My lowest sleeping heart rate is now at least 10 beats higher than before starting (it comes down during the week to about 10 over)
The night after taking the injection my sleep is crap, and the heart rate is 5+ higher again
I have lost 20lbs since mid March with no real effort, and we’re about to do some blood tests for specific cholesterol numbers, which was one of the reasons to try this out.
I notice no ill effects, I just had my three month checkup with the doctor and he thinks I’m good on maintenance mode at max dose, I’ve still got about 34 pounds as my total weight loss goal. Really an ideal case.
For my wife on the other hand she just has constant diarrhea which she blames on the drug, and is only on 5mg. She also gets headaches from the medicine. She’s lost only 20 pounds, even though she needs to lose another 120 or so to be “healthy weight”.
However, before she started taking Zepbound she was only able to walk a few hundred feet at a time, because her back hurt so terribly. The anti inflammatory “side effects” she’s experiencing have massively improved her quality of life, even without huge amounts of weight loss.
Like if your stomach really hated taco bell and you start taking a pill and now you get the same effect from artificial sweeteners you don't care because you're still within what's normal.
That's the level of side effects these things have.
As I stated, I originally tried semaglutide with no luck. I didn't try tirzepatide. I've been taking a very low dose of retatrutide - about .5mg twice a week. It seemed to be waning in effectiveness a bit so I upped the dose to 2mg/week for now. It's a night and day difference. Most days I go to the bathroom maybe two times, as opposed to the maybe 5-10 times I would need to unmedicated.
To be clear, this isn't an approved use of the medications (and retatrutide isn't approved at all yet, though it pretty clearly will be). However, they slow down gut motility - and as a bonus for your refusing to eat during week-long work trips, they'd probably at least help with that too, in terms of hunger.
I feel sick for three days in a row after taking it. Even after several months on the same dose. I get horrible gut cramps, sour stomach, near constant nausea, and occasionally vomiting and diarrhea. I have to take my shot on Thursday night because I'll feel bad the next day and supremely sick the next two days. If I took it earlier or later in the week it would absolutely impact my ability to work during the work week.
It has had amazing effects. I've lost about 60 lbs in the last year and my A1c is now around 6.2.
It's a very effective drug, but it is brutal on my body. I'm not sure anything in the medication is causing the weight loss. It just makes me feel so sick that even if I'm hungry I don't feel like eating.
The medication does make me feel fuller faster, so I eat less when I do eat, and I stay fuller longer. This helps me lose weight because it reduces the number of calories I consume.
The side effects make me feel so sick in those days after that I am effectively fasting all day (I have a small dinner, but keep drinking water so I don't dehydrate). That helps in losing weight.
That said, my original comment was meant slightly tongue in cheek - I know it is effective, but sometimes it's kind of darkly funny to think feeling bad from it is having the highest impact.
The hardest part about this diet for me has been finding sources of protein that get me at my goal with the small sizes of the meals I do eat.
I am at the second dose up from the starting dose (5 mg vs 2.5mg), and the side effects are about the same between the two doses. They didn't start out that way, but they ended up at about the same level of misery.
I tried Trulicity when it first came out. It was not as effective, but the side effects for me personally were less.
I'm on Mounjaro for type 2 diabetes, not weight loss, so my main focus is on how it treats my t2d. The weight loss is a nice side benefit.
What dosing are you on? If you’re still doing 2.5mg (smallest available in the auto injectors) perhaps try a compounding pharmacy for a month or two and you can experiment with lower doses and a different dosing schedule?
During my peak weight loss period I found that matching my injection schedule to the 5 day half life of Tirzepatide and adjusting the dose downwards to match this schedule helped with any side effects - including the “fading” of effects those last 2 or 3 days for me. There are half life calculator spreadsheets available on the internet that can help dial it in and keep your theoretical concentration more flatline vs peaks and valleys.
The current dosing regime is based on the single FDA trial that LLY did and is certainly not going to be the common practice a decade from now. It’s largely designed around patient compliance than anything else.
That said - everyone responds to this drug much differently. My little group I’m in is all over the map. Some folks lose weight consistently with tiny doses every 2 weeks, some are going above the recommended maximum weekly dose.
