GLP-1s Are Breaking Life Insurance

Unnoticable meaning doesn't have any effect at all, or just no bad side effects?

I'm just reporting my cached knowledge of people saying they experienced some adverse side effects. Also injections are not fun, even though they are probably a lot less annoying than they look.

Hi there - Mounjaro user here. I've been using it for about a year at this point.

I feel sick for three days in a row after taking it. Even after several months on the same dose. I get horrible gut cramps, sour stomach, near constant nausea, and occasionally vomiting and diarrhea. I have to take my shot on Thursday night because I'll feel bad the next day and supremely sick the next two days. If I took it earlier or later in the week it would absolutely impact my ability to work during the work week.

It has had amazing effects. I've lost about 60 lbs in the last year and my A1c is now around 6.2.

It's a very effective drug, but it is brutal on my body. I'm not sure anything in the medication is causing the weight loss. It just makes me feel so sick that even if I'm hungry I don't feel like eating.

There's often side effects, including nausea, diarrhea, headaches, bloating, discomfort, etc.

As far as I can tell from forums, it's not like 5% have the side effects, it's like 80-90%.

But for the first time in decades, I felt full. I didn't want to finish a meal, it was too much.

My body regulated my food intake in what felt like a natural way.

I hadn't even realized my body had somehow lost that fundamental mechanism of appetite control. It made me realize I wasn't weak willed, something is different about my body than other people.

But it comes with a price. The side effects I had were quite bad and so I stopped (though I now read that if I switch to a different brand, I might be ok).

I often didn't want to leave the house due to a dicky tummy. It could come/go in waves. But often can last a whole week.

Plus you've got to inject yourself every week. Often you can't drink as it makes you sick. Even when you're doing everything 'right' you can feel a bit off.

If you do over-indulge (with food or drink) the side effects can sometimes be massively amplified and you feel terrible for days.

So amazing in some ways, but it's not like taking a vitamin tablet. There are costs and making one slip up can result in suddenly feeling awful for a day or two.

Perhaps I was just particularly prone to the side effects, but it seems to happen to a lot of people (I found Mumsnet threads about it useful, they are quite revealing as they seem to be fairly honest and willing to share their experiences)

> because most users return to normal indicators within about 2 years

Because they stop taking GLP-1s after 1-2 years, not, it seems, because the meds stop working.

No, it's a miracle drug that drops mortality by a ton. The indicators aren't being faked. The weight causes the mortality, and the weight loss reduces it, and the weight regain reintroduces it. GLP1RAs introduce some noise to the indicators but not enough to cause what you're implying.

It's a maintenance medicine, not a cure, so if people stop taking it, they return to the same problems they had without it.

The drugs do not reduce mortality much or even at all. Such drugs may improve quality of life though. Except for severe obesity, 40+ BMI, life expectancy is not lowered much in men and even less in women in the setting of obesity. It's just that being obese makes all sorts of markers worse, yet people do not die much sooner. It's more about improving quality of life.

"If we assume about 65% of people who start GLP-1 medications quit by the end of year one, that creates a big problem. When someone stops the medication, they'll usually regain the weight they lost, and in two years, most of those key health indicators (like BMI, blood pressure, blood sugar and cholesterol) bounce back to their starting point. "

So in addition to the quitters returning back to normal after they got life insurance underwritten when they were healthy, we have the unknown of the longevity of people on the glp-1 drugs.

Subtly different: you read "most...return to normal...within 2 years", it says "When someone stops the medication, they'll [return to baseline]"

Then from there, I click through the 65% #, assuming they have a good study on 65% of people stop after a year. Nah, they don't. It's super complex but tl;dr: specific cohort, and somehow the # getting on it in year 2 is higher than the # of people who quit in year 1.

I have a weak to medium prior, after 10m evaluating, that the entire thing might be built on more sand than it admits.

Lot of little slants that create an absolute tone - ex. multiple payouts over the "lifetime" of a life insurance policy. (sure, it's technically possible)

Also there's no citation for the idea this mortality slippage happened because of GLP-1, and it's been out for...what...a year? Maybe two?

That's an awful lot of people who were about to die, saved in the nick of time by...losing weight? Again, possible, I'm sure it even happened in some cases.

