[A_Duck]

I expect a second-order effect of cheap GLP-1s ending obesity will be to relieve the pressure on food manufacturers to make their products actually healthier

There are many other risks* than obesity from consuming UPFs, and we may find we've just removed the main stop-loss on worse outcomes

*Diabetes, all the biome/gut stuff which is getting better understood, colon cancer, etc etc

[stdbrouw]

The thing about second order effects is that they are almost never larger than the first order effect.

Furthermore, GLP-1 users report having fewer cravings or just reduced appetite in general, whereas what you describe would require some sort of "calorie reduction pill" which would allow people to lose weight without altering their relationship to food. But that pill does not exist.

[immibis]

FWIW it exists: https://en.wikipedia.org/wiki/Orlistat

[stdbrouw]

Hah! Thanks for the correction.

[estearum]

> The thing about second order effects is that they are almost never larger than the first order effect.

Sounds clever but this is just a labeling trick. When a second order effect is larger than the first order one, we just rename them to first order and intermediate effects.

For example, the first order effects of growing GLP-1 prevalence are actually consumption of prescription pads, new demand on pill bottles, and gas consumption of pharma sales reps.

The second order effect is weight loss in patients who take the drugs.

[stdbrouw]

Cute and thus worthy of an upvote, but whenever I see scientists or economists refer to first or second order effects it pertains to things that are subsequent to each other in time, or at least intended vs. ancillary. I don't think anyone except for a Stafford "the purpose of a system is what it does" Beer acolyte would designate new demand of pill bottles as the first order effect of a new medication.

It's just something that statisticians have observed across many fields: you theorize about how potentially huge a particular interaction effect or knock-on effect could be relative to the main effect, you read about the Jevons Paradox and intuitively feel that it can explain so much of the world today... and then you get the data and it just almost never does. No reason why it couldn't, just empirically it rarely happens.

[estearum]

The demand for pill bottles literally does grow before anyone takes the medication, no?

And correct I agree they wouldn't designate the demand for pill bottles as the first order effect. That's because despite happening first, it's not the most important object of analysis. That's why it's a disproof of your earlier claim that second order effects aren't more significant than first order ones: because if they were, they'd be considered the first order effect.

[skissane]

> The demand for pill bottles literally does grow before anyone takes the medication, no?

Only really in the US. In most other countries they use blister packs instead. Global consumption of blister packs is so huge (not just for prescription medications, also OTC, vitamins, supplements, and complementary medicines), even a blockbuster medication likely only makes a modest difference to manufacturer demand in percentage terms.

[skissane]

> For example, the first order effects of growing GLP-1 prevalence are actually consumption of prescription pads, new demand on pill bottles, and gas consumption of pharma sales reps.

I take injectable tirzepatide prescribed by an electronic prescription… so impact on pill bottle demand and prescription pad demand in my case is literally zero.

And I doubt pharma sales reps have a lot of work to do selling GLP-1 agonists-who needs to convince doctors to prescribe a drug when there’s dozens of patients inquiring about it?

Yes the article is about pills, but most people are on injectables still (that may change over time). It likely has increased demand for needles and sharps containers. But in dollar terms, that’s a small percentage of the demand for the medication itself.

[estearum]

...

You are missing the point.

s/pill bottle/blister pack/

s/prescription pad/e-prescriber submissions/

All irrelevant to the convo :)

[skissane]

They are all irrelevant to everything, because in dollar and percentage terms they are a drop in the ocean

[triceratops]

On the contrary, it may force them to make the products healthier. I've heard many GLP-1 users reporting an aversion to processed foods and cravings for healthy food.

[sergioisidoro]

I was thinking exactly this. People consume processed foods because they highjack our evolutionary responses. If GLP1 agonists make people immune to those high fat, big carb diets, perhaps we would see a decline of these strategies and instead seeing companies compete for the low appetite of people through smaller quantity yet high quality foods, rather than fast large quantity food.

[thrwaway55]

This feels overly optimistic. You want to optimize for existing foods that are still high fat big carb and don't have the quality qualifier. I'm not familiar with the biological pathways that GLP1 operates on but I'm sure food companies will be working on adversarial products

[cheald]

My experience hasn't been aversion so much as just total apathy. The magic they once held is completely broken, and I'd rather eat real food.

[dexwiz]

Ancedata, but those around me on it seem to have a lower tolerance for fatty and oily food, also increased sensitivity to sugar.

[mrguyorama]

Eating healthier for a while itself will reduce your palette for these foods, and make normal food taste better.

If you limit your sugar intake for a bit, American bread becomes quite the tasty treat.

It might not be direct action of the medication, but the medication making it easier to fix your habits can have huge dividends, similar to how giving an ADHD person stimulant meds make them less likely to die from misadventure or substance use because they self medicate less.

[cptskippy]

> UPFs

I think the current NOVA Classification for Ultra Processed Foods is flawed and often drops food containing preservatives and stabilizers into the same bucket as nutritionally poor items.

It also doesn't do a good job distinguishing value or health outcomes from consumption and simply lumps all UPFs into the same bucket. In otherwords fortified whole-grain breads and sodas are both UPFs but objectively they are not the same in terms of nutritional value or health outcomes.

The NOVA Classification's intent is to flag products where processing replaces whole foods, or adds cosmetic or functional additives to engineer taste/texture. It doesn't really factor in actual nutritional value or health outcomes from consumption.

We need to come up with a better system to identify to denote healthy or unhealthy foods, and also to identify foods that contain ingredients that have unknown impacts on our health outcome. Our current regulatory environment is to permit until proven harmful, so having something to flag x-factor ingredients would be beneficial.

[adolph]

> pressure on food manufacturers to make their products actually healthier

Probably not. Food manufacturing is not high margin. The things that would make "products actually healthier" are higher cost both in terms of inputs and in terms of shorter shelf life.

If people eat less and total sales volume decreases, there will not be additional money to change products lines. Expect corporate consolidation and a focus on children and glp-holdout populations, similar to cigarette manufacturers.

Similar to vapes, I could see the development of "ceremonial foods" that are chewed but not swallowed, like gum but with broader effects. Imagine something that approximates the experience of the crinkly bag, oily smell and physical crunch sensation of chips that then evaporates after the crunch. It would maybe even have a double bag for discretely spitting out the too small to crunch anymore shards of a saliva-phobic food grade meta-material.

[wolvoleo]

They'll just make the food more expensive. It's something they've been doing for decades, sneakily.

I remember the YORKIE bar which had the letters of the name stamped on each piece (it was a segmented chocolate bar).

Eventually someone in my house noticed the stamped letters were gone, turned out they moved to a smaller bar with only 5 segments. It was hard to notice otherwise.

[kingstnap]

In practice, food manufacturers actually market "protein fortified" versions of products for GLP-1 users.

The idea is basically that doctors recommend you keep a high protein diet while on the drugs because a calorie deficit without protein will lead to muscle wasting.

[ceejayoz]

> relieve the pressure on food manufacturers to make their products actually healthier…

Maybe, but with the new pressure of "people are eating less" to deal with.

[array_key_first]

Even if there are other poisons, eating less poison is still better than eating more poison.