The FDA will likely approve the diabetes drug tirzepatide for weight loss(nbcnews.com)
nbcnews.com
The FDA will likely approve the diabetes drug tirzepatide for weight loss
https://www.nbcnews.com/health/health-news/weight-loss-drug-affordability-rcna60422
105 comments
I'm also one of those people who finds it more convenient to eat 1 meal per day when busy. It also started in my early 20s, but I've never been on stimulants. I got in the habit of eating irregularly in grad school which made it even easier to continue. I rarely have any appetite within an hour of waking up, and ive almost never eaten during this window. Not clear to me which is the cause vs effect.
I know some people who are on the opposite end and have problems functioning after missing lunch. None of them have ever intentionally fasted, though again it's hard to separate cause from effect.
What is clear is that different people's bodies form very different expectations surrounding food intake, and we are mostly unaware of this collectively.
I know some people who are on the opposite end and have problems functioning after missing lunch. None of them have ever intentionally fasted, though again it's hard to separate cause from effect.
What is clear is that different people's bodies form very different expectations surrounding food intake, and we are mostly unaware of this collectively.
No Adderall works via a completely different pathway.
Not at all, nor do all prescribed users of Adderall experience any change in appetite.
> Adderall increases the level of serotonin in your body, which can cause your appetite to decrease, leading to weight loss. This can be a good thing if you are trying to lose weight, but it can also cause stomach pain.
Adderall and other stimulants activate the chemoreceptor trigger zone in the brain and that can mediate feelings of hunger, nausea, trigger vomiting etc.
To add to this, stimulants can release dopamine or even bind to dopamine receptors in parts of the brain responsible for emesis, which the CTZ is part of.
Adderall might lead to downstream raising of serotonin levels, but the drug itself doesn't act on serotonin and I'd be genuinely surprised if the emesis symptoms it can cause were mediated by serotonin and not the dopamine it acts on.
Drugs that block dopamine receptors in the CTZ, like compazine, are regularly prescribed as antiemetics.
Adderall might lead to downstream raising of serotonin levels, but the drug itself doesn't act on serotonin and I'd be genuinely surprised if the emesis symptoms it can cause were mediated by serotonin and not the dopamine it acts on.
Drugs that block dopamine receptors in the CTZ, like compazine, are regularly prescribed as antiemetics.
Low metabolism perhaps?
I suggest reading the new book, Burn: The New Science of Metabolism.
Low metabolism tends to cause weight gain, so probably not. Iirc, people with low metabolism eat more to get their energy levels and/or temp up high enough until their weight gain brings up their metabolism to a more normal range.
There's a lot we don't know, but from what I gather microbiome tends somewhat towards homeostasis such that you tend to eat in a way that maintains the current status quo. Among other things, this is linked to things like whether or not you are at risk for obesity.
I am currently taking this drug in an attempt to get my blood sugar level down. I have lost about 15 lbs but my insurance did not want to cover it. Thankfully, Eli Lilly has a $25 coupon to cover it.
I’m also on it, originally started it for weight loss, and am down 35lbs in 4 months. However I’m starting to wonder if I was diabetic or pre diabetic, as I no longer feel my blood sugar changing throughout the day.
The drug has been great, with minimal side effects. Simply not interested in food, and always feel full.
The drug has been great, with minimal side effects. Simply not interested in food, and always feel full.
Does the coupon make it cost $25, or just reduce the cost by $25? Any other specifics on this would be super helpful!
I’m seeing one of the doctors quoted in the article and they say nobody knows what’s going on with pricing or what will happen next year when the drug gets approved.
The coupon is from the manufacturer and brought the total cost to $25 out of pocket. However, in Oct the rules changed and now there is lots of confusion about eligibility and costs. Most pharmacies refuse to deal with this at all, and last week I paid $500 (for a monthly dose).
The coupon is from the manufacturer and brought the total cost to $25 out of pocket. However, in Oct the rules changed and now there is lots of confusion about eligibility and costs. Most pharmacies refuse to deal with this at all, and last week I paid $500 (for a monthly dose).
At let's say a 10 pound per month weight loss, that means losing 100 pounds would only cost $5,000. I know it doesn't quite work that way, but $500/month sounds a lot, but $5,000/100lb sounds like a bargain.
Unfortunately 90%+ of people need to continue taking the drug to keep the weight off.