Enough to skew mortality slippage from 5.3% to 15.3%?

I thought they were 98% accurate?

Wait...is the slippage graph net life increase slippage? Or any slippage?

Because it's very strange this explosion happened in exactly the year of a global pandemic that had sky-high mortality rates for older people.

... I just switch life insurance providers?

Seriously, that's just not that big of a deal. It takes like a few days at most for simple term life. Can't speak to the other policies, which I understand are mostly tax vehicles anyway, but it's not hard to simply get a new life insurance policy if your current one goes kaput.

That’s one reason the ACA shifted it to a mandatory (in most cases) category: https://www.healthcare.gov/preventive-care-adults/

Minimal, but minimal progress in the US was/is still progress.

hmm...doesn't this possibly incentivize ozempic subsidies even more?

If you know a "customer" of yours (an individual employee) is only going to be with you until they either change jobs or go on Medicare, then it seems the name of the game then is to make sure that nothing catastrophic happens to them until you can hand them off to someone else.

In which case, they should definitely go on ozempic. Even if the effects of ozempic immediately come off after usage, it's a short-term enough solution that benefits the insurance company, no?

> You’re thinking too highly about the incentives of the US healthcare system. Since insurance is tied to your employer (and therefore changing every few years)

Most people don’t change jobs or insurance companies every few years. When they do, it’s often within similar regions and industries so the chances of ending up right back under the same insurance company are significant.

Regardless, the issue is more complicated than your line of thinking. Insurance companies have very small profit margins. Current GLP-1 drugs are expensive, around $1,000 per month.

So each patient on GLP-1 drugs costs an extra $12K per year (roughly) or $120K per decade. That would have to offset a lot of other expenditures to break even from a pure cost perspective, which isn’t supported by the math. So the only alternative would be to raise everyone’s rates.

I know the insurance industry is the favorite target for explaining everything people dislike about healthcare right now, but at the end of the day they can’t conjure money out of nothing to cover everything at any cost demanded by drug makers. These drugs are super expensive and honestly it’s kind of amazing that so many people are getting them covered at all.

> I don't think GLP-1s are particularly expensive

On-patent GLP-1s (all of them right now) are actually extremely expensive. Right around $1000 per month.

I don’t want to discourage anyone who needs them from seeking treatment, but their discontinuation rate can be somewhat higher than you’d think from a life-changing drug because many people don’t like certain effects or even encounter side effects.

Weight loss drugs are also a challenging category for OTC because they’re a target of abuse. People with eating disorders and body dysmorphia already seek out black market GLP-1s at a high rate and it would be a difficult situation if they could pick them up impulsively from the medicine aisle. It’s also common for people to misuse OTC medications by taking very high doses hoping for faster results, which has to be considered.

There’s a libertarian-minded angle where people say “Who cares, that’s their own problem. Medications should be free for everyone to take.” I was persuaded by those arguments when I was younger, but now I have a very different perspective after hearing about the common and strange world of OTC medicine abuse from my friends in the medical field. Just ask your doctor friends if they think Tylenol should still be OTC if you want to hear some very sad stories.

yeah this is true. When people say that obesity is worse than smoking, I'm like "Have you looked at the actual stats on this?"

> Medical insurance companies often already go out of their way to pay early to save in the long run

Literally LOLed when I read this. Health insurance companies might pay lip service to this and make some token gestures like free preventative care, but in my experience health insurance companies frequently shoot themselves in the foot by denying care that later ends up costing them even more when the patient's untreated condition worsens.

Medical insurance in the US is not incentivized to save money. In fact it's just the opposite. The ACA requires that 80% of premiums be paid out to medical expenses. If an insurance company encourages people to get preventive care and lowers its expenses, that means they also have to lower premiums. So they actually want costs to be as high as possible since they get to keep 20%.

It's not a gamble, it's an application of the law of large numbers. But yes, changes in the underlying assumptions (e.g. mortality rates) can make the whole calculation untenable.

Well no, obviously not, but we do have 20 years of data, and aside from a still-tiny-but-slightly-elevated thyroid cancer risk, there’s really not much showing up in that data.

Actually yes. Not as much as with ADHD medication, but obvious subset of addictive personalities that have relief from addictive behaviors (beyond eating addiction) with semiglutide.

