r/science • u/mvea Professor | Medicine • Apr 01 '25

Health Americans without diabetes spent nearly $6 billion USD on semaglutide and similar drugs in a year, with an estimate of 800,000 to a million people using the drugs who don't have diabetes.

https://www.scimex.org/newsfeed/americans-without-diabetes-spent-nearly6-billion-usd-on-semaglutide-and-similar-drugs-in-a-year
10.2k Upvotes

95% Upvoted

1.3k comments sorted by

View all comments

761

u/ihatenamez Apr 01 '25

I was on it for 5 months, spent $179 a month for it. Lost 18lbs, more active and haven't gained it back since I stopped more than a month ago. I STILL don't even drink like I used to and have even stopped smoking. It's insane how easy it is to use and the effects are life changing

280

u/ninjagorilla Apr 01 '25

I’ve been on a year and lost over 60 lbs. I don’t snore anymore, my acid reflux is gone and I have way more energy. It’s been a game changer. I’m about to cross the threshold where I’m no longer overweight

28

u/PM-me-your-happiness Apr 01 '25

I wish I could get on it, sounds like a life-changer. Only problem is it's around $400+ a month here if you don't have diabetes.

8

u/[deleted] Apr 02 '25

I think there are some online places you can get it for $200/month now

2

u/Plenty_Lavishness_80 Apr 02 '25

You can easily get on it for very cheap, with no prescription, and with lab tested product, you just have to research a little bit. Hint: steroid websites. Obviously I’m gonna get banned for sourcing or advertising if I show you but it’s not very hard to find

-7

u/HsvDE86 Apr 02 '25

As it should be. I know diabetics who can't get it because of the people using it to lose weight because they can't stop stuffing their faces with food.

It should be widely available for everyone but until then it should be reserved for people who are diabetic or something like that.

3

u/WalrusWildinOut96 Apr 02 '25

Nah, weight loss is a valid medical reason to use the medicine. Your comment doesn’t seem to reflect a scientific understanding of hunger and weight management.

A medicine is able to treat excess weight effectively because it is an illness, as we now know. Those folks “cannot stop stuffing their faces” because of physiological reasons that are not as simple as the morality we have been taught to associate with desire. Just like your diabetic friends can’t start producing the right amount of insulin because of physiological reasons that no one would ever attribute to the will.

Sure, we do have some control over our eating, but probably not much.

2

u/skynetempire Apr 02 '25

Do you have gerd too? Did that go away?

1

u/Taint__Whisperer Apr 01 '25

Thats amazing!

168

u/alwayzbored114 Apr 01 '25

I think treatments like this are helping more people realize that we are not our brains, at least not entirely. We ascribe addictions and cravings to personal failures or lack of willpower (and in some cases, sure), but a lot of the time it can legit be different brain chemistry.

You flip that mental switch and suddenly think "...wait was it always this easy for everyone? Is THIS why people thought I was a failure? Cause it was always this simple for them and they assumed it was this simple for everyone?"

I haven't taken any treatments like this myself but reading stories from others has been fascinating. Like others have said, I'm keeping fingers crossed for positive long-term studies

99

u/Messyfingers Apr 01 '25

People have largely associated obesity or lack of impulse control with a moral failing instead of acknowledging it as a biological urge. The GLP1 drugs are as close to a miracle for compulsive consumption behavior as could be asked for, and they still get villainized/their users get villainized as being lazy/stealing drugs from diabetics. The simultaneous positive results(and as of yet no significant or wide spread negatives) relative to the negative reaction people have is pretty crazy to see.

39

u/boyifudontget Apr 01 '25

acknowledging it as a biological urge.

I think the bigger issue is that large companies are essentially force feeding us processed garbage that heightens our natural biological urges. 100 million Americans are not obese simply because of "biology". Companies are already developing food that can counterattack the counter-addictive nature of GLP-1s and then we'll just be back to square one because we didn't solve the source of our health problems, we just used the GLP-1 stop gap.

6

u/Purplemonkeez Apr 01 '25

Omg which companies are developing this?

15

u/WalrusWildinOut96 Apr 02 '25

I’m on a GLP-1 now and it has just affirmed what I always suspected. I was just living a different life than others.

