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I'm an Army vet. Despite growing up playing all kinds of sports and having an active lifestyle I was always overweight. Even after I joined the military and was in training for a while (working out multiple times a day and eating a strict diet for months on end) I still was barely able to keep to an "average" body fat and was in and out of the Army weight control program my whole career. One time in my second year in the Army, to get off the program I cut to less than 1200 calories a day for 6 months while doing heavy physical activity (physical training every day, working outside in the Texas summer, and then going to remedial physical training at the end of the day) to cut 15 pounds from 190 - 175. I was absolutely miserable and borderline unhealthy just to make "the standard". I was almost a heat casualty one day I was so dehydrated and malnourished. I've been out of the Army for 10 years now. I'll never be able to attain that level of physical activity again, my weight slowly creeps up year by year as I get older and less able to do physical activity and need more and more medicine to treat conditions that either started in, or are a direct result of my Army service resulting in weight gain. It really annoys me when people try to simplify weight management to "just work out more" or "just eat less". It takes so much more in some cases.

My wife has lost over 50 pounds using ozempic. She has tried every diet in combination with exercise and never had the success she's had with ozempic. I'm so happy for her and she hasn't had this kind of confidence since before our kids were born.

these medications are not inherently expensive, they are grossly overcharged. This is sheer profiteering.

Trulicity and Mounjaro have saved and transformed my life. Super-fat since I was 6-years old, I went from 405 lbs. (at 5'1") 2 years ago, to 193 lbs. today... and still going down. I am out of wheelchairs, no more walkers, or canes. The changes are more numerable than I can list here, but know my life is 180 degrees different. I now walk 3+ miles a day. I do resistance training 3x a week. Alcohol and Diet Coke (8-10 cans a day for decades) taste like watered-down dirt, so it is 120 oz. of water (at least!) a day... without even pushing it. My HbA1c has gone from 9.0 to 5.3. My kidneys are happy. My liver is thrilled! My lipid panel is 100% normal. My feet are not breaking like they did just from walking around the house. I am ALIVE! Take these forever? Sign me up!

I've lost lost ~90lbs twice before (high-school, college) doing it the "right way" before trying this medication on my third try. I've lost 130lbs. Before the drug- imagine low-key starving 24/7 or never being able to take a full breath of air, ever. It's torture. 90% of my mind was stuck on food. It was debilitating. On Ozempic I feel like I can think/do other things! I know what satiation feels like. It's life changing. Liberating! But now my insurance won't cover it because it's too expensive. Our healthcare system is sh*t.

I love that you talked about the judgment that people with obesity get from the public and medical professionals. My daughter has been in the 95th percentile or higher for weight since she was 2 months old and when she got to be around the age of eight, I noticed the doctors started to act differently. All of a sudden they were less interested in finding out why she may be having this issue and switching the conversation to diet and exercise, so as a person in her early twenties she has been on more diets than anyone ever should, all of which had minimal effect, if any at all. I'm curious if a medication like Wegovy or one of the three receptor medications the doctor was speaking of could have a long-term effect if it's used for a more significant amount of time to the point where the person is no longer categorized as overweight, maybe 5 to 10 years. If their body does still return to their original weight, there needs to be research into why the body wants to maintain weight and what can be done about that root cause. I heard in an interview with a bariatric surgeon that diet and exercise only works effectively long-term for about 5% people. That's a terrible success rate. It's time to stop blaming people with medical conditions and expecting them to use systems that have a chance 95% failure.

Having been on these meds for a while to manage my insulin, just wanted to add: 1) there's a huge supply problem. I had to switch from Ozempic to Mounjaro bc i couldn't get my rx filled consistently, and now 3mos into my new rx I'm starting to run into the same issue. Just can't get the meds. 2) when we talk about loss of appetite, we're not talking about skipping thirds at the buffet. Some days i completely forget to eat at all - and then predictably deal with exhaustion and lethargy and brain fog, etc. And if you do remember to eat and grab the wrong thing or slightly too much, have fun being up all night with nausea or indigestion or both. The gi issues aren't debilitating until they've been going on for a year and you're *tired*. Might still be worth it (it is for me), but it requires very careful management

I am overweight but I am going to wait. I remember doctors talking about pain management in the nineties and rise of Oxycontin. I will wait and see.

I recently started this medication and it is truly insane how dramatic the effects were in the span of a few days. Lower spontaneous appetite, little to no desire to snack out of boredom, easier to stop when I'm in the middle a meal. It makes me wonder if this is what other people experience on a day to day basis. And mind you, it's not like I haven't had success with weight loss in the past. I lost about a hundred pounds over a couple years, and once I hit a threshold, it was almost impossible to lose more. And whenever I dropped below that threshold, hunger would be nearly continuous. Now I can actually mentally calorie count and I'm seeing weight loss without feeling light headed, fatigued, nauseated, or intense and painful hunger. I'm hoping the effects are even stronger at high doses. And I really hope that these drugs go down in price soon. This could seriously help billions of people.

