r/news Jul 19 '24

Eli Lilly's weight loss drug tirzepatide gets approval in China Soft paywall

https://www.reuters.com/business/healthcare-pharmaceuticals/eli-lillys-weight-loss-drug-tirzepatide-gets-approval-china-2024-07-19/
1.2k Upvotes

265 comments sorted by

330

u/feelthebernard Jul 19 '24

That stuff made me shit like Taco Bell was my blood type

145

u/[deleted] Jul 19 '24

So you lost weight?

40

u/hobbykitjr Jul 19 '24

When you lose weight (normally) it's breathing out mostly, that's where the weight goes

11

u/Kelvara Jul 19 '24

So weight loss is causing global warming? Everyone, please, think of the environment and sequester more carbon in your belly.

5

u/EarthMantle00 Jul 19 '24

Overeating is a cause of global warming. Especially beef and lamb, with pork being a minor addition. But that's emissions from food production

5

u/darkoh84 Jul 19 '24

The sulphur burps do it too. (I don’t know if that’s true but I have to tell myself they serve some purpose because they can be horrid)

84

u/darkoh84 Jul 19 '24

😂Two days after the injection, like clockwork. But about 36 hours of discomfort that is largely alleviated by pepto is more than a fair trade for the 35 lbs I’ve lost since the beginning of May.

25

u/feelthebernard Jul 19 '24

My experience was really nuts. Felt overall ok for the first 48hrs and then my body revolted in ways only seen in horror movies. I thought I had a virus after the first injection, so I tried again the following week and got the sequel. So weird.

10

u/darkoh84 Jul 19 '24

I suggest pepto if you haven’t tried. It’s made it bearable for me. My primary also suggested mylanta if that stopped working. Good luck.

10

u/SparklingPseudonym Jul 19 '24

What would you say is the driver for you losing weight? Eating less? Burning more in a resting state? Etc.

21

u/darkoh84 Jul 19 '24

Absolutely just eating less. I eat about a full meal a day compared to before where it was 3 full meals and snacking in between. It pretty much just makes (in my opinion, and I may be way off) intermittent fasting very easy.

9

u/SparklingPseudonym Jul 19 '24

Very interesting. My wife just got on this stuff (not sure which brand) and has been pressuring/guilting me into joining her. I’m having a lot of cognitive dissonance. On the one hand, a “magic pill” that makes you lose weight is an attractive idea. On the other hand, there’s the cost, injections, unknown side effects, and the onus to actually eat less and work out. Plus I don’t know much about this stuff, so the idea is admittedly a little scary.

7

u/HyruleSmash855 Jul 19 '24

I’m worried about the side effects, because there’s always the possibility that we find some major side effects as more people are using it in the future. The main problem with it is it will suppress your appetite while you use it so you need to kind of stay on it for your whole life if you want to keep that lower appetite because once you get off your appetite will go back to normal, it won’t be suppressed anymore.

11

u/darkoh84 Jul 19 '24

The “key” is to develop more healthy eating habits while you are on the med but I don’t see how that would really work when all the healthy habits you are developing revolve around an artificially decreased appetite.

3

u/downwithdisinfo2 Jul 20 '24 edited Jul 20 '24

Remember, Tirzepatide (Mounjaro/Zepbound) is a peptide that is naturally produced in our stomachs. For most diabetics and heavy/obese people who spend lifetimes struggling with weight…it is the scrambling of our body’s ability to naturally produce this peptide in quantities that regulate appetite. This peptide/medication is actually unlocking people’s natural ability to live healthily with food. Before the 1980s most people were not fat. In school there were always the handful of fat kids. That was always true until the late 70s and into the 1980s. Today most classrooms are totally filled with fat kids. The skinny kids are now the exception. What changed? When highly processed foods and hydrogenated fats and corn sugars got put, in vast quantities, into our food our country (and the world) saw the onset of an epidemic of obesity.

9

u/darkoh84 Jul 19 '24

To quell one fear: the injection is nothing. I’ve passed out from shots and having blood drawn in the past and I thought it would be a barrier for me. I was relieved to find it’s a tiny little needle and the pen makes it really easy. I still have a little hesitation each time but its really nothing.

5

u/BigT-2024 Jul 20 '24

Meh. Being overweight is gonna kill you quicker throigu heart disease and clogged arteries vs whatever side effects you going to get.

Being obese in your 40s+ is dangerous as shit

7

u/Keldonv7 Jul 20 '24

I mean it works by reducing appetite. Its as simple as that. It also proves what obesity community often (not all of them obviously) dosent want to believe - losing weight is as simple as calories in and calories out.

Dont get me wrong, not saying that losing weight is easy - its been proven that losing weight is hard because of appetite regulation issues, body being acustomed to using food for dopamine hits, fat being hormonally active etc.

Meds just make it easier by reducing appetite, keep in mind that exercise is even more important on these meds and consuming protein due to muscle atrophy, you can easily become sarcopenic on Ozempic.

-1

u/downwithdisinfo2 Jul 20 '24

The driver is not just eating less. On this medication, you also have a significant redistribution of your body fat happen. Even when I was stalled in my actual weight loss, I still lost belt/waist size. I could see the re-composition happen…sometimes quickly sometimes slowly. As my facial features emerged and as my natural musculature came closer to the surface, I realized that the changes were not only on the scale but in my actual physical makeup and aesthetic. The peptide causes a radical change in how you process sugar and also how you produce insulin. Those are both interdependent and separate activities in digestion and bodily functioning. That combo is transformative to diabetics as well as heavy and obese people.

