Much has been said about the GLP drugs and their interactions with all kinds of addictive disorders. Alcohol, drugs, even gambling... Anecdotally, I "struggled" at times with gaming (not joking). I would find myself skipping meetings at times or ducking away to play online sometimes. It never became a real issue but I knew I did it and it was embarrassing.
Once I started on tirzepatide, and then with retatrutide, the "urge" to swap over to my PC between meetings and load up a game is pretty much zeroed out.
Is this an "addiction" or a form of "abuse" similar to alcohol or other drugs? I would have said no some time ago, but now I'm not sure. I definitely feel like, looking back, I was more or less "addicted" to video games. I don't want to romanticize it as some sort of "escape", it just is what it was.
This was an unintended side effect (benefit?) of the drug for sure, in addition to acute weight loss of course.
Unlike many others, even after titrating down and coming off the GLP's, I have not felt the urge to binge food, video games, or anything else. I maintain a healthy, active lifestyle and have kept my weight exactly where I prefer it. My relationship with my body and my time has massively improved. I feel like I am at risk of sounding like a complete shill, obviously, but in my mind these drugs can be something that absolutely has the potential to turn life around for many, many people.
I think it's probably still useful to distinguish addictions with hardcore substance related barriers to quitting (think withdrawals) from addictions where the barrier is a lack of dopamine or serotonin or simple habituation.
For people with normal executive function, the second category of problems should be fairly tractable to overcome, whereas the first is still quite difficult.
The second only really becomes an issue when you have a bit of executive dysfunction.
Maybe that distinction is important and one merits the term addiction while the other doesn't? Though both categories seem to be relatively treatable with drugs that massively improve executive function, so the parallels are pretty glaring.
Most of the addiction literature I've read says that physical addiction is overestimated: even heroin addicts regularly go through physical addiction, either involuntarily because they can't get it, or voluntarily (through treatment efforts, or simply deciding to sober up for e.g. a wedding or other important event). What makes them addicts isn't that they can't stop, it's that they start up again.
Conversely, people hospitalized for something acutely painful often get addicting (or, withdrawal causing) painkillers in amounts and at purities street users can only dream of. And once it's over, they go through withdrawal, and it's deeply unpleasant, and they never want to do it again. People going through something like that aren't more likely to become opioid addicts than anyone else, according to old study results (I may be able to dig them up if you're interested).
It's of course different for chronic pain. But then, the reason for people wanting to start up again is pretty obvious.
I think I have heard the same. People whose lives are hopeless are much more likely to get addicted. The addiction then makes their life worse which causes this downward spiral of despair.
People with physical addictions can choose not to use drugs etc. Smokers can take 12 hour flights and they don't involuntarily take out a lighter and cigarette and smoke half way through. It is about self control.
What do you now do instead of gaming? Do you find you have swapped for a different activity or a more balanced allocation of time among other things? Or do you still spend your off hours in the same way, but kicked the compulsion for gaming all day?
I do the work I probably should be doing, or side projects, or spend time with my kids, or go on a walk, or follow up on that thing I've been putting off, or any of the other million things that are more productive and fulfilling than video games are. It's embarrassing to admit that I was a grown man who would put off basic, important tasks just to play games but I did. Now I don't.
It's not even really about choosing not to, either... it really does feel fundamentally like I cannot even derive a dopamine response to video games at all anymore, period. Same could probably be said about doom scrolling social media or whatever else. I just get no false positive feedback loop from the act.
If it works for you keep it up. As someone who finds video games an art form I find the 'avoidance to do better things' quite similar to someone who might avoid reading or watching movies as a hobby.
I suppose if you just play the same game day in and day out and it has no real substance (which admittedly is probably the largest gaming segment) it might be a good thing to get rid of the habit. But some games are masterpieces and they often hit very different than other mediums because you are the protagonist making choices. In my opinion some of the best stories come in the form of games and I find it a real shame there's a portion of the population who think they're a complete waste of time.
I think there's also something to be said here about being addicted to work. I know such people and it's just as sad even if it's what society expects of them.
