[swatcoder]

> it could save the health care industry billions as these people with obesity will otherwise require epesneive treatments if the remain obese.

"Could" is doing a lot of work there. We don't really know what to expect for these patients 20 or 40 years out.

Long-term outcomes and population-scale polypharmacy risks are not really clear, and won't be for decades.

These drugs enable a valuable intervention for individuals at high risk of health hazards and it's fantastic that they're available, but the perspective changes when you look at outcomes for tens (hundreds?) of millions of people over long spans of time -- there are a lot of inescapable unknowns. One can't actually be sure that the benefits of fast, widespread use will outpace the costs, or at what scale.

Many genuinely effective drugs have gone through exactly this kind of hype cycle only to lead to regret, embarassment, and/or skepticism later on.

Good science, and the good public policy that's informed by it, moves slowly.

[bryanlarsen]

Liraglutide has been in wide use for 14 years and trialled for a decade before that; we do have a good idea of what to expect for patients 20 years out.

Semaglutide was approved in 2017 and been very widely used (>9 million people). That's been wide & long enough to determine that risks are either exceedingly rare or significantly slow acting.

OTOH the risks and costs of obesity are massive and well known. We're weighing massive known benefits against risks that are either rare (likely less than 1 in a million) or take decades to manifest.

[moate]

Exactly. I’m old enough to remember the Fen-Phen fallout.

A truly harmless weight-loss drug is the white whale of the pharmaceutical (assuming it can be profitable enough to offset the losses that would go along with the decrease in needed treatment for problems ancillary to obesity). These drugs, so far, seem pretty good but some of the side effects should take the shine off for people who thing this is ”The Cure” for obesity.

[mech422]

check out the DES babies (0) or Thalidomide if you want to see how little we understand long term effects...My mom was a nanny and one of the girls she raised was born sterile due to DES her mom was given _to support pregnancy_ !

0) https://en.wikipedia.org/wiki/Birth_defects_of_diethylstilbe...

1) https://en.wikipedia.org/wiki/Thalidomide_scandal