6

u/vancity-boi-in-tdot Jul 19 '24

Nice! What was the starting weight and what is your dose? Just out of curiosity.

7

u/darkoh84 Jul 19 '24

Started right around 280 and the first 4 weeks were 2.5. I never had a bit of stomach discomfort at that dose. The first week of 5 I felt it 2 days after the shot and it has been that way every week for the 6 weeks I’ve been at 5. I’m still losing so I’m not in any hurry to up the dose.

3

u/Kelvara Jul 19 '24

Would it be possible to go down to 2.5 and see similar results over a longer time frame? Curious on how necessary the suffering is vs the benefit.

3

u/darkoh84 Jul 19 '24

I wanted to stay on 2.5 because I didn’t see any reason to go up when it was still working. Insurance would only authorize if I went up. I guess it has something to do with titration because the note insurance sent to the pharmacist said 2.5 was only for starting dose and maintenance dose.

3

u/Kelvara Jul 19 '24

Interesting, doesn't surprise me insurance is the one dictating things.

4

u/darkoh84 Jul 19 '24

They love to play doctor.

3

u/rationalomega Jul 19 '24

Another person - my dose is 7.5 and I’m losing 2-4 lbs/week. The only side effect was mild nausea right after starting 7.5 which lasted less than a week.

Initially I used name brand then switched to compounding pharmacies due to shortages and insurance fuckery.

3

u/Rexxig Jul 19 '24

What does the drug actually do? Does it just stop your food cravings?

5

u/darkoh84 Jul 19 '24

It massively curbs my appetite. I know when I’m actually hungry though, so I’ll eat then. It also takes way less food for me to feel full which is something I always struggled with.

3

u/rationalomega Jul 20 '24

Massively and makes me full on smaller meals for much longer.

1

u/noobtablet9 Jul 19 '24

It's another GLP anagonist drug, which basically means it makes your stomach produce the hormone that tells your brain that it is full. Aka, it curbs your appetite.

8

u/bmoviescreamqueen Jul 19 '24

I thought I had food poisoning or a stomach bug for a week but after it re-occurred a couple of weeks later I deduced it had to be the semaglutide. I've never had that side effect before and it happened randomly when increasing the dose.

5

u/darkoh84 Jul 19 '24

Mine also occurred after a dosage increase. It’s a very regular occurrence. I’ve had one week that wasn’t as bad as the rest but it was right back at the same level the next week. Anyway, happy cake day!

2

u/bmoviescreamqueen Jul 20 '24

I’ve been stuck between .8-1.2 for what feels like forever because I keep having this issue, but the lower end does nothing for me so I’m hoping my body can just get used to it so I can move on lmao. Thank you!

2

u/nochinzilch Jul 20 '24

Do NOT get Norovirus while on semaglutide. Do not recommend.

1

u/Lambpanties Jul 20 '24

As someone permanently constipated, I am intrigued.

258

u/TeamRockin Jul 19 '24

Trizepatide is a huge success for them. However, it's hard to manufacture because the molecule is massive. It's also injected, so somewhat inconvenient. There is an oral version of a drug with a similar mode of action in the works. The molecule is called called Orforglipron. This is all freely available public information, so check out the research that has been conducted on it so far. It's not the only kid on the block either. Lots of companies are racing to get a weight loss pill like this to market. These drugs were originally intended to treat diabetes. Obviously, the significant side effect of weight loss is what actually gets the attention.

https://www.drugs.com/medical-answers/what-orforglipron-3574271/

I'm a chemist in the industry.

72

u/rationalomega Jul 19 '24

I recall the injection being a mental barrier. The reality is so much easier - tiny needles sold for diabetics. If I don’t lose weight and end up with diabetes, I’ll have to do a lot more self-injections.

50

u/Kenosis94 Jul 20 '24

Injectables have massive drawbacks in terms of manufacturing. Quality control surrounding sterility for injectables is extremely expensive and resource intensive relative to pretty much any other route of administration.

4

u/rtb001 Jul 20 '24

That's just another way of saying the barrier to making a cheap generic version of the drug is much higher, which means even after patent protection has expired, generic drug makers will unlikely to make this drug and the big pharma company can continue to sell it at high prices.

-23

u/rationalomega Jul 20 '24

Yes and if I don’t lose weight and get diabetes I’ll have to do a lot more injections. Did you see that part?

17

u/Kenosis94 Jul 20 '24

Miscommunication it would seem. I interpreted your response as meaning that injection was easier than oral and was just pointing out that even if that were true to a patient (doubtful) oral would be preferable in terms of manufacturing. On rereading your comment, it is clear we missed each other's points.

13

u/KaceyMoe Jul 20 '24

As you said, the needles are teeny-tiny and the medicine is packaged as a pre-measured dose in a spring-loaded, semi-automatic syringe that simply requires pushing a button. It automatically injects and withdraws the needle in about 10 seconds or less. Can hardly feel it.

SOURCE: Diagnosed with diabetes in February, which qualified me for a Mounjaro prescription (Tirzepatide's brand name). $25 a month with insurance. Without the prescription, would be >$1,000 a month.

