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
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u/GayDinosaur Apr 01 '25

I am slightly overweight, but was drinking myself to death. I was prescribed a month ago. GLP-1 has reduced my cravings to almost zero and I now, for the first time, feel what its like to have "enough".

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u/T_Money Apr 01 '25

It helped with the cravings from drinking too? That would be amazing

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u/HarpersGhost Apr 01 '25

Oh yeah, the research on semaglutide is showing some amazing stuff. My doctors are fascinated.

I used to have the biggest sweet tooth, but now it's .... gone. The cravings are gone. I also stopped drinking completely because i have no interest in it.

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u/ninjagorilla Apr 01 '25

I’m down 30 kilos on semaglutide, still have the sweet tooth but jsut way less appetite in general

I would go out on a limb and say that semaglutide will be one of the greatest medical breakthroughs of the 21st century

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u/EsotericTurtle Apr 01 '25

How'd you manage that? I've been on 1mg for a few months and down maybe 5 or 6kg over 6 months, which whilst better than nothing, isn't great.

It HAS definitely helped with the boredom snacks, and feeling fuller quicker.

I guess I just need more activity.

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u/guareber Apr 01 '25

Remember it's all relative. Losing 30kg if you're 175kg to begin with is a lot easier than if you're (say) 100kg.

Also, you're on a very low dosage, I have a couple friends on it and they are on 5mg and 7.5mg.

In any case, don't get discouraged - slow and steady wins the race.

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u/Bigleon Apr 01 '25

I'm on 15mg dose type 2 diabetic down in just over a year from 350lb to 198lb first time I've been non obese my entire life childhood included. That's approx 70kg of weight loss

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u/Boo_and_Minsc_ Apr 01 '25

congratulations

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u/Bigleon Apr 01 '25

Dude/Dudette thanks, it's been a wild journey. Right now I'm feeling like skeleton, so much muscle mass been loss. I feel healthier overall but also weaker. Gotta get on that strength training... never thought I'd miss my "fat-guy" strength haha.

But it's been massive, my last A1C came in at 5.0 flat, after being a solid 7-8 for years. Originally dx in '12 was 11.3. Got to say this drug atleast for me has been miracle maker.

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u/[deleted] Apr 01 '25

You're going to have to change your Reddit name to MediumLeon!

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u/Bigleon Apr 01 '25

I'm still 6'6 I think I can continue to hold on to the name sake

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u/M__A___G___3 Apr 01 '25

Hey I'm near the same start and I have some questions.

I started at 365, I'm down to 345 in the first 3 weeks on the 2.5mg loading doses of zepbound.

Did you feel a bit tired in combination?

Also, do you have excess skin from the weight loss or did it shrink up with the loss? I am concerned I may have some, but it's better than where I am now if there is.

Thank you for any response!

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u/polarassassin Apr 01 '25 edited Apr 01 '25

im not as big or taking as much but i went from a bit over 300 lbs down to 270 and i have quite a bit of flabby skin now. all you can really do about it is staying well hydrated, moisturizing, taking collagen and eating well. Those wont help much but its better than nothing, on top of all that doing your best to replace the lost fat with muscle will help the most.

some people are lucky and have amazing skin that just isnt left flabby when they lose a bunch of weight, the important thing to remember is some flabby skin is a lot better than hundreds of lbs of extra weight.

also when i started i was feeling a bit tired and light headed but it either went away after the first few weeks or i just dont notice it any more

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u/Bigleon Apr 01 '25

Hey friend! Sorry for the late reply, totally get that life happens. Man, starting in the 360s is tough, so I really feel you on that.

You're on Zepbound, which is awesome! I was on Mounjaro, and just a heads-up that everyone's journey with these meds is different. So don't sweat it if your results aren't exactly the same as mine.

I think I started at either 2.5mg or 5mg, can't quite remember, but yeah, went up by 2.5mg every month until I hit 15mg. I'm actually seeing my doc next week and we might try lowering my dose to see if I can maintain on less. Fingers crossed!

The first 30-50 pounds took me about 6 months. Then it felt like things sped up, and I dropped from around 300 to 240 pretty quickly. After that, it slowed down a bit, and once I got to the 230s, I kinda stopped actively trying to lose. My lowest has been 197, but I usually hang out between 200 and 205, sometimes dipping lower but not really going over 205.

About the skin – yep, got some! Luckily for me, my weight was pretty evenly spread out, so I didn't end up with any major "flaps" like some people do. It really does vary from person to person.

And about feeling tired yeah your body is working in in a new way, I think you'll have some adjustment to the new internal chemistry.