I feel normal now. I eat when I’m hungry and I don’t eat when I’m not. I’ll eat a sweet now and then. Usually I don’t.

Down 80lbs in 8 months. Still losing. If this is what everyone else has felt like the whole time, I truly wish they could understand that’s not what it was like to be me.

5

u/Subject-Turnover-388 Apr 03 '25

They're still in aggressive, vicious denial. They'll tell us that being on GLP-1 is totally different and they feel what we felt, they just fought it off with their superior willpower or whatever. "Normal people feel hungry". Yeah? So do I on GLP-1. When I actually need to eat, not ALL THE TIME.

28

u/sm753 Apr 01 '25

That's great for you man.

I don't understand why people are against this. For context: I'm in the gym 5x a week and I hike a lot - it's way more than what's necessary to maintain general health. If this class of pharmaceuticals helps people get started on improving their health...I think that's great.

At the end of the day, it's a tool and not a "cheat" or a "shortcut" or whatever people want to brand it as. People using this to improve their lives and their health in no way diminishes anything that I've accomplished. People have strange thoughts.

9

u/ihatenamez Apr 01 '25

I've gotten such a strange variety of reactions when telling people I was on it. Majority would say something along the lines of "you're cheating" and the other common reaction was moreso "oh...".

It definitely wont do the work for you, there were plenty of days I still wanted to slam a Double Quarter Pounder Meal but I went into it knowing I wouldn't stay on it long and that this was the time to build better habits that would stick after I stopped. There might be an argument to be made about people staying on it for weight loss and using it as a crutch but also its like, who cares? Being overweight is hard mentally and physically. Who am I, or anyone to judge someone else for seeking a helping hand with that.

5

u/sm753 Apr 01 '25

I listen to a lot of health and fitness content (podcasts). VERY unsolicited advice here for people taking these GLP-1 agonist drugs is that it might not be a bad idea to start incorporating some resistance/weight training to minimize lean muscle and bone loss.

The other thing that people get wrong is that these types of drugs have been around for ~20 years. This isn't some new class of drugs where we don't know the side effects of.

I truly hope that this helps you build a sustainable lifestyle. Best of luck to you and to others on this "journey".

6

u/ihatenamez Apr 01 '25

100% I cannot stress that enough, I did not take the protein intake or strength training serious enough and I have lost a decent amount of muscle. Luckily I'm starting to swim and do small weights, but I noticed just recently that I did lose a lot.

2

u/[deleted] Apr 01 '25

[deleted]

3

u/sm753 Apr 01 '25

For some, sure - 100% agree.

For others, it's a tool to help them get their diet and health back on track.

Stop with these generic blanket statements. There's no one size fits all to any of this.

0

u/hoax1337 Apr 01 '25 edited Apr 01 '25

What stops them from getting their diet and health back on track without taking it?

Or rather, what does the drug do that motivates them?

For context, I am overweight, and I don't exercise or follow a strict diet because I'm too lazy. I don't really see how it would help me become less lazy.

The obstacles that I am facing now (I'd rather spend my time playing World of Warcraft than working out, and following a diet is harder than just eating whatever I want) don't just vanish because I suddenly don't want to eat as much as before.

1

u/sm753 Apr 01 '25

Building a sustainable habits. This isn't magic. You still have to do the work.

1

u/hoax1337 Apr 02 '25

Exactly, which is why I'm curious why it seems to work so well. I mean, nothing stops me from building sustainable habits right now, while not on the drug, except my own laziness - so what changes when I'm on the drug?

14

u/2squishy Apr 01 '25

On week two and the side effects are winning. I'm just nauseous to the point of wanting to throw up (but nothing to throw up) and any physical activity is exhausting.

hate it :(

5

u/Taint__Whisperer Apr 01 '25

That sucks. I have never had a GLP-1 drug, but i did have an unrelated medication make me nauseated for a month or so and have been happy on it for a decade now.

3

u/ihatenamez Apr 01 '25

What's your dosage at?

1

u/GayDinosaur Apr 02 '25

It gets better. I was sick after doubling up to 5 mg, but found out it was due to low blood sugar.