It’s an expensive drug but there is increasing competition in the drug category which will be good for consumers in the long run.
It’s an expensive drug but there is increasing competition in the drug category which will be good for consumers in the long run.
Do we actually know if weight loss from these medications is associated with improved health outcomes in non-diabetic people? Like does it fix joints, does it fix heart disease, blood pressure, etc?
As long as it doesn't damage those things by itself, either it will help them or we're totally wrong about what causes them.
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Very likely so. I know of at least one study in which they are interested in determining if weight loss from semaglutide results in a similar decrease in cancer rates that they see in bariatric surgery patients.
The drugs cause you to eat less and the mechanism of the drug may, in and of itself have some cardio protective effects. To get a drug approved for diabetics, you have to demonstrate it doesn’t cause cardiovascular issues because the comorbidity among diabetics is so high, and other drugs have a history of helping with blood sugars but causing cardiovascular issues. On those measures, iirc, semaglutide specifically showed my that the treatment group saw a significant reduction in cardiovascular events. I’m on mobile so can’t provide links at the moment.
The drugs cause you to eat less and the mechanism of the drug may, in and of itself have some cardio protective effects. To get a drug approved for diabetics, you have to demonstrate it doesn’t cause cardiovascular issues because the comorbidity among diabetics is so high, and other drugs have a history of helping with blood sugars but causing cardiovascular issues. On those measures, iirc, semaglutide specifically showed my that the treatment group saw a significant reduction in cardiovascular events. I’m on mobile so can’t provide links at the moment.
Dulaglutide is a drug in the same class that has been around longer there is a modest improvement for cardiovascular events.
5.4 years on the drug:
https://pubmed.ncbi.nlm.nih.gov/31189511/
5.4 years on the drug:
https://pubmed.ncbi.nlm.nih.gov/31189511/
Your link says “ in type 2 diabetes” in the title. I’m interested in non-diabetics, given this is going to be approved purely to unfat people without diabetes.
I had the same curiosity as you but realized there can’t possibly be any long term studies because this class is new, and very new for weight loss. I just searched for the longest term study for the class.
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Disclaimer - I'm just a mere biochem grad who've taken some grad level courses in physiology so my question is coming from curiosity and healthy dose of ignorance.
I took a cursory glance at the wiki page (https://en.wikipedia.org/wiki/Tirzepatide) and it seems like it's working wonders on weight loss by targeting satiety. Weight loss still occurs when calorie out exceeds calorie input so it's not fundamentally changing anything as far as I know biochemically. Why is it so popular then? Should we be concerned about needing drugs to treat obesity? My guess is that patients who lose weight this way still needs this drug to keep it off.
Medical professionals/experts - please ream me or just correct me if I'm wrong here.
FWIW - I also struggled with weight loss. I was 284(!!!) during peak covid but managed to get myself down to 224. I'm hoping to get it down to 174 by end of this year. I found fasting + exercise + will power to be key for weight loss but I also understand that this is an anecdote and won't work for others.
I took a cursory glance at the wiki page (https://en.wikipedia.org/wiki/Tirzepatide) and it seems like it's working wonders on weight loss by targeting satiety. Weight loss still occurs when calorie out exceeds calorie input so it's not fundamentally changing anything as far as I know biochemically. Why is it so popular then? Should we be concerned about needing drugs to treat obesity? My guess is that patients who lose weight this way still needs this drug to keep it off.
Medical professionals/experts - please ream me or just correct me if I'm wrong here.
FWIW - I also struggled with weight loss. I was 284(!!!) during peak covid but managed to get myself down to 224. I'm hoping to get it down to 174 by end of this year. I found fasting + exercise + will power to be key for weight loss but I also understand that this is an anecdote and won't work for others.
This is a regressive opinion.
If we have tools available that can solve problems—as humans are not perfect—then why not use them? Do you not enjoy the benefits of other medicine that solves problems you have, like susceptibility to Covid?
We should always be on the conquest to improve our livelihoods. If that means introducing a drug to combat obesity so that scores of people can extend their lifespans by being healthier, that is a good thing.
If we have tools available that can solve problems—as humans are not perfect—then why not use them? Do you not enjoy the benefits of other medicine that solves problems you have, like susceptibility to Covid?
We should always be on the conquest to improve our livelihoods. If that means introducing a drug to combat obesity so that scores of people can extend their lifespans by being healthier, that is a good thing.