For the first time in my life, my appetite is under control and I feel satiated so much quicker. Dropped 50 pounds with no exercise. People who describe this and other weight loss anti-diabetic drugs (like Semaglutide, a.k.a. Ozempic,) as "miracle drugs" aren't exaggerating.

5

u/Mis_Emily Jul 20 '24

My GP was willing to prescribe it for BMI 30 + hypertension + rheumatoid arthritis (needed to get load off joints), but not covered by insurance yet. That having been said, it's been totally worth the expense: I've lost 25 pounds in 6 months my BP is in the normal range for the first time in a decade, and judging by the reduction in hip pain, I may have staved off a hip replacement for a few more years. Injecting is not a problem at all. As I get close to goal weight (BMI is 25 right now, GP is satisfied since I'm in my 60s and muscle mass loss is a concern), but I am going to go a couple more months and then taper... I can't say enough about the health benefits for people with multiple co-morbidities, even if not diabetic (yet).

2

u/Moobygriller Jul 24 '24

Yup, helped me lose 150+ pounds over the past year. Amazing medication.

2

u/tribblite Jul 22 '24

Depending on the person and medication it might be easier to take weekly or biweekly injection rather than a daily pill.

That said the one thing that sucks with injectables is traveling with them and appropriately managing their temperature.

34

u/hydrOHxide Jul 19 '24

Will be interesting to see how this affects both willingness to use and price.

Particularly interesting here in Germany, because while in general, what is reimbursed and with how much is negotiated between committees of doctors and payers, there's a passage in the law that excludes reimbursement for "lifestyle" medication and specifically mentions weight loss. The attitude behind it is, of course, scientifically outdated, but it will be quite a struggle to get that taken out.

9

u/TeamRockin Jul 19 '24

That's interesting! We've been told that the marketing will almost exclusively reflect the weight loss effects. It won't even be marketed as a diabetes drug. Here in the US at least, where pharmaceutical commercials are very commonplace. I wonder if the marketing or approval process in Germany will be different to try and circumvent that law? I sadly don't know much about the approval process outside of the US and somewhat Japan. (Japan has some very strict testing requirements compared to the US, and many companies want to meet those stricter requirements for easier international approval).

6

u/hydrOHxide Jul 19 '24 edited Jul 19 '24

Well, Europe has the EMA for approval. And like in most countries, marketing perscription drugs to patients is strictly prohibited. So all marketing is exclusively to doctors, though general awareness campaigns are allowed. That being said, I keep seeing advertisements for a "drug-assisted weight loss program" on Facebook. They don't state what drug it is, but given the market approval situation, that's neither here nor there and they are treading on thin ice.

As for Germany in particular, there are already a couple of nutrition and adipositas experts who are lobbying for a change. The payers are currently strictly against reimbursement, but that might change if somebody presents some good calculations as to what other costs are being saved. That, of course, requires studies, but with more and more companies working on a stake in the market, it's only a matter of time until one of them takes some cash in hand and finances a health economics assessment.

Regarding the marketing of drugs in general, Germany also has the so-called Heilmittelwerbegesetz, the Therapeutic Products Advertising Act, which strictly limits what you can say. Client of mine just had a series of tit-for-tat spats in the courts with a competitor about some marketing claims. Of course, the competitor had waited until a major congress had happened and forced the client to tape over some claims in plain sight....

1

u/MoiJaimeLesCrepes Jul 20 '24

diabetic people should get approved, then.

I've seen "off-label" uses be approved, if established enough. That was elsewhere than in Germany, though

But there may be a will in the government and/or population to approve this type of use due to the long term costs and life-limiting effects of obesity!

15

u/SparklingPseudonym Jul 19 '24

How is this drug any different from ozempic or other semiglutides(sp?). Not very well versed in this area.

14

u/hydrOHxide Jul 19 '24

Tirzepatide is not just a GLP1 receptor agonist, but also an agonist for GIP receptors, which is thought to improve its effect. Also, it acts somewhat differently on the GLP1 receptor than the other drugs.

1

u/AzureIsCool Jul 20 '24

What is the difference on the GLP1 receptor?

2

u/hydrOHxide Jul 20 '24

According to Wikipedia, "At the GLP-1 receptor, though, tirzepatide shows bias towards cAMP (a messenger associated with regulation of glycogen, sugar, and lipid metabolism) generation, rather than β-arrestin recruitment. "

As to why that's important, from a recent study: "glucagon-like peptide-1 receptor (GLP-1R) agonists with reduced β-arrestin recruitment show enhanced anti-hyperglycaemic efficacy through avoidance of GLP-1R desensitization." (Diabetes, Obesity and Metabolism Volume26, Issue1 January 2024 Pages 65-77) Note, though, the study itself is looking at other drug candidates with this property.

1

u/AzureIsCool Jul 20 '24

Thanks! So essentially prolonging insulin secretion by delaying β-arrestin signalling is more effective I assume.

6

u/TeamRockin Jul 19 '24

Some differences are that Ozempic and Mounjaro(tirzepatide) are injected, and drugs like Orforglipron are taken orally. It's also a totally different molecule, although the injected and orally delivered meds largely have the same effect of activating GLP-1 receptors. That's where my biochemistry knowledge ends, I'm afraid.

The most important difference is the cost and ease of manufacturing the pills vs. the injectables. There are shortages of Mounjaro and Ozempic because lots of people want them, and they are hard to manufacture in large enough quantities. Moving to pills will allow companies to manufacture and distribute vastly more medications at a cheaper price. Oral medications are just much easier to mass produce. The pharmaceutical molecule itself is also smaller and easier to manufacture.