Ozempic has made a huge impact on my life. I have binge eating disorder, and ozempic quiets the “food noise.” So far I’ve dropped from 414 to 378 pounds. I don’t expect to ever be skinny, but I’d be happy being able to walk without pain again. Also, I had Stage 3A chronic kidney disease… and now my kidneys are healing! ~~~ Edit: Weighed at the doctor’s office. Down to 364. I’m losing around 5 pounds per month. I’m happy that it’s not happening too fast. 😊

I'm a type 1 diabetic, on insulin starting from 14 years old. And it is defenitely a big problem to be told at this age, that you have to take some medicine for the rest of your life. It was 24 years ago, and I still remember how my whole world broke into pieces when I heard this. If there are some ways to avoid it, it's better to avoid it.

I was diagnosed with type 2 diabetes last year, so my doctor first prescribe me Metformin, then earlier this year Ozempic. At the beginning of this year I started doing a keto diet to help with reducing my sugar intake. Between that and the Ozempic, I've dropped about 50 lbs this year. Since starting it, I'm not that hungry anymore. When I do eat, it is very little portions.

I started on this med, it was amazing. Dropped 40#, felt great, started running again, then insurance stopped paying and I can't pay for it out of pocket. That's probably a huge part of people stopping this med...

I saw that episode of Doctor Who. I know how this ends.

I had hyperinsulemia caused by high dose of prednisone which put 100 lb on me in 10 months. Neither exercise or diet stopped me from gaining weight. I went to the best doctors in the world and they told me my body was basically a fat making machine because I had too much insulin I stored everything as fat and that fat created estrogen which created more insulin. Even when I could lose weight with extreme exercise and dieting I put it back on the minute I stopped. It was very depressing because prior to all this happening I was very athletic. Then I got COVID in 2020 and my A1C went from managed to off the charts so they added Ozempic to my medication. This is the first time I felt like I had control over my body and my weight since everything happened. I've gone down three sizes. I gain and lose weight like a normal person. Meaning if I eat too much I gain weight if I eat a little less I lose weight on top of the Ozempic loss. I am so extraordinarily grateful for this medication. There's no sadder feeling than the feeling you have no control over your own body. It gave me the control back. And it took off the weight that the steroid medication and my insulin issues put on.

I’ve been on zepbound for two months, and it has been one of the most life-changing things that’s ever happened to me. I have been able to implement a far healthier lifestyle, both when my life is relatively normal and predictable and also when going through my child’s brain tumor diagnosis, stressful appointments, family visiting, etc. Before this drug, I would have been dealing with my son’s tumor and feeling guilty about the junk food I was eating. Now I can eat intuitively a WFPB diet (and a little junk food because I don’t want to restrict myself). Also, I haven’t had side-effects, and I think it’s from WFPB and intuitively eating/stopping eating when full

I've struggled with my weight and obesity my whole life and Ozempic has been an absolute game changer for me. I cannot describe how much your quality of life increases when you finally lose weight and begin to feel like the person you've always been meant to be. It's not only improved my physical health, but my mental health and confidence as well. I have energy and I feel mobile in a way I wasn't able to be before, and I feel a lot of hope for my life and my future that I haven't felt in a really long time. Being obese puts you in this mental prison that makes it extremely difficult to change anything about your circumstances. Maybe exercising and calorie counting helped at one point, but chances are the regimen you needed to follow was unsustainable and you ended up gaining all the weight back and then some. Putting so much time and energy into something only to see any positive results disappear is soul crushing and further entrenches you in this hopeless feeling that things will never change, you're stuck this way and you just have to live with it. I spent so long just not wanting to leave my house because I didn't want to be seen by anyone. How can you make any positive changes in your life if you don't even feel good enough about yourself to step outside your front door? That's why Ozempic is a game changer. I didn't have to change anything about my lifestyle, the suppression of my appetite was enough to pretty much immediately begin losing weight. After a year I'm now down 74lbs and I feel amazing. I feel good and have the energy and confidence now to go out and be active and do the things I want to do. I don't think it can be overstated how beneficial this drug can be for people who struggle with obesity, it's completely changed my life and I'm perfectly happy to take it for the rest of my life because it is more than worth it. I just hope they're able to bring down the price and make it accessible to everyone who needs it, because the impacts on society will be huge.

This is a huge problem with capitalism, we created a food environment that makes people fat and unhealthy, yet there is no financial incentive to regulate food so instead we are going to rely on a medication because that can be profit incentivized.

4:37 The first thing I noticed is that I don’t obsess over food and other bad habits, I have no desire for. It’s liberating. it’s like someone stopped the lambs from screaming.

