that range after two months, down about 30 pounds, and it took no effort whatsoever.
I feel amazing. Muscle mass is also doing fine, and I'm well into middle age so any protective properties of youth are largely gone, still having no problems there.
cm2187
Same for me, I don't recognise those symptoms (loss of taste, loss of impulses). My understanding is that all it does it to replicate the signal the stomach sends when it is full, and so you just feel full / a bit burpy, even on an empty stomach. But you do enjoy the same taste than before the drug.
That being said side effects vary and lots of people mention it gives them nausea. I can easily imagine how that would interfere with taste.
op00to
I actually appreciate food far more now, because I am no longer worried that I have to consume “enough” food. A small amount is just as satisfying. A large amount makes me ill, and you only make that mistake once.
tasty_freeze
I resonate with your comment about appetite loss. It is surprising how much it has affected my happiness, to have this few times a day pleasure taken away.
A month ago I suffered through a norovirus infection, the first time for me. In three days I lost six pounds (my BMI is 21.2 now). At first I wasn't surprised or worried -- after all, I had emptied out my digestive tract and was dehydrated. But a month has gone by and my appetite has been AWOL. I've lost another pound (5'11" @ 152 lbs). I have an appointment next week with my doctor's PA to see if something else is going on.
The taste of food is the same, but the craving is lacking. When I eat, my guts are telling my brain it is time to stop eating, as if I had eaten a pound of mashed potatoes only an hour ago.
raincom
Maybe, Norovirus affected GIP and GLP-1 hormones. This could be a new research avenue for weight loss. GIP and GLP-1 are product of the research about the Gila monster lizard, which eats three or four times a year and survives.
crazygringo
I'm curious -- do you have any brain fog? Are you able to exercise? When you exercise, do you wind up eating more, i.e. the caloric amount that you exercised?
I've never had any psychological difficulty with losing weight. I don't care if I'm hungry.
But what happens when I eat less and lose weight is that I have trouble concentrating. The glucose my brain needs just isn't there. And if I do physical activity, forget about it -- my blood sugar is going to my muscles and I'm unproductive for hours afterwards as I just can't think. Also, if I go to the gym, my muscles take a week to recover instead of a couple of days, because they're just not getting the glucose they need to repair themselves.
I don't hear any of these complaints from GLP users though, which baffles me. Not eating enough affects us in lots of ways besides just being hungry. How has it been for you?
ragazzina
> But what happens when I eat less and lose weight is that I have trouble concentrating. The glucose my brain needs just isn't there.
This is crazy, I have the completely opposite effect. On keto + calorie restriction I feel much more alert and sharp.
mac-mc
It's because people are different, sometimes on a genetic level. What works well for one person does not work well at all for another, like the parent commenter, I do not work well without carbs. Keto puts me in a low-energy, semi-depressed state, while eating +80% of my calories as starch led me to lose about 15lbs of fat and now I'm the lowest body fat % I've ever been in my adult and teen life and my HOMA-IR went from 3 to 1.6!!!!
And my genetics also showed this to be the case too!
DrBenCarson
Well yeah in ketosis your brain is running on a different energy source
PeterStuer
Your muscle repair would come primarily from protein. I used to train quite intensely and this protocol worked for me (timings matter):
- 45 mins before workout: small bowl of oatmeal with milk
- 30-0 mins before workout start: 1 liter of water pre-hydration
- During workout: 1/2 liter of water per half hour of intense cardio training, less so for resistance
- Straight after workout: double black espresso coffee (high caffeine)
- Hit sauna for extensive slow cool-down, drinking one sports drink (sugars and electrolytes)
- hour later: full meal of mainly lean protein
Never had issues with muscle pains or "fog".
If you go really deep beyond your usual sustain, feeling physically exhausted and needing rest afterwards is normal. Eating your way through it is not the way to go.
crazygringo
> Your muscle repair would come primarily from protein.
This is a common misconception.
Yes, muscles are made from protein, and so you need additional protein to provide new "building blocks".
But the process of muscle repair uses a far greater amount of glucose to actually do the work of assembly. Estimates are generally that you need something like 10x as many calories from carbs/fats to build muscle, compared to the actual protein required.