I don't think this is regressive. He's suggesting that people will gain the weight back when they go off of the drug and their appetite returns, which is a legitimate concern given that we don't know if it's safe for people to take this drug long term because it hasn't been around all that long.
I disagree. Have you ever seen how obese people eat? If an obese person spends 5 years on this medicine, then goes off it, they’ve spent 5 years eating less. That’s at least some level of knowledge with real results.
Patients do indeed need the drug to keep the weight off. They have proven this. But that is not an issue at all. Individuals who have gained a significant amount of weight do not produce leptin, grehlin, and other related hormones in the same way that people at a normal weight do. Once you’ve put on a significant amount of weight you can’t just expand the size of your fat cells you make new cells entirely. Even if you remove those new cells via liposuction, the body recreates them as a homeostatic response. The result is that something like 10% of obese people that lose weight have kept it off two years later. The people who keep it off have been studied extensively as a group and generally they weigh themselves daily and many of them count calories meticulously. As soon as they stop doing that, they regain the weight. It’s a path dependent outcome. Once you’ve walked the path to obesity, your body fights you walking back towards healthy. This drug adjusts some of the same hormones that get out of whack when you’ve been overweight before. Unfortunately not all of them can be safely played with (giving people leptin and leptin like hormones tends to cause cancer for example). But these seem to be both safe and effective.
There really shouldn’t be a stigma associated with taking drugs like these for the rest of your life.
There really shouldn’t be a stigma associated with taking drugs like these for the rest of your life.
Individuals who have gained a significant amount of weight do not produce leptin, grehlin, and other related hormones in the same way that people at a normal weight do. Once you’ve put on a significant amount of weight you can’t just expand the size of your fat cells you make new cells entirely.
That's a good point I hadn't considered. Thanks!
That's a good point I hadn't considered. Thanks!
Do you have any data on how long these “path dependent” effects are measurable for?
I remember reading a study on the effect of obesity on sperm counts in men, which showed a significant increase in sperm counts for the men once they lost weight after a few months.
Sperm replace themselves more quickly than other cells in the body, but presumably the same normalization should occur in this case absent some sort of persistent self reinforcement mechanisms.
I remember reading a study on the effect of obesity on sperm counts in men, which showed a significant increase in sperm counts for the men once they lost weight after a few months.
Sperm replace themselves more quickly than other cells in the body, but presumably the same normalization should occur in this case absent some sort of persistent self reinforcement mechanisms.
> patients who lose weight this way still needs this drug to keep it off.
Purely anecdotal N=1 but I was also 285 at one point in my life and went through an intensive weight loss program through my work and lost about 60 lbs in 3 months. That was about 15 years ago. Since then I've done several 3 day fasts and many weeks of One Meal A Day. I think that program showed me experientially what its like to go without as much food as I thought I needed.. so even when the program ended I had a totally different concept of food. Maybe this drug can do something similar. I think so much of overeating for a lot of people is just purely habitual or a misconception that 'my body needs food every 3 hours' when really it doesn't at all, that's just how you've currently conditioned it.
Purely anecdotal N=1 but I was also 285 at one point in my life and went through an intensive weight loss program through my work and lost about 60 lbs in 3 months. That was about 15 years ago. Since then I've done several 3 day fasts and many weeks of One Meal A Day. I think that program showed me experientially what its like to go without as much food as I thought I needed.. so even when the program ended I had a totally different concept of food. Maybe this drug can do something similar. I think so much of overeating for a lot of people is just purely habitual or a misconception that 'my body needs food every 3 hours' when really it doesn't at all, that's just how you've currently conditioned it.
You're totally right! Just to add on for the overeating - I think it's easier to overeat in the states due to just larger portions and prevalence of processed foods which often contain sugar and fat, thus leading to higher calorie intake.
Food was very much a comfort thing so I would stress-eat during exams, stressful jobs and so forth.
The other thing I noticed is that I got less hungry(!?) when I ate less after like fasting for 2 weeks. It seems to me that eating less after getting over the initial hump was key for my weight loss.
Food was very much a comfort thing so I would stress-eat during exams, stressful jobs and so forth.
The other thing I noticed is that I got less hungry(!?) when I ate less after like fasting for 2 weeks. It seems to me that eating less after getting over the initial hump was key for my weight loss.