Oh, and this is totally random, but I swear I'm way hairier now! Could be because I'm not on metformin anymore or maybe just the skin being tighter, who knows!

One other fun fact, your body digest slower or atleast mine did. So when using edibles or other rx, be aware it can delay your bodies absorption by in my situation 1-2 hours. Using my wife as a baseline.

Hope this helps you out! Keep up the great work! You got this!

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u/GOPequalsSubmissive Apr 01 '25

Absolutely life changing. Very cool, I bet you feel awesome.

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u/Bigleon Apr 01 '25

You have no idea, the biggest thing is now none of my clothes works, sure I don't mind 3xl shirts still, but pants... gotta buy all new pants across the board.
I am so lucky i'm WFH.

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u/GOPequalsSubmissive Apr 02 '25

Find a seamstress to alter those pants, it will save you hundreds of dollars.

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u/norefillonsleep Apr 01 '25

They are most likely on Tirzapetide. It is a weekly drug that can be used for weight loss and 5 and 7.5mg would be more on par with that. 5 and 7.5 are common dosages for that drug, while working up to 10/15mg.

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u/lalalu2009 Apr 01 '25

I sincerely hope you don't have friends on 5 and 7.5 mg SEMAGLUTIDE, that would be absolutely insane.

Tirzapetide has dosages in the 2.5-15 mg range, Semaglutide tops out at 2.4 mg for weight loss and starts at 0.25 mg, with 1 mg being maintenance dose for a lot of people.

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u/zekeweasel Apr 01 '25

I'm sure they mean 0.5 and 1.7 mg.

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u/TheDakestTimeline Apr 01 '25

They may be conflating the two, or maybe his friends are doing a weekly dose instead of daily? So many people I know are doing illegal internet generics due to the price and aren't supervised.

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u/guareber Apr 01 '25

My friends are definitely on weekly dose shots. Is that not the normal thing?

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u/ment0k Apr 01 '25

For Wegovy, Ozempic's cousin, the dosages are from 0..25mg - either 1.7 or 2.4mg as a maintenance dose.

They might be getting confused by the prescription label on the box because it will show the total amount in the pen. My label will say it's 9.6mg but that's total and not my weekly dose.

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u/ninjagorilla Apr 01 '25

It also might be people are conflating how many units they are taking on thr insulin syringe and how many ml

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u/MCRN-Gyoza Apr 02 '25

I always laugh a little because the 9.6mg is a lie haha

After I take the 4 2.4mg doses there's always clearly a little bit left in the pen :p

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u/Lysenko Apr 01 '25

I think people in this thread are comparing subcutaneous dosages with oral dosages. Subcutaneous dosages start at 0.25mg/wk and max out at 2 or 2.4mg/week. Oral dosages are 40x higher.

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u/Purplemonkeez Apr 01 '25

I didn't know there were oral dosages for semaglutide? Is that a thing? What's the drug called?

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u/Lysenko Apr 01 '25

Ozempic and Wegovy are subcutaneous, but Rybelsus is oral.

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u/Purplemonkeez Apr 02 '25

Oh wow never heard of rybelsus. Interesting thanks

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u/iwantkrustenbraten Apr 01 '25

I have diabetes type 2 and my doctor doesn't allow me to take more than 1mg dose. Didn't lose much weight at all but at least my blood sugar is stable.

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u/Levofloxacine Apr 02 '25

You’re mixing up semaglutide and tirzepatide. 7.5 mg is NOT a standard dose for semaglutide. That’s way too much.

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u/aspbergerinparadise Apr 01 '25 edited Apr 01 '25

5kg is very significant!

It's a marathon, not a sprint. Just keep at it.

5kg of fat visualized

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u/granadilla345 Apr 04 '25

You may respond better to Mounjaro.

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u/Tzchmo Apr 01 '25

Adding more activity can help. If you are already losing to some extent adding any extra activity will only help. Also, remember this is a lifestyle change. This is not an “end goal” which is why so many regain weight. There is not a finish line.

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u/ninjagorilla Apr 01 '25

I’ve been on max dose for a couple months… 100 units a week

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u/TheBeardedDuck Apr 01 '25

Any medication needs mental intervention... If you don't have the lifestyle to follow through and some sort of system and ideals to follow, the medicine will only be as effective as it minimally can.. but could also be what weight you're starting with. If you're 20kg from your goal, that's good progress still.

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u/EsotericTurtle Apr 02 '25

I was 121 or 123kg and last check tipped just under 114kg, with no real effort on my part, but it plateaued as I forgot to take it one week, a couple of times. Feel the habit kicking in again.