So no -- muscle repair actually comes primarily from glucose, if you're measuring calories. But the point is that you need both. If you eat plenty of protein but your blood sugar is low, the muscle growth/repair will be extremely slow, or just not happen at all.
Also, your protocol is entirely about the workout. I'm talking about the 48h afterwards, when the growth actually occurs in response to the stresses incurred during the workout.
op00to
No brain fog. I walk at a very brisk pace ~6 miles a day. My calories are far less than before I started. I have to be very careful to have enough protein. When I exert myself, the recovery period is the same time as before.
crazygringo
Do you have any idea of how many calories you eat per day?
I get so confused because the small amounts of food that people talk about eating on GLP, don't seem like enough to sustain themselves long-term.
Are they exaggerating? Or do they talk about not eating dinner, but that's because they had 1,700 calorie lunch at the burger place? Or is that just during weight loss, and then once a target weight is hit, they're eating like a normal (healthy-weight) person again?
I just genuinely don't understand how people are surviving with the diets they describe.
loeg
No brain fog, but in my experience it does impact exercise (similar to any other caloric deficit). Both maximal efforts (e.g., heavy barbell squats) and endurance (hours on the bike).
maleldil
> being overweight will be a choice
Not everyone can take these drugs. Some people will have severe side effects. It's very common to have nausea, vomiting, etc., and some people will experience these frequently enough that the prescribing doctor will rescind the prescription.
abirch
gastroparesis is a real side effect two, it’s where the food in your digestive tract stops moving. As in 30% of food is present after 4 hours
The rate is over 1% which isn’t a lot nor is it nothing https://jamanetwork.com/journals/jama/fullarticle/2810542
cyberax
It looks like it's mostly caused by having too high doses of GLP-1 too soon.
ChiperSoft
This was me. I’ve been on them for four years and actually gained fifty pounds
The drug keeps me from binge eating, which is huge, but if I take enough to actually lose weight then I have weekly bouts of food poisoning because the sugars in my gut start to ferment. An entire day sitting on the toilet while holding a bucket because it’s coming out both ends.
taurath
I tried, I got some results but it meant that my entire body’s digestive system felt like it stopped working. Constipation, nausea at the drop of a hat, finding I’d have to take a fast acting prescription anti nausea multiple times a day. I’m not that overweight, and I felt like my body was getting far less healthy and like I was starving myself. This is on the lowest starter dose, too! It just… yeah, it works as I’d expect an extreme appetite suppressant would.
xattt
Are these the same effects that folks would get if they stopped eating cold turkey?
Would Zofran throughout the day help with the side effects until the body adjusted?
j_timberlake
Those side effects are from injecting weekly doses, right?
I'm curious if daily oral doses which are smaller will solve a bunch of these problems at once, while also mitigating the supply-chain problems.
brianbreslin
The oral semaglutide (sublingual dissolving) is like 10% as effective as the injected version. But it presumably could be given in higher doses to counteract that. I'd be shocked if the manufacturers aren't working on a more effective non-injectable version.
loeg
FWIW, you can inject half as much twice a week, or whatever schedule works for you. I do it every 3-4 days.
esseph
My wife was on daily doses and it made no difference. She's now having long-term problems, over a year after getting off of it.
asveikau
> My morning starbucks routine has changed from 2 food items to just 1, which alone saves me $200/mo (sorry starbucks).
Starbucks food is especially calorie dense. I realized this when I lost a bunch of weight in 2018 and I noticed the calorie counts on the printed cards that some stores have. Even for junk food, Starbucks junk food is more calorific than average for the same items.
I started to consider that for a typical customer's consumption, McDonald's might actually be healthier than Starbucks. Which totally goes against the image people have of both places.
People think if they are "going for coffee", it's better for you than having a milkshake and following it with candy. But it's essentially what they're doing.
Taikonerd
"Starbucks's greatest trick was convincing grown-ups it was OK to have a milkshake for breakfast."
(I heard this somewhere on the internet, about the Frappucino.)
vjk800
It's weird that I've never been overweight and you describe basically how I normally feel.
I've never felt hungry in the morning. I've never eaten a lot. When I was younger, I often forced myself to eat more, because I felt bad about how I wasn't "big enough" (which feels silly now as a proper adult).
Impulse buying food and snacking is something I only do if I haven't eaten for a long time, i.e. if I'm actually very hungry.