I have issues with my appetite. I eat a lot. So my fix was to exercise a lot. Which worked out fine. But now my hip has a pretty severe issue causing me to go from ~1,500+ calories per day burn to about half.
Add to that the fact that I sleep worse due to pain...
So my appetite is even worse, as I eat to compensate the lack of energy because of my bad sleep.
I want these meds, if only until I've had my surgery and have completely recovered.
And after that? We'll see..
Food abuse is instilled during childhood, it's incredibly hard to change. For alcohol abuse we accept that abstaining is the right thing to do. Can't do that with food, so we need some help.
If these meds work with minimal side effects, and people are genuinely having a benefit, why not?
Add to that the fact that I sleep worse due to pain...
So my appetite is even worse, as I eat to compensate the lack of energy because of my bad sleep.
I want these meds, if only until I've had my surgery and have completely recovered.
And after that? We'll see..
Food abuse is instilled during childhood, it's incredibly hard to change. For alcohol abuse we accept that abstaining is the right thing to do. Can't do that with food, so we need some help.
If these meds work with minimal side effects, and people are genuinely having a benefit, why not?
Why do we accept it for alcohol but not for food? If someone could invent a drug for avoiding alcohol consumption, why wouldn’t an alcoholic use it?
Because abstaining from food will eventually lead to starvation and death.
It exists. Naltrexone. Amazing drug.
Oh gotcha. I'm really sorry to hear that and hopefully your recovery goes well.
>If these meds work with minimal side effects, and people are genuinely having a benefit, why not?
I suppose that is true! It's been my experience that if something is too good to be true, then it often is. I hope I'm wrong here though.
>If these meds work with minimal side effects, and people are genuinely having a benefit, why not?
I suppose that is true! It's been my experience that if something is too good to be true, then it often is. I hope I'm wrong here though.
>Should we be concerned about needing drugs to treat obesity?
This comment of yours made me think of this comment from another article about another obesity drug I read recently:
"The history of medicine includes the following story many times: there’s some condition that doctors recommend lifestyle changes for. Then an exciting new medication comes out that treats the condition effectively. Over a generation or so, doctors go from demanding the lifestyle change, to gesturing at the lifestyle change before prescribing the medication, to mostly just prescribing the medication. We saw this with cholesterol and statins, with hypertension and ACE inhibitors, with depression and SSRIs. You can form your own opinion on whether this is good or bad, but we’re probably in the very beginning of this process with obesity. Opinions will be all over the map for a while before the inevitable pharma company victory makes everyone agree that semaglutide is first-line therapy."
https://astralcodexten.substack.com/p/semaglutidonomics
This comment of yours made me think of this comment from another article about another obesity drug I read recently:
"The history of medicine includes the following story many times: there’s some condition that doctors recommend lifestyle changes for. Then an exciting new medication comes out that treats the condition effectively. Over a generation or so, doctors go from demanding the lifestyle change, to gesturing at the lifestyle change before prescribing the medication, to mostly just prescribing the medication. We saw this with cholesterol and statins, with hypertension and ACE inhibitors, with depression and SSRIs. You can form your own opinion on whether this is good or bad, but we’re probably in the very beginning of this process with obesity. Opinions will be all over the map for a while before the inevitable pharma company victory makes everyone agree that semaglutide is first-line therapy."
https://astralcodexten.substack.com/p/semaglutidonomics
I think your concerns are appropriate, but if there are people for whom drug-free practices are too difficult and not working, it might be a good alternative. It's probably better than bariatric surgery.
It's also not necessarily either-or: maybe lower doses might be enough to get someone over a hump or something with exercise and other lifestyle changes. Or some dosing protocol in tandem with other things might allow people to go off the drug eventually. Or maybe not. But it's early and who knows what research will show. Having another option that actually works and isn't harmful is better than not having that option.
It's also not necessarily either-or: maybe lower doses might be enough to get someone over a hump or something with exercise and other lifestyle changes. Or some dosing protocol in tandem with other things might allow people to go off the drug eventually. Or maybe not. But it's early and who knows what research will show. Having another option that actually works and isn't harmful is better than not having that option.
honestly, what is wrong with you?
Yikes. Gogo gadget thyroid tumors, not at a great place for a tumor.
https://www.drugs.com/dosage/tirzepatide.html
https://www.drugs.com/dosage/tirzepatide.html
It causes thyroid tumors in rats, and thyroid tumors are among the most curable cancers.