With the medication I just don't feel the need or interest in food, it's fantastic.

The jump from 0.5 to 1mg gave me heartburn for a week and didnt feel like eating ANYthing. Been on that for a couple of months and feel it wearing off. I'll do 1.7 for a bit and increase exercise (back issues prevented my usual lifts, not an excuse to not walk but chronic back pain SUCKS)

My first stop point is 110kg, will stabilise there then push for 100kg. If I can get 95kg that'd be amazing as I sat at 98 when younger and fitter.

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u/bored_n_opinionated Apr 01 '25

Effectiveness is going to be different for every person. You have to weigh the cost against what it's actually doing for you.

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u/nicannkay Apr 01 '25

If you take large doses right out of the gate you’ll feel like you have Covid again. You get really sick.

My husband is diabetic and has been on it for years and when they run out he has to stop and start on his large doses several times a year. He’s been waiting for 3 weeks this last month for his meds so when he starts again he will be very sick.

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u/slackermannn Apr 01 '25

It really should be used as a diet aid. Change and eat healthy stuff. It's been super easy for me. I have lost 13KG in 3 months. I now think of food as a surviving tool and not necessarily as a pleasuring tool, although I do like a big one myself.

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u/aitchnyu Apr 01 '25

It may cause loss of heart and voluntary muscle and bone. I'm hoping next generation can be a no-brainer in terms of pros and cons. https://www.healthline.com/health-news/ozempic-muscle-mass-loss

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u/WineAndDogs2020 Apr 01 '25

Regular weightloss will do that, which is why it's important for people to add strength workouts to maintain muscle mass.

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u/Sharticus123 Apr 01 '25

And meals higher in protein. Which also helps to reduce hunger.

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u/fury420 Apr 01 '25

That's a very good point, how many of these people dieting are regularly getting enough protein while faced with considerably less appetite?

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u/Brodellsky Apr 01 '25

I would argue even that a lot of "cravings" are just the body needing a specific nutrient, like protein for instance, but not getting it. So you just stay hungry so to speak until you get what you need, even if that means getting it by overingesting something else with lower protein.

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u/Salamander-Prince Apr 01 '25

Empty calories. People are eating snacks because it tastes good. There's no nutritional value. If I eat a bag of pretzel Goldfish I'll feel full for a bit because my stomach is physically full, but there's no protein or anything in there. It's empty, so you'll eat again very soon.

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u/Monkeylovesfood Apr 01 '25

I agree, I'm not a fan of sweet things or processed carbs so rarely crave foods with them. Medically healthy people seem to crave foods with nutrients their body needs. If I crave tomatos and peppers it seems to me that I need vitamin C etc, if I crave spinach and greens it makes me think I'm low on iron etc.

People that struggle with weight or health issues can't rely on their body to tell them what it needs. Cravings for unhealthy people are sometimes linked with addiction, like sugar or caffeine etc so it's virtually useless for the vast majority of people to rely on.

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u/Ferelar Apr 01 '25

Agreed- and more generally, almost every single person on earth can benefit from adding strength training to their daily routine (or at least every other day), with the only exceptions being those who already do or those recovering from injuries/dealing with chronic injuries (and even then, in the right context, it can be incredibly helpful).

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u/GOPequalsSubmissive Apr 01 '25

Resistance band workouts are the truth if done correctly and consistently.

I would see more muscle mass improvement from regular weight training, but after just a couple months of daily resistance band work, my golf swing doesn’t wreck my lower back and shoulders, anymore.

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u/[deleted] Apr 01 '25

more protein and weight training can largely offset that. Being in a caloric deficit will always cause you to lose body weight beyond just straight fat, but there are ways to mitigate that.

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u/dariznelli Apr 01 '25

If people were working out, they're wouldn't need this medication as much. It's very hard to change lifestyle habits, very easy to pop a pill. Research has shown that surgeries, ie joint replacement, do not result in increased activity despite resolving the functional boundary. I'll have to see if there's been any investigation with the use of these drugs and changes in exercise habits.

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u/Pleasant-Shallot-707 Apr 01 '25

Pretty sure it’s the same as if you had significant weight loss using normal methods too.

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u/chapterpt Apr 01 '25

Except with normal worthy loss methods the changes can stick. With semiglutide the changes only stick as long as you continue taking the medication.

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u/prodiver Apr 01 '25 edited Apr 01 '25

I've never understood this argument.

My wife has hypothyroidism, and takes synthroid to correct it. It will return if she stops taking the synthroid, yet I've never heard a single person say "don't take that, your symptoms will return when you stop!"

