Lawsuits claiming Ozempic, other GLP-1s led to blindness become second mass litigation over the drugs

https://www.reuters.com/legal/government/lawsuits-claiming-o...

This is from a year ago. Millions of people are on GLP-1s, there's definitely not a mass blindness that's ongoing.

Not to mention the first people on these drugs were type 2 diabetics who are the exact group that's at risk for NEON.

Think of all the things they're not gonna be at risk for, not being diabetic now.

It’s a shame that this has to be pointed out every time. People really need to engage in critical thinking and risk assessment.

I’ve seen headlines about a potential link to hair loss lately.

all of the side effects that people are attributing to tirzepatide seem to be ones that are symptoms of losing a lot of weight quickly and eating a low calorie diet for an extended time.

hair loss is a symptom that fits into that category.

In reality, though,

Crashing intakes tend to be self-regulating; you cannot really eat very little food for long periods without suffering.

GLP-1s make it very easy to crash your intake by simply injecting a higher dose, so the "negative effects" of crash dieting are easier acquire on GLP-1s for vast majority of population.

If one eats less, perhaps that alone could lead to hair loss.

No I'm just wondering how addictive they are once your sclera turn blue.

N of 1, but I had serious low drive/motivation side effects from Wegovy. Everything enjoyable became less enjoyable, from alcohol, to running, and after a couple of months, even getting out of bed. I lost weight slower than I had previously with old school calorie counting (most of which I have kept off to this day). Within a couple weeks of getting off it I was back to normal.

My conspiracy theory is that a lot of people must be getting this global lowered reward sensitivity from GLP-1s but are ignoring the negative sides of that effect because they like being skinny.

I felt something like that affect, though not very pronounced, for the first couple weeks. Since then I've felt completely normal. Life is way more fun now.

Caveat: I've not been on GLP-1s.

Sounds quite a bit like when I started the probiotics I've been on for quite a few many years now: When I started these ones, I actually started feeling worse than before. Ultimately though, after IIRC about two weeks of feeling worse than before, things got better.

I started out being lethargic all the time (in hindsight: way, way too many years, I just didn't put 2+2 together on multiple symptoms!). Migraine headaches from certain foods as well as any amount of alcohol and even non-alcoholic beer for example, essentially anything that produces histamines (which certain foods as well as alcohol consumption does).

After the probiotics "fought and won the battle" against whatever was inhabiting my intestines before that, I felt totally fine. No more lethargy. Could eat all the histamine rich foods in the world (Roquefort, here I come again, you're soooo tasty! Maybe with a glass of red wine too) and be fine. Never looked back. Life is way more fun now.

I might want to get on GLP-1s to not like alcohol and too much Roquefort now, while still not being lethargic, lol!

One thing that colors how I view it is that I am more in the "would like to lose 15 lbs" space than the "needs to lose 50 lbs" space at this point in my life. I have a BMI of 27 and ran a half marathon right when I first tried Wegovy, and I already weigh 30 lbs less than I did at my 2021 peak. My A1c is 4.6. I actually recently reached out to my doctor about trying a different GLP-1 and she told me that given my labs and that I haven't been gaining weight she doesn't feel right prescribing me one.

So I am a lot more picky about side effects than I would be if I seriously needed to lose weight or had diabetes.

With a BMI of 27 why would you try GLP-1s at all? I would also be less forgiving of side effects if I were in that situation.

But my BMI was like 39, and now it is ~25. My blood test results the last couple of years have been phenomenal. All of the extra cardiac testing I've done suggests I managed to dodge a lot of the effects of being obese, which is just genetic luck (heart disease does not run in my family, most of my immediate ancestors lived well into their 90s and all of them died of something other than heart disease, even though some were fairly overweight).

I have played a little roulette with GLP-1s lately because I am curious, and found that at my current weight (5'11" or so and 175lb) seems to be where my body is willing to go, and that's about it. I stalled out pretty abruptly, and if I increase the dose all I get are uncomfortable side effects and no real weight loss -- even though the discomfort pushes my caloric intake well into the "cannot get enough vitamins and minerals" level. It's remarkable. I was once 165 naturally but 30 years ago, and that just isn't a realistic goal any more, so says my body. This is fine, I feel very good now. Well, when I'm on the maintenance dose ;-). Then I have no side effects, I just live a normal life eating normal amounts of healthy food and having a way easier time exercising than when I was heavy.

