As mentioned in a previous post, there are a lot of things about which nobody knows very much. The GLP-1 drugs have been around for a while, although mainly as a diabetes treatment. As weight-loss aids, however, they are relatively new and untried. When any discovery comes along, questions arise.
Which patients will or could be harmed? Which sufferers will receive the most benefit? Scientific American said,
Another unknown is who will respond to these drugs — and who won’t. It’s too early to tell now, but the drugs seem to be less effective for weight loss in people with type 2 diabetes than in those without. Conditions such as fatty liver disease and having fat around the organs, known as visceral body fat, might also affect how people respond to different drugs…
How much will the patients pay? How much would they be willing to pay if they had a lot more money to start with? Where will the funds come from instead? Can the team that wrote a particular paper continue to do meaningful work in this area? How about the pharmacology? What other drugs does this new thing clash with, causing an iatrogenic disaster?
Bloomberg journalist Lisa Jarvis raised several questions, such as:
[…] Why do some people on GLP-1s […] experience a total body transformation, while others lose only modest amounts of weight — or nothing at all?
[…] Is there a way to figure out who needs these drugs to avoid a heart attack or diabetes, and who is perfectly healthy in their larger body?
[…] Is constant therapy sustainable — or even required?
Jarvis states, “Some 44% of people taking Wegovy report nausea, and nearly a third experienced diarrhea.” People know this going in, and give it a chance anyway, and a very large number of them seem to stick with it despite the discomfort. The sickness seems to be a feature, not a bug. If that is what it takes to stop people from overeating, they seem willing to put up with it. But is it a life sentence? Or at least, will the necessity for periodic injections segue into discovery of how to make wider and more efficient use of alternate routes?
Time out?
Apparently, huge numbers of users want to know if they may self-prescribe a break from their medication regime. (The professional consensus on that is, “No.” But a certain number will do it anyway.) Resistance understandably crops up a lot, around holiday times. And reportedly, someone who stops their meds abruptly will become ravenously hungry, and prone to eat an enormous amount of barbecued ribs and hot fudge sundaes.
If a user does take a break, the next big issue seems to be whether they should pick up again with the dosage they previously used, or whether they need to fall back to a smaller dose and then crank it up again. Journalist Ross Woolen wrote,
It takes the body some time to adjust to these potent medications, and those infamous gastrointestinal side effects tend to be at their very worst in the first few days of a new higher dose. With longer pauses, the worry is that your body might lose some of the tolerance that originally allowed you to step up your dosage.
Starting over with the high dose that was typical before the break “could be more than your body is ready to handle, resulting in extremely uncomfortable side effects.” Medical professionals prefer to play it conservatively, recommending a cautious approach before escalating. This is not yet backed up by published studies apparently, but is the tactic preferred by doctors, who definitely prefer to be consulted rather than see patients tailoring their own medication schedules.
Patients who invent unauthorized dosage schedules might encounter surprises. They may not be aware that it takes at least a week for the last dose to clear their system. If someone wants to devour a big meal on a certain day, careful planning is needed. Even though they might have an enormous appetite, the mere ability to chew and swallow a large amount is no guarantee that the organs farther down the line will cooperate. There may still be “ugly gastrointestinal side effects.”
Your responses and feedback are welcome!
Source: “‘Breakthrough’ Obesity Drugs Are Effective but Raise Questions,” ScientificAmerican.com. 01/10/23
Source: “Do You Really Have to Take Wegovy Forever?,” WashingtonPost.com, 10/19/23
Source: “Is It Okay to Skip an Ozempic Shot Now and Then?,” EverydayHealth.com, 11/15/23
Image by Holly Lay/Attribution 2.0 Generic
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