GLP-1 agonists; diabetes drug and now weight loss

[Dona Ferentes]

and these comments from Resmed CEO Michael Farrell give a twist to conventional thinking that CPAP would be impacted

On GLP-1s: "We believe that increased utilization of GLP-1s to treat obesity will bring many new people into the healthcare funnel, activating them to see their primary care physicians, as they strive to achieve and maintain weight loss."

On weight-loss drug users: "For patients prescribed a GLP-1 medication, the latest data show a 10.7 absolute percentage points higher propensity to start PAP therapy* over those without a GLP-1 prescription."

*Positive Airway Pressure therapy

 

[Dona Ferentes]

"Novo Nordisk has exceeded the Danish nation’s GDP, and they are now the biggest company in Europe in terms of market capitalisation,” says a Copenhagen Business School economist. “Almost 20 per cent of all new Danish jobs in 2023 were created by Novo Nordisk – we’ve never had that before,” he adds.

Novo Nordisk has always played a large part in Danish society but now, with the spread of the injectable weight-loss medication Wegovy, it has become a globally recognised name. Bloomberg and Fortune recently put the company’s market value at $US570 billion, while Goldman Sachs estimates that by 2030 the global market for anti-obesity medications could grow to $US100 billion.

 

[finicky]

For 6 months I've been using allulose, or a combo of allulose and monk fruit as a coffee sweetner.
It's said to behave as a mild GLP-1 agonist and has little or no effects on blood glucose or insulin?
I haven't noticed any weight loss but might have lower food cravings that I can ascribe to it - not sure.
Main reason I use it is to combat 'metabolic syndrome' - i.e for blood glucose and insulin control.
Taste-wise it's closer to sugar than anything else I've tried. I get it shipped from iHerb.

Yes, I’m Excited about Allulose - David Perlmutter M.D.

Allulose, a rare sugar, has gained significant attention in recent years due to its numerous health benefits, primarily concerning metabolic health. To be sure, it seems like it is everywhere …

drperlmutter.com

Is Allulose Safe?

Allulose has gained popularity as an artificial sweetener that tastes more like real sugar. But it may merit caution. Experts explain.

health.clevelandclinic.org

 

[qldfrog]

For 6 months I've been using allulose, or a combo of allulose and monk fruit as a coffee sweetner.
It's said to behave as a mild GLP-1 agonist and has little or no effects on blood glucose or insulin?
I haven't noticed any weight loss but might have lower food cravings that I can ascribe to it - not sure.
Main reason I use it is to combat 'metabolic syndrome' - i.e for blood glucose and insulin control.
Taste-wise it's closer to sugar than anything else I've tried. I get it shipped from iHerb.

Yes, I’m Excited about Allulose - David Perlmutter M.D.

Allulose, a rare sugar, has gained significant attention in recent years due to its numerous health benefits, primarily concerning metabolic health. To be sure, it seems like it is everywhere …

drperlmutter.com

Is Allulose Safe?

Allulose has gained popularity as an artificial sweetener that tastes more like real sugar. But it may merit caution. Experts explain.

health.clevelandclinic.org

My turn to give you medical advice after your recommendation to go and contact rotten former PM Julia organisation for psychiatry checkup...
We grow in tropical sunny coast : yacon, or Peruvian ground apple.
Juice can be used as sugar even for diabetics ..or just much as a snack
Available in green shops or local markets and swap meeting in Qld

 

[finicky]

Yacon eh? Will check it out. I'm in northern rivers NSW, so I suspect I would need a processed form that I can buy on iHerb.
I have self diagnosed metabolic syndrome or possibly diabetes. I've never gone to a medico to get a diagnosis. I do what I can at home, including almost giving up alcohol, losing some weight more activity, no added table sugar and lots of supplements.
Just joking about Beyond Blue in case it was obscure.