If I go out drinking, I also make a point not to eat very much before or during the drinking, because otherwise I just feel sick after like one beer.
raphman
Is this person an expert of any kind? They throw around dozens of numbers without any sources. For example,
> 'A movie theater chain recently analyzed their user data and discovered that 72% of their profits came from concessions, primarily from impulse purchases made by people who swore they "wouldn't buy anything."'
This combination of non-descript source, precise numbers, and 'quotes' looks like the usual bullshit one reads in self-help books. I conducted a quick online search but couldn't find any direct source for this claim (although the number might be in the right ballpark).
llm_trw
Is there any evidence for general impulse control?
I'm seeing papers claiming both increased and decreased impulse control.
qnleigh
This article also throws out a bunch of trends and then attributes them to Ozempic with no evidence.
> America's largest mall operator, Simon Property Group, is converting anchor stores into medical centers and wellness spaces.
Maybe that's because malls have been struggling for years and are trying new tactics in response to that?
> Whole Foods is shifting from endcap promotions to subscription services.
So many industries are shifting to subscription services, because it's so lucrative. What evidence do we have that this is triggered by Ozempic patients??
When will I get downvote privileges on this site...
Earwig
Yeah, I’m also having a lot of trouble finding sources for the specific claims they’re making (even, say, the NFL stadium redesign thing, which feels like it should be easy to find). And taking into account the AI-generated lead image, I’m a bit skeptical of all this.
KaiserPro
I would point out that it isn't unforeseen, given that genz don't drink, go out or do drugs to anywhere near the extent that millennials did at the same age. (https://www.statista.com/chart/30783/alcohol-consumption-by-...)
I would also gently point out the evidence for tempering alcohol only seems to be evident with people who have high BMI https://www.pulsetoday.co.uk/news/clinical-areas/mental-heal...
So yes, its worth thinking about how our economy is organised.
But the thing that is going to kneecap the US economy in the short terms are one of the following:
o Tariffs
o Cutting government spending (especially welfare)
o a steep rise in unemployment caused by government firing of civil servants
o fucking with the structure of the monetary system
o AI eliminating whole classes of jobs (taxi driving, phone centers, clerical work, etc etc)
dehrmann
Genz just swapped traditional vices for social media...which also deals with impulse control.
kansface
I wonder which is more harmful?
fallingknife
I can't say which is more harmful, but social media is a hell of a lot less fun
ReptileMan
>I would point out that it isn't unforeseen, given that genz don't drink, go out or do drugs to anywhere near the extent that millennials did at the same age
Kids these days
whamlastxmas
No dessert until you finish your bong hit, sweetie
macintux
Interesting, but I’m not sure I buy it.
I certainly don’t think Simon is preparing for this massive economic shift; I think they’re reacting to an existing trend.
> America's largest mall operator, Simon Property Group, is converting anchor stores into medical centers and wellness spaces. They're doing this because they recognize the writing on the wall.
Malls have been dying for years, and COVID felt like the nail in the coffin.
mlhpdx
The large scale economic evidence in the article is as easily attributed to population growth and aging.
dumbfounder
Malls around DC are crazier than ever. But I am not sure if people are spending money or not.
bobthepanda
There are different classes of mall. In general those class A malls targeted at higher income stores and shoppers have been more resilient over the past decade than middle or lower. (Nordstrom vs Macy’s vs. Kmart)
macintux
The Indianapolis metropolitan region used to have 4 major shopping malls, all owned at one time by Simon.
One was completely shut down in 2022 after years of decline, another lost all but one anchor and was auctioned off for unpaid property taxes.
ForTheKidz
It's straight up miserable to be in mclean/tysons between october and february. Truly it is america's asshole. And yes, people conspicuously consume more than ever. I think this is likely not true of most malls, though, the shopping culture here is just nuts.
IgorPartola
Because in a lot of places there is nothing else fun to do. There is in particular nothing to do for teenagers. They aren’t welcome at most places and the mall is about the only place where you can go and (a) not be run out of there and (b) not have your parents worried that you are getting up to no good. So teenagers grow up in the malls and as adults are habitually going back.