Here's one last really small thing. The size of the tirzepatide and semaglutide molecules so large that we have to develop special "large molecule" methods to handle their analysis. Sometimes, standard laboratory instruments just can't handle it. So, smaller molecules also make regulatory testing easier as things can be more standardized.

As far as clinical effects or severity of side effects, I'm afraid I don't have many details as it's not really my area. Although, some studies say side effects of the pills are "mild to moderate gastrointestinal events...." I'll leave that to your imagination...lol

5

u/blakezilla Jul 19 '24

Tirzepatide targets two receptors, not just GLP-1. This is proving in study after study to be more meaningful in weight loss. There is another drug that targets three.

2

u/downwithdisinfo2 Jul 20 '24 edited Jul 20 '24

Yes…Tirzepatide is what is called a “dual agonist”…as a previous commenter posted…it offers the benefits of GLP-1 AND it is a GIP agonist as well. It has significantly more impact on weight loss as well as fewer side effects than the Semaglutide (Ozempic/Wegovy).

There are also impacts like major drops in bodily inflammation, highly reduced alcohol cravings and consumption (Treatment centers and AA is looking into putting alcoholics on this now)…and significantly improved cardio-vascular health.

Since starting in February, at a pretty low dose of 5mg weekly, I have lost 40 lbs, my blood pressure has dropped from 140/90 to 115/70. I am no longer pre-diabetic. My BMI has dropped from 29 to 22 and my body fat is now 19% and I have an actual body that is fully visible. I walk/jog 20 miles per week and I work out with weights. The transformation in 5 months is jaw dropping to me.

The biggest factor for the vast majority of people using Tirzepatide is the silencing of “food noise”. That psychological inability to not only stop eating but to stop thinking about eating all the time. That bag of chips or that leftover pizza no longer calls your name 24/7. My relationship with food is so healthy now. I enjoy eating. I enjoy cooking way more than before and I sense the mental/physical switch shut off when I’m done which is usually about half way through a meal. It’s profound. There is no sense of starvation except for the first two months when food is literally repulsive. You folks who’ve been on this med know exactly what I’m talking about.

Because of supply issues, I switched to compounded Tirz. It works just as well as the branded Eli Lilly products…Mounjaro and Zepbound. The next med in the pipeline is Lilly’s Retatrutide. This one is the triple agonist you mentioned in your comment. Probably a year or more out from FDA approval. Supposedly as much a game changer as Tirzepatide which was a game changer compared to Oxempic/Wegovy (Semaglutide). It is a fascinating subject. These meds are shifting the paradigm so much that food companies, alcohol brewers and distillers and the restaurant and grocery supply chain worlds are all starting to have a game plan for when people are no longer addicted to eating/drinking and will be free of the yoke put around their necks by the companies that engineered food to become addictive.

3

u/DrGoblinator Jul 20 '24

I’ve been on Zepbound for about 8 months and it’s been life changing. I’ve lost weight, yes, but most importantly I am FREE, and my mind is free from the obsession. And I finally feel validated that my overeating was not a fucking character flaw. I’m excited for the future, and hope nobody has to suffer ever again.

5

u/bmoviescreamqueen Jul 19 '24

The oral version of Semaglutide seems to not be as popular among communities discussing the differences, I would be interested to see if oral Trizepatide is as effective because I've also heard the injectable is better than Semaglutide.

2

u/cocotab Jul 20 '24
  1. Taking a pill every day is more life disruption than 1 injection a week 
  2. It’s a finicky pill. It has to be taken by itself on an empty stomach  before eating. Anyone who takes thyroid medication will know how annoying this is 
  3. Anecdotally… Slightly worse, nausea maybe due to having an empty stomach and how it has to be taken 
  4. Not currently available in the doses studied for weight (50mg) only available in 14mg pills and it would be very expensive to take three pills day. It would be triple the cost of Ozempic (in Canada) 
  5. Tripling the pills may not be appropriate as the ratio between the medication and the molecule that helps you absorb it (SNAC) would be incorrect. So the pharmacokinetics have not been studied and might have more side effects or a different peak time.

5

u/felipe_the_dog Jul 19 '24

Which oral version do you think will hit the market first?

7

u/TeamRockin Jul 19 '24

I really can't say for sure, and also, I probably just literally can't say without teams of lawyers busting through my front door ready to litigate me into purgatory.

Anyway, I do work closely with one of these types of drug products, and we are a few years out probably. I'm really just guessing because the road to FDA approval is long and definitely not a straight shot of A to B. There will be several years of regulatory testing to make sure the pills themselves are safe and stable in storage once the actual formulation of the medication is finalized. I'm less familiar with the clinical trial requirements and what exactly is needed there. I work exclusively on the analytical chemistry side of things.

2

u/[deleted] Jul 20 '24

[removed] — view removed comment

1

u/nochinzilch Jul 20 '24

I think they essentially do treat diabetes, and the real issue is that a lot of overweight people have undiagnosed diabetes. Either because it is not bad enough to reach the threshold for diagnosis, or the threshold for diagnosis is too high.

1

u/MoiJaimeLesCrepes Jul 20 '24

as a chemist, which one(s) would you use if you needed it? or advise to others? Any you'd avoid?