I think the context here is important. regardless if videogames are an artform
or not. putting off work, parenting or whatever are priorities in life to get a videogame fix is not the same as playing video games in your leisure time when is not an impulsive decision
Can't speak for OP but I largely spend it reading (and web). I bought a kindle recently because I found the ipad/iphone were too distracting to reliably avoid web surfing instead of a book. I view the switch to long form content as a form of information dieting in the same way as a switch to whole foods.
> This was an unintended side effect (benefit?) of the drug for sure, in addition to acute weight loss of course.
Is it possible that video games were your escape from a world in which you were obese, with all that it can entail, and losing the weight removed the need to escape?
It could also be simply that as you lose weight, you have more tonus (something that I experienced myself), and activities that are inherently passive (watching TV, playing videogame) seem less relatively compeling than more active alternatives.
Not true for everyone, or perhaps even most playing in this space.
Every batch friends of mine have ordered has been independently tested for purity and dosing. Random batches also tested for sterility.
Plenty of folks yolo it, but it’s not like it was a couple years ago. Lots of group buys being done that order a large batch and then do random sampling for lab testing.
Not to defend buying research chemicals of unknown safety, but that isnt what he said. Independent labs test for purity and provide certification to the companies that sell them. Those certifications can be verified by anyone. So its much less trust necessary to know what you are getting.
I think it depends. With tirzepatide (my first encounter with GLP1 meds) I got acute appetite suppression, perhaps too acute. I living comfortably on sometimes 1500 calories or less per day, and I track my calories religiously. We are talking maybe 1 cup of yogurt with frozen berries in the morning, and 1 whey protein shake around 3pm (Fairlife milk + 2 scoops whey) and I would be absolutely full until bed. No energy deficiencies to note. I worked out regularly 5 days a week.
This caused rapid weight loss. A side effect of this rapid weight loss and lack of food intake I also attribute to my thinning hair and dry, splotchy skin outbreaks. Any sort of overeating on tirzepatide (for me) caused severe sickness, or nausea.
Retatrutide, by contrast, causes far less pure appetite suppression (my dosage is also lower) and has another mechanism which helps me maintain leanness while also eating extra calories. I think I prefer the reta, but if I ever felt the need to very simply destroy my appetite again I wouldn't hesitate to use tirzepatide again.
I procured both tirzepatide and retatrutide through the peptide "grey markets" so one was not harder to come by than the other.
League of Legends is “used” by a lot of people as medicine. Nobody hides away to play Stanley Parable. Lots of games, lots of genres, difficult to generalize.
I'm going to put on my Boomer pull-yourselves-up-by-the-bootstraps hat, but are you concerned about the loss of grit resulting from changing your behaviors without the drug?
Definitely not GP, but I think it’s pretty clear that whatever grit there was to have, GP did not have it. “Die an early death due to being overweight or build the grit” is strictly worse than “lose the weight without building the grit, or build the grit”, and it’s even more so when you realize that “or build the grit” was never in the cards. Because then the choice becomes “die an early death or don’t“. Building the grit can be done on other, hopefully less lethal, projects.
Not the GP, but do you think Serena Williams - world number 1 womens tennis player for 319 weeks, who trained for 5 hours per day at her peak - has insufficient grit?
Grit, or willpower, or whatever you want to name it isn't a unique, constant value. There are plenty of athletes who could spent hours training every day but are overcome by addictions. People who grind at work but cannot fill paperwork to save their life. That will diligently do something for months then stops after an unexpected interruption.
There's probably generally a bit of correlation. But just because someone can be very focused and go to extreme lengths in one aspect of their life doesn't mean they can consistently do it in every aspect of their life.
What do you mean "grit"? Does doing something more efficiently mean you lose it? What's the difference, say, between someone using an LLM to help them code and someone else using a drug to help them diet? Is the coder using an LLM losing their "grit"? Do you walk to work in 30 inches of snow, uphill both ways, in the rain? Are you concerned about your loss of "grit" by not doing so? This argument continues to baffle me.
I didn't take the GLP to help me with addictive behavior traits beyond my diet, but I observed tertiary benefits of the drug.
As I've titrated my dose down to zero, I've retained those habits and my weight. I'm in the best shape of my life and mentally healthier than I've been in over a decade.
