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Is it ethical to take the diabetes drug Ozempic when you don't have diabetes?
Replies
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& there you have it with the profiteering. That way with all too many drugs, products and services.2
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Adventurista wrote: »& there you have it with the profiteering. That way with all too many drugs, products and services.
Yeah.
We have to rely on pharmaceutical companies for our health, but the way they price gouge people doesn’t help us trust them at all.
The whole epipen thing springs to mind.
As does the price of a single insulin bottle.
https://medicine.yale.edu/news-article/the-price-of-insulin-a-qanda-with-kasia-lipska/
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MargaretYakoda wrote: »Adventurista wrote: »& there you have it with the profiteering. That way with all too many drugs, products and services.
We have to rely on pharmaceutical companies for our health,
In some cases this is true but as a society we have developed bad habits and want at pill to help us rather than take personal responsibility for our health.
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Theoldguy1 wrote: »MargaretYakoda wrote: »Adventurista wrote: »& there you have it with the profiteering. That way with all too many drugs, products and services.
We have to rely on pharmaceutical companies for our health,
In some cases this is true but as a society we have developed bad habits and want at pill to help us rather than take personal responsibility for our health.
I don’t dispute that many people would be better off if they exercised more, or made better choices in their diet.
But it’s not the entire picture.
And “as a society” there are many things we could do better.
But that’s not the topic of this conversation.
I’m of the opinion that people who are rich enough to take Ozempic off label without worrying about the monthly cost aren’t typical, and very likely make other immoral choices daily. They don’t care about the opinions of rabble like us. They’re gonna do whatever they want no matter what.
The rest of us? If our medical team has prescribed a semaglutide, especially if insurance is covering it? It’s very likely medically necessary, and probably is prescribed when everything else is not enough to get the patient out of an unhealthy state. So I’m not gonna judge.
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I was diagnosed with type 2 diabetes last week on Wednesday. After fasting (morning), my blood sugar was 220 when we did the blood work, and the 90-day glucose AC1 was 6.7. The diagnosis was a shock and a wake-up call. A mental breakdown.
I had it coming. Last year in April I was already prediabetic. What did I do? Nothing!
The numbers are not dramatic yet, but it is diabetes and I will be put on medication if I don't find a way to control it. I am obese. My weight and my laziness are the problem, and so are my food choices. My diabetes will get worse if I don't react.
I am lucky it's only type 2 diabetes, at least I can give it a try.
The first thing my doctor recommended was Ozempic. My answer without thinking, "NO!"
According to my doctor, Ozempic and similar meds are harmless (even though there are no long-term studies) and they are the new miracle cure for weight loss. I weighed 348 lbs last week (today 342 lbs because I have reacted.) I signed up here, bought a glucose meter reader, and now check my blood sugar 3-4 times a day. I do not want to be on diabetes medication if I don't have to be. I am learning to eat right and yes, I have been hungry and guess what? It hasn't killed me, it just shows me that my portions have been out of control. I closed our Doordash account. The fridge is filled with veggies, the fruit bowl is full. I spent $80 on cookbooks for my new lifestyle. My husband is all for it.
I am 59 years old. I could just give in (up?) I understand why obese people like me want to lose weight so badly. What I don't understand is why you would want to inject yourself with a medication you don't need.
To me, it all sounds a lot like the painkiller pandemic they created when they put everybody on oxycodone.
It's not about ethics. At the end of the day do what is best for you.
As for me, it's not in my best interest to inject myself with diabetes medication every day if I can avoid it! That's my opinion and I will stick to it and will try my best to reverse the diagnoses and lose weight and gain health.
I am writing this not to judge or offend but just share my story.8 -
I was diagnosed with diabetes in January. That was a major shock to me!! I also spent a week in hospital in February due to the effects of a diabetes Rx that I am apparently allergic to. (ugh) My dr says I should be taking Ozempic because of this drug allergy but my employer's health plan doesn't want to cover it and so it is a battle. I don't know if all the off-label users of the drug are driving up the cost of the meds, but I would think it does (after all - supply and demand, right?). I think it is unethical for people to use life-saving drugs for non-life-saving reasons especially if they lie about to save their pocketbook, but I also think it is unethical for big pharma to be making so much profit from a life saving medication.5
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ByeByeToDiabetes wrote: »I was diagnosed with type 2 diabetes last week on Wednesday. After fasting (morning), my blood sugar was 220 when we did the blood work, and the 90-day glucose AC1 was 6.7. The diagnosis was a shock and a wake-up call. A mental breakdown.
I had it coming. Last year in April I was already prediabetic. What did I do? Nothing!