For semaglutide, the newest and most potent GLP1.

United States: The main patent is expected to expire around 2032. Monthly Price: $950 - $1,350+ (cash price without insurance)

Norway: The main patent is expected to expire around 2031. Monthly Price: $109 - $301 (cash price equivalent in USD)

Grey market from China is around $250/year for tirzepatide

There are group chats with tens of thousands of people and I havent seen any issues with the drug

According to all the studies, this is absolutely the worst thing that you can do. GLP-1s are revolutionary, but when you go on them, you should intend to stay on them for life. When patients first go on them, they lose both muscle and fat, and when they go off them, they regain just fat, and in many cases they're in a worse situation than they would be if they hadn't gone on them in the first place.

Letting your weight fluctuate up and down in giant swings is, in many ways, harder on the body than just staying at a steady weight, even if it's overweight.

I’ve been on it for years, at a lower dose though, the counter action by the body is probably dose dependent so my theory is lower for longer is more sustainable. I think people get attached to the rapid weight loss, coupled with the high expensive, incentivizes higher doses. I take gray market supply and it’s rather cheap.

Also it should be mostly used as an adjunct to strict diet and exercise.

Anecdotally, the dose required to maintain a stable weight seems to be lower than the dose required to lose weight. Most people tend to regain some weight when going cold turkey.

The safety profile of the drugs with diabetics, and the health benefits that come from the associated weight loss may make permanent use a net benefit for most people. There appears to be little, if any, "course correction" effect from taking it for short periods of time.

Can you explain what you mean? What you say seems to strictly contradict how the meds are supposed to work.

Why not? We have an overweight and obesity epidemic that has persisted through everything else we've gotten enough political capital to try thus far. The "miracle" drug is the most promising direction we've had in a long time. Whatever possible adverse long term effects have to be (plausibility they actually happen) x (harm they cause) > known harms of being overweight.

The scale of the solution is allowed to match the scale of the problem which is on the order of 2/3 of adults or 200,000,000 people.

That is the ideal model for treatment of those types of mental health disorders. Often patients have blockers that prevent them from resolving underlying issues. But through a drug they can get into a headspace that allows them to work through them with talk therapy, and then learn new habits and eventually go off the drug.

In practice, this doesn't happen that often, no, but it's a theoretical goal. Probably because we're in the pre-GLP-1 era with regard to mental health meds. Maybe that will change.

The analogy to your example is that someone who has to take Mounjaro for diabetes will always have to take it even after losing say 100 pounds. Or Metaformin even.

GLP-1 in those cases helps manage the problem better.

But for those who are not in those cases where Type 2 Diabetes has sunk in, then they need to use the opportunity to get better while on it and kick themselves into high gear or they will have learned nothing from the experience

I feel like your example shows the inverse of what you want. SSRI are actually great at helping the person develop healthy mechanisms (compared to GLP-1s), because they reduce the mood swings & negative thoughts, allowing the person to be more productive & be more involved in their therapy, in reading, journaling, doing sports, etc. It's just that it might take two or three years and not months, which is fine because SSRI also have much more limited side effects compared to GLP-1s.

GLP-1s don't do that directly.. but at least they might help people move more, and give them confidence to do more for their health instead of seeing it as a lost cause.

I started in Aug 2024 and stopped in Oct 2024. I paid for it from one of the pharmacies that made it in Florida. I injected myself with insulin needles that they send you.

From what I understand you don’t have to be obese and have type 2 diabetes. In my case, I was obese and did not have diabetes but I might have been going down that road

I have been off since Oct 2024. Also, I did continue to lose weight the traditional way.

After I stopped, a coworker told me about Vida which my work offers as a health benefit.

Using the Vida service where I got a registered dietician to show me what to eat, I tracked my food and water intake and tracked my exercise. I had protein and fiber goals to hit.

You can’t do it all on the medicine - it is a lifestyle change. The medicine was the catalyst but not the reason I kept the weight off. I wanted it. But because I wanted it, I wanted to use the support system that my work paid for.

I think there is a lesson to be learned here

I know some serious cases where there were non-habitual problems but... "healthy habits" is nothing to laugh about. People literally are what their habits are. All of our behaviour is habits, and changing behaviour takes time and effort.