Honestly I was finding the last 15 lbs to be stubborn, and had a borderline mild sleep apnea test that meant my doctor offered it and my insurance would cover it. I also wanted to see what all the hype was about.

That's fair.

I forgot about sleep apnea. I was struggling with adjusting to CPAP, and never really succeeded. After losing a fair amount using tirzepatide, I did a repeat sleep test and my sleep doc gave me the green light to put the CPAP in storage.

In the end, a year after the borderline sleep apnea test, we optimized my thyroid medication dosage (I had hypothyroidism the whole time but my dose was too low) and I went on a multivitamin, and after a couple of months, the sleep issues that were why I'd gotten that test in the first place went away. And, it's easier to lose weight when my thyroid is properly treated.

I was beating my head against those sleep issues for years, and had multiple doctors sit down and tell me that I probably "just had a high sleep need." In the end, I'm not sure whether it was the thyroid or some vitamin deficiency (before the multivitamin I was on iron, C, and D separately), but it turned out to be very treatable.

>But my BMI was like 39, and now it is ~25. My blood test results the last couple of years have been phenomenal

If you’d lost the weight without GLP-1s, your blood test results would still have been phenomenal. Most of the effect you are seeing is the result of lowered bodyfat% through calorie deficit.

now, in your case calorie deficit comes from GLP1 use but in others case it can come from sustainable dieting which is little more tricky execute properly than just injecting a drug.

> If you’d lost the weight without GLP-1s

I've lost the weight several times over the last 30 years. The test results were never so dramatically improved. Your hypothesis may be wrong.

You're not the only person to report anhedonia. This shouldn't be downvoted.

> My conspiracy theory is that a lot of people must be getting this global lowered reward sensitivity from GLP-1s but are ignoring the negative sides of that effect because they like being skinny.

Possibly some of them could also be unintentionally countering the impacts through things like self-medicating with caffeine.

I have no personal experience with GLP-1s but suddenly quitting caffeine after decades of daily use was pretty eye-opening in terms of how much it was boosting my baseline mood. And I'm not talking about being cranky for a couple of days after quitting, I'm talking about a very noticeable sustained change from when I was a frequent caffeine user to when I stopped having it altogether.

Seconding this without straying too far from the topic.

My entire life I have been underweight and also ridiculously hooked on caffeine. At work I would easily go through 5-8 cups of coffee in a day.

I quit caffeine to become a parent a few years ago and suddenly I am able to put on fat and muscle so much easier.

I think the fact that 95% of our society consumes one of the best weight loss drugs (caffeine) anyway really skews a substantial portion of the data.

Speaking of which, nicotine is another effective weight loss drug. I have to wonder if some portion of the increase in median BMI (ignoring the morbidly obese) in America over the last 50 years is it becoming less socially acceptable to chain smoke.

Looks like it's typical to gain 5-10lbs when quitting smoking.

Edit: pulled up the data and there's been a 30lb increase in median weight in America, so (loosely guessing) the smoking effect is probably somewhere between 5 and 10% of that change.

> Speaking of which, nicotine is another effective weight loss drug.

Nicotine is a very useful drug that is sadly so very, very bad for you.

It has weight loss impacts, acts as a stimulant and is actually one of the better non-prescribed treatments for ADHD (as well as being super associated with schizophrenia).

After I got my ADHD diagnoses I noted that this was always called out in the literature, and I have been addicted to nicotine for the past 25 years or so (on a vape now, which appears to significantly reduce some of the bad side effects, but is still probably not good for me).

> don't require the personal discipline of caloric deficit

This reminds of a of Reddit thread I saw on r/cholesterol where a similar sentiment was expressed. Several cardiologists weighed in with comments to the effect that "personal discipline" has been tried for the last 50 years or so and has utterly failed to arrest heart disease and that, yes, GLP-1s are a miracle drug.