The numbers are not dramatic yet, but it is diabetes and I will be put on medication if I don't find a way to control it. I am obese. My weight and my laziness are the problem, and so are my food choices. My diabetes will get worse if I don't react.
I am lucky it's only type 2 diabetes, at least I can give it a try.
The first thing my doctor recommended was Ozempic. My answer without thinking, "NO!"
According to my doctor, Ozempic and similar meds are harmless (even though there are no long-term studies) and they are the new miracle cure for weight loss. I weighed 348 lbs last week (today 342 lbs because I have reacted.) I signed up here, bought a glucose meter reader, and now check my blood sugar 3-4 times a day. I do not want to be on diabetes medication if I don't have to be. I am learning to eat right and yes, I have been hungry and guess what? It hasn't killed me, it just shows me that my portions have been out of control. I closed our Doordash account. The fridge is filled with veggies, the fruit bowl is full. I spent $80 on cookbooks for my new lifestyle. My husband is all for it.
I am 59 years old. I could just give in (up?) I understand why obese people like me want to lose weight so badly. What I don't understand is why you would want to inject yourself with a medication you don't need.
To me, it all sounds a lot like the painkiller pandemic they created when they put everybody on oxycodone.
It's not about ethics. At the end of the day do what is best for you.
As for me, it's not in my best interest to inject myself with diabetes medication every day if I can avoid it! That's my opinion and I will stick to it and will try my best to reverse the diagnoses and lose weight and gain health.
I am writing this not to judge or offend but just share my story.
Hi, please note that GLP-1 medications are well known to cause thyroid cancers and pancreatitis among other things. Although ozempic, wegovy, zepbound, etc are new, the class itself is not new.
Hope this helps1 -
Hi, please note that GLP-1 medications are well known to cause thyroid cancers and pancreatitis among other things. Although ozempic, wegovy, zepbound, etc are new, the class itself is not new.
Hope this helps
I’d be interested in seeing what peer reviewed studies you’ve got on this topic.
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MargaretYakoda wrote: »Hi, please note that GLP-1 medications are well known to cause thyroid cancers and pancreatitis among other things. Although ozempic, wegovy, zepbound, etc are new, the class itself is not new.
Hope this helps
I’d be interested in seeing what peer reviewed studies you’ve got on this topic.
Ozempic has a black box warning for it. That being said, the connection has only been seen in animal studies, and is definitely debatable.2 -
sollyn23l2 wrote: »MargaretYakoda wrote: »Hi, please note that GLP-1 medications are well known to cause thyroid cancers and pancreatitis among other things. Although ozempic, wegovy, zepbound, etc are new, the class itself is not new.
Hope this helps
I’d be interested in seeing what peer reviewed studies you’ve got on this topic.
Ozempic has a black box warning for it. That being said, the connection has only been seen in animal studies, and is definitely debatable.
Lots of drugs have a black box warning.
Metformin has a black box warning for lactic acidosis. If someone is a T2 diabetic they’re very likely to be prescribed Metformin.
I’d still like to see which journal articles @lunasash was referring to so I can read them for myself.0 -
I had this conversation with my wife about a month ago. My first reaction, honestly, was to scoff at people who have been using what I saw as a 'crutch' to enable weight loss. I've always maintained a healthy weight through diet and exercise, so everyone can do it. And while that may be true, she pointed out that most people don't. So the theoretical "everyone can do it" isn't very valuable if no one is doing it.
But being overweight & obese carries significant health risks long term. It raises your risk of cardiovascular disease, diabetes, cancer....etc. So I could get on my high horse and wag my finger at everyone...or I can accept that there is a way for people to achieve something that will make them, overall, healthier in the long run. Is it the best way? Maybe not. But maybe the best way is the way that actually works. Mine doesn't involve drugs...but I know many people whose it does.0 -
I had this conversation with my wife about a month ago. My first reaction, honestly, was to scoff at people who have been using what I saw as a 'crutch' to enable weight loss. I've always maintained a healthy weight through diet and exercise, so everyone can do it. And while that may be true, she pointed out that most people don't. So the theoretical "everyone can do it" isn't very valuable if no one is doing it.
But being overweight & obese carries significant health risks long term. It raises your risk of cardiovascular disease, diabetes, cancer....etc. So I could get on my high horse and wag my finger at everyone...or I can accept that there is a way for people to achieve something that will make them, overall, healthier in the long run. Is it the best way? Maybe not. But maybe the best way is the way that actually works. Mine doesn't involve drugs...but I know many people whose it does.
Lot's of what you wrote makes so much sense.
I am obese and have said "no" to the drugs because my way of living made me heavy. It's not just about portions, it's also about eating right. I have given food too much power, have made it a crutch for everything that went wrong in my life, and have made it a reward when life is good.
