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Re:GLP-1 pills are coming, and they could revolutionize weig... by CharlieDigital on Tuesday October 08, 2024 @10:55AM (#41778031)
Curious if there's been any accounting on the long term impact in terms of cost on the healthcare system.

On the one hand, obesity is associated with many other ailments such as heart disease, diabetes, etc. that cost the system a lot of money.

On the other hand, well, longer life spans impacting Social Security, Medicare, etc.

Re:GLP-1 pills are coming, and they could revolutionize weig... by JumpCrisscross on Tuesday October 08, 2024 @11:18AM (#41778295)
> Curious if there's been any accounting on the long term impact in terms of cost on the healthcare system

Savings on the order of $100bn per year [1].

> longer life spans impacting Social Security, Medicare, etc.

An obese person dying early may well wind up costing the system more than a healthy person dying old. (Most medical costs are incurred terminally. The obese have more-complicated terminal paths.)

[1] https://healthpolicy.usc.edu/research/benefits-of-medicare-c...

Re:GLP-1 pills are coming, and they could revolutionize weig... by swyx on Tuesday October 08, 2024 @10:59AM (#41778067)
??? how is cost on the healthcare system the thing to be worried about over longer lifespan and quality of life? strange thing to focus on lol

but i think if you think it thru, 1 should dominate 2, and 2 should be reduced as well.

Re:GLP-1 pills are coming, and they could revolutionize weig... by CalRobert on Tuesday October 08, 2024 @11:02AM (#41778098)
People who need to ensure these programs are well funded definitely need to consider it.
Re:GLP-1 pills are coming, and they could revolutionize weig... by freedomben on Tuesday October 08, 2024 @11:05AM (#41778146)
Are you prepared to make the doctors work for free?
Re:GLP-1 pills are coming, and they could revolutionize weig... by CharlieDigital on Tuesday October 08, 2024 @11:11AM (#41778209)
I mean, I'm contributing to the Social Security system here so I'd like to know how it's going to impact my long term retirement. There's nothing malicious about it; purely a question of accounting and math.
Re:GLP-1 pills are coming, and they could revolutionize weig... by AmericanChopper on Tuesday October 08, 2024 @11:08AM (#41778174)
Health care costs is how individual people’s terrible lifestyle decisions end up impacting everybody else. If somebody wants to live some awful unhealthy lifestyle it really should be their own choice to do so. Except for the fact that it drives up everybody’s insurance premiums, and in countries where the government either partially or entirely subsidises healthcare costs, it gives the government an outright moral mandate to start nannying everybody’s health choices.

If somebody wants to live an obese lifestyle, I really think that’s up to them. But I’d be much happier about it if it didn’t cost me so much money.

Re:GLP-1 pills are coming, and they could revolutionize weig... by rickbutton on Tuesday October 08, 2024 @11:20AM (#41778324)
Do you think addicts should receive treatment? Do you think that people who make bad decisions deserve to live? Do you extract the exact amount of value from society relative to the amount you put in, or do you take more than you give? Are you sure? Please explain.

Your perspective is frankly disgusting. I hope you don't have any vices. The point of a society is to pool resources together to improve the collective. Different people in different positions of power and ability have different needs. Hopefully you don't personally have any power to exclude people from that group. I hope that the powers that be don't decide that you deserve less for some reason.

Re:GLP-1 pills are coming, and they could revolutionize weig... by AmericanChopper on Tuesday October 08, 2024 @11:31AM (#41778464)
I don’t think being addicted to laziness and having a glutinous appetite is exactly comparable to say, being addicted to heroin. But yes, I do think addicts should receive treatment, just as I think obese patients should (and do) receive treatment for all the diseases they end up with. But addicts, like the obese, impose many of the costs of their own bad life decisions onto others. It’s what you’d call a negative externality, and if some magic treatment came along to fix drug addiction, I would also be very happy to see that negative externality addressed.
Re:GLP-1 pills are coming, and they could revolutionize weig... by JumpCrisscross on Tuesday October 08, 2024 @11:37AM (#41778540)
> don’t think being addicted to laziness and having a glutinous appetite is exactly comparable to say, being addicted to heroin

Based on what? The reward pathways are remarkably similar. And unlike heroin, you can't go cold turkey on eating.