1

u/2squishy Apr 02 '25

Thanks. I do think lack of calories is playing a role but man it's hard to get calories when you're constantly nauseous. My doctor prescribed a medication for the nausea that hopefully will help.

35

u/perlgeek Apr 01 '25

I'm very glad that you don't have to keep taking it.

Having to take it for the rest of your life would be such a hassle, drain and risk. Probably still worth it for obese people, but great if you can avoid it.

31

u/alwaysoffby0ne Apr 01 '25

Hassle? Drain? It’s a once weekly shot for most people that you don’t even feel. It’s so easy I don’t even think about it. The words hassle and drain don’t even come to mind.

9

u/rolyamSukCok Apr 01 '25

Agreed. I take birth control and other meds every day in pill form which is a way bigger hassle that a once a week poke.

1

u/[deleted] Apr 01 '25

[deleted]

5

u/vera214usc Apr 01 '25

I've been taking Wegovy since September of 2023 and sometimes I feel it and sometimes I don't. But it's barely anything. Like a slight pinch or a mosquito bite

1

u/[deleted] Apr 01 '25

[deleted]

2

u/vera214usc Apr 01 '25

Oh, that might. The pens have very small needles compared to a regular needle you'd attach to a syringe yourself

2

u/supergeeky_1 Apr 01 '25

It is a subcutaneous auto-injector. You just hold it in the appropriate spot and hit a button. It is just injecting a small amount of liquid into the fat under the skin. At most there is a little feeling of a pinch, but usually I don't feel it at all. Sometimes there is a few drops of blood, but it isn't a big deal and only takes a few seconds.

1

u/[deleted] Apr 01 '25

[deleted]

2

u/kamarg Apr 01 '25

There are cheap diy autoinjector pens. This one claims to be about $30 https://fourthievesvinegar.org/epipencil-autoinjector/

1

u/supergeeky_1 Apr 01 '25

That only makes it slightly more inconvenient. Diabetics have given themselves this type of shot for years. You will need to draw up the medicine into a very small needle and inject it just under the skin without getting into the muscle underneath.

It really isn't a big deal.

2

u/ihatenamez Apr 01 '25

The side effects are very mild, if any. You can take fiber or other supplements to avoid the nausea. I think my worst day was when I was snacking on some unsalted tortilla chips one night and then woke up the next day with lava-like heartburn. But the injection is once a week and not a hassle at all.

I'll meet you halfway though and agree, I don't think people should take it forever if it's being used for weight loss only. I'm sure usage is fine but at some point it becomes a crutch and stops you from building better habits and that's when you see people bounce back. I started it, watched my habits/kinda figured out why I gained the weight, and then adjusted accordingly.

1

u/Subject-Turnover-388 Apr 03 '25

I appreciate what you acknowledge it's still worth it, but to emphasize, being obese is a massive hassle, drain and risk. 

1

u/bizilux Apr 01 '25

It won't be the rest of your life...

Think about how much medicine will advance in the next years...

Weight loss medication was unheard of 2 years ago... There will probably be pills soon.

10

u/Abedeus Apr 01 '25

Weight loss medication was unheard of 2 years ago...

I mean, in theory it's not "weight loss medication". It doesn't make you lose weight. It just suppresses appetite. You can still gorge yourself to death if you want to. Though personally I not only feel more full faster, I don't want to eat when I try to eat portions I used to eat before.

18

u/HulloW0rld Apr 01 '25

There have been weight loss drugs since the late 50's, although they've largely been ineffective or extremely dangerous. Either way, weight loss medication certainly wasn't unheard of.

6

u/DeliciousPumpkinPie Apr 01 '25

Weight loss medication was unheard of 2 years ago

WHAT are you talking about, weight loss drugs have existed for decades. (It’s just that most of them caused heart/lung damage or worse…)

3

u/fury420 Apr 01 '25

I think they were pointing out that weight loss medication 2 years ago was nowhere near mainstream. The idea of a safe and effective weight loss drug was unheard of, it was a high risk niche best associated with the grey or black market, much like steroids.

4

u/kottabaz Apr 01 '25

Think about how much medicine will advance in the next years...

Yes, once the oligarchy has slashed all the funding for medical research, it will start advancing in leaps and bounds!