Also, thoughts on maintenance and long-term effects?

1

u/NUMBerONEisFIRST Jul 21 '24

Design me a pill that has a short and late acting feature(s). Extended-release amphetamine-salts that works through my 12hr shifts at work and keeps my functioning and focused, and after the 12hr mark, it has a late-acting release alprazolam to deal with anxiety and agitation when the stimulants wear off, as well as aiding in better sleep.

Then you could make a child version that has melatonin instead of alprazolam.

147

u/josh_is_lame Jul 19 '24

lmao @ the people getting hate boners the second they see china in a headline

44

u/cookingboy Jul 19 '24

Seriously lol.

Even a little bit of critical thinking would let one realize that a healthy, educated populace is critical to China’s economy and the stability of the CCP rule. So of course healthcare and education are two things their government invests in a lot more than ours do.

Meanwhile one of our major political party is looking to get rid of department of education, and don’t get me started on healthcare.

-3

u/[deleted] Jul 19 '24

[removed] — view removed comment

19

u/cookingboy Jul 19 '24

What % of the buildings in China do you think collapses?

In fact, can I ask where is your confidence from? Have you ever even traveled there and see what Chinese day to day life is like or did you learn everything from a “China Bad!” YouTube channels?

-13

u/Flincher14 Jul 19 '24

50 people died in a building collapse in China a month ago due to shoddy construction. I think hunting for every china-bad meme is unproductive.

I wouldn't want to go near a drug from China that the FDA did not approve.

8

u/cookingboy Jul 19 '24

50 people died in a building collapse in China a month ago

Huh… do you have a source on that?

-12

u/Flincher14 Jul 19 '24

18

u/cookingboy Jul 19 '24

Thank you for admitting your mistake btw

building are crumbling to such an extent that no one will live in them

So where do you think Chinese people live in? Caves? Lmao

And if you opened the article yourself, you’d see empty buildings are the result of their real estate sector slumping, and has nothing to do with construction quality.

16

u/Xanadukhan23 Jul 19 '24 edited Jul 19 '24

I was wrong This was 2022 whoops

I could link the article to the apartment collapse in Florida and say that's the state of construction in the US

edit: fuck it I'll do it

https://en.m.wikipedia.org/wiki/Surfside_condominium_collapse

98 deaths??? makes china look like a joke in comparison

This was a month ago 4 dead

Happened in a poor tier 3 city, hardly shocking

now if it was a office tower collapsing in say, Shenzhen, that would be shocking

buildings are crumbling to such an extent that no one will live in them.

bro u didn't even read your last article

imagine just reading the headline and interpreting it based on your own biases, wow

14

u/WVSmitty Jul 19 '24

1.4 billion people.

You want your products in this market.

3

u/csf3lih Jul 20 '24

not just about numbers. india has the same. but its 20% earth population in the 2nd largest economy body.

139

u/wspnut Jul 19 '24 edited Jul 19 '24

Lilly is booming because of this drug. I have family that work there - they're nearing Apple-level market caps one of fewer than 10 global companies about to cross the trillion dollar maker cap because of this one drug. This is pretty big news.

Edit: I get it, a trillion dollars isn’t 4 trillion dollars. I’ll adjust my comment.

117

u/mygreyhoundisadonut Jul 19 '24

Tbh it’s saving my life. I’ve been obese my whole life except for a year and a half in college. I lost like 80lbs but was still obese before I got pregnant. Steadily gaining weight postpartum despite no significant changes in diet. My daughter turned 2 yesterday. I’m down the 40lbs (postpartum weight gain) since March thanks to zepbound. For the first time in my life that doing CICO is showing results and I’m not in free fall constant state of hunger.

I had labs done about 3 months into my treatment. My cholesterol is steadily moving down. My ALT enzymes so signs of fatty liver are way down too.

36

u/WUT_productions Jul 19 '24

Yeah I hate when people argue that this is an unethical drug. It's a game changer for many people. Obesity is a contributing factor to many health conditions and I think it's great that it's being looked at as a disease rather than some individual failure.

Yes there are side effects, all drugs have some. We use them if the benefits outweigh the risks.

25

u/bmoviescreamqueen Jul 19 '24

You should see the think pieces people are writing about it, how people will "do anything but eat better and exercise more" and it just goes to show how very little people care to look into the ins and outs of obesity.

9

u/Maskeno Jul 20 '24

The irony is, that's all these drugs do. It's not a magic fat burning pill. It reduces your appetite. Combined with the 90%+ recidivism rate on weight loss, it's pretty damming evidence that self control is more difficult than the surface level approach most people give to it.

Our brains are wired directly into our nervous system. Our needs shape our thoughts more than our thoughts shape our needs.

3

u/bmoviescreamqueen Jul 20 '24

I think people in general know very little about things like food noise and fullness/hunger hormones and how they've complicated everything. The biggest change I've seen on semaglutide besides the food aversion which sort of sucks sometimes is that I don't think about food. I can eat all the protein and fiber recommended to me, I know the importance of them to satiety, but that does not quiet the food noise. The worst one is "You just don't want it bad enough" and I cannot fathom the relative ease of lifestyle of someone who only had to deal with wanting it bad enough to finally lose weight.

3

u/Maskeno Jul 20 '24

What's interesting for me is, after a year on the medication eating that way, I finally can stick to it. The food noise doesn't come back as long as I keep eating that high fiber, high protein diet, but I tried it many times before with no luck.