 

[qldfrog]

Yacon eh? Will check it out. I'm in northern rivers NSW, so I suspect I would need a processed form that I can buy on iHerb.
I have self diagnosed metabolic syndrome or possibly diabetes. I've never gone to a medico to get a diagnosis. I do what I can at home, including almost giving up alcohol, losing some weight more activity, no added table sugar and lots of supplements.
Just joking about Beyond Blue in case it was obscure.

Yacon will grow in your areathey sell it there.

Yacón - Wikipedia

en.wikipedia.org

What you may need this, go for low sugar reduce starch and get good meat fish stop seed oil but use macadamia oil..plentiful in your area, olive oil and butter cream
Edited to correct

 

[Dona Ferentes]

Novo Nordisk says new obesity pill reduces weight by 13.1pc

Ozempic maker Novo Nordisk says its highly anticipated experimental weight-loss pill Amycretin was safe and tolerable for patients in an early-stage trial, with mild-to-moderate side effects.

The company said in March that a phase-one trial of the pill version of Amycretin showed participants lost up to 13.1 per cent of their weight after 12 weeks. That compared to weight loss of about 6 per cent after 12 weeks and 15 per cent after 68 weeks in trials of Wegovy.

Novo presented full data from the phase one study at the European Association for the Study of Diabetes meeting in Madrid on Wednesday.

“What we see in the study period is a 13.1 per cent weight loss with a side-effect profile comparable to what we normally see with incretin-based therapy, so primarily gastrointestinal side effects,” Martin Holst Lange, Novo’s head of development, said.

One serious but non-fatal adverse event was reported during the trial with 60 participants, according to the data presented at the conference. There were no reports of severe side effects for patients taking Amycretin, while there were a total of 242 reports of mild and moderate side effects.

Amycretin targets the same gut hormone that Wegovy mimics, known as GLP-1, but also a pancreas hormone called amylin that affects hunger.
In the Amycretin trial, the side effects were related to gastrointestinal discomfort, including nausea and vomiting, similar to those seen in trials of its other medicines from the same drug class.

 

[Faramir]

Apple Cider Vinegar also reduces the effects of amylin (ie slows it down - slows down the process of breaking up sucrose into its two separate components: fructose and glucose.) ACV also has a lot of other benefits. Just drink a teaspoon with a cup of water through a straw and rinse your teeth straight after.
Why take Amycretin if it makes you feel sick?

 

[finicky]

Tip for anyone nauseated by apple cider vinegar. I hated the stuff but now take it daily diluted with water before my meal. What you can do is have another drink ready to hand - can be anything you like, such as coffee, smoothie, or even a piece of fruit like an orange, but not water. Then you pinch your nose hard and slug down the diluted ACV - all that you'll experience is the neutral acid sensation. Maintaining the pinch on your nose, chase the ACV away with the other drink. It works because the disgusting 'taste' of ACV is primarily olfactory.

 

[Dona Ferentes]

twists and turns...
.

Will Ozempic crush the junk-food business?​

Developers inventing products for big food companies are trying to work out how to sell convenience food to those who suddenly crave fresh fruit.

by Tomas Weber

Trinian Taylor, a 52-year-old car dealer, pushed his cart through the aisles of a supermarket as I pretended not to follow him. It was a bright August day in Northern California, and I had come to the store to meet Emily Auerbach, a relationship manager at Mattson, a food-innovation firm that creates products for the country’s largest food and beverage companies: McDonald’s and White Castle, PepsiCo and Hostess. Auerbach was trying to understand the shopping behaviour of Ozempic users, and Taylor was one of her case studies. She instructed me to stay as close as I could without influencing his route around the store. In her experience of shop-alongs, too much space, or taking photos, would be a red flag for the supermarket higher-ups, who might figure out we were not here to shop.

Auerbach watched in silence as Taylor, who was earning $US150 in exchange for being tailed, propelled his cart through snack aisles scattered with products from Mattson’s clients. He took us straight past the Doritos and the Hostess HoHos snack cakes, without a side glance at the Oreos or the Cheetos. We rushed past the Pop-Tarts and the Hershey’s Kisses, the Lucky Charms and the Lay’s – they all barely registered.