WarOnPrivacy
I was last in NoVA in 2019 and shopped at the Sears at Landmark. It was the last store. Crazy=yes.
jijji
In October of 2023, when Walmart CEO told Bloomberg [0] that ozempic was partially responsible for sales declining, other shares including Coca-Cola [1] started to fall as well....
[0] https://web.archive.org/web/20231006122607/https://www.bnnbl...
[1] https://www.marketwatch.com/story/coca-cola-and-pepsicos-sto...
glp1guide
I think this is the appropriate response — it’s clear that lack of appetite control is driving purchases a nontrivial amount of the time for junk foods — companies that depend on that revenue have never really had a challenge until now
iszomer
COVID? I felt it was horror subgenre of the backrooms. which popularized the idea of liminal spaces, that sealed it's fate.
bobthepanda
There were a lot of different things happening but COVID certainly cut out some straggling malls.
In general this was a correction. The US ranked first in 2018 for retail sq ft per capita at 23. To put this in context, the next highest country, Canada, had 16 sq ft per person, and most developed countries sit around 3-4 sq ft per person. https://www.statista.com/statistics/1058852/retail-space-per...
aljgz
> When companies like Google see their healthcare costs drop by $12,000 per employee annually and productivity increase by 25%, we observe a restructuring of corporate America that makes remote work a minor adjustment.
In my entire office, there's one overweight person that I know. Out of thousands of employees. There could be more, and other cities might be different, but you get the idea.
The author intentionally or mistakenly applies some numbers to whole populations.
Keep chaining impacts while eliminating small coefficients, your end result will be off by more than a few orders of magnitude.
EDIT: I need to be more clear about my point: My BigTech office does not represent my country stats: Canada has a 26% obesity and 36% overweight adult population. Just taking those numbers, applying them to all populations is wrong.
The analysis is wrong in other subtle but important ways as well. A 25% increase in performance of an allegedly low performing group of a company would not increase the overall company's efficency as much.
brokensegue
40% of Americans are obese and way more are merely overweight. Either your office is small, a huge fluke, weirdly selected or you're not observant enough.
xboxnolifes
6th option: They are overweight, but do not know, so they don't recognize what overweight looks like. But also, it's pretty easy to not look overweight if you're not obese. 30 pounds can be as little as a few waist sizes. I can gain and lose 15 pounds without looking like I changed at all.
Workaccount2
I am 6ft and 165lbs and work with a bunch of overweight people. They are normal weight and I desperately need to eat something - according to them.
brokensegue
That counts as not observant to me
anal_reactor
When you're like 5kg overweight it can definitely hide well, especially if your body shape is proportional.
treis
That 40% isn't evenly distributed.
LostMyLogin
Most of these studies use BMI which doesn't differentiate between muscle mass and fat. The number is likely much lower. Additionally, your numbers are off. I think you are looking at the number of people considered overweight, not obese. There were only three states in 2023 with an obesity rate over 40% [0]. The number usually hovers between 30 and 35%.
[0] https://www.cdc.gov/obesity/data-and-statistics/adult-obesit...
llm_trw
The 40% of Americans who are obese don't work at Google.
IncreasePosts
Well, here in boulder, there are a lot of tech workers, and it is one of the thinnest cities in one of the thinnest states. Having said that, Colorado in 2025 despite being one of the thinnest states is still fatter than the fattest state in 1990.
llm_trw
This is what gets me.
Homer Simpson was meant to be a fat idiot barely hanging on.
In the 40 years since the first episode he's gone to being average weight and fitness.
Economically he's now wildly successful for being able to own a house on a single income with three kids. There are people making over $800,000 today who can't afford that.
bgnn
Luckily there's the rest of the world.
llm_trw
The rest of the world is just 30 years behind the Us.
The Netherlands today are fatter than Missisipi was in 1985.
Denvercoder9
Or not in the US.
thfuran
>The author intentionally or mistakenly applies some numbers to whole populations.
You're doing it far worse than they are. The obesity rate in the US is something like 30%, with some regional variation.
Marsymars
> In my entire office, there's one overweight person that I know. Out of thousands of employees.
That seems incompatible with the numbers that show something like 3/4 of the US population being overweight.