The good news is that it is not impossible, and it really is possible to change bit by bit for most people suffering from obesity.

I don't think somebody who walks 10k+ a day, maybe goes to gym a couple of time a week, limits calorie intake to a comfortable and reasonable 2000 kcal per day, would suddenly bounce back to 130kg!

> but if “healthy habits” were enough then people who’d lost weight the traditional way would keep it off.

That's because a lot of the "traditional way" methods are pseudoscience at best, outright quackery that's going to send you into serious malnutrition issues or eating disorders at worst. Every two or three months you see a new diet fad pushed through the yellow press rags, and none of it anywhere near being considered scientifically valid - usually it's some VIP shilling some crap story to explain how they lost weight, of course without telling the people that they have the time for training and the money to pay for proper food, 1:1 training and bloodwork analysis.

A lesson often learned painfully: in most cases there isn't a reward for doing things the hard way. You could argue that a magic weight loss drug will prevent people from making important lifestyle changes, but all else equal, a magic drug that helps you lose weight with seemingly no other downsides is an obvious net win for health. Losing weight once you put pounds on is hard, for both mental and physical reasons, and even just being able to lose weight is probably a huge help as it puts in reach what many consider to be intangible after years of failure.

I haven't tried a GLP-1 agonist myself because I'm not exactly severely overweight, but I do absolutely struggle to keep weight off. It's amazing how easy it is to re-gain weight and how hard it is to keep it off. If the worst side-effect of GLP-1 agonists is that it makes life insurance quotes harder, whatever; I think it's totally acceptable that some people will still struggle with improving their habits, I don't think it's likely to make it any worse. In my opinion I suspect it is likely to make it a bit better, by helping you break out of the cycle.

P.S.: since there is some neighboring discourse about whether being fat is a disease or a lifestyle choice, I'll just say this: I don't personally think it matters. I don't think arguing this distinction will actually help anyone. I don't really care for body positivity and I don't make excuses for my poor habits or being overweight, but I still don't think it makes losing weight much easier.

Why is obesity the only disease that taking medicine for is “cheating”? Which is more important: instilling your particular version of “discipline” into people, or saving billions in healthcare costs and millions of lives from suffering?

That's a great idea!

Can you show me what we're doing in USA to help children and people develop the habits and discipline for long term lifestyle change?

Because I've never learned anything about nutrition, macros, high sugar content and all of the healthy food I should learn to eat on my own.

We did not have home classes in any of my education in US at all, they were a thing in the past but that wasn't a thing in my middle hs or hs or college at all in NY in 90s/2000s.

All of my bad habits were from my parents and they were not good eaters.

Depends on your circumstances. If you're a bit overweight and want to lose weight: it's perhaps not helpful. If you're obese and everything just seems hopeless: fuck it – do anything that will bring your weight down to a manageable level first, and then start working on habit and lifestyle changes. Energy levels, the motivation of seeing progress, and that type of thing are hugely important.

I'd be okay with that so long as nobody can have Nicorette, the birth control pill, or Viagra. I don't have a problem refraining from smoking, I've never gotten pregnant, and my dick works, so it must be some innate discipline in me that others must learn, so no meds for them.

See how ridiculous that sounds?

Giving people the magic antibiotic cheat code seems antithetical to helping them develop habits and discipline to avoid bacterial infection.

You could apply this same stupid logic to many medications.

Blood pressure medication comes to mind.

They are, they're basically mathematical inverses of the same product.

Big Annuity can charge you more, in fact, if it has reason to believe you're going to live unusually long, so playing the GLP-1 dance with them would only be profitable in reverse. Pretend to be the unhealthiest person on the planet, lock in an annuity, then get on the drip stat.

Nailed my broader point. Could we go through contortions to see who is going to pay unreasonable costs for GLP-1s (health insurance, life insurance)? We could, but that's silly accounting to see who still gets to make the profit and who has to end up with the bill for empowering the human to fix their reward center. The shortcut is to provide GLP-1s to everyone who needs them at scale, as inexpensively as possible (to pull forward the improvement in health and quality of life outcomes until improved protocols arrive). The semaglutide patent is about to expire in Canada, China, India, and Brazil, for example.

https://www.labiotech.eu/in-depth/novo-nordisk-semaglutide-p...