Clumsily, close on his heels, Auerbach and I stumbled right into what has become, under the influence of the revolutionary new diet drug, Taylor’s happy place: the produce section. Taylor used to nurse a sugar addiction, he said, but he can no longer stomach Hostess treats. A few days earlier, his daughter fed him some sweets. “I just couldn’t,” he said. “It was so sweet it choked me.”

For decades, Big Food has been marketing products to people who can’t stop eating, and now, suddenly, they can. The active ingredient in Ozempic, as in Wegovy, Zepbound and several other similar new drugs, mimics a natural hormone, called glucagon-like peptide-1 (GLP-1), that slows digestion and signals fullness to the brain. About seven million Americans now take a GLP-1 drug, and Morgan Stanley estimates that by 2035 the number of US users could expand to 24 million. That’s more than double the number of vegetarians and vegans in America, with ample room to balloon from there. More than 100 million American adults are obese, and the drugs may eventually be rolled out to people without diabetes or obesity, as they seem to tame addictions beyond food – appearing to make cocaine, alcohol and cigarettes more resistible.
The prospect of tens of millions of people cutting their intake down to about 1000 calories per day (about 4200 kilojoules), which is half the minimum amount recommended for men, is unsettling the industry. Late last year, Lars Fruergaard Jorgensen, the chief executive of Novo Nordisk, which makes Ozempic and Wegovy, told Bloomberg that food industry executives had been calling him. “They are scared about it,” he said.
Ozempic users such as Taylor aren’t just eating less. They’re eating differently. GLP-1 drugs seem not only to shrink appetite but to rewrite people’s desires. They attack what Amy Bentley, a food historian and professor at New York University, calls the industrial palate: the set of preferences created by our acclimatisation, often starting with baby food, to the tastes and textures of artificial flavours and preservatives. Patients on GLP-1 drugs have reported losing interest in ultraprocessed foods, products that are made with ingredients you wouldn’t find in an ordinary kitchen: colourings, bleaching agents, artificial sweeteners and modified starches. Some users find that many packaged snacks they once loved now taste repugnant. “Wegovy destroyed my taste buds,” a Redditor wrote on a support group, adding: “And I love it.”

Lusting for the unpackaged​

The day before I followed Taylor around the supermarket, I sat in on a focus group facilitated by Mattson’s consumer-insights team, listening to people describe how the weight-loss drugs have transformed their cravings. Larry Wynns, a 69-year-old, who joined via video call, described being emptied of desire for what he used to love. Before Wegovy, said Wynns, who is now 35 pounds lighter than he was in the spring, his “whole life was fast foods.” Now, “my first place I hit when I get to the store is produce,” he said. “My favourite is Mount Rainier cherries and apples, peaches, pears.”

Most of the other participants felt like that. Almost everyone’s cravings for ultraprocessed foods had been replaced with a lust for fresh and unpackaged alternatives.

Major food companies are scrambling to research the impact of the drugs on their brands — and figure out how to adjust. “The whole field is still a little stunned,” said Ashley Gearhardt, a food-addiction researcher and psychology professor at the University of Michigan. But for Mattson, which for almost 50 years has invented products for the nation’s biggest food conglomerates, the Ozempic threat could be a boon.

I first walked into Mattson’s glassy facility by the San Francisco airport on a beautiful Bay Area morning mid-year. Barb Stuckey, the company’s chief innovation and marketing officer, who describes herself as a hypertaster and whose tongue can detect changes in barometric pressure, greeted me in the hall carrying an armful of milk cartons. I followed her through the lab, past scientists experimenting with gummies and blitzing high-protein smoothies and carrot soup, out back to the “trophy wall”. On the shelves were rows of packages and bottles for products that Mattson had either dreamed up or helped scale and shepherd to market. There were deep-fried chocolate Hostess Twinkies, Hungry-Man frozen meals and arrays of frozen meals, ice creams and condiments from America’s largest brands.