(And yeah, BMI isn't great, but it works pretty well with an aggregate population of sedentary individuals, which the population at large is.)
thundergolfer
The population of a specific Google office could be two std deviations from the mean. My office area, SoHo NYC, has a dramatically lower obesity rate than the USA average. Maybe 10-20% of the population is overweight, let alone obese, and it’s mostly the service workers.
luckylion
But 1 of 1000s? That sounds like it's made up, or a very, very, very fitness-focused company.
appleorchard46
Obesity causes many health problems, but it's also a symptom - of our poor relationship with food, of the way American society is set up around instant gratification, of the predatory nature of food manufacturers.
Though treating the symptom is undeniably good, it also lets the deeper problems that lead to it go unchecked, and my fear is that it will lead to novel problems down the line. How recreational drugs are being replaced by social media is a good example of this; less harm to the body, undeniably good, but still harmful to the mind, and enabling new industries to pop up and find new ways to exploit people.
To be clear my problems aren't with Ozempic, and I believe it should be researched further and, if safe (which seems to be the case), widely available. But the fact is that many nations are able to maintain healthy weight without drugs, and I think if we fail to continue asking why that is, the same societal patterns that led to self-destructive individual behavior in the first place will remain unaddressed.
hn_throwaway_99
I agree with everything you've written, and I think your thoughts about Ozempic are spot on.
In the US, though, I don't mean to be super pessimistic but the problems are now so ingrained that I don't really see them improving for at least several generations. Stuff like:
1. Basically everywhere except for a few notable cities are organized around the car. Even if you wanted to walk places in a lot of towns it's near impossible or dangerous due to the road architecture. Fixing this now that it's built is an enormous challenge. I'll be long dead and gone before even a dent is made in it.
2. For decades we've been going in the wrong direction, and I don't see that changing anytime soon. I'm often shocked and saddened by how, well, "thick" high schoolers are these days. Like when I was a kid, there were certainly "fat kids", but it really wasn't that common. And we had a joke that when people went to college they would gain the "freshman 15" due to the all-you-can-eat dining hall plans. To me it looks like the freshman 15 now starts for high school freshman. And while I don't have kids, I've also heard others say how childhood has drastically changed since I was a kid. So much "hanging out", which used to be a physical activity, is now just done on phones. Except for organized sports, kids these days get much less "ad hoc" physical activity. High school is usually the thinnest/most fit a lot of people will be in their lives, and so I think we've condemned a ton of kids to a lifetime of obesity and health problems.
I'm all for changing our structural issues, but I'll take an imperfect solution now over something I don't think will come to pass for decades.
a_wild_dandan
GLP-1 drugs offer palliative mercy for terminal societal malaise. You're in the bargaining stage.
thisisnotauser
The destructive behavior is overeating and this treatment eliminates the overeating. The problem is human beings are imperfect creatures. This drugs corrects the hormone imbalance that leads to overeating. It is fixing the actual problem.
The idea that medical treatment makes us weaker is genuinely harmful nonsense on the order of claiming vaccines make us sick, and you should seriously reconsider your position here.
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bobbylarrybobby
Where did these hormone imbalances come from, when and why did they arise, why aren't they uniformly distributed across the globe? Answering these questions may lead to a root cause of obesity and obviate the need for medication altogether.
toomuchtodo
Do you believe overeating to not be the equivalent of depression, schizophrenia, addiction, or bipolar disorder requiring medical intervention? If so, why? This is brain chemistry.
LostMyLogin
> The idea that medical treatment makes us weaker
Do you have any concern that it's an over correction and leads to significant undereating? Which is also terrible for you. Genuine question for the record.
farts_mckensy
They're not saying medical treatment makes us weaker. Can you refute what they're saying without strawmanning them?
andbberger
name some nations that maintain healthy weight without drugs? your dogma isn't supported by the data. obesity is a public health problem and it's not caused simply by junk food
ascorbic
Japan and South Korea. Much of southern Europe. It depends how you define healthy, but most of Europe has obesity rates below 20%. And that's just if you're counting rich countries.
Earw0rm
The article posits that 80% of the top income quintile will be on this medication.
I have to ask, why? (I'm not in the US, I should add). Like, sure, is the average American overweight? Yes. Are 80% of the top 20% of earners? Seems pretty doubtful, plenty of the rich look to be in reasonable shape.
That statistic suggests that 80% of successful people have such poor impulse control that they end up seriously overweight or obese. And I say that as someone who likes a treat every couple of days, but exercises enough to maintain a fairly healthy weight.