I am sure Ozempic and others would silence my cravings, but what if I stop talking them?
No drug will change my way. It might make me thinner but I have a feeling I would have to stay on it forever to keep the result.
There are no longterm studies about these new wonderdrugs. That alone scares me.
Most of us like the easy way out. Appetite suppressants, meal replacements, and pills to help us lose weight. The grocery aisles are full of it. I have tried many, also have tried diets and some work, but when I stop dieting, I go back to my old ways and gain all the weight back.
I wish everybody well who is on it, but for me, it's about so much more than 'just' losing weight. I need to reprogram myself and I am on it. :-)
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Re: Drug manufacturers and unholy levels of profiteering
https://fortune.com/europe/2024/03/28/ozempic-maker-novo-nordisk-facing-pressure-as-study-finds-1000-appetite-suppressant-can-be-made-for-just-5/
I agree that pharmaceutical companies are profiteers, as a generality.
That's really not a very good article, though, IMO. Incomplete facts, just fanning outrage for clickbait. I thought Fortune would know better on some of the technical details.
They talk about the cost of the raw materials, and the relative cost of various parts of the delivery system, but they don't know the production (process) costs, replacing that with opinions from health-care economist types. They mention the major costs of research, but seem to just shrug over how that would be amortized over the profitable life of the drugs. Novo Nordisk claims 75% of gross profits go rebates/discounts. But we don't know the gross profits per drug, let alone net, because apparently they don't release that information.
I'm not saying the current price is justified. I'm saying that I think the article adds more heat than light.I had this conversation with my wife about a month ago. My first reaction, honestly, was to scoff at people who have been using what I saw as a 'crutch' to enable weight loss. I've always maintained a healthy weight through diet and exercise, so everyone can do it. And while that may be true, she pointed out that most people don't. So the theoretical "everyone can do it" isn't very valuable if no one is doing it.
But being overweight & obese carries significant health risks long term. It raises your risk of cardiovascular disease, diabetes, cancer....etc. So I could get on my high horse and wag my finger at everyone...or I can accept that there is a way for people to achieve something that will make them, overall, healthier in the long run. Is it the best way? Maybe not. But maybe the best way is the way that actually works. Mine doesn't involve drugs...but I know many people whose it does.
It has been a good learning experience for me, as someone who also did NOT use one of these drugs to lose from obese to healthy weight, to read people's accounts here of the effects of the drug for them.
A common thing I see is people saying it quieted - sometimes but not always fully silenced - "food noise" that was constantly in their heads. While that was somewhat surprising to me, I can understand that that could be literally a physiological, possibly hormone-related effect. (To understand what that "food noise" idea means, I'd suggest reading some of those posts on other Ozempic/Wegovy/etc. user threads. I can't explain it clearly here because it's someone else's feelings, not mine.)
I'm lucky. I don't and never did have anything like that constant and seemingly obsessive "food noise". I do have cravings, and temptations to eat tempting yummy things, and some tendency to over-eat if fatigued or stressed. Those are things I can manage, and frankly it wasn't all that super-difficult for me once I fully committed to do it. For lucky me, there was no obsessive drive, no constant uncontrollable food thoughts, not much (maybe no) emotional drive to eat in order to feel a psychological sense of well-being. It sounds like you may've been lucky in that way, too, which is great.
Honestly, I don't see a reason to doubt people's self-reports, especially when there are many such reports from different people. It helps me to feel more empathy toward those who have that seemingly more obsessive component to their eating behavior. I do still feel like some people use the opportunity with the drug to work truly hard on establishing new and more health-promoting habits. However, there are a few who maybe over-rely on the drug to do all the work?