Big Food is practised at spotting perverse openings for new products in our faddish drives for self-improvement. In 1978, for example, Heinz bought Weight Watchers, added products such as cheesecake and made a tidy profit. That acquisition heralded a trend of health-conscious rebranding that peaked in the 1980s and ’90s. Nestlé started Lean Cuisine, and Chef America began selling Lean Pockets alongside its Hot Pockets. (The difference between the two was about 125 kilojoules.) Conagra Brands introduced Healthy Choice, a diet-conscious frozen-meal brand. McDonald’s made McLean Deluxe hamburgers. Nabisco came out with Snack Well’s fat-free cookies.
There is little the industry hasn’t tried to keep health-conscious consumers eating. Companies can seal clouds of nostalgic aromas into packaging to trigger Proustian reverie. When they discovered that noisier chips induced people to eat more of them, snack engineers turned up the crunch.

“I feel like I’m constantly defending Big Food,” Stuckey told me when I brought up the industry’s history. And perhaps she is right to be. Eating is more convenient now, and it can be cheap; poor harvests don’t have nearly the same impact that they might have had in the past. Breakthroughs in processing that made possible products such as dehydrated chicken soups, frozen French fries and Jell-O instant puddings helped reduce domestic burdens on, for the most part, women – many of whom then entered the workforce.

The trade-off is obesity. Caloric consumption per capita in the United States has plateaued since 2000, while Americans have slightly intensified their physical activity. At the same time, the obesity rate has swollen by more than a third. Probably, the culprit is the food. Ultraprocessed products, the consumption of which has increased over the past 25 years, are often highly refined and rich in starch and sugar – we digest them, quickly, in the stomach and small intestine before they get to the colon, which is home to the gut microbiome. As emerging research shows, when we eat unprocessed or minimally processed foods, our gut bacteria consume as much as 22 per cent of the energy. With ultraprocessed products, our bodies soak up all 100 per cent of the kilojoules.

Big food’s answer to changing tastes​

Right now, the industry’s adaptation to Ozempic is in its infancy. While Ozempic is threatening to turn off the industrial palate, Mattson believes that industrial foods may just need to be tweaked. Though many ultraprocessed foods and drinks turn off a lot of GLP-1 users, some are breaking through: on GLP-1 forums, people celebrate Fairlife, a line of sweet protein shakes owned by Coca-Cola. And Mattson has already dreamed up an arsenal of other potential winners.

In a glass-walled conference room, Mattson scientists prepared for me some of its foods tailored to GLP-1 users that are being conceptualised. Amanda Sinrod, a senior food scientist in a white lab coat, placed a plate of soft brown cubes on the table. She explained that she had enriched each NourishFit brownie bite with two grams of whey protein, for maintaining lean muscle mass during rapid weight loss. A peanut butter swirl would push that protein level even higher. Whey protein can have a grainy texture and chalky off notes, but the NourishFits were defectless, smooth and sweet with remote echoes of cocoa. About one-third sugar and about 15 per cent fat, the bite-size portions were “self-limiting,” Sinrod said. Servings could be packaged individually.

Then there was a chicken stick, wrapped in see-through plastic, that looked like a riff on string cheese. “A supercharged mozzarella stick,” Sinrod said. It had 13 grams of protein, and its grill lines were real – for now. (To scale up, the quadrillage, or char marks, might be faked using caramel colouring.) It was a grown-up rendition of a classic kid’s snack, Sinrod said, that an adult could throw in a bag. It tasted felicitously of citrus. (GLP-1 users report craving fresh, acidic flavours.)
A small cardboard tub of salty, freeze-dried chicken soup was followed by no-carb tacos, also chicken, with an endive leaf taking the role of the tortilla. “Taco Bell could go for this,” said Stuckey, who was sitting on the other side of the table and watching me eat. To wash it down: a translucent protein shake in psychedelic purple with lashings of sweetener and lingering medicinal notes of berry.