I think this is a valid point, and the reason I haven’t tried these drugs and don’t plan to. There are huge benefits to developing the mental strength and discipline to lean into discomfort consistently and just do what needs to be done- and all types of addiction provide one of the hardest, and therefore most valuable and useful obstacles here. As Marcus Aurelius said “The impediment to action advances action. What stands in the way becomes the way.”
I’ve found that the general act of leaning into challenges and mild physical discomfort has a ripple effect on my mind, and all types of addiction and dopamine seeking behaviors become automatically less interesting- almost exactly like what people report on these drugs. If I take a cold shower or work out every morning even when I don’t feel like it- pretty soon I’m eating healthier and limiting my alcohol, caffeine, and screen time without even really trying to.
That said, it only works if you manage to actually do it. It’s much better to get over addiction with a drug than to continue suffering from the addiction, and be unable to escape, especially something that causes as much damage as alcohol can.
One idea I had was to set a deadline for overcoming an addiction, and to just use the drug if you reach the deadline and the mental approach is still unsuccessful.
I wonder if you have more ”grit” than Sugar Ray Leonard, one of the greatest boxers of all time. His fight with Roberto Duran are legendary.
As so many boxers (and many athletes for that matter) he was addicted to drugs and alcohol for many years. Probably sexual abuse he suffered as a kid had something to do with it. He was able to quit, but I think cold shower and a run in the morning was not quite enough to do it.
Nobody just starts abusing their body with chemicals. It is not difficult to quit, you can stay off your Jones for months, but if you do nothing to the demons that made you enter the 36th chamber in the first place, you are going to slip sooner or later. It takes more than a splash of cold water on the face.
Marcus Aurelius was literally a god and the emperor of the world. He prob had little bit more resources to help gim other than stoism. Similarly if you have loving family and friends, a good therapist and some sort of medication,you canmaybe wim the fight with the devil that gets you to use. Training and getting used to being uncomfortable surely helps, but you won’t kick anything for long only with them.
Therefore these drugs won’t be a solution either. Are you going to use them rest of your life? Whatever it is that makes you want to drink, smoke, shoot, gamble or whatever is still going to be there. Bit used together with therapy and loving environment might help. Of course, most addicts have no access to any of these resources.
I agree with all of what you said, and I'd argue that the stoics including Aurelius probably would have as well. Leaning into discomfort is just a step that can help you actually do things like get therapy and be present and engaged in a loving environment. At least for me that's the case- I have seemed to need all of those things together as a system to really thrive in life, not just one or the other.
CBT and ACT are modern therapy methods based on stoic methods, very widely used, and very effective for regular people that aren't emperors.
They are most often effective if you can afford them was my point. I have ADHD as well and boxing (waking up before work to run in cold November morning, 9 rounds with a heavyweight who had nobody his size to spar, thousand ab movements afterwords and hey it’s only Tuesday) helped me tremendously with focus, staying of the booze and so on, but if I had not done years of therapy and had meds as well as found more varing environment, I prob would no be hete. And I was lucky to have a god job to pay for all that.
I do think you need tremendous mental effort, or grit, even to fight serious addiction. But it is only a start.
Not doubting your expertise, but I am skeptical of the idea that this method of intentionally leaning into discomfort only works for some minuscule abnormal subset of people that are just wired differently. Instead, I suspect it's tapping into something deeper about how our reward system is structured, something extremely related to how these GLP-1 agonists work, which explains why they are both effective against a shockingly wide array of seemingly different situations.
The basic idea seems to be at the core of both a lot of modern self help gurus advice that seems to actually work for a huge fraction of the people that really commit to them (David Goggins, Wim Hof, etc.) as well as modern psychotherapy systems like CBT and ACT that are proven clinically effective.
How many people are really trying this approach, and it not working for them? More often, I see people saying it sounds like it royally sucks (which is true and basically the entire point), and never trying it- which is valid, but doesn't really demonstrate that it wouldn't work for them.
It absolutely is a "nociceptive hell" at first for everyone that tries it, but when you connect that with intention, purpose, and meaning it eventually transforms into something almost enjoyable. Becoming strong enough to meet discomfort or pain feels amazing, especially for someone that usually experiences the opposite of that.