In a way, I'm coming to see it as somewhat analogous to medications for hypothyroidism (which I have). It's possible to cope with untreated hypothyroidism, but it's objectively harder to lose weight. Untreated, there is a dragginess or fatigue that reduces activity, so reduces calorie expenditure (among other negative effects that can hinder weight loss efforts). It would be easy for others to say "hypothyroid people are less active, but they're just lazy, and should try harder". (People don't usually say that, because they understand hypothyroidism better.) Having been there, it's not laziness, even though - yes - a hypo person can push themselves harder and do more, but it's not a fully voluntary thing that can be turned around just by trying harder. The drugs are important, and change the hormones so the body simply feels and behaves differently. I think the GLP-1 drugs may be analogous.2 -
I suggest most of you making comments on this site read more about the drugs you are talking about. Obesity was declared a disease about 10 years ago for a reason. Before you speak about things you no nothing about do your research. An obese person does not necessarily choose to be obese. They have metabolic issues. It is not a matter of calories in and calories out. Science has shown that. Yes, for some that do not have the gene or the propensity to have the disease they can make the choice to stay obese. But those of us that have tried everything, over and over again, years at a time and do not see an improvement don't start telling me if I only had more self-control, the problem would just go away. You do not know what you are talking about. Please do some research before you speak.1
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timesurfer7 wrote: »I suggest most of you making comments on this site read more about the drugs you are talking about. Obesity was declared a disease about 10 years ago for a reason. Before you speak about things you no nothing about do your research. An obese person does not necessarily choose to be obese. They have metabolic issues. It is not a matter of calories in and calories out. Science has shown that. Yes, for some that do not have the gene or the propensity to have the disease they can make the choice to stay obese. But those of us that have tried everything, over and over again, years at a time and do not see an improvement don't start telling me if I only had more self-control, the problem would just go away. You do not know what you are talking about. Please do some research before you speak.
I did my research and speak as I please. There are no long-term studies on what these medications will do to people who aren't diabetic. So, good luck to you! There are people out there who need the wonderdrugs, just like some heroin addicts need to be put on methadone so they can stay clean.
Our pharmaceutical industry has something for everyone. If you want to quit smoking, put a patch on it or chew gum to keep the very substance you want to get rid of in your system.
I am sorry if you don't like my opinion. I have lost 11 pounds on my own so far and you know what, it's hard. I am hungry at times and the voices in my head are as loud as they were when I quit smoking many years ago. The voices in my head don't need medication, they will shut up, because I will succeed on my own. I don't want to be on a diabetes medication because as of right now I actually have diabetes (but my blood sugar was yesterday for the first time in normal range).
Imagine that, I actually would qualify for Ozempic and don't want it.
The difference between me and you is that I -not knowingly- chose to be obese by my lifestyle. It's not a disease, it's not inherited. I did it because I love to eat and I have used food to satisfy needs that can't be satisfied with food. I chose chocolate, cakes, sugary sodas, fatty food, and fried food, just like I chose to smoke or to drink (quit both years ago). I got slowly, over many years, bigger and bigger and let it happen. I do not wish for a magic wand, I need to change my ways and I need to show some responsibility. Will I succeed? I hope so.
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timesurfer7 wrote: »I suggest most of you making comments on this site read more about the drugs you are talking about. Obesity was declared a disease about 10 years ago for a reason. Before you speak about things you no nothing about do your research. An obese person does not necessarily choose to be obese. They have metabolic issues. It is not a matter of calories in and calories out. Science has shown that. Yes, for some that do not have the gene or the propensity to have the disease they can make the choice to stay obese. But those of us that have tried everything, over and over again, years at a time and do not see an improvement don't start telling me if I only had more self-control, the problem would just go away. You do not know what you are talking about. Please do some research before you speak.
That is very rare -that metabolic issues are so extreme that they outweigh CICO.
Of course people should check for things like thyroid issues that can muck up the equation and get them corrected.
But I dont think there is any gene preventing people from losing weight
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timesurfer7 wrote: »I suggest most of you making comments on this site read more about the drugs you are talking about. Obesity was declared a disease about 10 years ago for a reason. Before you speak about things you no nothing about do your research. An obese person does not necessarily choose to be obese. They have metabolic issues. It is not a matter of calories in and calories out. Science has shown that. Yes, for some that do not have the gene or the propensity to have the disease they can make the choice to stay obese. But those of us that have tried everything, over and over again, years at a time and do not see an improvement don't start telling me if I only had more self-control, the problem would just go away. You do not know what you are talking about. Please do some research before you speak.
There are metabolic circumstance, no doubt about it that can make it difficult but it still comes down to CICO in the end and there is no 1 gene that prevents weight loss. There are no ward studies where obese people can't lose weight when in a deficit. What needs to be done to meet the criteria for that weight loss is multifaceted, is it a disease, I disagree on that one and believe that is more industry and politically driven. Britain, all Scandinavian countries and all Asian countries don't classify it as a disease and actually most Countries don't.
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What good is a diet, weight loss drug, or weight loss surgery at the stage of obesity when this is looking more like a lack of education, psychological coping mechanism, mental illness, an issue with codependency, and/or a trauma response?
I don’t judge people using tools such as Ozempic to support their treatment. But, I do think it’s useless unless you treat the underlining problem.
We can’t make people live in a bubble where they’re safe from ads, commercials, and hyper palatable foods, but I don’t think the answer is- here’s a pill!
When companies can make money on food options, diets, and pills, you can’t depend on them to “do the right thing”. We need to take it upon ourselves to get the proper treatments, and use the tools responsibly.