My Ozempic-optimised banquet was fine, it was fine, but compared with ripe Rainier cherries, I feared, Larry Wynns might have found it a little dull. The mild flavour profiles and engineered textures of Mattson’s inventions were similar to existing packaged foods, such as Betty Crocker cake mixes and Tyson Grilled & Ready chicken strips. Were products like this enough, I wondered, to break through Ozempic’s defences and excite people whose relationship to food has been turned on its head?

Rewiring taste receptors​

GLP-1 drugs change far more than our metabolic processes. There are GLP-1 receptors in the hypothalamus, the area that regulates hunger and signals fullness, and in the brain’s dopamine reward system, the primitive, so-called reptilian desire circuitry involved with addictive behaviours. It seems that GLP-1s, by regulating the release of dopamine, may make the flavour profiles of ultraprocessed products, many of which have been optimised to stimulate the brain’s reward system, less appealing.

Mattson is betting on convenience winning out. Although Larry Wynns is now buying mainly fruits and vegetables, he still turns to Healthy Choice frozen meals in a pinch.

Given Big Food’s track record, it’s likely that the companies will succeed at finding products Ozempic users crave. But what if they’re too successful? I asked Nicole Avena, a professor of neuroscience at Mount Sinai who studies sugar addiction, whether she thought it could be possible for food companies to engineer, intentionally or not, compounds that would make GLP-1 drugs less effective. Avena told me it was plausible. The food industry, she pointed out, has cabinets of formidable, reward-triggering compounds with which to experiment. Companies could end up counteracting the drugs to some degree in their efforts to make foods more rewarding, she said.
I asked Mattson’s chief executive, Justin Shimek, an easygoing, ursine Minnesota native with a PhD in food science, whether he worried about that possibility. He helped invent the chemical formulas that make marshmallows change colour or reveal hidden images upon their contact with milk. But making GLP-1 products, for Shimek, is also personal. He has struggled with his weight since childhood. Early this year, he started taking a GLP-1 drug. His “food noise,” the droning monotone of want that torments many who end up on the drugs, has since vanished – along with more than 22 kilograms. He no longer craves sugary lattes.

Shimek, who is in talks with the “biggest of the big” food companies about designing GLP-1-optimised products, said he was not anxious about Big Food’s trying to overwhelm the brains of GLP-1 users with hyper-rewarding compounds. Taste and pleasure are “very important,” said Shimek, who seemed to be choosing his words carefully, but these were “not the only thing”. There is “an honest desire” in the industry, he added, to support people in their weight-loss journeys. Shimek wouldn’t say which companies he is speaking to about GLP-1 products. “We are professional secret keepers,” he said.
Stuckey had her team think about companies that might be a natural fit for their optimised creations for GLP-1 users. As I was finishing my Ozempic-inspired lunch, they started throwing around ideas. Could the NourishFit brownie become a high-protein cake mix sold by Betty Crocker, a General Mills brand? Or Hostess, Stuckey said, could easily start a GLP-1 line: “Nobody would know it was from Hostess.” Because GLP-1 side effects include gastrointestinal issues, how about reaching out to General Mills, the owner of Fiber One, Stuckey said, and offering to help it design products targeted to GLP-1 users?

A 40-something restaurant owner from Pennsylvania had explained to his fellow participants in the Mattson focus group that, since starting on Wegovy, he now has to force himself to eat. Beef jerky is one thing that’s just about bearable. But his fibre levels are way down. So Stuckey suggested a jerky infused with a fibre source. Maybe inulin? Maybe psyllium husk? “That is a really disgusting idea,” she said. “But we’re good at making things taste good.
.
END

RFK Jr is on to you ..ha ha

 

[Dona Ferentes]

embedded in the story

Barb Stuckey, the company’s chief innovation and marketing officer, who describes herself as a hypertaster and whose tongue can detect changes in barometric pressure..

