Just an update on the expanding science in the treatment of obesity!

https://www.nature.com/articles/d41586-023-02092-9

https://www.gq.com/story/the-next-ozempic-will-probably-be-a-pill/amp

https://amp.cnn.com/cnn/2023/06/23/health/eli-lilly-pill-orforglipron/index.html

https://nypost.com/2023/06/27/new-triple-g-weight-loss-drug-may-be-better-than-ozempic/amp/

About 20 years ago I was prescribed the weight loss miracle pill: Reductil (sibutramine). It was great. Killed my appetite to the point I was eating once a day & I lost weight. But when I did eat I wasn’t interested in prepping good healthy meals. I must have been so lacking in necessary nutrients & vitamins. And I didn’t sleep - like only getting an hour or so a night for months. (Actually think it contributed to my developing poor sleeping habits which have only improved since my surgery.) when I went off the med my appetite came back as did my weight because I ate in the same way as I had before. Then came the news they were taking it off the market because of side effects they’d newly discovered - anal leakage, cardiac issues (strokes, heart attacks, etc.). Yikes.

It’s why I worry about these medications. What happens when they stop taking them, what long term side effects are they yet to discover & what impact does the reduced food intake have on their general health & is that being monitored?

Yes, we were on a reduced diet & many of us lost our hunger & appetite for a time after our surgery but we were also given guidelines to ensure we met nutritional needs & foods we should or shouldn’t be eating. We also had regular blood tests to ensure we weren’t low in anything & our health wasn’t being affected. All of which contributed to us changing our eating behaviours & helped us learn how to make better food choices. Those with diabetes who are on these meds would, I’d hope, already be aware of their nutrient needs & how to regulate their eating.

But I understand some believe these medications are their their best/only option because they don’t want to or can’t have weight loss surgery. I just wish that when they’re given their prescription they’re also given a referral to a dietician, nutritional guidelines & their health is regularly monitored.

Just my opinion. No judgement. We all do what we feel we have to do which is best for us & our lives.

Incretins like GLP-1, GIP, DPP-4 were isolated in the 1980s, these mimetic have been in trials since the 1990s and received FDA approval in the early 2000s for the treatment of Diabetes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6497767/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707151/#:~:text=First in man studies reported,36)amide in human subjects.

What’s new is the technology (delivery, longevity, combination), indications for obesity, insulin resistant, metabolic dysfunction, cardiovascular issues, PCOS and even addiction. The consensus is that these medications are long term. No need to worry about what happens if they go off of them because they are intended to be a life long commitment for most (but so is WLS).

https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.14496

As far as support with lifestyle, Wegovy (FDA approved for obesity) offers a support program

https://www.wegovy.com/coverage-and-savings/get-wegotogether-support.html?gclid=EAIaIQobChMIh6Tc2Ynm_wIV1TjUAR3YdgGuEAAYASADEgLARfD_BwE&gclsrc=aw.ds

Also Weight watchers just bought one of the biggest telehealth prescribers of this class of medications

https://www.nbcnews.com/news/us-news/weightwatchers-buys-telehealth-platform-sequence-ozempic-wegovy-rcna73753

I’m all for new tech and there hasn’t been any major breakthroughs in the management of obesity that works this well since WLS. Many candidates for WLS may never pursue it, also many WLS patients battling regain may not be eligible for revisions. The access to a pharmacological route that works is an amazing step in the right direction and I’m absolutely on board with the advancement of the science in this field.

Edited June 28, 20233 yr by GreenTealael

10 hours ago, Arabesque said:

What happens when they stop taking them, what long term side effects are they yet to discover & what impact does the reduced food intake have on their general health & is that being monitored?

When I had my initial consultation with the surgeon, we discussed weight loss meds. He said that if I wanted to go that route, I would have to be on them for the rest of my life. That when I got off the meds, the weight would come back. That much, at least, is known. You're really not supposed to get off the meds.

did anyone else try the ones that stopped you absorbing fat and it came out in your poop? they were doozies if you ate anything slightly fatty it came out very quickly in your poop lol, oh dear, I remember it well, needless to say I didn't stay on them long.

1 hour ago, SleeverSk said:

did anyone else try the ones that stopped you absorbing fat and it came out in your poop? they were doozies if you ate anything slightly fatty it came out very quickly in your poop lol, oh dear, I remember it well, needless to say I didn't stay on them long.

No, but I remember when Olean (the food additive) came out. Anal leakage was one of the side effects. I avoided those products like the plague.

2 hours ago, SleeverSk said:

did anyone else try the ones that stopped you absorbing fat and it came out in your poop? they were doozies if you ate anything slightly fatty it came out very quickly in your poop lol, oh dear, I remember it well, needless to say I didn't stay on them long.

Oh dear, yes me. I was fine on this drug, eating good home cooked non greasy food. Then we went abroad on holiday to Europe. I tried my best to eat what looked ok but not knowing how it had been cooked really messed with me. One day I had to run to the loo. I seriously could not believe the amount of yellow oily stuff that coated the toilet. I had a terrible time trying to clean my mess up. I never took another one of those tablets again, meaning to only stop them while the holiday lasted but once home I never bothered again.