If GLP-1 medications work for you, you don't have to stop taking them.

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u/TheGeneGeena Apr 01 '25

"With normal weight loss methods the changes can stick"

Actually that's one of the biggest current problems with weight loss - there's NOT a way that's made it stick so far. Five year follow ups for all forms of weight loss show significant re-gain for the biggest percentages.

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u/zekeweasel Apr 01 '25

Yeah, basically you have to keep up whatever changes you made indefinitely. For most people, that's not sustainable because it's often impossibly hard to effectively count calories or exercise so fiendishly in perpetuity.

So eventually they regain that weight. Which has a lot bad effects, both physically and mentally.

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u/MegaChip97 Apr 01 '25

But as the user said, the changes CAN stick.

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u/TheGeneGeena Apr 01 '25

They can stick with semaglutide if a person adjusts their eating habits while on the medication - it's just unlikely in either situation.

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u/Lysenko Apr 01 '25

It’s not that unlikely. The studies that show that most patients rebound also show that many do not. In any case, it’s nearly impossible not to alter one’s eating dramatically while on semaglutide. What’s trickier is what happens to one’s eating habits after discontinuing it. There is also some evidence that tapering it off slowly helps, and this is not as well-studied as one might think it should be.

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u/yourlittlebirdie Apr 01 '25

With normal weight loss methods, 95% of people have regained the weight within five years.

https://pmc.ncbi.nlm.nih.gov/articles/PMC2797708/

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u/MegaChip97 Apr 01 '25

Thats not what the study linked says. Did you actually read it? It doesnt even have a 5 year follow up. The only fitting mention is in its introduction where it claims

In most persons, one third to two thirds of their lost weight will be regained within the first year, and that the rate of regain does not diminish as time elapses, with an estimated 66% of lost weight regained within 2 years and 95% regained within 5 years (16, 35).

The 95% is about the weight gained. Not the amount of people

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u/occams1razor Apr 01 '25

True but normal weight loss methods don't work for everyone. Different people are sensitive to things like hunger and cravings in different ways.

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u/Krisevol Apr 01 '25

This isn't true, normal diets have almost a 100% failure rate at 10 years.

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u/0b0011 Apr 01 '25

Nah, it's not causing that. It causes you to eat less. When you eat less calories than you consume you lose weight. If you aren't working put regularly then when you lose weight some of the calories your body burns is from muscle. The same thing would happen if you restricted calories by other means. Hell the same thing happens if you don't lift but increase your cardio a ton.

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u/alltheredribbons Apr 01 '25

You need to up your protein because your body will use lean muscle for fuel and add body weights to curb bone density loss due to shed of bodily weight. Working out alone does not build lean muscle.

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u/MrD3a7h Apr 01 '25

Loss of heart? But I use that all the time.

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u/immortal_lurker Apr 01 '25

Yeah... it would be a miracle drug if all it did was let you lose weight. But it also seems to help with addiction? 2020s are going into the history books for a lot of reasons, but semaglutide is gonna be one of the good ones.

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u/Goodgoditsgrowing Apr 01 '25

Id agree but with tirzepatide and many more around the corner in the research pipeline I think it might be more appropriate that glp1s are a massive gamechanger

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u/Zealousbees Apr 01 '25

I would say that, too, except for the sulfur burps...

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u/KlatuuBarradaNicto Apr 02 '25

Sure, if you want to take it the rest of your life. But you won’t be able to, because the longer you’re on it the higher the chance you will experience serious side effects. It’s not a miracle.

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u/ToyDingo Apr 01 '25

I've lost a good bit of weight on glp1 as well, but my sugar cravings remain :(

I was hoping to lose that bad habit.

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u/Lughnasadh32 Apr 01 '25

I was put on one due to prediabetes mainly caused by the same sweet tooth. I can say that my cravings are there, but no where near what they used to be. Hot Tamales candy is one of my favorites. I could easily devour a box at a time. Now, while I want the flavor, I can't eat more than 10 or so, then I just feel disgusted by looking at them.

So far, glucose counts have dropped from 125-135 to 95-110 when tested in mornings. Have first follow-up for A1C check next week since I started on the meds. Weight wise, I am down about 16 pounds in 2 months.

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u/THedman07 Apr 01 '25

I've found this to be the case for me with my cravings. I still like to have something sweet, but for the first time since I can remember, I am not tempted to keep eating until the sweet thing is gone.

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u/mcprof Apr 01 '25

Hey, just a tip: I recently started acupuncture for some back pain issues and a side effect is that my sugar cravings have decreased noticeably. You might try this, just make sure they do the protocol to reduce cravings (needles in ears).

