Semaglutide Has Changed the World | Hacker News Reader

Semaglutide Has Changed the World

chadnauseam.com

50 pointspaulpauper16 comments

The notes about the author, and the accompanying Reddit post, about feeling full remind me about an anecdote with a friend who was an alcoholic.

Somehow we got on the topic and it came up about how I would drink and just stop.

His comment was very telling. He said “You can stop?”

It just plays to how different people coexist but live in a different reality. Whether it’s eating, or drinking, or whatever haunts us. Just because some of us can “just stop”, doesn’t mean others live in a world like that.

Yeah, I have the same issue. If Semaglutide only works by making me less hungry, it won't do anything for me, because I don't need to be hungry to eat, and I don't stop when full.

I eat when I see food, and I stop when I no longer see food. Paradoxically, I don't eat seafood.

The fix to this is simple, I limit the amount of food within my reach. I'm definitely too lazy to cook, and usually too lazy to order takeaway too.

>usually too lazy to order takeaway too.

Apps such as Uber eats ruined this for me.

In my country, this didn't change much (except everything is through an app now), as everything has always delivered.

A very interesting drug. Unfortunately, it's generally not covered by insurance unless a patient has already proceeded to an additional (more serious) health complication like diabetes. Thereby necessitating another pharmaceutical intervention, this time with a lifetime of treatment attached.

Yep. A patient typically has to be morbidly-obese and have tried stimulant weight-loss medications. The issue with waiting until someone is metabolically-ill is diabetes becomes very expensive to treat when there's insulin, anxiety, depression, high cholesterol, wheelchairs, blindness, and/or amputations involved. A former neighbor overfed himself to death not long after retirement by maintaining blood glucose levels of 400-700 mg/dL. Another issue is that it seems being overweight causes metabolic changes that lead to less satiety. OTOH, being underweight can lead to an anorexic spiral down too.

yeah, anorexia does spiral. once I started missing enough meals, I didn't have the energy to get food, and then I stopped feeling hungry. I had to force myself to eat during recovery because my stomach physically shrank. I didn't even look pretty, I was all bony.

My grandfather was so depressed from losing his wife that he didn't realize he was killing himself. He started skinny, but when he died, he was skin and bones. I would hypothesize the combination of depression and lack of white and brown adipose tissue lead to a spiraling down of hunger and metabolism.

Starvation hunger doesn't extend beyond a few days. I went a month without meaningful calories when I had the opportunity to do so. I had water, vitamins, minerals, and fish oil (to keep the gallbladder emptying and to maintain a lipid balance for neurological and skin health). I have the reserves at present to go roughly 140 days without eating because I'm currently a XLT-sized flabby-tabby. I'm working towards a goal of being slightly underweight.

The other side of being overweight is, my belief, the correlation and causation of numerous "Western diet" cancers by providing an overly-hospitable environment for emergent cancer cells to thrive that would otherwise be killed off in a nearly-continuous starvation mode that most humans experienced for all but the past 100 years. Chemotherapy stops cell division (adds cellular stress) as does calorie-reduced diets. The problems with extreme calorie restriction are the overall wasting of body tissues (including muscle), inability to concentrate, and lack of energy. On the plus side, a person would seem to reduce their risks of cancer and potentially extend their lifespan.

that's a really interesting theory re: cancer, but isn't wasting a symptom of cancer as well? or perhaps the weight loss spiral only comes into play once the cancer is advanced, or as a side effect of chemo.

Check out joincalibrate.com. It’s getting prescribed for weight loss without complications more regularly these days.

Sadly it's an insurance issue more than a prescription issue.

We recently got Liraglutide for a family member and it's worked wonders. (It's an alternative to semaglutide, and only available as an injection). They've lost weight for the first time at age 64, mostly because they just don't feel hungry all the time anymore. They're super happy to see the stretch marks on their belly.

It costs around INR 12,500/month though for a total of 3 injections, after a 20% discount, which is super expensive. (For comparison, a strip of 15 tablets of Hydroxychloroquine costs INR 110, and all their other medicines for diabetes, hypertension, depression, insulin etc cost INR 6000/month combined). And insurance doesn't cover any medication here unless it's 30-60 days pre/post hospitalization.

To induce anti-anorexia or obesity, take mirtazapine. It's used in the elderly for this purpose. Delta 9 THC also has a similar reputation.

It had the opposite effect when I tried it.

This doesn’t explain why different developed countries have massively different obesity rates. At least some of the problem has to be cultural.

It seems to be, presumably in the types of foods that each country eats. Eg more deep-fried foods, sugary desserts, etc will lead to more weight gain for the same frequency of eating.

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