- hey pal, I'm calling you a fraud.

 

[Dona Ferentes]

Novo Nordisk plunged 20.8 per cent on European markets after the Danish drugmaker revealed disappointing results in a late-stage trial for its experimental next-generation obesity drug CagriSema, wiping as much as $US125 billion off its market value

 

[Garpal Gumnut]

re. Novo Nordisk. And they say Bitcoin has no underlying value. It is all too complicated for me. Eat, drink and be merry for tomorrow we die.

gg

 

[finicky]

Eat, drink and be merry for tomorrow we die.

Undoubtedly Garpal but prolonging 'health span' is the word (two words).

 

[Dona Ferentes]

It’s not just obesity. Drugs like Ozempic will change the world.​

The Economist
02 Jan 2025


Every day seems to bring more exciting news. First, the drugs tackled diabetes. Then, with just an injection a week, they took on obesity. Now, they are being found to treat cardiovascular and kidney disease, and are being tested for Alzheimer’s and addiction.

It is early days yet, but glp-1 receptor agonists have all the makings of one of the most successful classes of drugs in history. As they become cheaper and easier to use, they promise to dramatically improve the lives of more than a billion people – with profound consequences for industry, the economy and society.

In the three years since semaglutide was approved for treating obesity, it has taken America by storm. After decades of disappointing “miracle cures”, these drugs work.
Image-conscious influencers and well-heeled financiers are not their only users. Already one in eight American adults has been on glp-1 drugs. Novo Nordisk, maker of semaglutide, branded Ozempic for diabetes and Wegovy for weight loss, and Eli Lilly, which makes tirzepatide, a more effective alternative, have together added about $US1 trillion ($1.5 trillion) in market value since 2021.

The action is now moving beyond America. With over two-fifths of the world overweight or obese, demand for glp-1 drugs is voracious. Pharma companies are racing to make them work as pills, which would be cheaper to produce than jabs, and to reduce their side effects.

Generic versions for older GLP-1 agonists are entering the market. Semaglutide is to come off patent in Brazil, China and India in 2026; eight such drugs are in the works in China. That is just as well. As incomes in the developing world have risen and life has become more sedentary, people’s waistlines are catching up with those in the West.

Not just curbing obesity​

Curbing obesity would be consequential. Yet glp-1 drugs promise to do much more. Overweight patients on semaglutide have been found to suffer fewer heart attacks and strokes; the benefits, astonishingly, seem to be largely independent of how much weight is lost.

Tirzepatide improves sleep apnoea. Trials show that glp-1 agonists reduce chronic kidney disease in diabetics, and there are signs they may lessen brain shrinkage and cognitive decline in Alzheimer’s. Studies of health records suggest that they may help with addictions, too; people already on glp-1 drugs in America were less likely to overdose on opioids or abuse cannabis or alcohol. Researchers are even talking, in hushed tones, about their anti-ageing effects.
These drugs act in the gut, but they also bind to receptors all over the body and in the brain. They appear to reduce inflammation and interact with mechanisms linked to cravings and feelings of reward. With every new finding, researchers are learning more about the workings of disease and the links between the body and the brain.

Naturally, more work is needed. Although glp-1 agonists have been used in diabetes for 20 years, some of the newer findings are based on observational studies and will need to be supplemented by randomised trials. Patients may need to remain on these medicines for their whole lives, and their long-term benefits have yet to be quantified.

That makes the costs uncertain, too. For now, the drugs are expensive: tirzepatide is priced at over $US500 a month in America. Their immediate side effects, which can include nausea, pancreatitis, diarrhoea and muscle loss, may be off-putting; the effects from decades of taking them are uncertain. Some worry about the medicalisation of everyday life, and whether people will binge, knowing they can fall back on a cure.