Good to hear Dr. Dhruv Khullar's point of view. I've asked about it a few times with my doctors. They ran me through several meal/fitness programs and they're still side stepping it. They've warned me that I'm almost pre-debritic and still they haven't been able to justify the cost. It is getting really hard to hear "you need to lose more weight or you'll be diabetic" yet they can't help me "help myself" with something like Ozempic because it is too expensive. If I can't lose the weight I need to, and I end up diabetic, then I'll be on the very medications they say are too expensive. Makes no sense. I'm retired military, and spent the last 15 years of my career working out six days a week, and living on food I absolutely hated but had to keep that lifestyle up because it was part of my job. Do they sell Tapeworm over the counter? :) (Just kidding Trumpers, do not eat Tapeworm to lose weight, it was a joke. Drink bleach instead).

I want to share my experience with the peptide found in Ozempic. As someone with ADHD, I have noticed that it has had a similar effect to Adderall. Additionally, it has significantly reduced my desire to snack or consume large meals. It’s worth noting that these observations are based on just three days of use.

I started Trulicity in 2011. The first side effect I noticed what's the constipation. Other than that, the drug totally worked. Until 2023 when it became a rare species. Lily, the makers of the drug said shipment were fine, it was the distributors. The distributors said it was Lily. I ended up on Ozempic because nothing else was available. It works ALMOST as well. Now I hear people complaining about stomach pain and constipation. THIS IS A UNIVERSAL SIDE EFFECT. All you need to do is admit the problem, add 1 Ducolax every other day and your set.

I've found this as a good part of managing my Type 2 diabetes. The most frustrating part is that my pharmacy can't get my prescriptions in stock when I need it.

without insurance 150.- euros (no longer available over the counter due to shortages and preference of patients with prescription), with public health care and prescription, 5.60 euros - Spain

Probably the reason they stop taking it after a year is that it’s not covered by insurance and costs about $1000 out of pocket per stick

I was put on Ozempic last fall. Medicaid made my doctor prescribe it to me, even though, my A1C was at 5.5. I made it through 3 weeks before I gave up on it. I never had such nausea and cramps in my life, and I had emergency surgery to remove an ovarian cyst in tortion. The last week, I ate less than 1,000 calories total. A slice of toast here and there because it was all I could stomach. The last day before my next dose, it all wore off at once. I was starving and my blood sugar dropped. I was at work and my vision was going dark and tunnel. I drove home (not the best idea), instantly shoved a piece of bread into my mouth, and checked my blood sugar. 32. That shit was dangerous. Those 3 weeks, I missed 6 days of work because of the pain and nausea and I hadn't called out of work for over 20 years. The last week, I spent in my bed because the only relief I had was when I was lying on my side.

One of the things that I think people should keep in mind about forever-drugs (especially behavior-altering forever drugs) is availability. I didn't use to think about that before the pandemic and now we've been getting hosed by drug shortages quite a bit, especially ADHD drugs. That's why I'm really skeptical about trying to get on it for cosmetic reasons. If you get a shot from a boutique, there's no guarantee it'll still be there a week later or that the 'recreational' price won't skyrocket.

I have lost 110 pounds in 11 months. June will be one year for me. I was 330 when I started on Ozempic. I am praying that at my next weigh in I will be under 200. It has been a dream of mine for 37 YEARS!!! Ever since I delivered my daughter in the mid 1980's. The fact that I am actually looking at being under 200 pounds is incredible. I have type 2 diabetes (on the cusp of it) so my doctor recommended Ozempic because he believed my weight was caused by the diabetes. I have changed completely. The only thing though is that they put me on lipitor because of cholesterol. I am not sure if I would even still BE here (death) if I had not gotten on Ozempic 11 months ago. I think it saved my life. This has helped with other physical issues as well. (Swollen feet, incontinence, inability to workout - ALL of that is gone!)

It’s not a little vomiting. It’s non stop vomiting & diarrhea for some users. Don’t minimize the risk of side effects. If it causes this side effect, you won’t stay on it. The slow emptying of the gut is the reason you aren’t hungry. Food rotting in your gut makes you feel full. Eat another bite & everything comes up. When the stomach finally lets food go through, it will be in the form of diarrhea. (Dumping) Talk to a GI before using this drug. GIs know about pancreatitis, slowed gastric emptying (gastroparesis), and other side effects of this drug.

Unfortunately for people like me who struggle with weight and have diabetes, but also have Gastroparesis, we are unable to take these new weight loss drugs

This doctor has been one of the best doctors to explain a little of everything really well.

The first week you take the drug your body is adjusting and you won’t feel the full affects for a few weeks. I’ve been on ozempic for 7 months under the supervision of a doctor and have lost 70lbs which is life changing. I have lipodeoma and this new drug is the only thing that has effectively helped me to lose weight. You completely lose your appetite so you need to eat clean and get plenty of protein. I’m going to be on this for life but I’m willing to sacrifice a few things to be healthy so I can live longer. I live in Europe so it’s €150 per month.

From my understanding, a large part of the reason people stop taking Ozempic and related drugs is due to the fact that it made food no longer appealing to them. Given a broad culture of food appreciation within basically every cultural group in the developed world, no longer being able to derive much pleasure from the act of eating is really devastating. Everyone is different and their reasons for discontinuing the use of the drug are certainly not limited to this.

