Well that explains some of it, those tend to be the proportionally most obese towns.
Ozempic, GLP-1 and other modern diabetes / weight loss medications
- Thread starter ISUCyclones2015
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Shouldn’t that be decided by your doctor, not the pharmacy?
Should be required to include a full body frontal to post in this thread. Would love to see all the incredible physiques we apparently have on this board.
Doctor can prescribe and you can pay out of pocket, it’s just not in the formulary. Only if the first drug doesn’t work or has adverse effects.
Then why even mention "they didnt even try changing their habits first, they just went straight for the easy button?" That's clearly a direct judgment of those people. It's a clear indication that you believe people have to earn the right to be healthy before they can explore every avenue towards health. That's why you're getting the pushback. Maybe you didn't mean it that way and you just didn't write it clearly. But that's how most of us took it.
Whole series of podcasts on this topic from Dr. Mike, and a bonus episode of American Glutton with Ethan Suplee and Dr Mike. Fascinating stuff. Dr Mike is a bodybuilder, former powerlifter, former obese person, and has his PhD in exercise science so he knows his stuff. Ethan is that actor from Remember The Titans who lost like 300lbs. These guys are real ones when it comes to fighting obesity.
https://open.spotify.com/episode/79sDmwmM8iGbSslxm0Ryc8?si=vwnoX2bFSH6A-U0hyGUVxA
https://open.spotify.com/episode/4TDHP8YP5p5h3FkELR5PqL?si=Kxop_RffT8ONgNsaWkVQDw
I’m ignorant when it comes to how doctors handle this (like most of us who haven’t talked to a doctor about it personally)what I hope is happening is that when the patient gets a prescription, they also get an appointment set up with a nutritionist or exercise specialist.
It’s good that they are getting healthier but hopefully life changes are happening at the same time so they can come off this. I feel this should be an aid and not a life long use type deal.
There's a lot going on here...
First, PCPs aren't adequately trained in nutrition or exercise to really help people directly. They aren't able to create a nutrition plan or a workout for their patients. They can refer people, but it's an exceptionally small percentage of people who will actually follow up on those referrals, and an even smaller percentage who will turn those referrals into lifelong habits.
Second, these drugs are primarily for chronic illness which means they are lifetime prescriptions. They are not meant for onetime weightloss. If you go off the drug, the old habits/cravings will return and so will the fat gain. Either that or you will be constantly fighting your cravings and hunger and be emotionally miserable and maybe a little less fat. There are two different "types" of obesity. There's the "I'm just fat and probably could do it with diet and exercise," and there's "I have underlying emotional or mental issues that make weightloss especially difficult." We have to acknowledge that second group, for whom lifelong intervention is necessary. Whether thats drugs, or gastric bypass, or whatever else.
Finally, 80+% of body composition is due to nutrition. For fat loss, there really isn't any amount of exercise that is effective. You have to get that calorie deficit by eating less. And the current combination of our physiology / psychology and food environment means people are going to need external help for the foreseeable future. Unless we plan to change the food environment, which would certainly be healthier but would also massively disrupt the economy.
I never did not acknowledge either group. I said that giving them as much info as possible and if that can get 50/25/ even 10% able to drop weight, change their lifestyle to a more healthier one that allows them to quit taking the drug, then that would be positive. I don’t understand why having them meet with other experts also, is a bad idea.
If people are doing well on the drug and losing weight along with all the other benefits that go along with it, even if they have to take the drug for the rest of their life, seems like a small trade off to me. I would rather extend and enjoy the time I have left, even if that means that I am taking ozempic for the next 20 years or more. Hopefully I get the chance. A classmate of mine from high school passed away on Friday, was 63, way too young to pass.
My cousin has type 2 and takes Trulicity, and has lost 20 lbs over 3 months or so. One quick shot in the butt cheek once a week. He says his doesnt get hungry much during the day and actually prefers to eat lighter type foods now. Not sure what it costs but I think his insurance pretty much covers it. He hasnt had any side effects that I know of.