Re:GLP-1 pills are coming, and they could revolutionize weig... by AmericanChopper on Tuesday October 08, 2024 @11:57AM (#41778802)
Well the food addiction or sedentariness addiction diagnosis are a lot more controversial than a heroin addiction diagnosis, though I can see how they have some things in common. I think labelling any observable manifestation of poor impulse control as a medical addiction is more of a social trend than a legitimate scientific discovery.

The bigger difference though is that we all eat food, and for most of us includes at least some absolutely delicious food that would be incredibly unhealthy to eat in large quantities. We’re all (more or less) exposed to the “addictive substance”, it’s just some people have the ability to deprive ourselves constantly indulging that impulse, while others don’t. We don’t however, need to take small doses of heroin every day to survive.

Re:GLP-1 pills are coming, and they could revolutionize weig... by JumpCrisscross on Tuesday October 08, 2024 @12:02PM (#41778858)
> labelling any observable manifestation of poor impulse control as a medical addiction is more of a social trend than a legitimate scientific discovery

What gives you the confidence to overrule medical professionals on this? (Note: I am not a doctor and have zero medical training.)

> We’re all (more or less) exposed to the “addictive substance”, it’s just some people have the ability to deprive ourselves constantly indulging that impulse, while others don’t

One, I’d challenge we’re all similarly exposed. I grew up in a house with no sugary sodas and plenty of leafy greens with each meal. Many people did not.

Two, we know from drug addiction that there is no global measure of addictiveness. Some people can smoke a cigarette or cigar or two, on average, per year. Others get hooked after their first draw. There is no reason to suspect something similar isn’t happening with obesity.

Re:GLP-1 pills are coming, and they could revolutionize weig... by AmericanChopper on Tuesday October 08, 2024 @10:08PM (#41783776)
I’d say it stops being a useful descriptor at that point. If any activity that a person can possibly find rewarding in any way can be addictive, then everything is addictive. Because for any activity that you can possibly think of, you’ll find definitely find somebody who likes doing it.

By this criteria, I’m sure you’ll be able to find at least one eating glass addict somewhere in the world. But if we can stretch the definition to include glass as an addictive substance, then it kinda stops meaning anything at all.

And when I say these innovative addiction diagnoses are controversial, I mean within the community of clinical experts, which they are.

Re:GLP-1 pills are coming, and they could revolutionize weig... by Eumenes on Tuesday October 08, 2024 @11:47AM (#41778667)
Based on common sense. Not everyone has tried heroin, but most people have overgorged themselves - maybe eaten too much ice cream or candy or pizza. I am guilty of that, and make sure to make it a rare occurrence and keep myself in shape.
Re:GLP-1 pills are coming, and they could revolutionize weig... by JumpCrisscross on Tuesday October 08, 2024 @11:52AM (#41778726)
> Not everyone has tried heroin, but most people have overgorged themselves

You're assuming everyone who tries heroin becomes an addict. At first glance it looks like "approximately 1 to 12 months after heroin onset, an estimated 23% to 38% of new heroin users have become dependent on heroin" [1]. By coincidence, that seems to mirror American obesity prevalence [2]. (Obviously heroin is more addictive than food. Don't do heroin.)

[1] https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...

[2] https://www.cdc.gov/obesity/php/data-research/adult-obesity-...

Re:GLP-1 pills are coming, and they could revolutionize weig... by rickbutton on Tuesday October 08, 2024 @11:36AM (#41778530)
> I don’t think being addicted to laziness and having a glutinous appetite is exactly comparable to say, being addicted to heroin.