I also found food choices matter. A lot. The best part of tirz for me was being given mental space to stop eating shit food and start eating “clean” consistently. When on high dosing I absolutely would have a bad day if I decided to take my shot and then eat a typical American diet later.
The primary mode of action from the drug is simply you eat less. But it shouldn’t be due to you feeling too sick to keep anything down. That sounds pretty horrible.
tbqh being extremely overweight sucks in a whole lot of ways. While the side effects sound miserable, they will only be temporary. The damage done to my body and metabolism as a result of being this heavy for this long piles up every day, so if I have to suffer like this then I'd rather do that than have a stroke and die in front of my family.
I'll add that while it isn't a big deal, I definitely feel the needle; sometimes worse than others. (I'm using 8mm 30 gauge needles.)
If you have very little body fat, your glutes are probably a better place.
Source: I take HCG and have to use injection 2x a week. 27G is my favorite..
https://medneedles.ca/products/1ml-27g-x-1-2-sol-care%E2%84%...
It’s a rapidly absorbed peptide suspended in water, it could even be used with a transdermal patch, so it doesn’t matter that much where it gets in or how deep. Best to avoid painful areas though.
You do not want the drug meant to subcutaneous to go into the blood steam. This is true for GPL-1s (all peptides for that matter), as well as insulin, and definitely mRNA vaccines.
I've never used Ozempic, but my understanding was it used a device similar to insulin pens--dial you dosage, attach needle, insert needle, press at the base of the pen to inject the selected amount. Also no way to pull back to see if you hit a vein/artery.
Either way super simple and quick. Fairly painless. I had a weird rash one time, but apart from that a total of about 15 injections haven't had any issues on either Ozempic or Trulicity in terms of injections. Others may have difficulties, but it's been super easy IMO.
Peptides don’t have the same negatives as say insulin, but preferable to not have them in your bloodstream nonetheless.
And it's mostly for people who have plenty of stomach fat, so even less chance of hitting something else.
I went down this rabbit hole after being handed a 100 pack of insulin needles and an estradiol vial with zero instruction - seemed irresponsible at first, but it turns out it's pretty hard to mess up.
https://www.cmh.edu/siteassets/media-documents-for-depts-sec...
SubQ has an even lesser risk of hitting a blood vessel.
Eli Lilly will soon release key data on its weight loss pill orforglipron - https://news.ycombinator.com/item?id=43465346 - March 2025
I don't think it's made any difference to any addictive tendencies or my bad habits (and with ADHD, those certainly exist). It certainly helps with the appetite of course.
This is definitely anecdotal evidence, but it's wise to hold on longer for more data to come in before advocating for it on those grounds alone.
My heartburn I suffered from is completely gone but that’s because I just absolutely stuffed my face, I felt like I could never eat enough food.
The pen has about 4 doses in it so you twist it to set your dose. You attach a needle tip to the pen and give yourself a poke, press an inject button on the top and a spring loaded ratchet system pumps in the dose amount you set (making a wonderful ticking noise as it progresses). Pull out and toss the needle and put it back in the fridge for next week.
I do manual injection which involves doing the full prep work. It takes about 3x as long to setup but is still only about a 3-5 minute process in total.
The auto pen misfired the other day and I called Eli Lilly and they immediately emailed me a voucher for a free 4 pack of the shots. It’s also eliminated my sleep apnea (via the weight loss).
https://glp1.guide/content/are-glp1-side-effects-all-the-sam...
It was a while ago, but IMO the list still plays
https://glp1.guide/tag/category-side-effects/
https://glp1.guide/tag/category-risks/
I try to tag all the new news of negative side effects there
And which of them are issues that people massively changing their diet and dropping weight, while also making lifestyle changes like exercising more (due to finding it easier after losing weight) would be likely to experience?
I can still eat whatever I want I just choose not to. For example, had burgers, fries and ice-cream for lunch on Saturday with the family and then just a protein shake for dinner.
I also don't snore anymore. I used to snore terribly, my wife would wake me up at least once a night to tell me to roll over. Not at all now.