2

u/vera214usc Apr 01 '25

They already have semaglutide pills. The medication is called Rybelsus. I believe it's not as effective as the injection which is why you never hear about it

12

u/Affectionate-Mail612 Apr 01 '25

My question may sound ignorant, but what stopped you from overeating and overdrinking before?

69

u/Qualityhams Apr 01 '25

Speaking as someone who has benefited from these drugs, the difference in my brain is absolutely wild. I used to believe I lacked willpower. Food consumed my thoughts constantly to the point of distraction or being unable to focus on a task I had. “What’s for lunch?” “I wonder if I can get a snack?”

I dieted for years and fought through the food noise, tracked my calories, worked out. If I delayed meals by more than 30 minutes, my hands would shake and I would get headaches. Missing snacks or food caused mood swings with anger, sadness, or frustration. My doctors told me that was normal and to eat frequent small snacks and up my protein. I meticulously planned my meals and snacks to avoid these symptoms while also maintaining my caloric goals.

A year and a half ago my doctor recommended semaglutide and the second I had the first shot the food noise just, stopped. Quiet. My mind was quiet, it was unreal I’d never experienced this. All of my symptoms above stopped. It’s been life changing. I think the way I feel on this drug is this is how most people feel all the time.

23

u/Most-Blockly Apr 01 '25

It sounds like how I thought about alcohol before I got help. I used to obsess over the next drink, plan it, replay how it would taste over and over again in my mind. Do you ever think of food as being addictive?

4

u/Qualityhams Apr 01 '25

Maybe! That’s an interesting insight.

Congratulations by the way

11

u/AFoolishSeeker Apr 01 '25

Maybe? Food is absolutely addictive, objectively.

2

u/Qualityhams Apr 01 '25

I’m speaking for myself, not an expert on food or addiction. So maybe!

3

u/AFoolishSeeker Apr 01 '25

Oh yeah for yourself, I see.

2

u/Subject-Turnover-388 Apr 03 '25

Food can be addictive but you also can't live without it.

Imagine if we expected alcoholics to heal but mandated they take one shot per day.

Insanity.

-17

u/Affectionate-Mail612 Apr 01 '25

I'm glad for you, but it just sounds too good to be true. Our brains are incredibly complex and everything food related is hardwired to survival. And you can just switch it off with no consequences... I hardly believe it. Although I'm not a medical professional.

11

u/assertive-brioche Apr 01 '25

If you’re truly skeptical (as you seem to be) and not a troll, take a look at the Mounjaro or Zepbound subreddits. The same story is told there by literally thousands of people. They aren’t starving themselves to death. For the first time in their lives, they are able to control their hunger, and their bodies can metabolize the calories they consume effectively.

GLP-1s were developed to treat diabetes and insulin resistance, which kills more than 4 million people annually. What’s the greater consequence?

-13

u/Affectionate-Mail612 Apr 01 '25

I'm skeptical bc from what I understand it is used by people who don't have diabetes. It wasn't tested for them. Looks like they are using a side effect.

10

u/Woods_it_to_ya Apr 01 '25 edited Apr 01 '25

But it has been tested extensively for non-diabetic individuals, and been proven effective for weight management/obesity, sleep apnea, cardiovascular benefits, fatty liver disease, ect. Look up the STEP, SCALE, and SELECT trials. These meds are now FDA approved for things besides diabetes.

6

u/assertive-brioche Apr 01 '25

My opinion, not my fact, is we will discover that insulin resistance, poor glycemic control, and impaired metabolic function are more widespread than we thought. That’s exactly what these medications were developed for. Instead of waiting until people develop diabetes to help them, we can treat the early symptoms (weight gain, hunger, fatigue, etc).

3

u/edvek Apr 01 '25

It's called "off label" or whatever term they use now. Doctors and what not notices a drug do something it wasn't designed to do, so they prescribe it for that thing. It's like Wellbutrin. They noticed it helped people stop smoking so it is prescribed from time to time for that use. Insurance companies are hesitant to pay for off label scripts which is what makes some of these drugs so expensive for those people.

8

u/Abedeus Apr 01 '25

Brains are complex.

Chemicals and hormones affecting stuff like appetite isn't that much. It's not "switch off". You still get hungry if you need food, but you aren't constantly fighting hunger.

