Welcome to Debate Club! Please be aware that this is a space for respectful debate, and that your ideas will be challenged here. Please remember to critique the argument, not the author.

Diabetes drug significantly cuts body weight in adults with obesity

2»

Replies

  • Bridgie3
    Bridgie3 Posts: 139 Member
    Theo166 wrote: »
    Below is the mechanism
    Semaglutide acts like human glucagon-like peptide-1 (GLP-1) so that it increases insulin secretion, thereby increasing sugar metabolism.

    This is an important comment, because insulin resistance isn't cured by adding more insulin.

    I'm using a freestyle libre lately, to measure my blood sugars, and it has led me to get lower and lower carb in my diet, because that way my blood sugars don't go crazy. For instance, 1/2 tsp sugar will send me upwards of 11, 12... bad stuff.

    Been watching a few youtubes and I think the consensus for type 2 diabetes is to lose weight to reduce resistance - but also to reduce carbs. That way I won't make as much insulin, and can resensitise to it.

    Either way I have to say it's making me feel a lot better, and I don't get anything like as hungry.
  • Bridgie3
    Bridgie3 Posts: 139 Member
    edited February 2022
    Dante_80 wrote: »
    tsazani wrote: »
    Obesity and T2D are protective mechanisms the body uses to protect itself from excessive consumption of sugar and carbs.

    A medication is NOT the answer. Cutting out / down the poison is the answer.

    Sugar and carbs are not a poison. Excessive consumption in any possible macronutrient mix can result in obesity and T2D.

    I can't find the original post by Tsazani. Which is a shame, because sucrose and hfcs, in the quantities the western world consumes it in, IS toxic. It is very toxic.

    Fructose is a 5 sided molecule, that your body cannot metabolise properly and that your brain can't see. It has to be dealt with in the liver, and creates a fatty droplet and triglycerides. Glucose is fine, but sucrose is 1 fructose and 1 glucose molecule. So that's fatty droplets, triglycerides, LDL cholesterol all being made right there, to deal with this stuff. You get to use some of it, but mostly it gets stored.

    Overconsumption of fructose can lead to cirrhosis of the liver, high cholesterol, definitely obesity. This is because when your body sees it, it tries to store it.

    As to glucose, being what all carbohydrates end up as, the safe six sided molecule, this will intially have some storage in the liver as glycogen, which is fine. But what happens to the glucose that goes into the blood?

    Answer? Insulin.

    You eat the carbs, the insulin shows up and hurtles round, bringing the glucose into cells, and storing it as fat. You're in store mode. And you'll mop it all up and tidy it away in a couple of hours and then find yourself hungry again. This is how high carb eaters can eat a pile of food and still be starving. Their bodies are storing the carbs as fat, so those carbs aren't available to be used.

    So if you are eating carbs, and they're going into your blood, and your body is storing them, that is the antithesis of what you are attempting to achieve.

    :smile:
  • ReenieHJ
    ReenieHJ Posts: 9,724 Member
    TBH I'd never heard of this approach before and know nothing about it. But I was talking with my dd last night and they'd prescribed the injection for her. Luckily her insurance wouldn't pay for it so she canceled her appointment to go forward with it. She said it'd cost her about 1K a month.

    I am so skeptical of using drugs to make this happen. It's scary to think about as far as long-term consequences. I remember using Dexatrim way back in my late teens. I became so fidgety, irritable and nervous I had to quit. I'm not anti-drug per se but feel that everything causes a reaction of some kind. :/

    Simply put, there is no easy way to achieve desired weight loss. But it can be done.
  • BeYourBestSelfDeb
    BeYourBestSelfDeb Posts: 64 Member
    I personally in the past was prescribed victoza but experienced side effects. He switched me to Trulicity and I am doing much better. My new endocrinologist is supportive of me taking it. As he explained it is not an insulin. It is an enhancer for insulin. I feel it helps curb my appetite and I am not having food cravings or feeling the need to eat between meals.

    I think it is always best to talk to your dr and figure out what is best and may work for you because we are all different. What works for one person may not work for another. I wish you well.
  • chris_in_cal
    chris_in_cal Posts: 2,520 Member
    Is it up to MFP standards to discuss Semaglutides? Are there some MFP rules regarding this? I believe things are censored according to MFP standards, but I've not read any published standards for MFP posting. Do they exist?
  • cmriverside
    cmriverside Posts: 34,416 Member
    edited July 2023
    Is it up to MFP standards to discuss Semaglutides? Are there some MFP rules regarding this? I believe things are censored according to MFP standards, but I've not read any published standards for MFP posting. Do they exist?

    What? What do you mean?