Sigh, as a T2 diabetic that's been on this for a while, the lack of supply is becoming a real problem. This is in Australia, where the drug is available on the PBS for T2 Diabetes.
On the flip side, people who are overweight are already on the road to T2 diabetes.
Obesity isn't just a cosmetic issue, it is a disease with very real health implications. If behavior modification doesn't work to lose weight, we shouldn't deny people effective treatment.
The supply chain will adjust to meet demand.
Obesity isn't just a cosmetic issue, it is a disease with very real health implications. If behavior modification doesn't work to lose weight, we shouldn't deny people effective treatment.
The supply chain will adjust to meet demand.
All these new "weight loss" drugs are semaglutide peptide
https://en.wikipedia.org/wiki/Semaglutide
No way messing with insulin production doesn't have long-term delayed consequences.
https://en.wikipedia.org/wiki/Semaglutide
No way messing with insulin production doesn't have long-term delayed consequences.
They are in the same class as semaglutide.
We know being obese has long term delayed consequences.
And they've been giving this drug to diabetics for a while and they seem to be fine and healthy.
We know being obese has long term delayed consequences.
And they've been giving this drug to diabetics for a while and they seem to be fine and healthy.
Sure, but being grossly overweight also has a tendency to “mess with insulin production”. That’s how type 2 diabetes works: your musculoskeletal cells become resistant to insulin and your pancreas produces more and more until it can’t keep up.
> No way messing with insulin production doesn't have long-term delayed consequences.
Not an expert, but this sounds most likely true.
Not an expert, but this sounds most likely true.
I'm sure this will have no long term side effects or risks! Is exercise + sound diet that difficult for people?
Empirically, yes. Very few people who attempt to lose a substantial amount of weight via diet and exercise are able to lose the weight and keep it off over the long term. The latter part is the problem for most people.
Clearly it is in the US. I think it's a generational lack of understanding and poor habits. From my perspective each generation of an obese family seems to get bigger and bigger, and pass on those non-existent or bad habits to their kids. If your parents aren't modeling exercise and good behaviors the only avenue you have to learn from is school and that's easy to get left behind.
On top of that you're marketed with the shittiest food all day, your school probably serves food where only things like pizza and burgers are palatable.
It's all really a shame because exercise and eating well clear your mind and make you feel better. Even if you're a healthy weight eating shitty and sitting all day does things to your mental health.
On top of that you're marketed with the shittiest food all day, your school probably serves food where only things like pizza and burgers are palatable.
It's all really a shame because exercise and eating well clear your mind and make you feel better. Even if you're a healthy weight eating shitty and sitting all day does things to your mental health.
Abstinence-only education always works!
I mean what percentage of the US is overweight these days, the number is scary high and it has a massive impact in productivity and Healthcare costs.
Here is Derek from MPMD talking about one of those diabetes 2 drugs being used for weight loss by people like Elon Musk [1]
Sadly because celebrities are using these drugs I can forsee many people who are only a bit overweight taking this when just eating better and working out would be so much better for them.
[1] https://youtu.be/hcNTHLdH5QE
Sadly because celebrities are using these drugs I can forsee many people who are only a bit overweight taking this when just eating better and working out would be so much better for them.
[1] https://youtu.be/hcNTHLdH5QE
You misunderstand how weight loss works; it's controlled by the HPA axis and various related brain/gut/pancreas/liver/fat cell interconnects, not the neocortex. "Stop eating" is an input from the neocortex. It has very, very little impact on food drive. "Satiation/Nausia" is an input from primary metabolic regulatory systems.
People that are 'only a little bit overweight' are usually in that state because they can't control their eating via the neocortex. You can't simply say "eat a little better"; you have to modify food drive. The signaling pathway this drug targets is the one that feed into food drive.
People that are 'only a little bit overweight' are usually in that state because they can't control their eating via the neocortex. You can't simply say "eat a little better"; you have to modify food drive. The signaling pathway this drug targets is the one that feed into food drive.
Eating better effects satiety.
Eating better and working out is hard. If the medication can get you a similar outcome with minimal side effects, that seems like a prudent protocol to prescribe.