This video, full if "I don't know" and "we have anecdotal evidence" wasn't an interview. It was an infomercial for Ozempic. I actually wrote down several things at points that made me furiously angry but instead, I'm just going to leave this comment expressing my displeasure as a whole. I've already left the Patreon behind but this interview came uncomfortably close to an episode of Joe Rogan's and that's enough for me to say I'm done making sure I stat on top of Adam's material. These last two glossed over the enormous responsibility of corporations in the reasons that climate change and obesity exist in the ways they do, as if they're contributions were a side note. Gross.

My insurance wouldn't cover Wegovy, but they would cover a gastric bypass. Since I was born with a heart condition, my doctor had concerns about surgery, so he sent the prescription to a FDA approved/state licensed compounding pharmacy. I have been on the medication for 5 months now and have lost 50 pounds. My blood pressure is now in the normal range and my arthritis has greatly improved. I am also now able to work out 5 times a week without debilitating pain and I have been able to stick to the nutrition plan I got from my dietician. I still have 70 pounds to lose, but this medication has been life changing.

I’m not overweight but have a paunch. I started keto in Jan 2024. Ive lost significant weight, think more clearly, have more energy and eat 1 meal a day. Im no longer hungry, nor crave sugar. Amazing!

I got ADHD and I am really really hoping that Ozempic and Wegovy take the heat off illicit stimulant use so that some day I can get a refill for my prescription without my physician needing to do a drug accountability check to make sure I'm not selling it on the side.

Im on vivitrol for alcohol and it has literally saved my life. Im all for any drug that could help people overcome their addictions.

I was on Wegovy under the suggestion of my doctor because I plateaued with my weight loss journey and was very frustrated. I think I may have been one of the very few folks who had a truly horrible experience on it. Sure - I didn't want to snack as much, but I also had to FORCE myself to eat and drink anything. I didn't even want to drink water - so unless I was setting a visual/audio reminder to drink something, I just wouldn't. When I did eat/drink anything, it tasted absolutely awful. This also meant I didn't want to cook anything anymore, or even shop for groceries. I was nauseous all of the time - sometimes feeling so sick that I couldn't move because it would trigger me to throw up. Between my just not wanting to eat (or forgetting to) and throwing up, I started to have blackouts. I suspect it's because my body was shutting down, but you also can't just quit taking it, you have to slowly ween yourself off. I told my doctor that I wanted to do that and they told me to try to stick it out (those side effects are really rare! You're the only patient I have who's had those! But you're losing weight aren't you?). I had to get a second opinion on the steps down to get myself off the med without further harming myself. Once I was off, I switched doctors completely. I also went to a nutritionist to help design a food program that works for me. Between that and changing my standard gym routine to more weightlifting to build muscle vs straight cardio, I'm losing weight again. The above are just food related side effects too, this drug affected me in other horrible ways - mostly by sucking the joy out of EVERYTHING. I feel like it just dulled me completely and made me totally apathetic to wanting to do anything. I was lucky - This drug sucked for me immediately, but I dread the long term side effects discovered 5, 10, 20 years down the line for those that stay on this.

TLDR: The answer is we dont know. Also, comments below clearly show that people havent watched the entire video. Also, here's a take from a PhD student in biomedical engineering. Overall, this video does cover both sides, but here's my take/response. I understand why doctors like he would be cautiously excited about Ozempic's potential toward obesity treatment. But we dont know the long term effects of constant metabolic change. It is noted that Dr. Khullar does acknowledge these concerns. However, it would be helpful if he would emphasize what we dont know and propose how costs can be decreased when trust in pharma is at an all-time low Again, please watch the entire video before making your comment. Also, please ask me any questions! I may not be a metabolic expert, but I have read metabolic science research articles before

The problem is you can never go off of it. So you are trapped to buy it, even if the price continues to go up. What if someone markets a poisonous batch? I see Sharon Osborne and she is withering away.

I'm slightly disappointed with Adam not discussing the very real, very serious and very deadly side effects of these medications. 60 Minutes Australia did a very interesting look into the strokes and heart issues caused by Ozempic. I recently lost a colleague who was prescribed Jardiance (SGLT2 oral med) last September, he was miserable while on it. It was suggested by the cardiologist to help his CHF to lose weight. It helped him lose weight, when he started it he was 235lbs in September and by December he was 175lbs. Everyone was congratulating him for the weight lost but I attended medical appointments with him and he was losing muscle mass along with the fat. He couldn't keep any meals down and was throwing up constantly. Any activity left him breathless and he was unable to get out of bed. I understand that he had compounded morbidity issues but these are not miracle drugs for everyone.

The biggest issue is we treat the symptoms and we never fix the problem. It’s not in any companies financial interest do even do that. It needs to be forced into effect and not subsidized

I appreciate the tension between fixing the underlying societal problem and putting an important bandaid on the problem. This episode made me think that MAYBE, just maybe, the bandaid will help facilitate the solution to the underlying problem. As people are able to beat their “small a” addiction to food (love that, btw), hopefully food manufacturers will adjust course as well to meet the demand. It feels like a long shot, but my optimism is peeking through. 😅

What's ironic is that people have always commented on my skinniness, and I hate it. I've been trying to gain weight for so long, and I think that people need to realize that there is no perfect body.

