[bartwr]

It's interestingly disingenuous that many claim of GLP-1 agonist miraculous effects on all kinds of health problems, where the same problems are "simply" solved by getting on a calorie deficit and lean. Liver, kidneys, heart, etc. If you have a non-alcoholic fatty liver disease and are obese, getting leaner will heal it. All those impressive results are on obese or diabetic people. So it is not only not a surprise, but also dishonest marketing or ignorance.

Don't get me wrong - those are miraculous drugs. First real non-stimulant low side effect appetite suppresion that will help millions. But let's wait for honest research on lean people before spreading marketing on how it improves overall health.

Also, how nobody mentions the need for increasing the dosage and tolerance build-up (just check reddits how much people end up having to take after months of continuous use). You cannot be on it "for life".

[bbatha]

The increasing dosage is to tritrate up to a dose not because you gain tolerance. There are patients on GLP-1 for over a decade. Also maintenance and weight loss dosages are different: see the dosing charts for ozembic vs wegovy which are exactly the same drug.

Even if folks gain tolerance that doesn’t seem overly concerning. Mental health drugs also have tolerance issues and changing medicines every few years, while it has challenges for the patient, is an accepted part of long term psychiatric treatment.

[leetnewb]

Just a narrow comment, but type 2 diabetes certainly isn't limited to the obese. Many lean people develop issues with blood sugar that can't be controlled with diet alone.

[bearjaws]

A friend's son, who is an EMT, was recently diagnosed with type 2 diabetes at the age of 21. He doesn't drink or eat sweets, except on holidays, and works out five days a week. Suddenly, he started feeling sick, was vomiting, and ended up in the ER, all within three days. It can really hit you like a truck.

[corry]

This is my #1 question on GLP-1: are we just seeing how humans do much, much better by being lean vs. the direct result of the drug?

A lean current-epoch human -- with our food abundance, access to modern medicines, higher standards of life, lower risks of injury, etc -- is likely going to be markedly healthier than a non-lean current-epoch human or a lean human from a prior age where medicine/food/etc was worse.

Or is it, in fact, the direct result of the drug?

[pdabbadabba]

> where the same problems are "simply" solved by getting on a calorie deficit and lean

Except that there apparently is mounting evidence that GLP-1 agonists also address some issues that are not generally addressed by just restricting calories. TFA touches on this briefly: "The weight loss involved with GLP-1 agonist treatment is surely a big player in many of these beneficial effects, but there seem to be some pleiotropic ones beyond what one could explain by weight loss alone."

I seem to recall seeing claims that they reduce COVID-19 mortality even controlling for BMI (possibly because they inhibit systemic inflammation), reduce alcohol consumption, and even (though I think just anecdotally) may help overcome gambling addiction.

See, for example:

https://pmc.ncbi.nlm.nih.gov/articles/PMC8425441/ [COVID-19]

https://www.ncbi.nlm.nih.gov/search/research-news/19361/ [Addiction]

[majormajor]

I don't know that you have to be disingenuous to both be enthused about these medications AND wish we'd never created the super-processed, super-sugary, make-people-crave-them-and-overeat-them modern American diet. Once you fuck with your gut biome for long enough it's not "simple" to solve it. It's incredibly difficult both discipline and metabolism-wise.