If it’s determined to be safe (statistically), why not? Might only be necessary until we can inexpensively synthesize miR-1: https://news.ycombinator.com/item?id=34196488
If it’s determined to be safe (statistically), why not? Might only be necessary until we can inexpensively synthesize miR-1: https://news.ycombinator.com/item?id=34196488
Why not both? A healthy lifestyle combined with pills that work.
If you're living a healthy lifestyle, then you probably don't need pills to lose weight. We know diet and exercise (with an emphasis on the diet) will yield weight loss, if it's maintained.
However, that's a big if. Behavior modification is hard. There are both physiological and emotional factors that need to be addressed, and cause many attempts at weight loss to fail.
The drugs are a second line treatment when behavior modification fails.
(And that said, exercise is still important. Overweight or not, it has a massive impact on longevity, physical health, and mental health.)
However, that's a big if. Behavior modification is hard. There are both physiological and emotional factors that need to be addressed, and cause many attempts at weight loss to fail.
The drugs are a second line treatment when behavior modification fails.
(And that said, exercise is still important. Overweight or not, it has a massive impact on longevity, physical health, and mental health.)
Unfortunately there aren't any shortcuts to good health
Apparently there is now.
Exercise and diet have positive health effects other than losing weight. Many people with normal weight according to BMI still have an unhealthy body fat percentage. That said, if this drug can keep its promise it will have an enormous positive effect on public health.
If you’re regularly doing something unhealthy (like smoking or eating lead paint chips), stopping that is both good for you and a shortcut.
My understanding is that the way the drug works is by improving your diet.
How do you know that?
The number of overweight people and diabetics far exceeds the number of celebrities out there. I think it's just demand driven by media exposure that is the issue
1100-1500/month is pretty brutal. It’s a bit of a middle finger pointed at lower income people
You can get these wholesale from China from "reputable" gray-market wholesalers who get the chemicals made at contract manufacturing facilities. Independent purity tests via HPLC are available for <$100 if you don't fully trust your supply chain. Semaglutide is very, very cheap in the gray market. It's somewhat less effective than Tirzepatide and has slightly more side effects if you ramp up the dosage too quickly.
If an annual amount is purchased on the gray market, this brings the monthly cost down to:
- Tirzepatide: $60/month
- Semaglutide: $10/month
- Liraglutide: $87/month
Note that in the USA, it is legal to import certain amounts of FDA-approved drugs if you have a prescription for them. However, just because something is the exact same chemical as an FDA-approved drug does not make it an FDA-approved drug. It must be manufactured in an FDA certified facility and be the same brand/manufacturer/packaging/labeling/etc as the approved drug.
e.g. importing generic Sildenafil/Viagra is legal if you can find the Teva(tm) brand generic sildenafil in, say, Mexico or Canada for a better price. But it must be the pills manufactured by Teva in the appropriate facility with NDC #0093-5342-56[0]. If you import generic sildenafil "Cenforce" from the (very legitimate but not FDA-approved) Indian pharmaceutical manufacturer "Centurion Laboratories"...
...that would still be potentially criminal smuggling. Even if the pills you import show via laboratory test that they precisely match your medical prescription, they are not "FDA approved" and therefore not legal to import.
A lot of people do though!
0: https://ndclist.com/ndc/0093-5342/package/0093-5342-56
If an annual amount is purchased on the gray market, this brings the monthly cost down to:
- Tirzepatide: $60/month
- Semaglutide: $10/month
- Liraglutide: $87/month
Note that in the USA, it is legal to import certain amounts of FDA-approved drugs if you have a prescription for them. However, just because something is the exact same chemical as an FDA-approved drug does not make it an FDA-approved drug. It must be manufactured in an FDA certified facility and be the same brand/manufacturer/packaging/labeling/etc as the approved drug.
e.g. importing generic Sildenafil/Viagra is legal if you can find the Teva(tm) brand generic sildenafil in, say, Mexico or Canada for a better price. But it must be the pills manufactured by Teva in the appropriate facility with NDC #0093-5342-56[0]. If you import generic sildenafil "Cenforce" from the (very legitimate but not FDA-approved) Indian pharmaceutical manufacturer "Centurion Laboratories"...
...that would still be potentially criminal smuggling. Even if the pills you import show via laboratory test that they precisely match your medical prescription, they are not "FDA approved" and therefore not legal to import.
A lot of people do though!
0: https://ndclist.com/ndc/0093-5342/package/0093-5342-56
>> You can get these wholesale from China from "reputable" gray-market wholesalers
Hard pass.