Most importantly, even though I am on a ton of test and deca, my blood pressure is normal, and my cholesterol has actually gone down.
Did I misread the article, my TL;DR of the article is that GLP-1 reduce the indicators or mortality without modifying the actual mortality (because most users return to normal indicators within about 2 years).
Because they stop taking GLP-1s after 1-2 years, not, it seems, because the meds stop working.
That's kinda wild, because it seems like holy shit if you're taking a drug that lets you drop 10-20% of your body weight from obese down to normal why would you stop taking it, but people do.
Source: UK based friend who says the pharmacy will refuse to sell them once they fall under BMI 25 (still overweight). They'd prefer to be on the tiny maintenance dose but it seems to be very hard to achieve (unless you're going off the market completely).
We'll also keep you on a small maintenance dose if you want, that's a conversation you'll have with your clinician and they'll judge whether it's medically appropriate. As far as I know, there's usually no reason to prevent you, though.
I don't think it's possible to send dms here....
As far as I know, though, you can move to us from another pharmacy even with a BMI of < 25, as maintenance has different criteria than new prescription.
I'm not a clinician, though, so I may be wrong. If you want to email me, I can ask the clinicians and tell you for sure.
In this sense it's like any diet: they "work", but if you don't permanently modify your food intake, the weight comes back as soon as you go off the diet.
I think that in a few more years the number may stay at 25% (or whatever) but that the makeup of the 25% may be different. That is, people will go off it and back on it if they see their progress reverse but that will happen to different people at different times.
Gating it behind mandatory expensive, difficult-to-schedule appointments with a specialist who is in abruptly short supply where the insurance company is doing their damndest to kick as many of them off their network as they can without getting caught to keep the shortage going is certainly part of that strategy. And the result is “people do not stay on the drug”, which is their goal, and if they don’t meet that goal they have an even bigger problem and can’t continue to exist as a functioning company.
The simple fact is, when it comes to drugs, the development is basically paid for by Americans.
I understand that's not really how it works, but people often go very much by feel more than anything else.
Source? Everyone I know who stopped taking it rebounded a bit, but not to where they were. And no literature shows 100% rebound to my knowledge.
Some of the prediabetics I knew who stopped taking it (N = 2) stopped being prediabetic (N = 1).
This might be the left-wing analog of climate denialism.
So in addition to the quitters returning back to normal after they got life insurance underwritten when they were healthy, we have the unknown of the longevity of people on the glp-1 drugs.
Then from there, I click through the 65% #, assuming they have a good study on 65% of people stop after a year. Nah, they don't. It's super complex but tl;dr: specific cohort, and somehow the # getting on it in year 2 is higher than the # of people who quit in year 1.
I have a weak to medium prior, after 10m evaluating, that the entire thing might be built on more sand than it admits.
Lot of little slants that create an absolute tone - ex. multiple payouts over the "lifetime" of a life insurance policy. (sure, it's technically possible)
Also there's no citation for the idea this mortality slippage happened because of GLP-1, and it's been out for...what...a year? Maybe two?
That's an awful lot of people who were about to die, saved in the nick of time by...losing weight? Again, possible, I'm sure it even happened in some cases.
Enough to skew mortality slippage from 5.3% to 15.3%?
I thought they were 98% accurate?
Wait...is the slippage graph net life increase slippage? Or any slippage?
Because it's very strange this explosion happened in exactly the year of a global pandemic that had sky-high mortality rates for older people.
[0] https://www.swissre.com/reinsurance/life-and-health/l-h-risk...
I don’t think that’s a typical experience for most people, other than the price
As far as I can tell from forums, it's not like 5% have the side effects, it's like 80-90%.
But for the first time in decades, I felt full. I didn't want to finish a meal, it was too much.
My body regulated my food intake in what felt like a natural way.
I hadn't even realized my body had somehow lost that fundamental mechanism of appetite control. It made me realize I wasn't weak willed, something is different about my body than other people.
But it comes with a price. The side effects I had were quite bad and so I stopped (though I now read that if I switch to a different brand, I might be ok).