Admittedly if there were a GLP1 for procrastination, I'd be on that stuff like a shot...
cedws
There are some signs that these drugs have effects beyond just apetite supression leading to weight loss. I recall reading something about them having a direct slowing effect on the metabolism, which increases longevity, among other benefits. I can foresee it being used like a supplement among those who can afford it.
wakawaka28
It will probably fuck up your body in ways that we can hardly imagine. Ozempic has been linked to lots of horrible side effects.
glp1guide
No it hasn’t— its well researched and the short to mid term (ish) side effects are well known:
TechDebtDevin
Its saved or extended 1000 lives for every one person whos gotten some GI stress from it.
wakawaka28
(Copied from a post that was flagged) Also, Ozempic suspected of causing:
Osteoporosis: https://www.womenshealthmag.com/health/a62282449/ozempic-bon...
Blindness: https://www.medicalnewstoday.com/articles/review-3-potential...
Stomach paralysis: https://www.webmd.com/obesity/ozempic-and-stomach-paralysis
https://www.nbcnews.com/health/health-news/ozempic-wegovy-li...
Genital infections: https://www.fda.gov/drugs/drug-safety-and-availability/fda-w...
Pancreatitis: https://healthylifebariatrics.com/ozempic-pancreatitis-sympt...
Intestinal paralysis (generally): https://www.healthline.com/health-news/fda-updates-ozempic-l...
Same, leading to colon removal: https://people.com/woman-sues-ozempic-manufacturer-colon-rem...
Depression: https://www.healthline.com/health-news/why-some-people-are-c...
Furthermore, people who say GLP-1 drugs are commonly prescribed omit the fact that diabetics are the main consumers, and their bodies probably work very different from those of normal people.
gcanyon
> Admittedly if there were a GLP1 for procrastination, I'd be on that stuff like a shot...
Me too! Maybe later... <kidding>
gibspaulding
> if there were a GLP1 for procrastination
Adderall?
hombre_fatal
Amphetamine for procrastination already has an analogy for weight loss: amphetamine.
The analogy for a GLP-1 agonist for procrastination would be something safer yet possibly more effective.
jijji
Guanfacine? Atomoxetine? safer, non-narcotic (not on a Schedule), non-habit forming, non-stimulant medication for attention deficit disorder (ADD)
glp1guide
> Admittedly if there were a GLP1 for procrastination, I'd be on that stuff like a shot...
This might be my biggest unknown with GLP1s, how does it affect people with reward system issues — it could dramatically worsen a procrastination problem if it dampen the will to reward seek.
Then again it has only seemed to do this for vices so far
SimianLogic
I think the point was that 80% would have insurance coverage, not that everyone would take it.
fundad
I think that’s 80% of people using the drug will be in the top quintile
submeta
Big food corporations profit from ultra-processed foods that manipulate our natural systems. They design products that override satiety signals using calculated combinations of sugar, fat and salt to activate brain dopamine pathways. Their priority is profit growth, not consumer health.
The consequences are significant health issues like obesity, diabetes and cardiovascular diseases. Healthcare systems struggle with preventable conditions while millions experience declining health and shorter lifespans. These corporations employ questionable strategies: marketing to children, lobbying against regulations, funding misleading research, and shifting responsibility to consumers.
Medications like Ozempic represent a threat to this model by reducing appetite and interrupting compulsive eating. Recent industry concerns about declining sales show how these medications could undermine their business approach. If consumers regain control over their eating habits, corporations may finally face consequences for practices that have profited from health problems for decades.
crazygringo
> Big food corporations profit from ultra-processed foods that manipulate our natural systems.
I've just never bought this.
Does grandma manipulate you when she adds sugar to her cherry pie? Does she manipulate you when she adds salt to her mashed potatoes?
Foods -- "ultra-processed" or not -- don't "manipulate" you. They literally just either taste better or taste worse. Grandma, and her grandma before her, used sugar, fat, and salt, and thank goodness they did. These are normal ingredients. It's not like they're nicotine or heroin or something.
I mean, is a fig tree "manipulating" you when its figs ripen with sugar so they'll be eaten?