Hard pass.
Unfortunately it's really expensive to research and produce drugs and somebody's gotta pay for it. The rest of world isn't willing to so it looks like rich people's insurance is the one that will foot the bill which means lower income people have to wait.
It sucks and it's a inefficient way to fund research but it's better than the alternative where no one funds this research and we (both rich and poor) never get the drug.
It sucks and it's a inefficient way to fund research but it's better than the alternative where no one funds this research and we (both rich and poor) never get the drug.
Another alternative is the government funding this research and/or buying the drug directly. This is what was done for the government ordering 30 billion dollars worth of covid vaccines from moderna, pfizer, and j&j.
Governments already fund much of the basic science research needed to find new drugs. That isn't the issue. The real funding issue is with stage 3 clinical trials, which now often cost on the order of $1B each.
In theory we could nationalize the whole industry and have the government run all clinical trials. So the decisions on which drugs to develop would then be based on lobbying and campaign contributions. Would that produce better outcomes than what we're getting now? The government has a poor track record on picking winners.
In theory we could nationalize the whole industry and have the government run all clinical trials. So the decisions on which drugs to develop would then be based on lobbying and campaign contributions. Would that produce better outcomes than what we're getting now? The government has a poor track record on picking winners.
What the difference between consumers paying for drugs directly or paying taxes that pay for the drugs?
Many. For one the government can now collectively bargain for better prices. They can also subsidize the drug such that its available for everyone who needs it, not just those who have great insurance or who can afford to pay entirely out of pocket. Keeping your working population healthy has massive second order effects on the economy, it would be an investment paying for medical care.
Where does this money come from? The people in this country who make way too much money to notice any decrease in quality of life from this potential tax hit. This country is full of such whales who could front a lot of money for collective good if we thought about things in a more redistributive manner instead of the "screw you I got mine" manner that somehow got perverted into the American way.
Where does this money come from? The people in this country who make way too much money to notice any decrease in quality of life from this potential tax hit. This country is full of such whales who could front a lot of money for collective good if we thought about things in a more redistributive manner instead of the "screw you I got mine" manner that somehow got perverted into the American way.
If the government is making the drugs how do they bargain for a price?
And if the inefficiency of the government in terms of defense spending is any indication, I’m sure we’d be getting way less for our money than we currently do.
And if the inefficiency of the government in terms of defense spending is any indication, I’m sure we’d be getting way less for our money than we currently do.
Most analysis of single payer versus the status quo suggest we'd all be saving money hand over fist. Sure the government is not the most efficient, but private companies are often even more inefficient unless you are a shareholder and your metrics for efficiency are profit versus the wellbeing of your customers.
Single payer systems are not more efficient at producing drugs, they just pay less for drugs by virtue of being a monopsony buyer.
If we had a single payer system we would pay less for drugs, but we'd also have less drugs. This is probably a good tradeoff in the short term, and a bad one in the long run.
If you get a disease today that has a significantly better prognosis than 20 years ago, what's the most likely reason? Better drugs. What is only 10% of our healthcare expenses, drugs. I don't think we should be so quick to cut funding to a sliver of healthcare expenses that is driving 90% of the progress.
If we had a single payer system we would pay less for drugs, but we'd also have less drugs. This is probably a good tradeoff in the short term, and a bad one in the long run.
If you get a disease today that has a significantly better prognosis than 20 years ago, what's the most likely reason? Better drugs. What is only 10% of our healthcare expenses, drugs. I don't think we should be so quick to cut funding to a sliver of healthcare expenses that is driving 90% of the progress.
"Most analyses"?
United Healthcare, the largest US insurer, has more members than the entire population of Canada. Why don't they get better drug prices than Canada?
And in terms of efficiency, please list all the new, innovative drugs the government has brought to market.
United Healthcare, the largest US insurer, has more members than the entire population of Canada. Why don't they get better drug prices than Canada?
And in terms of efficiency, please list all the new, innovative drugs the government has brought to market.
If the USPS ran like the DoD, the country would fall apart.
Government is capable of efficiency.
Government is capable of efficiency.
Pharma profits so far could pay for research thousand years into the future.
Pharma companies have profits that are around 13% mostly comparable to other companies of the same size doing lots of r&d.
Pfizer could fund research for two thousand years at only 10 million a year?
Lower income people of 2036 and beyond will have a magical medicine for probably 30 bucks a month.