Your opinion is that of a petulant child. Many years of research has shown that obesity is not this simple. Many chemical processes take place that influence one's ability to make better health choices, and many external factors put constraints on those choices as well. This is the exact same thing as hard drugs. Being obese is not a moral failing. When you say things like this, you show your true colors. You are not extending humanity to obese people, and it is very obvious.

I sincerely hope you reconsider your opinions. I hope you don't have any obese people in your life, or at least hope they don't read these messages. I think they would be disappointed to hear what you think of them.

And again, I hope you don't have any vices and are the perfect model of health, otherwise this would be a quite silly opinion to have.

EDIT:

I've been rated limited on comments so I'll post my last response here instead:

I have nothing further to say to this other than that you should consider talking to someone about your clearly deep-seated hatred for those who don't fit your model of participant in society; it doesn't seem healthy. Find an obese friend and show them your comments and watch their face as they read them. I wonder if you will find the humanity in their response that you are lacking here.

Re:GLP-1 pills are coming, and they could revolutionize weig... by Eumenes on Tuesday October 08, 2024 @11:52AM (#41778732)
> Being obese is not a moral failing.

Source?

Re:GLP-1 pills are coming, and they could revolutionize weig... by JumpCrisscross on Tuesday October 08, 2024 @12:15PM (#41778973)
Well, my not being obese isn't a moral virtue.
Re:GLP-1 pills are coming, and they could revolutionize weig... by AmericanChopper on Tuesday October 08, 2024 @11:44AM (#41778623)
I would say that your suggestion that grown adults should be absolved of responsibility for their own decisions is actually a quintessentially childish idea. The fact that you are so deeply offended by any suggestion otherwise is even more childish.
Re:GLP-1 pills are coming, and they could revolutionize weig... by JumpCrisscross on Tuesday October 08, 2024 @11:57AM (#41778804)
You're both wrong. Obesity increasingly looks like addiction--as with any addiction, it takes two to tango. But once you have an addict, shame is an ineffective treatment. Debating giving an obese person GLP-1 drugs is akin to challenging methadone for heroin addicts.
Re:GLP-1 pills are coming, and they could revolutionize weig... by AmericanChopper on Tuesday October 08, 2024 @12:09PM (#41778921)
I never suggested shame as an effective treatment. But refusing to acknowledge the reality of the situation is not an effective way to discuss the problem. Obesity is the result of lifestyle choices, and those choices do impose their costs on everybody in society. Which is why I would be very happy (and I would suggest everybody should be happy) if an effective way to address the problem was discovered.

The fact that an obese person is harming other people as well as themselves might be an uncomfortable truth for them to hear. But ignoring it doesn’t make it go away.

Re:GLP-1 pills are coming, and they could revolutionize weig... by JumpCrisscross on Tuesday October 08, 2024 @12:12PM (#41778945)
> Obesity is the result of lifestyle choices, and those choices do impose their costs on everybody in society

Granted. But why does it need to be said?

I'm a skiier. That lifestyle choice alone probably has a higher risk-adjusted cost to our healthcare system than if I were fat. I'd still miffed if prior to setting a bone my doctor decided to lecture me on the risks of skiing. I'd be positively furious if I got that from my health insurer.

> fact that an obese person is harming other people as well as themselves might be an uncomfortable truth for them to hear

Why do they need to hear it? There isn't a need. What they need is to not be obese anymore. That's treatment. My point is skipping the lecture and going straight to treatment is how we solve most medical problems.

Re:GLP-1 pills are coming, and they could revolutionize weig... by rowanG077 on Tuesday October 08, 2024 @11:05AM (#41778147)
Because it's literally a large chunk of the economy? Why wouldn't you worry about that. I certainly don't like to see a society where the young are enslaved by the old to pay for their medical treatment.
Re:GLP-1 pills are coming, and they could revolutionize weig... by crmd on Tuesday October 08, 2024 @11:15AM (#41778251)
In my view, the sole focus of the healthcare system should be maximizing human wellbeing.