You're not being manipulated. You're just choosing to eat what you choose to eat based on what you like.
lm28469
No matter how I look at it 60g of sugar in small bottle of coke is criminal. My wife bakes cakes for 10 people with less added sugar.
Junk food definitely is designed to abuse our natural instincts and needs, from packaging to ingredients. Go one year without processed food, you won't physically be able to drink coke or eat fastfood
crazygringo
> No matter how I look at it 60g of sugar in small bottle of coke is criminal.
I hate to tell you how much sugar grandma put in her lemonade, and in her sweet tea...
> My wife bakes cakes for 10 people with less added sugar.
That's extremely unusual. Different types of cakes take different amounts of sugar, but it's generally somewhere between 150g and 300g for an average-sized cake that might give 10 slices. That's between 3/4 and 1.5 cups of sugar. And that's without frosting or anything extra.
A cake with less than 60 grams of sugar... I don't even know what you'd call that. I mean, you'd never make a sponge cake or chocolate cake with such little sugar. It wouldn't even taste like cake. It would be more like a slightly sweet... bread?
Etheryte
Many foods and beverages include ingredients whose sole purpose is to hide how sweet it is because otherwise it would be unbearable in your mouth. Gives you a stronger high once it reaches your stomach though.
crazygringo
I don't know where you got that information, but no they don't. That's not a thing. You were misinformed.
submeta
Do you go to grandma every day to eat calory packed food? Does grandma deploy dozens of scientists who design food so that it has an addicting effect? Dozens of marketing experts who confront you with images to consume the junk? Lobbyists who try to convince that sugar is not causing health problems? Your analogy does not work. These corporations are creating products that cause massive health issues that cost society billions.
otterley
You should visit a food processing plant sometime. What they are doing with food is not what your grandma does when she cooks it from ingredients you can buy at the grocery store. And I bet your grandma doesn’t have a food chemistry lab to fine tune her recipes.
Similarly, fig trees don’t make Fig Newtons. They make figs.
crazygringo
Oh, I'm familiar with it. And you know what? They mostly are doing what grandma does. Just in vastly larger ovens etc. Even if you want to talk about corn syrup, what do you think grandma made her pecan pie with?
And the things that are different -- emulsifiers, stabilizers, natural/artifical flavors, etc. -- aren't actually making the product unhealthy, at least not in any way that causes weight gain. Those aren't sugars, fats, or salt. They're just making it last longer on the shelf, and have more flavor. But it's not changing the nutrition, and it's not making us eat more of it.
You really think Chips Ahoy is making you fat in a way that grandma's chocolate chip cookies don't?
bobsmooth
I've watched plenty of how its made. The ingredients look the same it just comes in huge quantities.
walleeee
Does grandma have a profit motive? Does grandma care about your wellbeing? Is grandma a vast conglomerate of strangers who couldn't give two flying fucks about you on a good day?
Is plain old sugar, animal fat, and salt unhealthy in large quantities? Of course, but eating grandma's mashed potatoes and cherry pie once a week will not materially affect your health. Meanwhile you pass 8 taco bells on your way home from her house, not to mention the 3 fast food ads you heard on youtube or the radio. Come on.
crazygringo
Right. But that's my whole point, you're agreeing with me.
It's not the food itself. The food isn't being "manipulated" in some sinister, unnatural way. It's not about supposedly addictive "dopamine pathways".
It's other things, whether convenience or advertising or whatever.
ragazzina
> Does grandma manipulate you when she adds sugar to her cherry pie?
Manipulation implies a purpose, so I’d say no. Does grandma have an ulterior motive? She adds sugar to express herself through the art of baking or does she need a favor?
> I mean, is a fig tree "manipulating" you when its figs ripen with sugar so they'll be eaten?
..Yes?
wakawaka28
Yeah it's anti-capitalist rants at every turn around here. Capitalism is the best system we have to make people happy in a fair way. It's not a system to teach people the benefits of moderation or charity. You're supposed to bring that to the table yourself. There's no economic system in the world that can fix character flaws.
submeta
Yeah, lets sell cigarettes and blame consumers for health issues because, you know, capitalism is the best system we have and the burden is on the consumers.