Internally, Lilly states that this may be the world's first "Trillion Dollar Drug". Just look at their stock price for the past 24 months.

Abusing Ozempic for weight loss is perilous because it can lead to severe nutrient deficiencies and metabolic imbalances. The body requires a balanced intake of nutrients for maintenance, and extreme dietary restriction can result in long-term damage to organs and systems but you will look good.

I am extremely obese and have a hard time getting around. I am not diabetic so no help is offered medically by insurance and I can't afford it on my own. I think it could help me get down to a weight that would allow me to walk swim and maybe hike again but I worry about getting off of it. I refuse to do gastric bypass surgery because friends and relatives have had complications, sometimes years later and one was fatal.

another issue with the ozempic shortages is the design of the pens themselves, there's so much left over in the pen after you use your doses.

Honestly if ozempic is good for addiction, I could really use help getting over my nicotine addiction. Too bad people are misusing it so horribly.

I was prescribed Ozempic for Diabetes and it was incredibly effective but it became so difficult to get because it became popular for cosmetic reasons. I could not get it for months at a time. So, we started Monjouro. It got my A1C from 11 to in the 6! Amazing results but now, again, the cosmetic users, now I cannot get. I have been waiting 3 months. I had gotten off insulin because of it and now I am using insulin again because I cannot get the damn medication. I really wish that those doctors who are prescribing this for people who really don't NEED it would think twice and remember those of us who truly need this to save our lives.

I keep hearing “if you stop taking it you will regain the weight” I don’t think that’s true. If you stop taking it and return to your old bad eating habits yes you will regain the weight but that’s the same with literally all other methods of weight loss.

This was mentioned only briefly, but a real struggle for a lot of people is the shortage of these medications. I have worked in pharmacy since 2005 and have never seen an entire class of drugs be on frequent backorder for such a long period of time. So many patients might get started and even work their way up to the highest dose, only for that dose to go on backorder along with the other drugs in this class. Then they're left with no alternatives.

The problem is that people are using it cosmetically but make it hard for people like me, who the drug was designed for, to get. That in and of itself is highly ridiculous.

I love the optical illusion from the cube on the bottom of your mic. I can see it going both in and out.

I think the risks related to muscle loss and malnutrition are being downplayed. Especially for long term/lifetime use. The consequences could be catastrophic. Yes, some doctors require a commitment to resistance training, and I am sure there is discussion about adequate nutrition. But don't we run into the same problem with long term compliance? The comparison to bariatric surgery is apt - when eating and exercise behaviors don't change, the resulting weight loss doesn't last. But then those are opportunities for new drugs and supplements. How much do you want to bet those are not in thr research/planning stages right now. These drugs are bailing the boat. Don't get me wrong, bailing is crucial. But we do need to find and repair the leak.

If you have a history of depression, please speak with your doctor before beginning GLP1 treatment. Worsening depression and SI are known (but lesser discussed) side effects, with new research emerging. I took a semaglutide compound for 3 weeks and lost 10lb, but it stoked my dormant depression into a full blown episode. It’s speculated that people with depression use food (often unconsciously) to release serotonin, achieving regular signals of joy or pleasure from the taste of food. In my case, within days of my first shot I had ZERO appetite, everything tasted bland and I had no desire to eat at all. Over the course of 3 weeks it was a huge challenge to get the proper nutrients when I had zero hunger cues and felt nauseated the whole time, but I did eat well through meal planning. I quickly became lethargic and withdrawn, then the melancholy set in hard. Discontinued after 3 weeks. The research is still being collected on these highly commercialized drugs… be careful out there folks!

I'm someone who's lost 220lbs by diet and exercise. I've been wrecked by the difficulty with the weight "set point" issue, and every day is a struggle to keep the weight off (but going on 10 years of keeping it off). The idea of injecting to take the pain of hunger and food hyper focus away is seriously enticing. However, I'm more worried about the idea that when I'm taking the drug, I'm pushing that weight set-point even higher to, say, as if I weighed 500 instead of 400lbs. I'm a bit cynical and I'm thinking that in 5 years, we'll see the after effects of this drug for people that were using it to drop 30lbs. Those users might be giving themselves a weight set point for someone 100+lbs more and that they might rocket up to that when they discontinue use.

I was obese my whole life and struggled as a child even with dieting, fast foward to my college years and my friend introduced me to lifting, macros, tracking, TDEE and overtime, I taught myself discipline. by the 90th pound lost, in my late 20's I found out I had un diagnosed ms for the past 8 years. didn't stop me there(yet), I'm down over 100 pounds just through consistency and educating myself on food and nutrition and not starving myself. the irony is, my sister is bigger than me(before and at the moment), but the difference is, I developed more discipline through this journey, while she resorted to ozempic. She's finally losing the weight, and the fault in my stars was not being by her side on her journey as she did need a bit more help.