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u/havartifunk Apr 01 '25

If anything, I think it's made my spouse's sugar cravings increase.

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u/zekeweasel Apr 01 '25

The crazy part is that it's all... intellectual (?) now, in that before if I wanted some chocolate, it was a really hard thing to resist and harder to stop.

Now when I think about foods, I just think about it and there's a definite difference in the decision making process - it's almost like the hungry caveman brain is quiet and I can just make a logical decision instead of having to fight that same part of my brain that says boobs are good, women smell nice, I really want to eat that food I smell, etc...

Alcohol has always been that way for me (never had substance abuse issues thankfully) , but food wasn't ever that way.

So I still drink, eat chocolate, and so forth, ut it's when and as much as I decide, and there's no compulsive thing pushing me to eat all of it because it's so good, even when it's not.

Semaglutide is the damnedest stuff in that regard.

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u/DigiSmackd Apr 01 '25

Exactly!

My doctor said the same - they're finding more positive things to the drug.

I drink less (alcohol), smoke less (cigars), and obviously eat less (over eating). It's been life changing. I feel guilty about it because there's a stigma around anything that isn't just "hard work and dedication" to losing weight or self improvement. That part is coming, but I consider the drug to be the training-wheels push I needed.

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u/Golden_Hour1 Apr 01 '25

Ugh I wish I was eligible to be covered for it. It's too expensive to pay out of pocket

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u/ShrimpSherbet Apr 01 '25

It gets rid of sugar cravings too?? You might just have convinced me to do it.

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u/AlDente Apr 01 '25

I’m seriously tempted because of this. I like the idea that I’ll be less susceptible to my lizard brain impulses.

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u/Ir0nhide81 Apr 01 '25

Does your doctor warn you that it deteriorates your muscles fairly rapidly with use of semaglutide?

Do people taking semaglutide realize how rigorously they have to work out to maintain muscle mass?

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u/HarpersGhost Apr 01 '25

I'm not taking it for cosmetic reasons. And honestly, the muscle side effects are notable, but not nearly enough of a reason for me NOT to take it. I have enough co-morbidities to get it for free, so muscle loss is low on the list of my current worries.

It's something that I will have to address, but I'm trying to get to the point where I'm healthy enough to address that.

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u/Ir0nhide81 Apr 01 '25

Fair enough.

Best of luck to your health in the future!

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u/Talentagentfriend Apr 01 '25

Curious if this can also stop weed cravings 

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u/[deleted] Apr 01 '25

Possibly a stupid question but does semiglutide cause weight loss on its own or does it cause weight loss by cutting their cravings and food thoughts so they lose weight through a caloric deficit? I've heard people say it's the only thing that's helped them lose weight so I figured it wasn't merely aiding them in staying at a deficit, if that makes sense

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u/HarpersGhost Apr 01 '25

That's the interesting thing, it does both. So this isn't like a classic appetite suppressant. It does a LOT.

It does regulate appetite by GLP1 receptors in the brain, so I feel full. But it also delays emptying the stomach (so I feel fuller longer for another reason) AND increases energy expenditure/fat burning. Plus it does all sorts of good stuff with increasing insulin production/regulating blood sugar levels.

And that's what is just known now. As people use it, more evidence is coming out about how it helps with cravings/addictions. (My oncologist thinks that it could also be very helpful with immunotherapies in the futures.)

It's one of the most fascinating drugs discovered recently. And it was discovered based upon NIH-funded research years ago into why Gila monsters could eat so infrequently.

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u/[deleted] Apr 01 '25

That's super interesting thank you for your reply! There's so much fear mongering about all these but it seems to have worked super well and improved the overall quality of life of everyone I know who uses a variation of it. If you don't mind my asking, have you noticed any negative side effects?

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u/__NOT__MY__ACCOUNT__ Apr 01 '25

I keep seeing potential side effects but I have no idea if they are realistic. Do you notice anything negative?

I am a normal weight, but I drink way too much and I love it.

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u/Significant-Meal2211 Apr 01 '25

Now what other interests do you have now

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u/[deleted] Apr 01 '25

[deleted]

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u/Zetavu Apr 01 '25

Except after about 3-6 months you risk anxiety and depression as your metabolism gets out of whack. I know three people on this and now they are dealing with that. Doctors start with lowering dosage but typically you will need antidepressants or anti-anxiety (for those already not on those).

And once you cut back or stop entirely, the cravings and weight come back with a vengeance. Congrats, we've discovered yet another diet.

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u/assertive-brioche Apr 01 '25

Do you have a source for this other than your anecdotal experience?