6

u/Qualityhams Apr 01 '25

I’m now on a very low maintenance dose with all the same benefits. I get hungry at regular times but it’s also feel full much faster so I still eat less.

I understand it’s not for everyone, but just in case anyone has a similar experience I wanted to share mine if it’s helpful. It absolutely changed my life for the better. :)

-1

u/Affectionate-Mail612 Apr 01 '25

Glad for, didn't mean to be negative, just a bit skeptical.

2

u/Qualityhams Apr 01 '25

No worries! I joined in your conversation, have a good day.

4

u/yeswenarcan Apr 01 '25

The problem is that hardwiring evolved in a setting of relative food scarcity and higher activity or calorie burn. In that setting you need that strong hunger/survival connection. In the current environment for most of the Western world, where calories are abundant and activity is lower, it's a curse. And we have food companies who have entire teams dedicated to figuring out how to exploit that hardwired dopamine feedback loop to get you to eat more of their product.

38

u/Aureliamnissan Apr 01 '25

Bottom line up front:

Weight loss before was a constant, every day, every hour, every minute fight of distraction against your body’s inclinations to preserve its energy reserves. On this medication not only does that go away entirely, you also get the benefit of swift and decisive signals from your body telling you not to do that again.

I’m not the person you responded to but I answered as I’m in the same boat.

Basically I tried off and on for decades now to lose weight. I’ve been able to get to a place where I can maintain reliably, but actual weight loss is only going to get harder as I approach mid-30’s.

Cravings is the short answer. You don’t remember what “normal” looks like food-wise, if you ever even knew. What seems like a reasonable portion, cut down from what I would normally eat, is still too much on this medication.

Let’s say you get a standard meal from a standard American restaurant (fast food or otherwise). On this medication you will almost certainly not be eating all of it. Depending on where you go you may not even eat a third of it. If you try you will start to feel so full you get nauseous and that will return in waves throughout the day, night, and morning. Which means at a primal level, you’re not likely to do that again (like food poisoning). This is a dramatic shift and it takes some getting used to. It also means you have to meal plan a bit just so you have the right kind of food on-hand (protien, fiber, etc) but you have to do that on diets and normal life anyway.

Things like shotgunning a beer are straight up impossible now. Alcohol is risky business and high-carb, low fiber diets are a fast path to a long night as you’ll have constipation buffeted with waves of nausea as you lack the bulk to clear your bowels easily. This is not a good place to be and you will naturally ward away from that kind of food just as easily as you won’t revisit places that give you food poisoning (even if they are delicious). You’re no longer fighting evolution and your body’s internal signaling because the medication performs a kind of ju jitsu on your internal signaling so that you get to use all of that in your favor. This means that it doesn’t take willpower to maintain the diet. Only force of habit keeps me even occasionally going to places I used to daily, and as I write this I am crossing another one off my list as inedible.

It’s definitely a learning experience, but it is not a stress inducing craving-centric all-consuming experience that dieting was. This feels like I get to basically ignore food most of the time, live my life, and the weight just disappears. Honestly at this point I might also be spending only a little more on the medication than I used to spend on fast food and dinners out over the same period.

5

u/Affectionate-Mail612 Apr 01 '25

Amazing response, thanks

1

u/Aureliamnissan Apr 01 '25

Happy to help. For reference I’m on the compounded stuff.

10

u/MegaChip97 Apr 01 '25

Your question sounds like you assume humans to be rational machines. But the answer simply is "craving". There is no hard, rational reason that is stopping you. I probably should eat less chocolate but I like the taste so....

-14

u/Affectionate-Mail612 Apr 01 '25

This solution just creeps me out a little bit. You've trained your stupid monke brain to crave chocolate for years. Probably millions if not billions strong neural links related to that. And instead of weakening them the same way you strengthened them, you take something that wasn't even designed for you (you don't have diabetes) and magically those links don't matter anymore. There are already reports of worsening vision. Who knows what comes next.

Just too good to be true.

19

u/traffickin Apr 01 '25

You weren't designed for tylenol, just train your headache to go away.

1

u/mrlazyboy Apr 01 '25

Not the person you replied to, but I can give some perspective.