If only talking to experts solved our problems...
You didn’t directly mention either group, but your argument seems to only be relevant to the one that wants quick weightloss for cosmetic reasons.
The drug leads to the change in lifestyle. For whatever reason, for some people the lifestyle isn't sustainable without the drug. "Well if you REALLY wanted to change..." Life isn't that simple. These drugs literally make you less hungry and reduce cravings. That leads to eating less and weightloss. Some people will leverage that to look good for a vacation or a wedding or a reunion or whatever. These folks probably don't "need" the drugs but I wouldn't stop them from using it. Those people shouldn't be on it long term just to make sure it's available to those who really do need it. I'd wager that people with the chronic diseases these drugs are meant for will need continuous help to fight those urges. If they go off the drugs, their quality of life will get worse because you can't just stop being hungry. "Don't be hungry" or "just don't eat even if you are hungry" aren't a lifestyle choices.
Comments are a bit all over the place here but I do want to remind people that if you are put on a GLP-1 inhibitor you are informed that you must begin strength training. Not general exercise, not BS getting in a certain number of steps or just being active but actual real strength training.
If you don’t do strength training and are seeing rapid weight loss you can be at risk of major health complications which can effect many organ systems including seeing major cardiac complications.
Also you should be engaging in regular conversations with your PCP about how you are feeling and what effects you are experiencing. Dosages can be adjusted, scripts can be swapped, other effects can be managed.
These drugs can work wonders but if you stop listening to your medical team then you could be in just as bad shape as you were before you started which is honestly how we got to this point as a society in general.
The drug isn’t a short cut, it is a life long commitment and if you go off of it then there is a very high likely that not only will you regain the weight but most likely will gain back even more then where you started.
If you don’t do strength training and are seeing rapid weight loss you can be at risk of major health complications which can effect many organ systems including seeing major cardiac complications.
Also you should be engaging in regular conversations with your PCP about how you are feeling and what effects you are experiencing. Dosages can be adjusted, scripts can be swapped, other effects can be managed.
These drugs can work wonders but if you stop listening to your medical team then you could be in just as bad shape as you were before you started which is honestly how we got to this point as a society in general.
The drug isn’t a short cut, it is a life long commitment and if you go off of it then there is a very high likely that not only will you regain the weight but most likely will gain back even more then where you started.
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Fix the food industry first. That's going to give us the best overall results.
Contact your insurance to see if they cover Wegovy or Zepbound and, if they do, what the qualifications are. Both are the weight loss versions of Ozempic and Munjaro, which are prescribed for pre-diabetes and diabetes. My insurance provider said too many doctors do not understand this and will try to prescribe Ozempic or Munjaro for weight loss. Usually you need one or more of the following to qualify: obesity (BMI >30), high blood pressure, high cholesterol, Type 2 diabetes, cardiovascular disease and moderate to severe sleep apnea.
I started in March 2023 on Wegovy, then switched in March 2024 to Zepbound, which has been much more effective. My side effects have been constipation, reflux at night and what I call "sloshy stomach", especially within a day or two of the injection. Smaller meals, eating earlier at night, drinking lots of water and adding Metamucil, etc the first day or two helps significantly. I also am careful with what I eat. Meals high in carbs the day of and day after my injection seems to affect me negatively. When I first started Wegovy, I stayed on a dose for two months before increasing to the next one - I think that also helped.
I also have been working with a weight loss management program through our hospital, which has been great. It's taken 2.5 years, but down 77 pounds. I've been in maintenance mode for 5 months now. That means I've lowered my dose and have extended the days between.
I think questions like those are what make it easy for me to wait on this, assuming I ever need/want it.
I'm (only?) ~20 lbs overweight and (only?) top end of OK range on blood glucose. So for me it's not something I need, I'd be the "easy button" guy people complain about. But as I get older maybe things get worse and it does become more of an option.
But it does seem like they are refining what works best, in what doses, for what situations; just more overall intel on it. So maybe in 5-10 years I will feel more confident about it. Plus generics should be available, so cheaper.