    If it's legal, we can talk about it. Here are the general Community Guidelines:
    https://www.myfitnesspal.com/community-guidelines

    This is posted in the Debate Club section, too. There will be lots of opinions here. You can read the Debate Club "rules" here:
    https://community.myfitnesspal.com/en/discussion/10331444/welcome-to-the-debate-health-and-fitness-category-please-read

  • chris_in_cal
    chris_in_cal Posts: 2,520 Member
    It seems a thread was removed from Debate Club today.

    I'm new in this "Debate Club" category and have never observed a thread being removed. I was surprised (though I could just be mistaken on this)
  • chris_in_cal
    chris_in_cal Posts: 2,520 Member
    Is it up to MFP standards to discuss Semaglutides? Are there some MFP rules regarding this? I believe things are censored according to MFP standards, but I've not read any published standards for MFP posting. Do they exist?

    What? What do you mean?

    If it's legal, we can talk about it. Here are the general Community Guidelines:
    https://www.myfitnesspal.com/community-guidelines

    This is posted in the Debate Club section, too. There will be lots of opinions here. You can read the Debate Club "rules" here:
    https://community.myfitnesspal.com/en/discussion/10331444/welcome-to-the-debate-health-and-fitness-category-please-read

    Thanks for the details.
  • cmriverside
    cmriverside Posts: 34,416 Member
    edited July 2023
    It seems a thread was removed from Debate Club today.

    I'm new in this "Debate Club" category and have never observed a thread being removed. I was surprised (though I could just be mistaken on this)

    Threads do get removed - all over the site.

    It would have to be pretty egregious to be removed here in Debate - however, sometimes the person who posts the thread can and does ask for it to be removed for whatever reason.
  • chris_in_cal
    chris_in_cal Posts: 2,520 Member
    - however, sometimes the person who posts the thread can and does ask for it to be removed for whatever reason.

    That seems likely, it was otherwise tame and informative. Thank you again.
  • Dante_80
    Dante_80 Posts: 479 Member
    Here is an interesting one from Reuters.

    https://www.reuters.com/business/healthcare-pharmaceuticals/most-patients-using-weight-loss-drugs-like-wegovy-stop-within-year-data-show-2023-07-11/

    Exclusive: Most patients using weight-loss drugs like Wegovy stop within a year, data show

    July 11 (Reuters) - Only about one-third of patients prescribed a popular weight-loss drug like Novo Nordisk’s (NOVOb.CO) Wegovy were still taking it a year later, while total healthcare costs for the group rose sharply, according to an analysis of U.S. pharmacy claims shared with Reuters.

    The annual cost of overall care for patients prior to taking Wegovy or a similar drug was $12,371, on average, according to the analysis. The full-year cost after starting the medication jumped by 59% to $19,657, on average.

    The costs for a similar control group of patients not taking the drugs decreased by 4% over the same period. The mean age of patients included in the analysis was 47 and 81% were female.

    Medicines such as Wegovy can cost more than $1,000 per month, and any improvement in health and subsequent reduction in medical costs is not likely to occur quickly.

    "This analysis points to the fact that there can be a lot of spending on people that are not likely to reap any long-term health benefits," said Khrysta Baig, a health policy researcher at Vanderbilt University who reviewed the findings for Reuters.

    "We need to better target who has access to them if we want to realize their full potential," she said of the obesity treatments.

    Novo Nordisk did not comment on the analysis, but said in a statement that "obesity requires long-term management" and "broadening coverage is key to ensure that those who need (therapy) can access and afford their medicines."

    Shares of the Danish drugmaker fell 2.3% on Tuesday.

    The analysis by Prime Therapeutics, a pharmacy benefits manager (PBM), reviewed pharmacy and medical claims data for 4,255 people with commercial health plans. They had all received new prescriptions of the drugs from a class known as GLP-1 agonists between January and December 2021, and had a diagnosis of obesity, prediabetes or a body mass index of 30 or higher.

    GLP-1 drugs, originally developed to help control blood sugar in patients with type 2 diabetes, also suppress appetite and promote a feeling of fullness.

    For the analysis, Prime Therapeutics excluded patients with type 2 diabetes to focus on obesity treatment.

    Nearly half of the patients were prescribed Novo's injected Ozempic or Wegovy, both of which contain the active ingredient semaglutide. Others were taking Saxenda (liraglutide), an older Novo GLP drug, or Rybelsus, an oral version of semaglutide.

    Overall, 32% of the patients were still taking the medicine for weight loss a year after their initial prescription. All the patients had insurance coverage for GLP-1 drugs, and the results did not differ materially based which of the drugs was prescribed, Prime said.

    Patrick Gleason, Prime’s assistant vice president for health outcomes and a co-author of the analysis, said this real-world data suggests a substantial drop in adherence compared to what was reported in clinical trials. In trials with adults, Novo found that 6.8% of patients taking Wegovy discontinued treatment due to gastrointestinal problems and other adverse events.