I often didn't want to leave the house in case I had a sudden case of the shits. It could come/go in waves. But often can last a whole week.
Plus you've got to inject yourself every week. Often you can't drink as it makes you sick. Even when you're doing everything 'right' you can feel a bit off.
If you do over-indulge (with food or drink) the side effects can sometimes be massively amplified and you feel terrible for days.
So amazing in some ways, but it's not like taking a vitamin tablet. There are costs and making one slip up can result in suddenly feeling awful for a day or two.
Perhaps I was just particularly prone to the side effects, but it seems to happen to a lot of people (I found Mumsnet threads about it useful, they are quite revealing as they seem to be fairly honest and willing to share their experiences)
> If you do over-indulge (with food or drink) the side effects can sometimes be massively amplified and you feel terrible for days.
Never had anything like that.
I wouldn't recommend that to everyone, but it helped a lot for me.
Happy people with no issues are less likely to post, or post as often.
That said, much sympathy for the people who do experience particularly bad side effects.
This must be an existing named bias, but my google foo is failing me.
- change your diet. you can't eat the same food at the same volume. or even is smaller volume if the food is a burger, etc.
- watch your drinking, your tolerance for alcohol is reset, and again on the volume thing
- drink a lot of water. apparently opposite to all the volume warnings above, lol
- split dosage and inject twice a week. (i dunno, talk to your doctor. also this only works when you have a vial and not the auto-injectors, though apparently the autoinjectors are way more expensive)
On the other hand, when i ask about what happens if you go on a bender and eat two burgers and lots of fries and drink a six pack?? From people that used to gladly do that: "gross, why would i do that?" That there is the real change.
This is likely a sampling error, and you see it with all drugs to some extent. No-one goes on a forum to announce to the world that they’re not having any side effects from [whatever].
While I have no doubt that obese people have gradually made appetite control harder for themselves, the full feeling you get on GLP meds is in no way the way us normal-weight people feel.
I too, could easy eat a whole bag of doritos after some pizza and then decide I want ice cream. I don’t do that because I know it’s an awful idea and so I maybe just have a pickle after the pizza instead.
On GLP-1 medications at a decent dose I don’t know if I could force myself to eat anything after half of my normal serving of pizza.
That’s not the way the rest of us normally are apart from rare exceptions, I assure you.
Personally, I really like how, on the medication, it's easy to say "nah, I'd better not". Off the medication, it's impossible, as I have to eat whatever is in front of me, or I won't stop thinking about it.
I literally have no feeling of 'full'. I used to. I have no idea when it stopped working, but it definitely stopped working.
You can't know what I feel. I can't know what you feel. I'm fit, I have zero appetite control.
If I stop doing tons of exercise, boom, problems. I got old, I stopped moving as much, boom, problems.
People like you are part of the problem, not the solution.
Honestly, you wouldn't say this shit to someone's face.
It was honestly hard enough posting this here in the first place and then a dick like you comes along.
Cheers thanks for ruining my day you prat.
Seriously, that's just not that big of a deal. It takes like a few days at most for simple term life. Can't speak to the other policies, which I understand are mostly tax vehicles anyway, but it's not hard to simply get a new life insurance policy if your current one goes kaput.
I would feel bummed out, but not angry or like I actually got ripped off, in other words. When I signed up for the 20-year term, part of what I was being asked to do was estimate how likely I think it is for this firm to actually be around for that full 20 years. That's just part of the game.
People with more complex medical conditions often can get life insurance from smaller, specialized providers... and at much higher rates. But the big mass-market players offering inexpensive term life products are only offering them that cheaply because they really control the risk profile during underwriting.
It's not a gamble, you transfer your risk to a collective.
The 'collective' part is a distraction when trying to understand insurance.
Similar for insurance to work you don't need to have a group of people who are in the same situation as you: in principle an insurer can work out the risks, even if you are in a unique situation.
It's just that working these things out costs time and money, so it's cheaper for you, if you are like everyone else.
But eg if you are a famous singer, you can insure your voice just fine. Companies also regularly purchase insurance against customers winning prizes. See https://en.wikipedia.org/wiki/Prize_indemnity_insurance
I'd argue that it should be illegal again, as a moral hazard (directly contributing to countless murders and other schemes) and as a particularly morbid form of gambling.