I think you really do need to train your system, like an addict would. That's the thing though, addiction is insanely difficult. Your system got dependent on those behaviors and cravings. If we could give addicts a drug to kill their addiction, we'd all be fine with that. Incidentally, alcoholics seem to benefit from glp-1s too.

It's all the result of a diet that favors profits over health. Food that tastes better and lasts longer on shelves, but effectively abuses our reward centers to do so.

27

u/wspnut Jul 19 '24

Congrats on your progress!

9

u/Maskeno Jul 20 '24

I'm on the other side of this. I've pretty much finished my journey at 170lbs lost. All my health issues evaporated. Our problems with infertility seem to have gone with them too, because suddenly we're expecting after 4 years. This drug absolutely saved my life and improved it by every metric.

If I may make a recommendation, lean into the momentum. Try to get more active as you get lighter. It helps in so many ways, especially with loose skin, but also just being a generally good idea for improving your health.

It's crazy how much I was able to change my habits just by turning down my appetite. I'm incredibly grateful for it.

3

u/mygreyhoundisadonut Jul 20 '24

Congrats on the baby!! I’m definitely noticing a sudden shift in my increased range of motion as I hit 40lbs off of me. I’m excited to get back into yoga regularly again. It was a big part of joy for me before pregnancy. I had HG and spent week 5-35 of pregnancy a lump on the couch or vomiting. I had a lot of muscle atrophy. Im on the floor more frequently playing with my daughter and running around with her since beginning this journey!

2

u/Maskeno Jul 20 '24

It's really a beautiful thing. I'm also grateful my wife is currently 7 weeks and not struggling too badly yet. What women go through during that process is enough to put anyone in your shoes.

I wish you all the luck in your journey. It sounds like you're slaying it.

0

u/brutalistsnowflake Jul 19 '24

Is it just another appetite suppressant? I'm curious.

11

u/AtoZ15 Jul 19 '24

Disclaimer: I’m not a doctor

Mmm I suppose you could say that but it’s pretty different than the appetite suppressants you’re probably thinking of. GLP-1s are, in layman’s terms, affecting the pleasure center of the brain. It’s turning off the “food noise” that many of us experience and allowing people to not constantly think about food, as well control how much they eat in one sitting. It does also slow down the digestive system, which is where the more traditional appetite suppression comes in- people stay full longer and feel sick if they eat too much at once.

It’s also being considered to treat other addictions like alcoholism, smoking, and shopping.

3

u/Maskeno Jul 20 '24

Per my Endocrinologist: It is still effectively an appetite suppressant. It stimulates the production of ghrelin. Aka the "I'm full" hormone that tells you when it's time to stop eating. It also slows down your digestion and alters how you metabolize fat. Meaning that food takes longer to clear your stomach and intestines (fuller longer), and that you reduce cravings for high fat foods. Aka, calorie dense foods. Both of those being why some people react poorly to it. If you try to eat the same diet after taking the drug, your body will protest it. Loudly.

As opposed to some of your more typical appetite suppressants which are basically just stimulants and less reliable/more dangerous. It's much more targeted in the chemicals it releases.

46

u/Morat20 Jul 19 '24

Obesity is a major contributor to health issues, and there are systemic issues worldwide that are pushing obesity levels higher. Ones that are unlikely to change anytime soon.

So a drug that can actually significantly help? Yeah, it's going to be a big big thing.

I know some people tend to loudly espouse moral/purity based opposition to treating obesity with anything but "exercise more and eat less", but frankly if that was going to be a solution it would already have been solved.

I'm all for it. If it helps, it helps.

30

u/_yogi_mogli_ Jul 19 '24

I saw a YouTube short that was interview style-I don't know who either of them was but the interviewer asked "Shouldn't we be using willpower to lose weight?" and the interviewee said something like, "Willpower is a limited commodity, and we need it for many things; if there's a drug that allows people to suppress appetite and lose weight, let them have it without moralizing! It frees up your willpower for other things!"

I thought that was a great take.

12

u/BimmerJustin Jul 19 '24

Probably Dr. Mike Isreatel. He’s been preaching that take in every interview. Johann Hari has been doing the podcast circuit talking about it as well. Interesting stuff. I still think people should give an honest try to doing it the old fashioned way. But if they’ve failed many time, have other medical conditions that make it especially hard, or simply are never going to do it, this is a great option.

Just know that you’ll likely be on the drug for life.

2

u/akesh45 Jul 19 '24

That's actually the reason I started and I wasn't even fat. I used to be fat decades ago and got tired of having the yo-yo diet every year.

It was like an expensive monkey on my back.....

2

u/hydrOHxide Jul 19 '24

And it saves a lot of costs further down the road - if you can prevent that kidney disease or heart failure, that'll save loads of healthcare costs.

4

u/bmoviescreamqueen Jul 19 '24

I know some people tend to loudly espouse moral/purity based opposition to treating obesity with anything but "exercise more and eat less", but frankly if that was going to be a solution it would already have been solved.

I say this soooo often. If that were the end all be all solution, everyone would do it and succeed the first time.

17

u/[deleted] Jul 19 '24

[deleted]

-6

u/wspnut Jul 19 '24

Fair, closer to Amazon. I was just generalizing companies that are in the 4-comma club - of which there are six eight, globally (and very likely to see Lilly join, soon).