Thankfully the 1980's was 40 years ago. There has been much progress since then. I think comparing these new GLP meds to the ones mentioned above is like comparing a Tesla to a Datsun.

The arguments against these drugs sound similar to what most of us heard about WLS. That someone knew someone who had horrible complications. That our stomachs are altered forever. That we will have to take supplements or meds forever. That they didn't need WLS to lose weight, so you shouldn't either.

I have personally taken a GLP med. And I have known a number others who have as well. This is an option for people who aren't WLS candidates, or may just not consider that an option for them. It's also far fewer hoops to jump through and is not as life altering as WLS. I have known several people who have maintained their loss for over 6 months while being off the med.

All the fearmongering seems unnecessary and unfounded IMO.

The more options and less stigmatization for medically assisted weight loss the better.

@SleeverSk @Jeanniebug @summerseeker

Well thank goodness those are not the options people have to chose anymore!

For inquiring minds:

https://time.com/6284941/mounjaro-weight-loss/

https://time.com/6284941/mounjaro-weight-loss/
https://time.com/6289928/new-weight-loss-drugs-orforglipron-retatrutide-tirzepatide/

https://time.com/6290294/weight-loss-drugs-ozempic-demonization-essay/

6 hours ago, sillykitty said:

That we will have to take supplements or meds forever.

My surgeon told me that in January of 2022. It's not like it was 30 years ago. He said that "obesity is like cancer, it wants to come back." My surgeon's words, not mine.

Are there exceptions to every rule? Of course! But, in general, for most people, obesity is going to be a lifelong battle.

Weight loss medicine has come a long way and I expect it will only get better and better. But, it's not perfect. Heck, my surgeon told me that I might regain my weight and need to go on meds to get the weight back off.

There's nothing wrong with having realistic expectations.

6 hours ago, GreenTealael said:

@SleeverSk @Jeanniebug @summerseeker

Well thank goodness those are not the options people have to chose anymore!

Indeed! I took Ozempic. It worked great. If my insurance would have covered it, I might have opted to stay on that rather than get the surgery. Unfortunately, it was about $1500 a month and there was no way that we could afford that.

1 hour ago, Jeanniebug said:

My surgeon told me that in January of 2022. It's not like it was 30 years ago. He said that "obesity is like cancer, it wants to come back." My surgeon's words, not mine.

Are there exceptions to every rule? Of course! But, in general, for most people, obesity is going to be a lifelong battle.

Weight loss medicine has come a long way and I expect it will only get better and better. But, it's not perfect. Heck, my surgeon told me that I might regain my weight and need to go on meds to get the weight back off.

There's nothing wrong with having realistic expectations.

That's exactly the point. Most WLS patients will take supplements and/or meds for life, so why is this an argument against weight loss meds?

I'm 100% a believer in realistic expectations. As I mentioned I've taken taken GLP meds, to control regain. But I disagree that everyone will necessarily have to be on GLP meds for life, you said "That much ... is known". Some people have a smaller amount of weight to lose and can manage maintenance once it is lost IME.

2 hours ago, sillykitty said:

That's exactly the point. Most WLS patients will take supplements and/or meds for life, so why is this an argument against weight loss meds?

I'm not arguing against weight loss meds...

Everyone is different. As I said, if I could have continued taking the Ozempic, I might not have gotten the surgery.

On 6/28/2023 at 9:28 AM, GreenTealael said:

Incretins like GLP-1, GIP, DPP-4 were isolated in the 1980s, these mimetic have been in trials since the 1990s and received FDA approval in the early 2000s for the treatment of Diabetes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6497767/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707151/#:~:text=First in man studies reported,36)amide in human subjects.

What’s new is the technology (delivery, longevity, combination), indications for obesity, insulin resistant, metabolic dysfunction, cardiovascular issues, PCOS and even addiction. The consensus is that these medications are long term. No need to worry about what happens if they go off of them because they are intended to be a life long commitment for most (but so is WLS).

https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.14496

As far as support with lifestyle, Wegovy (FDA approved for obesity) offers a support program

https://www.wegovy.com/coverage-and-savings/get-wegotogether-support.html?gclid=EAIaIQobChMIh6Tc2Ynm_wIV1TjUAR3YdgGuEAAYASADEgLARfD_BwE&gclsrc=aw.ds

Also Weight watchers just bought one of the biggest telehealth prescribers of this class of medications

https://www.nbcnews.com/news/us-news/weightwatchers-buys-telehealth-platform-sequence-ozempic-wegovy-rcna73753

I’m all for new tech and there hasn’t been any major breakthroughs in the management of obesity that works this well since WLS. Many candidates for WLS may never pursue it, also many WLS patients battling regain may not be eligible for revisions. The access to a pharmacological route that works is an amazing step in the right direction and I’m absolutely on board with the advancement of the science in this field.

small tangent break from this very insightful thread:

your smarty-pants science-talk is turning me on ❤️?❤️

3 hours ago, ms.sss said:

small tangent break from this very insightful thread:

your smarty-pants science-talk is turning me on ❤️?❤️

Wanna see my citations ?