I also have ADHD, which is explained in part as a developmental disability of executive control, but I find this approach to be extremely effective for regaining executive control, even to levels that people without ADHD lack. Basically, I suspect ADHD isn't a loss of executive control at all, but the executive control is being blocked by something like the feeling of pain or drug withdrawal, and that once you are okay with just having that bad feeling all of the time, you get your executive control back. I'm curious if GLP-1 drugs also help with ADHD? My prediction is that they would.
Can you define huge fraction and really commit? And cite evidence?
I disagree the basic idea of CBT or ACT is leaning into discomfort. In the senses articles suggest David Goggins and Wim Hof advise even less.
CBT and ACT work for many patients and don't work for many patients.
Some people liked intense exercise their whole lives. Some people hated it when they started but liked it eventually. Some people exercised daily since decades and hated every minute. Do you not believe the 1st and 3rd groups?
Pushing through bad feelings is a form of executive control. And ADHD impairments are not limited to impulse control. People who have ADHD who do not take medication have significantly higher rates of driving accidents than people who do not have ADHD or take ADHD medication. Proprioception, internal time perception, and working memory impairments are common.
> I disagree the basic idea of CBT or ACT is leaning into discomfort. In the senses articles suggest David Goggins and Wim Hof advise even less.
I am somewhat baffled by your statement, as I feel it is largely self evident being familiar with, and having tried both therapy methods with professional therapists, and both Goggins and Hof's advice for years. I think a simple wikipedia level explanation of what those things actually are would suffice to answer your question, so I have nothing major to add, unless I am misunderstanding you. Goggins whole shtick in particular is just this one basic point, make yourself as mentally tough as possible by intentionally always doing whatever is difficult. Hof is also just literally getting into very cold water consistently, which is really not easy- and he has no real philosophy or theory, he just has you do it and see what happens.
Perhaps the therapy methods are less clear, but reframing things or deciding on clear values and purpose, are in my view, psychological tools to make the difficult endurable, or in some cases even enjoyable. This makes more sense if you're seeing the methods in the context of how the ancient stoics used the same techniques that inspired those therapies- especially Epictetus.
> Can you define huge fraction and really commit? And cite evidence?
Not really, it's just firsthand experience from doing them, and having widely sought out and read the experiences of others that did online.
In other words, gathering your own anecdote, compounding that with other anecdotes through biased sampling (which kind of person will feel more motivated to share their anecdote on it? And which and anecdotes do you reject because they just didn't try hard enough?) and then projecting that onto every other human being and assuming they must experience the same thing you do.
“I am skeptical of the idea that this method of intentionally leaning into discomfort only works for some minuscule abnormal subset of people that are just wired differently”
That may be the aspect of this line of thinking that’s not clear then: it doesn’t work for anyone. At least, in so far as the free will is illusory, it is a hallucination that such people have that they made such decisions, and stuck to them. It’s the demon hand syndrome, the person hallucinating a rationale for its motion.
The free will question seems to be a red herring- philosophers and physicists can argue all they want about if something like free will is physically possible or not, but for all intents and purposes, even without free will, the path of someone overcoming, e.g. alcoholism after using these methods requires using them in a way that is challenging, and if you decide on the nihilistic stance that there is no free will so there is no point in ever trying to do anything, then you are guaranteed an undesirable outcome.
Perhaps beforehand it was somehow "pre-determined" which of these attitudes and paths you would take, but that is completely irrelevant for the individual just living life, they have no way to know that one way or another, or any reason to actually care, as they still need to act exactly like they have free will and made the right choice to actually play out a future as the type of person pre-determined to have a desirable outcome.
It doesn't actually feel any easier or less painful to accomplish something difficult, even if free will is some sort of illusion when looked at from the outside perspective. You still experience, e.g. trying and failing over and over and never giving up until you succeed.
I can buy that, for example perhaps there is something outside our control that decides if you are capable of never giving up, but you still cannot know until you decide to never give up and try it- so it literally does not matter except as a philosophical curiosity.
I think a more interesting biological (and philosophical) question is why and how exactly do these GLP-1 drugs work, and why exactly are they so shockingly effective? Maybe they do somehow act on the brain to offer exactly the same psychological benefits as the stoic approach I am talking about, by the same or related underlying mechanism, and they're essentially interchangeable but work more often?