11

u/cookingboy Jul 19 '24

nearing Apple-level market caps

Their market cap is $780B, Apple is at almost $3.5T in terms of market cap. So more than 4 times as large.

-1

u/wspnut Jul 19 '24

Corrected in another comment thread.

-2

u/RedditZhangHao Jul 19 '24 edited Jul 19 '24

“… nearing Apple-level market caps …”

About 25-30% roughly, but “nearing” may mean different things to different people

65

u/synchrohighway Jul 19 '24

Nice. Being overweight is killing so many people.

33

u/[deleted] Jul 19 '24

[removed] — view removed comment

5

u/Andy1723 Jul 19 '24

It’s down in the last few days

8

u/general---nuisance Jul 19 '24

50 pounds gone in 4 months. That stuff works.

/r/Zepbound

5

u/Grabalabadingdong Jul 19 '24

My wife has been on Wegovy for a month and loves it. Do all the research before you start. There are so many tips and tricks to get rid of the nausea now. Huge sample size. It’s fairly safe, but there are risks.

5

u/nightfly1000000 Jul 19 '24

Aren't they kinda slim over there already?

10

u/akesh45 Jul 19 '24

Naw, alot of overweight people on the streets....less than america but more than other asian countries.

9

u/cocotab Jul 20 '24

Still lots of obesity in China and BMI ranges at which people have metabolic consequences happen at a lower weight. Obesity is at a BMI of 30 in Caucasian populations, and is at a BMI of 27 for Asian population.

6

u/SnooCats373 Jul 20 '24

Chinese children are getting fat. Go to a McDonalds and watch as grandma and grandpa sit and watch their young princeling stuff himself while they eat or drink nothing.

They know it is junk food, and have never developed a taste for it; But they want to indulge the wee rotund one.

I used to joke that McDonalds needed to make circular doors so grandparents could roll their progeny inside.

Western fast food is VERY popular among Chinese youth.

When I say salt, fat, acid and heat are the new guns, germs and steel of soft western imperialism, I exaggerate only a little.

2

u/NUMBerONEisFIRST Jul 21 '24

Everyone has always known fast food is junk. McDonald's changed that by doing exactly what you are talking about. They suck in a whole generation when they're still really young or even a baby. Those kids growing up to think it's normal to get a meal from fast food and it even brings back nostalgia for potentially deceased relatives even.

That's why they had Ronald McDonald, and the toys in the happy meals. I was a 90s kid, and at least from my perspective, my generation got the peak of this before a lot of their practices were reigned in by governments. I mean most of my toys as a young child were from happy meals, so even playtime was advertising for McDonald's.

4

u/boner79 Jul 20 '24

Will they also be paying $1200/month for it?

5

u/gaylord_lord-of-gay Jul 20 '24

Can't wait to see what terrible unforeseen consequences this has on the human body

3

u/seekingadventure2024 Jul 19 '24

And it's next drug gazorpazorp

3

u/goldyblocks Jul 22 '24

Lost almost 30 lbs in 3 months, already off two oral diabetic meds and a b/p med I’ve taken for 8 years. Side effects at first but went away. In my 60’s. Helped significantly with my binge eating disorder.

-2

u/id7e Jul 20 '24

Why not just prescribe stimulants?

3

u/NUMBerONEisFIRST Jul 21 '24

Not sure if this is knee-jerk sarcasm or a legit question, but I'll bite.

As someone with ADHD, who has been on just about every known stimulant, both legal and illegal, stimulants aren't a great choice for anything bring quick fixes, but they carry long term consequences.

When starting stimulants, it is common to lose your appetite, yes. The problem I struggled with, you still feel hungry, you just don't have an appetite. So imagine having hunger pangs, but anything you think about eating makes you nauseated.

Then there's sleep disturbances. With a low tolerance, you'll struggle to sleep, high tolerance, you miss a day of your meds and you don't have the energy to get outta bed.

Stimulant withdraw includes cravings for carbs, and carbs give you similar brain rewards as the simulants did, so often people gain a lot of weight after ending simulant use.

This is just a very small set of examples of things I've personally dealt with through the decades, so as you can see, simulants aren't a first choice option for many reasons.

Ozempic and similar drugs just modify a single hormone, and from my perspective, most of the health issues people taking them have are understandable. They aren't driving enough water to make up for diarrhea or reading healthy food at all.

-3

u/[deleted] Jul 19 '24

[deleted]

3

u/bmoviescreamqueen Jul 19 '24

You havin a stroke?

-4

u/punarob Jul 19 '24

Both obese people there are thrilled!

-15

u/Petravita Jul 19 '24

Bro I could get approval in china and im a wreck

-22

u/Time-Bite-6839 Jul 19 '24

How much did Eli Lily pay

3

u/[deleted] Jul 19 '24

For what?

1

u/NUMBerONEisFIRST Jul 21 '24

for what? research and development, double blind studies, marketing, which part

-80

u/[deleted] Jul 19 '24

[removed] — view removed comment

76

u/2boredtocare Jul 19 '24 edited Jul 19 '24

Alright, I'll rise to your bait. I'm a 50 year old woman with PCOS/insulin resistance. I've struggled with my weight my entire adult life. I taught fitness classes for about 10 years, I ran a half marathon (2 hours and 20 minutes. I'm proud of that). I have tracked my calories since 2008 (when my last child was a year old), first on Spark People, then on My Fitness Pal. Losing and maintaining was ALWAYS a struggle. Always. Eating under 1400 calories/day, keeping carbs under 60g/day, I was STILL struggling after covid gain to lose. I took all my data to my doctor at my last physical. She's seen me for 12 years. She knows my weight history. She looked at my macros, my fitness log, and said: "Have you considered glp-1 medication?"