HDThoreaun
I actually feel the opposite. Ozempic is a massive risk to health food companies. When people know they can eat whatever they want and not gain weight they'll only eat what tastes best. All mcdonalds no sweet green so to speak.
fallingknife
"Big food corporations" lol. You think every professional chef doesn't know the same tricks? There are basically 3 things that taste good. Fat, salt, and sugar.
anonu
GLP-1 drugs also manipulate our natural systems. It's not a panacea. There are early indications of increased suicidal ideation in cohorts that take this drug. Caveat emptor
rsync
The real trend is deflation.
People are having fewer children.
Fewer miles are driven to fewer offices for fewer trips in cars.
Fewer impulse buys are being made and fewer dollars will be made by advertisements (according to the ops conjecture).
This is not inflationary. It is the opposite.
We live in a deeply deflationary world and we should not be confused by the local, transitory inflation that we may be experiencing at this moment.
BeFlatXIII
All this sounds fantastic for environmental sustainability.
fonkyyack
This! Consumption is made of impulse choices. (most of the times).
Also we are having fewer children, does this drug reduce also the impulse of having sexual desires? In that case that would be even worst.
bobsmooth
Maybe if everyone becomes skinny we'll start having more sex because everyone looks better.
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immibis
Monetary deflation is easy to solve: just print more money.
But who do you give it to? Well, obviously, you give it to billionaires because they are the best at managing money because they're billionaires. They can then spend it on wages, without having to produce anything useful because they are just getting free printed money.
slevis
Is GLP-1 really changing general impulse control? But I do buy the argument. If impulse controlling drugs are going to be effective, the economic impact is basically not quantifiable... not only the economic impact but it would change society as a whole in extremely fundamental ways (e.g. dating)
kadushka
So this drug would mess with my head – am I understanding it right?
KaoruAoiShiho
Everything messes with your head, this adjusts the mess levels.
bozhark
Maybe gut? Lot’s of serotonin receptors there, right?
bawolff
>- Movie theaters becoming "social experience centers"
>- Retail spaces becoming venues to "try before you subscribe"
>- Restaurants becoming "social nutrition centers"
>- Shopping malls converting to "wellness districts"
Except for resturants, all of these have had problems for a long time. People have been talking about the death of shopping malls since the 90s.
Feels like other factors are in play here.
goda90
I think an angle not covered is that the "impulse economy" actually degrades impulse control. Advertising, social media feeds, etc are all hammering away at people's willpower, and getting is addicted to giving in to impulses. If these things disappear, maybe even people who aren't on these drugs would have more impulse control.
I started Tirzepatide 3-4 weeks ago. (Mostly as an experiment to understand the hype around GLP's... I don't have diabetes and only very slightly overweight at 20% body fat). Even at the lowest 2.5mg starter dose which you're only allowed to stay on for 1 month:
- Extreme appetite suppression to the point where I've started calorie counting specifically to make sure that I'm eating enough. It's incredibly easy to forget to eat.
- No more feelings of hunger. At all. This is somewhat depressing. Eating is no longer enjoyable and feels like a chore. I woke up hungry for the first time in a while a couple days ago and was excited - jumped out of bed and ran to eat something just for the pure joy of it. I've only felt that a few times in the past few weeks, compared to every day off the drug.
- I completely stopped drinking. Have you ever been to a bar after eating a big meal at a restaurant, and had trouble drinking because you were too full from your meal? That's how I feel all the time. 1 or 2 beers and it becomes uncomfortable to have anymore.
- Normally I go grocery shopping and within 3-4 days, all the "good stuff" (snacks) I bought are eaten. Now, since I stopped snacking and eating much less, groceries simply last way longer. <-- $$ saved in groceries significantly offsets the monthly price of the medication
- My morning starbucks routine has changed from 2 food items to just 1, which alone saves me $200/mo (sorry starbucks).
- Haven't noticed anything regarding impulse control outside of food. No anecdata to share on that point...
After a few weeks on the drug, I'm 100% convinced that once this drug is widely available and cheap... being overweight will be a choice (choosing not to take the drug).
The most important aspect of the drug that makes it work so well is it forces you to change your habits, no will power required. It also punishes you for bad eating habits. (That late night trip to McDonalds will have you feeling like shit the next day).
I'm the kind of person that used to be able to order just about anything on a restaurant menu and clean my plate completely. Now I simply can't do that. It's actually kind of embarrassing being at a restaurant with friends and being completely uninterested in the food.