Wegovy, other weight-loss drugs scrutinized over reports of suicidal thoughts
reuters.com
reuters.com
https://www.frontiersin.org/articles/10.3389/fphar.2020.0127...
If you are low in GABA this will make you feel less depressed. If you are high in GABA it will make you feel more depressed.
The more interesting number is that the vast majority of people who discontinue, even after long term use, regain 100% or more of the weight they lost. Weight loss doctors talk about this drug as something like statins which you'll likely need to take for the rest of your life. I think that's the area that needs the most improvement.
Is it known whether this is primarily psychological or physiological?
Or in other words, is the weight gain simply caused by people returning to their poor diets/routines or is increased hunger (or something) a withdrawal symptom of the drug?
I took it for a month or so, and those symptoms only happened when you ate heavy/fatty food. With salads and other light food, I didn't get any symptoms.
The effect of the drug has been for her to not always be thinking about food, and the amount of food required to feel full is dramatically reduced. It also forces slower eating because passing the full point results in the same very uncomfortable "I ate too much" feeling that used to require much more food before.
Thats true for all weight loss. With or without drugs. Only surgery has a bit better stats on long term weightloss.
Reuters says they conducted an 'exhaustive review' which amounts to:
- In a government adverse event database there are 256 reports of suicidal thoughts or actions among people who took Wegovy
- these cover the period 2010-2023
- some of the reports may be duplicates
- No analysis or even discussion of base rates
- many paragraphs of irrelevancies.
Semaglutide doesn't make it so you don't want to eat, it makes it so you regret doing it. I quit it shortly after, since I only have a few extra kilos I want to lose (so it wasn't worth it), and because I didn't want to lose the weight by being punished for eating. I figure that if I'm going to have a list of foods I absolutely must avoid, why do I need the semaglutide?
https://en.wikipedia.org/wiki/Yakult
Am kind of thinking that the "rotting in your stomach" would be countered by the probiotic bacteria doing their thing.
I definitely agree it makes you regret over eating, but I also find it makes you not want to eat. Just enough of an edge to make weight loss a breeze
Even with fibre supplements I had to take stool softeners daily, bisacodyl fortnightly, and I just had an awful time on them.
I had passive suicidal ideation before I started taking it, I'm not sure if it got worse though although I did once move to the more active side.
Still - on a positive note - I did for once know what it was like to not feel hungry and to not think about food 24/7 as someone who has suffered from binge eating thanks to dopamine chasing adhd.
I know pushing on the toilet is the most common cause of hemorrhoids, but I hadn’t seen it linked to ED before. Is this based on research you’ve seen, or just a suspicion you have? If the latter, curious to hear how you’ve connected those two things.
Good luck.
I had a pool-related concussion a few years ago, and had to go back to the doctor because of persistent suicidal thoughts. The doctor told me, using more words than this, “This is normal, and statistically you are not likely to do anything about it. You should talk to your friends and wait for it to go away.” I was extremely frustrated that she hadn’t warned me about this at the first visit, in the way she had gone over other symptoms like light sensitivity and sleeping a lot.
She was right, though; the thoughts did stop after a few weeks. When I looked into it afterwards, what I found was typically doctors are advised not to tell patients that suicidal thoughts are a potential side effect, because knowing that made them more likely to happen.
And a measurable drop in weight may be give them more hope than any antidepressants could do.
(Antidepressants can be like taking painkillers for toothache if there's an obvious physical cause of the depression. They may offer some relief, but the real problem remains, and may be getting worse, e.g. if the antidepressants lead to further weight gain)
I wonder which way the arrow of causality flows, though? Everyone knows that severe obesity is a unhealthy and effectively already a slow form of suicide. A lot of the people you see on the extreme obesity programs have a childhood trauma.
Doesn't matter what initiates the cycle, but once you're in it, it's very hard to get out. You're not likely to manage to 'just exercise more'/'just eat less' once the depression sets in.
It's easy to not be too bothered to begin with, when you're just 'a bit fat' and 'mildly depressed', but the problems can slowly build up year upon year until you're morbidly obese and having regular thoughts of suicide.
Sedendary screen-based jobs don't help, neither does work-related stress. And the Covid period (lockdowns/WFH/isolation) put the cycle into overdrive for some.
These new drugs are a possible escape from that cycle, significantly reducing the willpower required to eat less.
I've recently been getting back to the gym and getting my diet cleaned up (for mental health reasons above any other), and as a result I've lost about 30 pounds in 3 months and gained some muscle along the way - far better than I thought was possible at my age.
I also saw a post on Reddit of scans of the legs of 2 70-year-olds; one active and the other sedentary. The active one was almost all muscle while the sedentary one was riddled with fat.