I'm one of those people that was on Ozempic and then not. In my case, I had to discontinue because my PBM began requiring a pre-authorization based on A1C. Though I am morbidly obese, I am not (yet) diabetic, so authorization was denied.

I would venture to say (prob repeating many others) that a huge reason for ppl quitting the med is cost. Ins coverage blows and most don't cover it. And some that do, do not cover it once your A1C goes down. Happened to a friend.

I was diagnosed with Type 2 last year and took Metformin for awhile. My doctor suggested I could benefit from Ozempic. I can say it's helped so much. My blood glucose is lower than it was on Metformin. I worry that all of the trendiness of this drug will cause shortages. I literally need it to keep my sugar under control.

ANY QUESTION: “We don’t really know.”

The cost to produce it is under 5 dollars per patient per month.

I work for a PBM and your guest is spot on about insurance companies putting hurtle in place. Most plans do indeed require you have tried dietary changes for at least six months and/or have tried XYZ first. And last month, a huge number of plans changed their approval for each strength from monthly limits to yearly.

GLP-1'S are helping my mind with food obsession, and my alcoholism. Feeling great!

Oh good, just what I needed. An actual medication I am on for its original purpose (Type-2 Diabetes) and actually changed my life for the better suddenly becoming a fad drug and, consequently, making my life and the lives of other diabetics harder because it's getting harder and harder to get it. (And I do absolutely blame the healthcare industry. While my insurance covers it entirely, I do see how much it costs when I order it and it's upwards of $1500 (One thousand five hundred dollars, this is not a typo) for a 2-month supply. Of an injection I take once a week.)

I started Ozempic when I got diagnosed with type 2 and I completely gave up soda around the same time for the same reason. I had tried to give up soda before as its my biggest addiction and always failed. I have not drank any for 3 months now and stopping it felt VERY easy this time. I kind of assumed it was the looming threat of diabetic death that did it but now I am wondering if the Oempic might have helped as well! That is so interesting.

I'm Type 2 diabetic, and I was prescribed Ozempic. It's been a godsend for my blood sugar, and I've managed to control my weight through a couple diet changes and starting a regular workout routine. My biggest issue with this Ozempic craze is that when people flood to it for weight loss purposes (which it is not currently FDA-approved for), it leads to a shortage of the drug for those of us who have diabetes and need the medication for that. My pharmacy has instituted a policy where they won't fill a prescription for Ozempic unless you can provide a documented T2D diagnosis. I'm interested to see where research takes us, as far as everything else GLP-1s can supposedly do. But as of right now, leave the Ozempic to the T2Ds who need it.

I'm diabetic and I took wegovy. I was constantly feeling like absolute shit when first injected because of the absolute nausea and the squicky feeling of somehow feeling the drug spread under my skin. I am shocked at how people can use it as a weight lost tool only. I undestand wanting to lose weight but for the hollywood elitw to be using it? Thats what bothers me about it. There are people taking this medication who truly need it and can't get it, while there are people who only want to take it for slight weight loss.

Ozempic/Wegovy activated my lactose intolerance. It's really good for weight loss, but it doesn't keep the weight off that long. It was nice to not crave food a lot, but... man, the digestive effects sucked. If you are genetically prone to IBS, avoid GLP-1 agonists. Also the puking was crazy even with the manufacturer suggested titration schedule

This touches on modern food systems and I know Adam has covered that before but I'd love to hear you talk to Chris Van Tulleken (or someone else with expertise) about ultra-processed foods.

Maybe one of the reasons they can’t stay on the medication is because insurance doesn’t cover it and they’re too expensive

I found this to be a really good conversation! Thank You for taking the time to really look into the GLP-1 meds and what they actually do, beyond people who ozempic shame, etc…..

I wonder if getting people skinny using these drugs will lead to our food supply changing. For example, creating a reduced demand for high calorie foods as well as maybe an increased demand for physical activities as people feel better. I am also curious if there are specific things we eat or consume or do that worsens on GLP-1 pathway. Maybe if we identify other things that can increase its activity we can get a better idea of strategies that aren't medicine.

What ever happened to fecal transplants from skinny people. I thought that was the magic bullet of sustainable weight loss.