Possibilities are thrilling​

Yet with time, experimentation and innovation, the benefits will become clearer, and the costs will come down. Healthy habits and good public health advice will still matter.
But practitioners have long despaired that nothing works for many obese people. If the drugs live up to their early promise, it would be perverse and cruel to deprive patients of medicines that could dramatically improve their lives. The drugs could hold the same promise for addiction.

Stand back and the possibilities are thrilling. In 2019 heart disease, stroke, diabetes, Alzheimer’s and kidney disease ranked among the top ten global causes of death. By 2050, as the world ages and developing countries’ health care improves, these diseases will take a bigger toll.

For patients, the new uses of glp-1 drugs would mean not just longer, healthier and more productive lives, but happier ones, too. In a world of abundance people succumb to their impulses even if they know their behaviour is harmful in the long term. Although glp-1 agonists may limit the pleasure of instant gratification, they promise to end intrusive cravings and improve long-term health.
The total bill for prescribing these drugs could be vast. Yet for governments, they would lower some other costs including medical bills for obesity and the burden substance abuse puts on the criminal-justice system. The state would raise less revenue from taxes on alcohol, but income-tax revenues would go up, as the workforce became healthier.
As the contraceptive pill encouraged women to stay in education and work, glp-1 drugs could lead to profound economic and social change by enhancing productivity and freedom.
Some business models could be upended. If cravings can be controlled, junk-food companies, advertisers and even drug dealers may shift their focus from quantity to quality.

Social norms could evolve. In the West thinness is prized as the ideal of beauty, because for so many it is hard-won, whereas obese people suffer discrimination and lower wages. If being thin is easier, that may change. Obesity and addiction may less often be seen as moral failings, but as illnesses that can be treated. The glp-1 revolution is just beginning. Its promise is tantalising.

 

[qldfrog]

It’s not just obesity. Drugs like Ozempic will change the world.​

The Economist
02 Jan 2025


Every day seems to bring more exciting news. First, the drugs tackled diabetes. Then, with just an injection a week, they took on obesity. Now, they are being found to treat cardiovascular and kidney disease, and are being tested for Alzheimer’s and addiction.

It is early days yet, but glp-1 receptor agonists have all the makings of one of the most successful classes of drugs in history. As they become cheaper and easier to use, they promise to dramatically improve the lives of more than a billion people – with profound consequences for industry, the economy and society.

In the three years since semaglutide was approved for treating obesity, it has taken America by storm. After decades of disappointing “miracle cures”, these drugs work.
Image-conscious influencers and well-heeled financiers are not their only users. Already one in eight American adults has been on glp-1 drugs. Novo Nordisk, maker of semaglutide, branded Ozempic for diabetes and Wegovy for weight loss, and Eli Lilly, which makes tirzepatide, a more effective alternative, have together added about $US1 trillion ($1.5 trillion) in market value since 2021.

The action is now moving beyond America. With over two-fifths of the world overweight or obese, demand for glp-1 drugs is voracious. Pharma companies are racing to make them work as pills, which would be cheaper to produce than jabs, and to reduce their side effects.

Generic versions for older GLP-1 agonists are entering the market. Semaglutide is to come off patent in Brazil, China and India in 2026; eight such drugs are in the works in China. That is just as well. As incomes in the developing world have risen and life has become more sedentary, people’s waistlines are catching up with those in the West.

Not just curbing obesity​

Curbing obesity would be consequential. Yet glp-1 drugs promise to do much more. Overweight patients on semaglutide have been found to suffer fewer heart attacks and strokes; the benefits, astonishingly, seem to be largely independent of how much weight is lost.

Tirzepatide improves sleep apnoea. Trials show that glp-1 agonists reduce chronic kidney disease in diabetics, and there are signs they may lessen brain shrinkage and cognitive decline in Alzheimer’s. Studies of health records suggest that they may help with addictions, too; people already on glp-1 drugs in America were less likely to overdose on opioids or abuse cannabis or alcohol. Researchers are even talking, in hushed tones, about their anti-ageing effects.
These drugs act in the gut, but they also bind to receptors all over the body and in the brain. They appear to reduce inflammation and interact with mechanisms linked to cravings and feelings of reward. With every new finding, researchers are learning more about the workings of disease and the links between the body and the brain.