There's no secret; it's diet and exercise, but obviously it isn't easy either. If ozempic can help with the one, then that's a big bonus.
I keep seeing people go in and lift the same weights every time while at an age they could easily increase the weight several times a week for months on end before starting to hit limits.
As it turns out, the simple rule of "calories in, calories out" is true and possibly the easiest heuristic to follow to lose weight. She has hardly increased her metabolic activity (calories out), but primarily shifted her diet (calories in).
The mentality around weight management would do well to focus more on sustainable diet changes rather than on exercise (not that the latter isn't important, but that diet management seems to me more attainable and effective).
The only way I did it was to log all my food and keep to a calorie limit every day. I get people that ask me how I did it all the time and I tell them I ate less food and they all look disappointed like I was going to tell them some magic trick. I've managed to keep the weight off by really only eating one meal per day, in the evening.
Exercise is good and important in itself but it won't help you lose weight, outside of extreme levels of activity.
Recently I accepted a $500 challenge to get down to a certain weight by a certain date, so I started taking the calorie in- calorie out bit seriously. I won the challenge of losing 30+ pounds and in so doing became very suspicious of the low-carb mentality I had adopted 25 years ago or so when the problem really surfaced.
To get through cardio I need carbs, and suspect that I would increase my overall calorie intake to get them as I was keeping my carb percentage low. Stop the exercise and I could take the weight off.
So I'm definitely back to the opinion that calorie balance is the real key (short of some metabolic disease). I'm 61 years old.
When I switch to salads and cut sugar, I still lose weight quite quickly.
I think these new drugs might be very effective intervention for a lot of people, and I really hope it helps you.
Semaglutide appears to have two main methods by which is works. Firstly, it increases the production of insulin, and secondly it makes you eat less.
Drugs that increase the production of insulin are typically prescribed for type 2 diabetes (which is a disease strongly linked with excess weight). However, in a lot of ways they are the exact opposite to what you want. With excess weight and type 2 diabetes, the immediate problem that the doctors are trying to treat is that you have too much sugar in your blood. Increasing insulin helps temporarily because it causes various cells around the body to pull sugar out of the bloodstream and store it in an alternative form. This includes fat cells. However, in the case of excess weight or type 2 diabetes, these cells are already full, and the body is effectively having to use higher and higher amounts of insulin to cram all that circulating sugar away. Adding more insulin causes further increases in weight and makes the problem worse in the long term. The problem isn't too little insulin - the problem is too much blood sugar, exacerbated by the fact that all the very full cells are reluctant to soak it up.
For this reason, not eating is extremely effective at fixing excess weight and type 2 diabetes. Since the problem is too much blood sugar, reducing the amount of sugar that we shove into the blood from our food is the right way to treat it. However, diets are difficult. The keto diet is great, but it's hard to stick to effectively, unless you absolutely love it and make a habit of it. The urge to eat a little bit more than you should or the wrong thing is extremely difficult to shake, and it's hard to get the right portion sizes in some societal setups. It can actually be easier to do fasting. That way you have set yourself a very simple rule to stick to, and it's completely obvious what breaks the rule. Don't worry, you won't starve if you have more than a small amount of body fat. Humans can survive for an extraordinarily long amount of time without food. The current record is 392 days[0]. The other great thing is after a couple of days you don't really feel hungry any more, and all sorts of other health benefits cut in. Willpower becomes much less of a problem than with restrictive dieting. There isn't any harm with not eating for a couple of days in a row every few weeks. I'd definitely consult with a doctor if you plan to fast for longer, but make it clear to the doctor that you're doing this and you want support to do it safely, not that you are open to being persuaded out of it.
Fasting is a scary thing to many people, including doctors, so you'll often get them tell you you're crazy or advise against it, but there's no reason for that. People have been fasting for all sorts of reasons, including religious, for millennia, without any serious problems.
Not eating is the single most effective treatment for type 2 diabetes. There are multiple people who have been diagnosed with type 2, and then after just a few days of fasting no longer have it. My conclusion having looked at Semaglutide was that it might help treat type 2 diabetes, but it'd only do that really by making you eat less because you feel like crap, and it has all sorts of other bad effects as well, so it'd be better to eat less while not feeling like crap instead.
So, my wife has had a few rounds of fasting about a week or two at a time. That anecdote shows about an average of a pound weight loss per day with no exercise, and the weight has stayed off. I have heard other people say that the weight tends to stay off after fasting when it wouldn't after just dieting.
I've been doing a good job avoiding GLPs just because I want it as a last resort option. But still, it wouldn't at all surprise me if this turns out to be one of a few explanations for the link.
I'm not complaining, but rather curious why. Is it provocative to suggest that obesity can be associated with depression?
Seems statistically insignificant to me, and more of a story because Ozempic is so famous.