This is long. Seriously, it's worth it. In February 2020, I was in the best physical condition of my life- 50, very thin, fit, doing great. March 2020, I caught Covid-19. It was a seriously strange infection, but after a week or so I felt I was recovering well only to get hit with a bacterial pneumonia that kicked my tail and took 3 rounds of antibiotics to recover from but I was recovering. Then my legs began swelling up like nothing I've ever seen before. Then I couldn't get up the stairs without at least 2 rest breaks. I began gaining 5lbs in a day, 7lbs a week, that sort of thing until I was 200lbs and barely able to walk. I was given pamphlets on dieting. I'm eating less than before and holy cow, I'm enormous. Very long, very painful and very, very expensive medical story short- I have heart failure with preserved ejection fraction, pulmonary hypertension, kidney failure that flirts with needing dialysis now and then, small fiber neuropathy, tinnitus from hell, and I'm now allergic to apparently everything. It's like I'm now 85 years old - and not the "running the Boston Marathon" sort, the sort where one begins to consider the virtues of self euthanasia. It was awful. So as part of my journey that cost me my life savings (surely SOMEONE can help me, right?) I ended up being prescribed Ozempic by an endocrinologist. I am not even kidding - it was like a miracle. Obviously, I lost weight. I also lost the shortness of breath. My legs stopped swelling. Sometimes I lost 5lbs a week. A year in, I was down almost 70lbs and I literally thought, "I feel alive again". The next week, I received a letter telling me my insurance wouldn't cover it any longer (actually, first it stopped with Ozempic and I switched to Wegovy and went another several months before they stopped coverage for that as well). I gained 60lbs in 60 DAYS. I was seriously considering finding a way to get to a nation that offered assisted suicide. Sure, I could buy the stuff elsewhere- $850/month, some place was offering it as an "experimental use only" thing for less than $400... Along with the massive health expenses I already have to contend with, I finally told my husband I was like an old dog and even though I was a beloved member of the family, it was just time. Then the FDA approved Wegovy for Heart Failure with preserved ejection fraction (there are many drugs for those with REDUCED ejection fraction, but not much and nothing good for those with PRESERVED ejection fraction). I was taking 4 heart meds that worked 25% as well and cost more than the Wegovy. It made zero sense... As a last ditch effort, my endocrinologist tried to get an approval for cardiac reasons. Denial letter bounced back so fast it was incredible- Wegovy wasn't approved for ANY diagnosis. And this is weird, but I'll take it - 3 days later, my doctor tells me that they received an approved prior authorization for the Wegovy based on heart failure. I was literally (I was told by my health insurance company) the FIRST approval for this reason they'd made. And good luck there, folks. Wegovy is harder to locate than the pot of leprechaun gold at the bottom of a rainbow. I managed to locate some and I took my first dose. 3-4 months before I will even get to a therapeutic dose. Folks, I went from an eye popping amount of diuretics and three other heart meds and stage 4 kidney failure to pulsing low dose diuretics maybe every 10-14 days (often even longer). My kidney function was just barely abnormal. On Wegovy. Six months off, and I am very close to another hospitalization for Congestive Heart Failure. I am using a walker. Some days, I cannot bend my legs they have so much swelling. You just cannot understand what it feels like to feel great, feel so bad that you're seriously considering ending your own life, then to feel great again only to find yourself in the same place again where you're wondering how bad things have to get before you just throw in the towel. I am 55 years old. As one doctor told me, "we don't give people blood pressure medications and then when their blood pressure is normal, take the meds away". I have no use for people who want to lose 15lbs before they go on tour or vacation or whatever. If I don't get this medication, I will die- whether long and hard or more quickly by choice is literally all the choice I have. Don't lecture me about weight loss until you find yourself waddling around on two legs that look like some photo in an old medical textbook about "dropsy". And DO NOT GIVE UP. Not everyone is willing or able to clean out their life savings, but you know your own body. I had a neurologist tell me that I didn't have neuropathy (the nerve sensations I was having were just absolutely bizarre. I would think someone was crazy if they told me some of the things I was feeling). So I see a rheumatologist at a major teaching hospital (I've seen ALL the specialists- and several super specialized specialists) and she recommended a very simple biopsy for small fiber neuropathy and sure enough- the biopsy was VERY positive for small fiber neuropathy. So I take these results back to the first neurologist and ask how he could tell me I didn't have neuropathy when he never even mentioned the biopsy. He says, well, (insert reason that basically said "that's not that common" which is debatable, but whatever). Then it turned out that in actual fact, the nerve studies the neurologist had done before he told me that I didn't have neuropathy actually DID show that I had it. When I called him out on it, his response was that it was better than the last time he had done the study. "Better than last time" hardly means, "nope, you don't have anything wrong". And that's one of the minor issues I've run into. Medicine is weird now. I've had an autoimmune disease for 25 years and I've never seen the medical field like this before. Patients are not being well served. Had I been like my parents and just said, "well, the doctor said..." I would be dead. You have a doctorate in living in your own body with extensive postdoctoral education in living in your own body. You know when something isn't right. Unfortunately, people are freaking out about things they read on the internet or simply not understanding what they're being told (which is the fault of medical care providers, who need to be less focused on churning patients and more on patient education) that providers have begun just treating everyone like they're stupid. If you haven't had that experience, be grateful. I will say- treatment when I'm thin and fit and when I'm huge and barely able to walk or breathe are wildly different experiences. FROM THE SAME DOCTORS. So Wegovy isn't just for weight loss. I think they're looking into Ozempic for chronic kidney disease now. People, I have taken a lot of medication and treatments in my life. The Wegovy is the first drug I've ever felt was nearly miraculous. I'm hoping that I can get back to where I was six months ago again.