Yes, but the obvious is also worth noting that the nature of those statements is necessarily heavily biased.

Cardiologists are either looking at the broader population or the individuals more likely to lack that "discipline". The majority of people are healthy and have no problems maintaining their health.

Healthy people are not healthy because of a rigorous discipline that unhealthy people are missing, though

Yes, exactly. I'd argue that healthy people are healthy because they have an accurate perspective of reality. Discipline is irrelevant.

> he majority of people are healthy and have no problems maintaining their health.

3 out of 4 people are overweight or obese in the US.

It's not the caloric deficit, it's the insulin. Cells don't have caloric receptors, only insulin receptors. I created an info site about this. Managing your insulin have the same effects as GLP-1 meds.

> Managing your insulin have the same effects as GLP-1 meds

You should tell the scientists about that, seems like they completely overlooked it!

Why mention your info site without providing a link? It's a little frustrating to read comments like this. Thank you.

> Personal discipline of caloric deficit

Or you can just eat whole foods and do exercise. If you're an able bodied adult with a job, a basic understanding of the effects of foods with unnaturraly high sugar content, and even a slight care about your looks; then you really don't need personal discipline beyond what day-to-day life requires.

Being fat honestly takes more effort than being at normal weight for someone who's 100% able-bodied.

Yeah GLP1s work, but it always boggles my mind how eager people are to jump on them over the alternative.

What if you’re not able bodied?

Not my place to talk about.

“just”

It's not hard.

If you can wake up on time everyday, shower everyday, brush your teeth, read emails; how hard is it to not eat obviously trash foods?

Nobody's asking you to learn a high cognitive load skill or play a competitive sport. You don't even need consider counting calories. Just stop eating things that aren't single (or few) ingredient fruit, meat, rice, potatoes, eggs, dairy, tomatoes, coffee, etc. Eat till you're satiated. Avoid added sugar / any sweet condiments.

No processed foods 6 days of the week. Jog for 10 minutes on days you're able to. Bodyweight squats. Short sprints if you enjoy them.

See how simple/doable those steps are? If you have the money for GLP1s and a fancy gym membership then by all means do whatever works, but acting like being fat in a first-world country is a difficult problem to solve is just strange.

> Just stop eating things that aren't single (or few) ingredient fruit, meat, rice, potatoes, eggs, dairy, tomatoes, coffee, etc. Eat till you're satiated. Avoid added sugar / any sweet condiments.

sure! depends on the exact poll but 50% of americans have reported issues with being able to afford groceries. 1/8th of households have actual food insecurity. whatever, that’s not even the main problem i have with your reply

> See how simple/doable those steps are?

i’ve already lost weight without GLP-1s using food tracking, etc. you don’t have to condescendingly prescribe lifestyle changes to me. it wasn’t simple and often did not feel doable, even though i am able to brush my teeth every day (?)

the objection i have is pretending these are simple, repeatable, or obvious pieces of advice that can slot in to any ‘ol lifestyle if you just care how you look or whatever

i’m also amused you couldn’t help yourself from saying “just” again

> i’m also amused you couldn’t help yourself from saying “just” again

When most weight problems can just be fixed by just telling those people what's wrong with their diets, and actually offering them a simple solution, why not tell them that?

I'm also not American, and the people in my city I live in largely don't seem to have issues with not being obese, plenty also have food insecurity.

Food insecurity being equated to gaining weight is a hilarious leap in chain of events. Food education and upbringing, sure, but insecurity? Doesn't that mean food is harder to acquire?

> Food insecurity being equated to gaining weight is a hilarious leap in chain of events. Food education and upbringing, sure, but insecurity? Doesn't that mean food is harder to acquire?

nope. it’s literally called the “food insecurity and obesity paradox” and it’s observed in high-income countries [0][1][2][3]

maybe if you had ~just~ done some research you’d be better equipped to more empathetically consider other’s perspectives and experiences

[0] https://pmc.ncbi.nlm.nih.gov/articles/PMC5394740/ [1] https://www.ahajournals.org/doi/abs/10.1161/circ.152.suppl_3... [2] https://www.jandonline.org/article/s0002-8223(07)01616-1/ful... [3] https://royalsocietypublishing.org/rstb/article/378/1888/202...