Naturally, more work is needed. Although glp-1 agonists have been used in diabetes for 20 years, some of the newer findings are based on observational studies and will need to be supplemented by randomised trials. Patients may need to remain on these medicines for their whole lives, and their long-term benefits have yet to be quantified.

That makes the costs uncertain, too. For now, the drugs are expensive: tirzepatide is priced at over $US500 a month in America. Their immediate side effects, which can include nausea, pancreatitis, diarrhoea and muscle loss, may be off-putting; the effects from decades of taking them are uncertain. Some worry about the medicalisation of everyday life, and whether people will binge, knowing they can fall back on a cure.

Possibilities are thrilling​

Yet with time, experimentation and innovation, the benefits will become clearer, and the costs will come down. Healthy habits and good public health advice will still matter.
But practitioners have long despaired that nothing works for many obese people. If the drugs live up to their early promise, it would be perverse and cruel to deprive patients of medicines that could dramatically improve their lives. The drugs could hold the same promise for addiction.

Stand back and the possibilities are thrilling. In 2019 heart disease, stroke, diabetes, Alzheimer’s and kidney disease ranked among the top ten global causes of death. By 2050, as the world ages and developing countries’ health care improves, these diseases will take a bigger toll.

For patients, the new uses of glp-1 drugs would mean not just longer, healthier and more productive lives, but happier ones, too. In a world of abundance people succumb to their impulses even if they know their behaviour is harmful in the long term. Although glp-1 agonists may limit the pleasure of instant gratification, they promise to end intrusive cravings and improve long-term health.
The total bill for prescribing these drugs could be vast. Yet for governments, they would lower some other costs including medical bills for obesity and the burden substance abuse puts on the criminal-justice system. The state would raise less revenue from taxes on alcohol, but income-tax revenues would go up, as the workforce became healthier.
As the contraceptive pill encouraged women to stay in education and work, glp-1 drugs could lead to profound economic and social change by enhancing productivity and freedom.
Some business models could be upended. If cravings can be controlled, junk-food companies, advertisers and even drug dealers may shift their focus from quantity to quality.

Social norms could evolve. In the West thinness is prized as the ideal of beauty, because for so many it is hard-won, whereas obese people suffer discrimination and lower wages. If being thin is easier, that may change. Obesity and addiction may less often be seen as moral failings, but as illnesses that can be treated. The glp-1 revolution is just beginning. Its promise is tantalising.

Interesting but all the other extra bonus from snoring to heart attack imho are just benefit of weight loss.
There is still for me a moral issue:
Overeat shxt food and pop up a few pills for your "illness" and all is good..
Yeah i am not millennial enough, but tempting to throw the sponge: i lost weight with IF, but it is never an easy battle.
Based on my scale, i am still overweight ..humm, these Christmas meal and Toblerone are still tempting and a pill would be so easy, just need labor to put it on subsidised ...

 

[Dona Ferentes]

Am in agreement there QF; too many "easy solutions" available

 

[qldfrog]

Am in agreement there QF; too many "easy solutions" available

I hope this was not irony
There is no "free meal" with medication, we tweak the metabolism to compensate for an existing excess and so it is nearly a given we will alter the balance.
With side effects
We just do not know it yet

 

[Dona Ferentes]

I hope this was not irony
There is no "free meal" with medication, we tweak the metabolism to compensate for an existing excess and so it is nearly a given we will alter the balance.
With side effects
We just do not know it yet

cricket not tennis (straight bat not spin)

I only have to look at some people on a cocktail of tablets / drugs, one or 2 for original condition and a Webster pack full of tweaks. Scary.