I've been on Ozempic for the better part of a year...on and off. Why on and off? Because I just get SO. TIRED. Of feeling like I'm on the verge of throwing up all the time. Just thinking about giving myself my shot can trigger me feeling nauseous. Even *watching this video* makes me feel nauseous, there's such a strong association with the drug and nausea in my mind now. It's not hideous, I'm not throwing up left and right, but it's always there, at a low level. I'm taking half the dose that I was prescribed and it's still omnipresent (at full strength I was basically nonfunctional). If I don't take it for a week, it feels so nice by the end of the week to just NOT feel constant low-level nausea that I usually push it out another week, then I grudgingly go back on it because I'm taking it due to diabetes and my general health, not specifically "to lose weight". The last time I checked I was down about 30 pounds from my pre-prescription weight, but that's not a lot compared to my overall weight, likely because I can't manage to stick to it consistently.

It’s saving my life. I was morbidly obese and I’ve lost 40lbs. It’s controlling my natural tendency to eat late at night or when I’m stressed. Just a matter of time how long the food industry lobbyists find ways to keep it out of our hands.

I am taking Ozempic for type 2 diabetes, haven't run the blood tests to verify that its working (yet)...but I have had notable knock on side effects. The most notable is a strange decrease in sexual desire. Not the kind of dysfunction associated with weight/age/etc, but just no longer really interested. I can become aroused, but I have difficulty remaining aroused because I get...bored? This is very abnormal for me, and coincidences with starting the medicine. So its definitely having some kind of psychological effect.

I’ve been a type 2 diabetic since the 90’s. I was on metformin, glimepride, and insulin. With Ozembic, I have lost 35 pounds, stopped insulin and glimepride, seen my blood sugar stay in range, just a giant improvement for me. Hopefully over time the price is reduced so people can be able to use this regularly.

Yeah my wife was on it for a short time because she's a type 2 diabetic, very borderline. We are hoping that it would completely eliminate her needs for insulin which he did, but she was allergic and had pancreatitis. I'm looking forward to trying the medicine. I'm not diabetic but I have an autoimmune disorder. Where my white blood cells attack my blood vessels, this causes damage to any organ that has lots of blood vessels: lungs, liver, kidneys, brain. My disease causes a lot of swelling so I weigh a lot more. I already eat well and didn't eat much (My disease causes chronic nausea so I don't really get all that hungry). But the extra weight just stresses my body more. And you're trying. But it's hard because you constantly hurt. So you're constantly tired which means you can't do very much. It's just a constant wall of obstacles and that's just living. That's not counting everything else that's stressful in life.

There a just an article out about how cheap these drugs can actually be made. Maybe you did this interview before they came out?

I take ozempic for diabetes, and getting used to the burps has been crazy.

really interesting conversation. thank you adam and Dr. Khullar.

This drug worked really well, but I ended up getting Pancreatitis every time I take the medicine. So I can't take it at all.

Disallow corn syrup as an additive and watch how fast things change.

gotta skip this one. i see ads for this shit everywhere and it triggers old eating disorder thoughts. it isn't easy to obtain but every time i see or hear about it i swear it burrows further into my brain to keep tabs on it for when it has a generic later.

My sister has been on it for months, she’s always tired because she’s pretty much starving her body. She can only force herself to eat very little. And she’ll need to be on a maintenance dose long term.

"Not everyone has a doctor becase not everyone has health inurance" That is a scary thought. Is that really how terrible the health system is in America? I can't comprehend that.

People criticizing ozempic users are not obese. It sucks

They put me on Ozempic for my insulin resistance and while I did lose weight I lost so much muscle, I had to stop it because I couldn’t even keep water down and I gained all the weight back plus 20kg more, and I was so sick from it I couldn’t exercise so now I’m heavier than when I started and have no muscle to keep me going, absolutely ruined my life.

I went on Ozempic in 2021. My employer changed insurance companies for 2022 and the medication was no longer covered. I lost 40 lbs and put on 80 as soon as I spotted the injections. I would caution anybody considering this medication to evaluate if they would be able to afford it out of pocket.

Was on mounjaro for 4 months - didn’t lose much weight and gained it back (had really bad gastric side effects in the end with celiac complications) It did help me quit smoking - also didn’t crave things as much. Part of why I didn’t continue also had to do with anxiety over the drug being covered / affordability

Medicare4All and nationalize big pharma now!

Should we be talking about the BMI fallacy if it's going ro be used as a metric in something this important? It was never intended to be used as a medical measure of healthy weight.

I was on ozempic for 3 months before my excellis medicaid decided they universally wouldnt cover it due to the extreme cost.

My girlfriend started Ozempic over a year ago because she has Type 2 Diabetes. Her weight hasn't moved at all but her blood sugar levels have been rock solid. In that way, the medicine seems to be doing what it's supposed to, which is good. Sometimes it's sold out a bunch of places because of people who buy it for weight loss only though, which is a problem for people like my girlfriend who actually need it for their health.

These medications also point out that the only way a person can actually lose weight is by burping and passing gas😂