At the very least, we should expect to see the same kinds of downsides you’d see for anyone who managed to eat way, way less and lose weight at a multiple-pounds-per-week rate for weeks and weeks on end without taking a drug to do it. They’d be truly miraculous if they achieved their results without even the same cost as doing the same thing without the drug.

No one seems to remember Fen Phen or its stratospheric rise and fall https://en.m.wikipedia.org/wiki/Fenfluramine/phentermine

That was one of my first thoughts.

It’s perfectly possible for a new hot to have a severe side effect that won’t be noticed for quite a long time.

Semiglutide appears to have undergone final clinical trials in the US around 2017. Given it hasn’t been on the market terribly long and has only an exploded in popularity relatively recently it doesn’t seem like it would be that hard for it to have a serious side effect in a small portion of the population that hadn’t been detected before due to the limited number of people taking it, the amount of time it takes to manifest, or both.

Obviously it’s providing significant benefit that risk could easily be worth it. But as it gets marketed towards more and more people that won’t be true for all of them.

Semaglutide is a 3rd generation GLP-1 agonist, though. We're 20 years in on GLP-1s at this point.

No one who brings up Fen Phen seems to grasp how long both that and GLP-1s have been on the market. We're up to 4x Fen Phen's run already (5-years Vs. 20-years). GLP-1 Agonists aren't new, they've just been approved for additional usages.

So why, after 20-years, and millions of people haven't fen-phen-like side effects appeared?

You do have to factor in the (probable) cost of not using Ozempic, aka keeping the pounds on. It may be imprecise, but as an example, if a person was likely to die within 10 years at their current weight, any bad effects beyond the 10 year mark have to be heavily discounted.

I assume parent was talking about cosmetic and convenient weight loss not medically necessary weight loss.

I'm sure there are plenty of people taking it as a shortcut to dropping 10 or 20lb or whatever, but I imagine most people taking it are in the "I need to lose 70+ lb of fat" range.

On the other hand, being overweight takes years off your life:

"Specifically, we found that BMIs from 40 to 44 were associated with 6.5 years of life lost, but this increased to 8.9 for BMIs from 45 to 49, 9.8 for BMIs from 50 to 54, and 13.7 for BMIs from 55 to 59."

I think for some people the roi is measurable and reasonable.

https://irp.nih.gov/blog/post/2020/01/extreme-obesity-shaves...

Being obese takes years off your life. Being slightly overweight is associated with best longevity.

BMIs from 40 to 44 is massively obese, not overweight.

The "perfect" fat percentage for men when it comes to health is around the 22% range. For women it's significantly higher. (35% iirc)

I'll try to find the study/abstract later if people care.

> If something sounds good too good to be true, it usually is.

You mean like antibiotics? Or vaccines?

> usually

I think this is superstition. Vaccines are a medical intervention that have almost zero downside. There isn’t some mythical cosmic cost-benefit scale that needs to be balanced in every new technology that is deployed.

Vaccines and antibiotics and germ theory are all things that seem “too good to be true” but nevertheless are. Should we be worried that clean fusion power, once commercialized and practical, is going to somehow cause some catastrophic unknown future event just because it yields immeasurable benefit to us?

I think this is just another form of magical thinking.