It will be too little too late for many by then
So we should stop designing new drugs because only future generations will benefit?
We should instead publicly subsidize the drugs that people need to be healthy just like we did for the covid vaccines that we offered to everyone at no cost.
It's covered by insurance and the manufacturer has a $25/month program.
Running shoes cost about $50-$100 for a decent pair and last for many months
1) Decent running shoes cost more than that and it's a prohibitive spend for lower income people.
2) This is an extreme oversimplification of the problem and feels to be made in bad faith.
2) This is an extreme oversimplification of the problem and feels to be made in bad faith.
I'd never consider exercise gear, esp running shoes to be 'prohibitive spend for lower income people', taking care of your health is probably some of the best money you can spend ... and you can most certainly buy quality running shoes for around $100. Here are some high quality trail runners for around 100, some under: https://www.saucony.com/en/saucony-peregrine/
Note that weight-loss is relying of a side effect. It might be a wonder drug, or it might have issues due to how that side effect affects patients (loss of appetite, insulin levels, etc). I hope it's a clear aid for weight loss but some caution is appropriate.
Sadly it seems that these drugs will be used for vanity without much regard for their safety.
Being overweight has risks, drugs have risks, choose your risk. Being overweight is quite a risk, so it's not impossible for a pill to be the better choice. Significant weightloss is not a vain thing.
It still requires a prescription and, therefore, a doctor moderates usage and safety.
There is some evidence that soleus push ups can induce significant insulin responses, without the need for drugs.
Soleus is the muscle below the calf and normally used when walking running and jumping
> All of the 600 muscles combined normally contribute only about 15% of the whole-body oxidative metabolism in the three hours after ingesting carbohydrate. Despite the fact that the soleus is only 1% the body weight, it is capable of raising its metabolic rate during SPU contractions to easily double, even sometimes triple, the whole-body carbohydrate oxidation.
https://www.eurekalert.org/news-releases/965506
Soleus is the muscle below the calf and normally used when walking running and jumping
> All of the 600 muscles combined normally contribute only about 15% of the whole-body oxidative metabolism in the three hours after ingesting carbohydrate. Despite the fact that the soleus is only 1% the body weight, it is capable of raising its metabolic rate during SPU contractions to easily double, even sometimes triple, the whole-body carbohydrate oxidation.
https://www.eurekalert.org/news-releases/965506
All right, this is a single Data point, and of course is anecdotal evidence… if you’re into taking health advice off the Internet rather than from your doctor… well you probably will end up disappointed.
OK disclaimers aside now: when I switched to clipless petals on my mountain bike, I dropped 12 lbs over the course of the summer. SPD clipless work the hell out of your calves when they are placed under the ball of your foot, especially in mountain biking applications because you spend so much time out of the saddle.
There is so many lurking variables here and nothing was normalized. I just thought that was an interesting connection.
OK disclaimers aside now: when I switched to clipless petals on my mountain bike, I dropped 12 lbs over the course of the summer. SPD clipless work the hell out of your calves when they are placed under the ball of your foot, especially in mountain biking applications because you spend so much time out of the saddle.
There is so many lurking variables here and nothing was normalized. I just thought that was an interesting connection.
Possibly related: Insulin resistance is impacted by muscle protein.
https://news.ycombinator.com/item?id=14667430
https://news.ycombinator.com/item?id=14667430
Your source is like the weekly world news of medical information.
I took Adderall XR once a day in college which completely suppressed my appetite and, combined with being a poor student that couldn't always afford lunch, I would frequently only eat one meal a day (either breakfast or dinner.) Since I graduated college many years ago, I also stopped taking Adderall but my sense of hunger has never returned. I always figured my body just got used to having my appetite suppressed and now I can go multiple days without eating and not feel any physical sensation or side-effect (including fatigue/irritation from lack of food or things like headaches.) Just the other day I went 40 hours without eating while traveling for the holidays and didn't even realize it until I went to a social dinner.
I've never thought too much of this. It seems like in pop culture/science nowadays "fasting" is generally seen/understood to be beneficial. I certainly don't mind because its helped me stay at a healthy weight, but in reading about this new class of drugs for weight loss recently I am curious as to what exactly is going on in my body and whether there's a similar mechanism at play.
Is there anyone who fasts regularly who's also experienced this loss of hunger sensation?