Do you have any data on how much of a problem that is?
But it's enough of a problem that there are quite a lot of legal journal articles about it, e.g.: https://scholarship.law.campbell.edu/cgi/viewcontent.cgi?art...
Life insurance has killed a lot of people. People who would otherwise be alive but for the existence of payouts upon their deaths.
If I sign up for a big life insurance, those guys better give me a body guard and a food sniffer to protect themselves from a big payout.
That, in fact, is the general (and beneficial) function of insurance: You only need to provision for the expected loss (plus some fee for the insurance), not the maximum loss (which many people could not afford).
Suppose you want to insure your home against fire, which could create damage of say $1m with probability 0.1%.
Without insurance, you'd have to put aside savings of $1m (the maximum loss), that would remain untouched with 99.9% probability, and be used to cover the fire damage otherwise.
With insurance, you'd pay the insurer $1m * 0.1% = $1000, plus a bit on top to cover their cost and profit. In case of fire, they cover your loss. Everyone wins.
So, with insurance you replace provisioning for the maximum loss by provisioning for the expected loss plus a fee.
(That's why one should not get insurance for small items (where one can cover the max), such as baggage or mobile phones or so, but for large items, such as house, life, health).
Similarly, I can't really understand insuring against expenditures that are certain. Eg insuring for the cost of routine pregnancy (as opposed to insuring for complications only). Or even worse: yearly allowances like 100 dollars flat for new glasses: just decrease my insurance premiums by that 100 dollars, please. (Unless it's a tax dodge, then it makes sense.)
Jeez.... I guess in that scenario I become a billionaire because it will be very easy to scoop up some VC money to snoop up some of those newly unemployed actuaries to monopolize the market at a profit margin an order of magnitude larger than any of my now non-existent competition, because this is a financial product and doesn't require months of building a factory or something to offer.
How many years experience do you have in the insurance industry that you're so confident to talk like this?
> because this is a financial product and doesn't require months of building a factory or something to offer.
How many financial instruments have you launched? If the answer is zero, you should refrain from any conversations on the topic because your opinion literally means nothing.
Onus is on you to prove that if every single life insurance provider was suddenly Thanos snapped out of existence tomorrow, we wouldn't see a swarm of hungry financial professionals swoop right back in to recreate the service within weeks. That seems like a laughable claim to me, but maybe you know something I don't.
> Term life is just not that complicated a product at heart
Sure, it's easy if you don't know what you're talking about and just make stuff up!
> Onus is on you to prove that if every single life insurance provider was suddenly Thanos snapped out of existence tomorrow
Literally nobody said that would happen. Now you're arguing points that nobody made.
You have no experience in the area, arguing things nobody said. You're perfect for VC money, lmao.
> That seems like a laughable claim to me
Nobody made that claim. Why are you laughing at things nobody is saying? That's weird.
> That seems like a laughable claim to me, but maybe you know something I don't.
I would 100% guarantee people that have worked in an industry know more about it than you do.
Textbook demonstration of the Dunning-Kruger effect. You have no knowledge or experience in an area, but you're confident you know how it works, moreso than the actual experts. https://en.wikipedia.org/wiki/Dunning%E2%80%93Kruger_effect
I think this very accurately sums up your comments.
Their study was mostly just a statistical artifact.
Right now, it would be hard for an amateur to make a living starting up a new life insurance company, because there's lots of competent competition.
However, _if_ all existing life insurers went bankrupts, then, yes, you could easily make a killing by starting a new slightly less incompetent life insurance company.
Yes, some life insurance companies can make mistakes or get unlucky. after a few went bankrupt from whatever you are imagining, you'd think that the remaining companies would change their risk models or simply charge higher premiums?
I wonder why life insurance isnt funding more research into things like metformin, where we have amazing long standing data but haven't done the real research. See: https://www.afar.org/tame-trial
What I mean is, you should be comparing the risk of GLP-1s versus the risk of obesity, because realistically this is the vast majority of people's risk analysis criteria here.