>Being fat honestly takes more effort than being at normal weight for someone who's 100% able-bodied.

This is nonsense.

Being fat takes literally no effort at all, all it takes is your discipline slipping a couple nights a week. Being a healthy weight takes (for some) perfect discipline every day, ignoring hunger, putting weight management before everything else in your life, etc.

I've worked physically demanding jobs in paralelll with both long distance running and weightlifting for about 15 years of my life, I've significant muscle mass and good enough cardio to run 15k any day without any particular prep, yet I've hovered around obesity mark for the last 10 years. And now as a parent, any effort to cook leaner food takes time I dont have, as does exercise.

I'm not on any weight loss drugs as I do not want to risk any negative side effects, already being a sleep deprived toddler-parent.

But life is short, and cutting weight can fuck with people mental and physical health a lot before things get better, so for those that need it, 100% do whatever it takes to get to a healthy weight first and then figure it out from there. Spending your 20s-30s-40s struggling and failing to keep a healthy weight is a slow death of its own.

60 years ago obesity in every stable country was a tiny fraction of what it is today. Are people 10-50x less disciplined today? Really? Or are there just more incentives for processed food companies to sell you their crap? Are quick dopamine hits so easily accessible that people are becoming less driven? Is mainstream society not pressuring obese people enough to change course for being unhealthy?

Yes there's WAY more distractions today, and all those factors make it harder to navigate life practicing healthy habits, but you still have agency. The natural state of the human body is to use calories. The brain alone burns an astonishing amount of calories just thinking. Also no one's force feeding you anything.

There's plenty of countries with a lower "quality of life" index that barely have obesity problems. Maybe the natural tendency of the human body is not to slowly get fat?

>Being a healthy weight takes (for some) perfect discipline every day, ignoring hunger, putting weight management before everything else in your life, etc.

Why does eating at maintenance calories require “ignoring hunger”?

If a guy is already 80 kg, at 10% BF, and their maintenance calories are 3,000 kcal, they can be perfectly happy and not in a state of hunger while eating 3,000 kcal.

I maintain 10% BF at an FFMI of 25; I am almost never hungry while eating at maintenance.

> But life is short, and cutting weight can fuck with people’s mental and physical health a lot before things get better, so for those who need it, 100% do whatever it takes to get to a healthy weight first and then figure it out from there.

Only if you are running massive deficits, which is what most newbies/crash dieters do. Emotional, knee-jerk-style dieting is not sustainable dieting.

> Or you can just eat whole foods and do exercise.

Why do you think people don't do that?

>Many here have expressed skepticism at GLP1s because they don't require the personal discipline

Personal discipline required for sustainable dieting is overblown.

People mostly crash diet in the name of dieting, then suffer and blame this suffering on "dieting."

Proper dieting is rare.

Even the weight loss studies which people often quote on how dieting/exercised failed obese people run 800–1,200 deficits, which make even an experienced dieter uncomfortable.

I look at GLP1s in a similar way as I do statins. In many cases - otherwise unhealthy people take statins, when with some discipline the would not need the statins. I don't believe this- GLP1s and statins are simply tools in our healthcare toolbox that are VERY effective.

The thought that discipline would eliminate the need for statins or GLP-1s is a nice fantasy. It appears that all it does is increase stress on the patient and make them feel like crap because they're blaming themselves for something out of their biological control.

When I had high cholesterol, I tried diet, which didn't touch it. I tried 9 statins, failed on all of them. Niacin didn't work. And now I stab myself every two weeks with Praluent, and it works beautifully. I'm looking forward to fewer heart attacks.

Diet and exercise didn't bring down my blood sugar numbers enough, and I've tried several drugs that didn't work for one reason or another, but now the GLP-1s seem to work where others didn't.

As far as I'm concerned, they're essential tools.