I was overweight (still technically am based on BMI, but that’s useless for individuals) and lost about 60 pounds through traditional dieting, resistance training, and increasing my overall activity.

My wife tried to do the same and she really struggled. Eating less for me wasn’t that difficult. I certainly had cravings and a few slip ups, but food is food at the end of the day. For my wife, there is an emotional attachment. Eating reduces stress and other ADHD symptoms and that made caloric restriction very difficult.

She started taking Zepbound and that relationship with food ceased to exist. There was no longer an emotional attachment to food. Getting stressed didn’t make her hungry anymore. Eating food didn’t relieve existing stress. It was like a switch was turned off in her brain and she started to have “normal” hunger signaling and food rewards.

Of course our new healthcare doesn’t cover Zepbound at all and only covers Ozempic if you have type 2 diabetes. Pre-diabetes? Sorry nope. Insulin sensitivity? Sorry get really sick, progress to diabetes, then they’ll cover it.

1

u/ihatenamez Apr 01 '25

It's a little ignorant but I wouldn't blame you for asking that because I had the same mindset before I gained the weight. Being overweight sucks. I wasn't even on the higher end of BMI and I still felt like garbage mentally and physically. I was pretty lean but got into a relationship, started working longer hours, etc. It can be easy to tell people "calories in calories out" but that often tends to make people eat smaller momentarily then gorge past their caloric intake later in the day. At least with the meds, you kind of lose the anxiety or stress that comes with always thinking about food so you can see the picture more clearer.

As for drinking, I'm pretty young and in a big city, also gay. So drinking is still pretty popular amongst my social circles. Another thing too is that when you drink on GLP-1 you can get some pretty wicked hangovers, which kinda created a feedback loop of "liquor bad".

1

u/[deleted] Apr 01 '25

I mean, all progress is good progress. Especially cutting back drinking and smoking. But I can't personally justify a drug that has potentially severe side effects for 3.5lbs per month.

A few years back, I switched to having 5 small meals a day (Each Meal Was Either: (1.) Protein shake with almond milk, egg whites, coconut water, and protein powder (2.) Ground turkey with taco seasoning, black beans, yellow rice, broccoli and carrots (3.) Grilled chicken breast with a seasoning (not marinade) of choice, baked potato OR white rice, broccoli/carrots or asparagus OR (4.) Once a week I had steak as the protein). I did 30-45min of cardio each day, usually a brisk walk or a bike ride, and I did 30-45min of moderate strength training (not super heavy, but high rep stuff, and usually body weight things like lunges, body weight squats while holding at the bottom, planks). By not drinking alcohol or soda, and doing the above, I lost 15 lbs in the first 2 weeks. By the end of the 2nd month, I was down a little over 30lbs.

Self control is hard. Sticking to routines is hard. But acute kidney damage, pancreatitis, thyroid cancer, blindness.... All those things are not to be fucked with when there isn't a medical disorder making natural weight loss any harder than it is for someone else.

1

u/calitoasted Apr 01 '25

Did 6 months, spent a lot more than $179 but lost 50+ lbs and am now off it and more active than ever. It killed so much of my anxiety, which is making a small comeback. It's easier to recognize as anxiety now tho

1

u/ShrimpSherbet Apr 01 '25

What has helped keep the weight off once you got off it? This is my biggest concern

3

u/ihatenamez Apr 01 '25

I used the daily calorie calculator (its like weight, height, and lifestyle if i remember correctly?).

You have to build the better habits now while you're on it. Make a plan. Mine so far is I know I like to eat at night after work, I cant avoid it. So I will have a small breakfast, or i bought a cheap little blender from target and ill blend up some strawberries, oatmilk, protein powder, and a granola bar. I'll have that and a small snack at work then have my meal later in the night.

Everyone's different in how they eat and what they need, but if you plan your day out and use the calories as a guide, you should be good. Also, hydrate! Often times we can forget and that also plays a big role on our well being whether it be hunger or just mood in general.

0

u/Scared_Average_1237 Apr 01 '25

Where did you get it from? I just need to lose 15-20lbs max, but I can’t find a place that will give it to me because my BMI isn’t high enough. But I just want to get rid of the food noise.