Obesity increases your risk of CVD, metabolic syndrome, diabetes, liver disease, kidney disease, joint diseases, and overall mortality. CVD, in particular, is the number 1 cause of death in many developed countries.
Like all drugs, GLP-1s come with risk. This fact, however, is worthless. We must ask if it is less risky than the aggregate sum of the above diseases. I think the answer is overwhelming yes.
Therefore, obese people should probably consider GLP-1 medications. Particularly if they have tried, and failed, weight loss before. Which every obese person has.
In addition, when considering the downside of medication, we MUST compare it to the alternatives. Many obese people are already on multiple life-long medications. Statins, hypertension medication, insulin and other diabetes management drugs, etc.
Not only do these medications require significantly more management than a GLP-1, but they, too, come with their own set of risks, which we must then add to the risk of disease.
I, personally, have taken multiple chemotherapy drugs to cure my cancer. These drugs make GLP-1s look like nothing. They have damaged my body in irreversible ways. They've aged my blood, exposed me to extreme levels of known carcinogens, raised my risk of mortality, and overall lowered my quality of life.
However, I am thankful for them. Yes, my risk of mortality is much higher. But, compared to cancer, which has a 100% chance to kill me, it was a worthy tradeoff.
First, the paper is talking about BMI rather than weight.
Second, what most people mean by "weight" in ordinary conversation is closer to body fat percentage than it is to BMI: Arnold Schwarzenegger was famously obese by BMI, but anybody who called him overweight during a conversation at the pub would likely be told he doesn't count.
Thirdly, the paper was close to statistical significance, even looking at young people and even with a cohort of a bit under 5000 people, so it doesn't rule out a correlation with BMI either (although yes, it does suggest BMI is a proxy for body fat, but this isn't a controversial statement).
Fourthly, GLP-1 agonists do reduce body fat[0], and body fat is the measure suggested by the paper you cited as being better than BMI.
[0] https://www.sciencedirect.com/science/article/abs/pii/S00142...
"Relatively high levels of significant side effects" is a vague and unhelpful claim:
High compared to what? What counts as a significant side effect here? What actually are the side effects in question? Are those side effects permanent and irreversible? Can they be avoided by adjusting the dose? Dozens of such considerations come into play.
No drug I'm aware of is perfectly safe, and I know many drugs indeed.
To the best of my knowledge, the combined risk of taking semaglutide utterly pales in comparison to the clear and present harms of obesity. The only clear downside is cost, and while I'm lucky enough to to have access to cheaper sources, they're not even that expensive when you consider the QOL and health benefits.
> Conclusion: Semaglutide displays potential for weight loss primarily through fat mass reduction. However, concerns arise from notable reductions in lean mass, especially in trials with a larger number of patients.
That's a significant long-term damage to health, quite possibly permanent for 40+ patients.
Intermittent/time-restricted fasting
https://jamanetwork.com/journals/jamainternalmedicine/fullar...?
That's simply how the body reacts to a caloric deficit, without additional exercise. If you combine both IFT and resistance exercise, you find no muscle loss at all:
https://pmc.ncbi.nlm.nih.gov/articles/PMC7468742/
That's an apple to oranges comparison, because there's nothing preventing someone from taking Ozempic from exercising on the side.
And in fact, other trials found that the overall ratio of fat:muscle lost was rather favorable, and that functional strength wasn't compromised:
https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.157...
>Based on contemporary evidence with the addition of magnetic resonance imaging-based studies, skeletal muscle changes with GLP-1RA treatments appear to be adaptive: *reductions in muscle volume seem to be commensurate with what is expected given ageing, disease status, and weight loss achieved, and the improvement in insulin sensitivity and muscle fat infiltration likely contributes to an adaptive process with improved muscle quality, lowering the probability for loss in strength and function*
Interpreting the risks and benefits of medication isn't a trivial exercise, if you're driven by a handful of studies or ignorant of the wider context, then it's easy to be mislead.