    "The majority of patients aren't getting the value of the product and there's waste, especially with an expensive therapy," Gleason said. "I was a little bit surprised by the persistency rate."

    Prime Therapeutics is owned by 19 U.S. Blue Cross and Blue Shield health insurance plans and manages pharmacy benefits for about 38 million people.

    Prime did not ask patients why their prescriptions stopped. Gleason suggested a mix of possibilities, including patients finding the nausea and vomiting side effects too severe or an inability to afford to keep paying co-pays or deductibles.

    Drugmakers and many doctors have been pushing for better insurance coverage of anti-obesity medications. They say employers, insurers and PBMs might be contributing to low adherence by imposing too many restrictions and high out-of-pocket costs.

    David Lassen, chief clinical officer at Prime Therapeutics, said it will take two to three years of data to better gauge the financial and medical outcomes for patients taking GLP-1 drugs for obesity. He said a majority of Prime’s commercial customers do not currently cover weight-loss medications.

    "This data doesn’t help move them off of that," Lassen said.
  • Lietchi
    Lietchi Posts: 6,840 Member
    Another recent article:
    https://edition.cnn.com/2023/07/10/health/weight-loss-medications-under-evaluation-for-suicide-risks/index.html

    "European regulators said Tuesday that they’d broadened an investigation started last week into the risk of suicidal thoughts among patients taking popular drugs for weight loss, like Ozempic, to include more potential cases and other medicines in the class.

    The European Medicines Agency is now evaluating about 150 reports of possible cases of self-injury and suicidal thoughts, the regulator said in a statement Tuesday."
  • kshama2001
    kshama2001 Posts: 28,052 Member
    - however, sometimes the person who posts the thread can and does ask for it to be removed for whatever reason.

    That seems likely, it was otherwise tame and informative. Thank you again.

    I did not see the thread in question, but it is possible it was SO tame it did not belong in Debate and so was moved to a more appropriate forum.
  • chris_in_cal
    chris_in_cal Posts: 2,520 Member
    edited July 2023
    kshama2001 wrote: »
    but it is possible it was SO tame it did not belong in Debate and so was moved to a more appropriate forum.

    That's possible. It was good. It seems some posters are attaching shame to the idea of using a semaglutide. "My way or the highway. You are cheating, etc." They often don't come out so bluntly, but it's the subtext.

    This poster was moving from "I am thinking if it is right for me." and all the medical and physical stuff, into "I am feeling some shame about taking it."

    That was good. It's important. It's definitely out there in the minds of many. I was looking forward to seeing it laid out.

    Like a flash, it was gone. Disappeared.
  • sollyn23l2
    sollyn23l2 Posts: 1,755 Member
    kshama2001 wrote: »
    but it is possible it was SO tame it did not belong in Debate and so was moved to a more appropriate forum.

    That's possible. It was good. It seems some posters are attaching shame to the idea of using a semaglutide. "My way or the highway. You are cheating, etc." They often don't come out so bluntly, but it's the subtext.

    This poster was moving from "I am thinking if it is right for me." and all the medical and physical stuff, into "I am feeling some shame about taking it."

    That was good. It's important. It's definitely out there in the minds of many. I was looking forward to seeing it laid out.

    Like a flash, it was gone. Disappeared.

    I've seen a few of these threads... to be honest, I don't think anyone is really shaming anyone for taking semaglutide. I think if you read them with the preconception "everyone will blame and shame me/us for using semaglutide", then that's what you're going to see no matter what the other people are actually saying. All I've really seen is people pointing out potential risks, which is fair. There are risks to everything, it's all about whether the tradeoff is worth it. To decide that, it's important to be aware of any potential outcomes, good and bad.
  • chris_in_cal
    chris_in_cal Posts: 2,520 Member
    sollyn23l2 wrote: »
    There are risks to everything, it's all about whether the tradeoff is worth it.

    Wise words, I agree. I'll be as discerning as I can, but certainly on a public internet forum there are comments coming from all directions. Most, at best, from a place of sincerity.
  • AnnPT77
    AnnPT77 Posts: 34,225 Member
    kshama2001 wrote: »
    - however, sometimes the person who posts the thread can and does ask for it to be removed for whatever reason.

    That seems likely, it was otherwise tame and informative. Thank you again.

    I did not see the thread in question, but it is possible it was SO tame it did not belong in Debate and so was moved to a more appropriate forum.

    It wasn't totally off the mainstream for debate. I assumed the OP asked for it to be deleted. It hadn't been heading into the ditch consistently in a way that usually gets a thread deleted for violating standards.

    If the OP did delete it, I'm sorry that they felt the need, but it's their prerogative. I'm not inclined to question that after the fact (which you didn't, kshama - that part was just a general comment).