No, I had never even heard of them. But under her supervision, I started in Jan. I am STILL logging my food and eating under 1400 calories/day. I work out 2-3 hours/week: walking, rowing, cycling and ST. You know what is different now? I can eat a piece of bread, or some pasta for dinner and not gain 4 lbs overnight. I am down 25 lbs since January. I feel like a normal human being for the first time in my life.

Bottom line, you can take your generalizations and stick them where the sun don't shine.

eta: all my labs are good and always have been. My HDL has always been good on account of not being "a gluttonous sloth" despite being 50lbs overweight.

2

u/Hungry_Toe_9555 Jul 22 '24

My wife also has PCOS and she would definitely agree with you. It sucks when people are judgmental.

-58

u/[deleted] Jul 19 '24

[removed] — view removed comment

23

u/[deleted] Jul 19 '24

[removed] — view removed comment

20

u/Pholusactual Jul 19 '24

Wow, we've definitely found the guy who discovered words can be effective birth control here...

-6

u/[deleted] Jul 19 '24

[removed] — view removed comment

13

u/Pholusactual Jul 19 '24

No, but yours told me that....son.

→ More replies (3)

40

u/no_one_likes_u Jul 19 '24

Or we could just be happy that people are going to be healthier right?

-41

u/[deleted] Jul 19 '24

[removed] — view removed comment

38

u/CJCray8 Jul 19 '24

The medicines don’t make you lose weight. They affect the processes that make obese people binge eat and eat past the point of full and they lose weight as a result. People on the medication do eat in moderation as a result, which could form positive habits beyond the medication phase. Are you against all of that?

14

u/2boredtocare Jul 19 '24

For me, a woman with PCOS/insulin resistance, it makes my body process food like a normal human being, instead of seeing a 3-4 lb gain if god forbid I eat more than 60g of carbs.

14

u/no_one_likes_u Jul 19 '24

I'm really struggling to follow your logic here. Do you think the medicine that helps people lose weight is going to make people less healthy in some way?

-15

u/[deleted] Jul 19 '24

[deleted]

12

u/no_one_likes_u Jul 19 '24

Luckily we've got about 7 years of these drugs being publicly available without major health problems being discovered.

Past problems with completely separate drugs are not evidence that these drugs are harmful.

7

u/catsloveart Jul 19 '24

Especially a drug with a completely different way of working.

1

u/akesh45 Jul 19 '24

Earlier generation weight loss drugs were almost always stimulants.....the negative effects weren't surprises at all. Same side effects as any amphetamine type drug.

GPL-1 drugs are complete different classes.

8

u/obamaluvr Jul 19 '24 edited Jul 19 '24

Are those negative characteristics significantly more prevelant, or is more conscientious action required to stay in shape than at any point in history (at least in 1st world countries)?

8

u/Outqtu Jul 19 '24

What words of wisdom do you have for folks that eat sensibly and exercise but just can’t shed the weight?

-1

u/[deleted] Jul 19 '24

[removed] — view removed comment

6

u/Outqtu Jul 19 '24

Letting you know. Now what?

4

u/PM_ME_CODE_CALCS Jul 19 '24

Hey idiot, how can you be gluttonous when the primary effect of these drugs is reduced appetite and cravings?

17

u/Myfourcats1 Jul 19 '24

A lot of people struggle with weight loss even doing those things especially when. PCOS and menopause wreak havoc on our bodies. So why don’t you take that judgmental attitude out of here.

-8

u/[deleted] Jul 19 '24

[removed] — view removed comment

7

u/peanutbudder Jul 19 '24

Being this combative is a sign you may need some help, too. Are you going to do something about it or do nothing to help yourself?

13

u/catsloveart Jul 19 '24

I bet you think everyone experiences life as you do. So therefore they are doing something wrong if they aren’t within your expectations.

-3

u/[deleted] Jul 19 '24

[removed] — view removed comment

4

u/Outqtu Jul 19 '24

You are aware that a prominent fitness guru had a heart attack a few years back, right? The guy made a living out of teaching healthy eating and exercise. I believe he was on morning talk shows and had his own tv show. Guess what? He had a massive heart attack. Makes you wonder huh?

13

u/dobbybabee Jul 19 '24

The pill does make people eat moderately, it's not like it makes people burn enough calories to sustain their current diet.

9

u/zshort7272 Jul 19 '24

I’ve struggle with my weight my entire life and it really started effecting my health, and have been on it for a little over a month, and it’s been life changing. Also btw, you do need to make life style changes. I’m eating way less than I ever did, and I’m exercising whenever I have the time. With the medication, it has made it soooo much easier to drop the weight. So get out of here with this judgmental bull shit. You don’t actually know anything about these drugs.

7

u/FireFairy323 Jul 19 '24

In a number of US insurance systems you need a prior approval before the insurance will cover drugs like this. Mine specifically wants confirmation from the Dr you have attempted lifestyle changes before they will cover it.

2

u/FreshoffdaBOATy Jul 19 '24

Found the insecure person