Strongly disagree on this. If there was nothing preventing the patient from changing their diet and physical activity / exercise level they could lose the fat through diet and exercise without resorting to taking semaglutides in the first place. Withdrawal studies show that there is a clear tendency for the weight to rebound after withdrawal from semaglutide use, therefore it's very hard to argue that it is the weight / fat mass alone blocking patients from indulging in a healthier lifestyle.
Semaglutide may help manage sustained weight loss by e.g. reducing the effect of reduced leptin baseline, however overall I remain highly skeptical of possibility for semaglutides to be "a first-choice approach to robust weight loss".
It's still better unless you were woefully weak, in which case a doctor should have prescribed adequate nutrition and physical activity.
Health insurance is one of the rare services where incentives between consumer and business are well aligned. The vast majority of people are healthy. Healthcare is expensive in the US because the uninsured population continues to rise out of "they're not making me pay for it": There are entire tranches (in the US) also don't buy insurance and use the ER and abuse EMTALA for their primary care (most of this is actually unintentional in my opinion, it's less educated populations in the US who are repeatedly taken advantage of and left to ride on government, which is extremely eye-wateringly bad at spending money). Personal experience here working in an ER.
The real pathway in the US to success is getting those populations onto private health insurance. Obama tried a heavy handed "health insurance mandate" that hilariously somehow passed the supreme court, but was so laughable mis-aligned with American ideals even Biden wouldn't enforce it.
What is apparent though is these populations are completely willing to pay bills like their cell service, gasoline, car payments, etc before investing in the most important thing (their health). This gives me hope there is a way forward by riding these perceived essential services somehow. I'm not really sure what the answer is here, but there is at least opportunity for some creative solutions.
I also think the disagreement here between red vs blue isn't the outcome: both want people to be healthy. Red doesn't want single payer, whereas blue does. Red ignores the fact these systems don't exist, blue ignores the fact that no other country in the world has the diversity of America and there are not functional examples.
(Food assistance is usually coupled with means testing.)
In liquidity preference theory insurers do not have perfect information so they must make a tradeoff between collecting information and acting on the information they already have. There will be a bias towards the present and the past, because more information is available about the past and present than the future. What's being "discounted" is uncertainty, not time. Hence there is also a general bias towards stability and conservatism (sticking with existing decisions, even if they are bound to become obsolete).
Now let's apply this to the article:
The insurers don't know if you can stick with your weight loss, so they will conservatively deny coverage until they are certain that they know your health/risk profile. According to time preference theory this would never happen since the insurer already knows whether you will succeed at weightloss or not.
[citation needed]
Insurers certaily don't mind you living longer. More payments, less payouts. They just need to update their predictive models or coverage policies to safeguard their margins. The 'problem' is transitory.
There are times when this is a problem, but even then it isn't the insurance companies that are complaining. There was a big "problem" during the beginning of the AIDS epidemic. For reasons I don't quite understand, the holder of the policy (the insured) can sell their policy to a random third party. The seller sells because they need immediate cash for end of life hospice treatment. The buyer buys because they know this person is about to die and they are going to get a cash payout of more than they paid for. This was a guaranteed payout because there was no treatment. This was a rare example of an investment with zero risk and high return. If you got the virus, you were going to be dead in a few months. This is a win-win for both the deceased and the new buyer, and it is neutral for the life insurance company because either way they have to pay the same amount to someone at the time of death.
The arrival of AZT cocktails threw a monkey wrench into the whole plan because suddenly a guaranteed death is no longer guaranteed and it leads to an ethical quandary because the "investor" doesn't get a return for their "investment" unless that person dies, and now they are literally wishing death on someone. (see also: There is no such thing as a risk free investment.)
https://www.theatlantic.com/health/archive/2018/10/viatical-... "The Gay Men Who Have Lived for Years With Someone Waiting on Their Death"
And I'm guessing just based on my own experience paying for term life that the actual premia differences aren't actually enough in most cases for the life insurer to simply pay out of pocket themselves; the differences probably add up to a few hundred per year per customer, whereas a year's worth of a GLP-1 agonist probably costs a couple thousand (for now, in 2025, and probably dropping rapidly).
Huh. Second order implementation details aside, this is an extremely fortunate turn of events for us.