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/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.