Humanity’s GDP is around $100 trillion per year. There is plenty of money for healthcare with many orders of magnitude to spare for other endeavors.

Bean counting here feels like Google in the early ‘00s proposing to make office supply expense reduction a business priority.

Re:GLP-1 pills are coming, and they could revolutionize weig... by JumpCrisscross on Tuesday October 08, 2024 @11:19AM (#41778305)
> is plenty of money with many orders of magnitude to spare

Putting infinite value on anything is a great way to incentivise a system that delivers little to none of it.

Re:GLP-1 pills are coming, and they could revolutionize weig... by rickbutton on Tuesday October 08, 2024 @11:31AM (#41778467)
There should certainly be measurements taken, costs considered, alternatives approached when building our healthcare system. No one has ever implied otherwise, ever. To imply that there is some level of healthy after which it doesn't make sense to seek improvement is the dehumanizing and anti-social part. What is the point of building an economy at all if not to improve the lives of the population? Opinions in this thread already seem to be that "people are healthy enough, and if not, it is due to their own choices" rather than "we should carefully consider how to optimize this system for efficiency" while focusing on the actual goal of improving lives for the average person as well as those who need more healthcare.
Re:GLP-1 pills are coming, and they could revolutionize weig... by JumpCrisscross on Tuesday October 08, 2024 @11:34AM (#41778499)
> imply that there is some level of healthy after which it doesn't make sense to seek improvement is the dehumanizing and anti-social part

No it's not. Every doctor triages. And every medical system has internal cost limits, whether implicit or implict, universal or variable, past which it will not treat. Sometimes that's enforced by gatekeeping entire categories of treatments; in other cases we have patients individually reviewed, e.g. for organ transplants.

If managing obesity is less expensive than treating it, there is a legitimate question around how the cost of that treatment should be split between the public and the individual. (Whether that cost be an explicit split or gatekeeping the treatment to only the most morbidly obese.) Thankfully, that's not the case--treating obesity, even chronically with super-expensive drugs, is still cheaper than the status quo.

Re:GLP-1 pills are coming, and they could revolutionize weig... by rickbutton on Tuesday October 08, 2024 @11:42AM (#41778596)
Correct, doctors do triage according to need and available resources. When you imply that there is some category of care that doesn't deserve treatment (or is too "costly" to provide), you are triaging and choosing economic growth over healthcare. I think that it is a rational decision to make, although it is certainly not the one that has the most respect for human life.
Re:GLP-1 pills are coming, and they could revolutionize weig... by JumpCrisscross on Tuesday October 08, 2024 @11:43AM (#41778613)
> When you imply that there is some category of care that doesn't deserve treatment (or is too "costly" to provide), you are triaging and choosing economic growth over healthcare

Yes, every medical system does this. (It's almost the defining difference between medicine and healthcare.)

America does it individually (and inefficiently). Europea by restricting access to expensive treatments. If you don't do this at some level, you'll wind up with edge cases constantly running up bills the economy can't pay for and a collapse of the healthcare system's solvency.

Re:GLP-1 pills are coming, and they could revolutionize weig... by selectodude on Tuesday October 08, 2024 @11:01AM (#41778089)
We can probably just extrapolate the numbers from people quitting smoking.
Re:GLP-1 pills are coming, and they could revolutionize weig... by rickbutton on Tuesday October 08, 2024 @11:14AM (#41778245)
I wrote a few paragraphs of response to this assuming that you are implying that there is a level of death/disease that is acceptable because treating it would not be cost-effective, but I deleted it because it would be uncharitable to assume you think that.

It would be interesting to see this information, but would not be useful to act on. If the answer was "it costs more to keep more people alive" (hint: it does, that is why we let so many die of preventable illness), should we keep less people alive and healthy? The pursuit of economic growth at all costs is a disease far more dangerous than anything you would treat in a hospital.