Ultimately, if we don’t care enough to take these steps, then why would they care?2 -
timesurfer7 wrote: »I suggest most of you making comments on this site read more about the drugs you are talking about. Obesity was declared a disease about 10 years ago for a reason. Before you speak about things you no nothing about do your research. An obese person does not necessarily choose to be obese. They have metabolic issues. It is not a matter of calories in and calories out. Science has shown that. Yes, for some that do not have the gene or the propensity to have the disease they can make the choice to stay obese. But those of us that have tried everything, over and over again, years at a time and do not see an improvement don't start telling me if I only had more self-control, the problem would just go away. You do not know what you are talking about. Please do some research before you speak.
What percent of people have a metabolic issue preventing them from losing weight in a calorie deficit? And does their medication resolve that issue? Will you please provide that research link you described?1 -
MargaretYakoda wrote: »sollyn23l2 wrote: »MargaretYakoda wrote: »Hi, please note that GLP-1 medications are well known to cause thyroid cancers and pancreatitis among other things. Although ozempic, wegovy, zepbound, etc are new, the class itself is not new.
Hope this helps
I’d be interested in seeing what peer reviewed studies you’ve got on this topic.
Ozempic has a black box warning for it. That being said, the connection has only been seen in animal studies, and is definitely debatable.
Lots of drugs have a black box warning.
Metformin has a black box warning for lactic acidosis. If someone is a T2 diabetic they’re very likely to be prescribed Metformin.
I’d still like to see which journal articles @lunasash was referring to so I can read them for myself.
You can look them up for yourself on PubMed. It is a free research database.1 -
What good is a diet, weight loss drug, or weight loss surgery at the stage of obesity when this is looking more like a lack of education, psychological coping mechanism, mental illness, an issue with codependency, and/or a trauma response?
I don’t judge people using tools such as Ozempic to support their treatment. But, I do think it’s useless unless you treat the underlining problem.
We can’t make people live in a bubble where they’re safe from ads, commercials, and hyper palatable foods, but I don’t think the answer is- here’s a pill!
When companies can make money on food options, diets, and pills, you can’t depend on them to “do the right thing”. We need to take it upon ourselves to get the proper treatments, and use the tools responsibly.
Ultimately, if we don’t care enough to take these steps, then why would they care?
Hopefully others feel this way also. For anyone who is overweight, we should be seeing a dietician and therapist at least.1 -
neanderthin wrote: »timesurfer7 wrote: »I suggest most of you making comments on this site read more about the drugs you are talking about. Obesity was declared a disease about 10 years ago for a reason. Before you speak about things you no nothing about do your research. An obese person does not necessarily choose to be obese. They have metabolic issues. It is not a matter of calories in and calories out. Science has shown that. Yes, for some that do not have the gene or the propensity to have the disease they can make the choice to stay obese. But those of us that have tried everything, over and over again, years at a time and do not see an improvement don't start telling me if I only had more self-control, the problem would just go away. You do not know what you are talking about. Please do some research before you speak.
There are metabolic circumstance, no doubt about it that can make it difficult but it still comes down to CICO in the end and there is no 1 gene that prevents weight loss. There are no ward studies where obese people can't lose weight when in a deficit. What needs to be done to meet the criteria for that weight loss is multifaceted, is it a disease, I disagree on that one and believe that is more industry and politically driven. Britain, all Scandinavian countries and all Asian countries don't classify it as a disease and actually most Countries don't.
Apparently there are several that make weight loss very difficult if not impossible.
Pulled from NCBI database:
Some genes can affect a person's ability to lose weight, but obesity is a complex issue with many causes, and genetics are not the only factor:
ADIPOQ
A genetic variant of this gene can cause people to regain weight after losing it through low-calorie eating. This variant is also linked to lower levels of adiponectin, a protein hormone that helps regulate glucose and energy metabolism. Low adiponectin levels can increase the risk of insulin resistance and intra-abdominal fat, which can lead to weight gain and Type 2 diabetes.
MC4R
Mutations in this gene can cause monogenic obesity and make it difficult for people to maintain weight loss, even with lifestyle changes.
HSP47
This gene is a collagen-specific chaperone that's expressed in fat tissue. Its expression levels correlate with body mass index, waist and hip circumference, and fat mass. Expression levels increase with obesity and food intake, and decrease with exercise, fasting, calorie restriction, and bariatric surgery.2 -
I think you are vastly over stating the genetic factors
Despite being only a generation or so ago (and therefore genetic pool not going to be significantly altered) - there were no overweight POW's, people in Irish potato famine, people in workhouses etc3
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