This topic is a great example of how results from down-in-the-weeds biochemistry immediately raise questions at the top levels of consciousness and existence.
“Leaning into discomfort” for personal change may well work for much more than a miniscule fraction of people. It may be that such success is made more likely by some structural predisposition – an attenuated neuronal response to negative reinforcement, or some other precondition that allows its “carrier” to keep plugging to a successful outcome.
But clearly, there’s also a more than miniscule fraction of people for whom that doesn’t work. Their preconditions may deflect them from even trying that particular path, or cause them to give up along the way. I really don’t know, but that fraction seems at least as significant as the fraction for whom uncomfortable personal development paths lead to success.
Early in my career, I strongly believed in free will. I mean, I had it, right? And I didn’t regard my consciousness as all that different from my fellow hominids, so they’re probably all similarly endowed, right? Except...
Over time, research with small molecules like epinephrine and the psychedelics showed that perception/decisions/will could be profoundly influenced by neurochemistry. Ditto for various neuronal illnesses that are associated with profound personality changes.
I regard the GLP-1 results as a further demonstration that “free will”, whatever that is, is fundamentally mechanistic. There are few, maybe no, organismic drives stronger than hunger. A weekly injection of a GLP-1 agonist turns that drive way, way down in most of those who try it. This commonly exhibits itself in profound behavioral modification: if you were an inveterate snacker, suddenly you’re not interested in snacks. You pass them by in your pantry and at the grocery store. Your cognition around snacking changes, to the extent that not only aren’t you snacking, but you might find yourself setting a reminder that it’s time to have lunch. Given the strength of the hunger drive, that’s a very big deal, and revelatory about how we work.
I used to think I understood “free will”. Lately, I find it increasingly hard to define. I’m moving more in the direction of Robert Sapolsky as more research results come in. It feels to me a bit like the “God of the gaps” phenomenon, in which the space available for faith in the supernatural grows smaller with every scientific discovery.
It’s a remarkable time to be alive and have the luxury of considering these questions.
Ah, you might have seen my reply to someone else addressing the free will question from a philosophical angle, but despite also being in the life sciences, I never expected you were thinking about it biochemically.
I think it's obvious that we don't have "free will" in that sense, it had never really occurred to me to consider otherwise- people are definitely quite driven by instincts, neurochemicals, etc. they they can't consciously choose.
However, I think my comment in the other thread still applies- that for an individual, it doesn't really matter one way or another- your firsthand experience is still going to be one of exercising your will to increase the odds of getting outcomes you want in life, or choosing not to, and definitely not getting them.
But there is some biological clue here about who we are, and how our brains work that is fascinating, when you consider the breadth of human health problems and challenges that these GLP-1 agonists influence. I can't wait to see what more is learned about this in the future.
Getting rid of an addiction also counts as strengthening your mind in itself. A healthier mind will be in a better position to strengthen and fortify itself.
After I started committing, really committing to consistently working out, a lot of other things fell into place more or less automatically. I stopped drinking, started eating very cleanly (I became ravenously hungry; junk food and sweets aren't appealing anymore), and stopped spending as much time on gaming. I know your broader point is about leaning into discomfort, but specifically leaning into exercise seems to bring extra benefits. Exercise is medicine, as they say.
I think for this to work psychologically, it just needs to be something difficult or uncomfortable that you can do an awful lot of in a way that is sustainable, and doesn't actively harm you... all the better if you actually benefit directly from it, like with exercising, but cold showers work just as well, simply because they're uncomfortable and take much less time than working out- I personally do both.
The issue with addiction is, it’s very often a symptom of other underlying issues. Relapse are common because too often the underlying problem isn’t treated. Overcoming the addiction is hard because it means facing the thing the addiction allows you to avoid.
Addiction is also common(ism) amongst those who suffer from NDP. In this case, is it truly addiction, or simply another tool in their NPD cache of weapons.
I don’t disagree with you. But it’s also important to be aware of some of the nuances and finer points. I also recommend reading “The Courage to be Disliked”. Not that it / Adler speak to addiction but it’s a thought provoking alternative to the Freudian paradigm.
If I can change my behaviour and achieve good health outcomes, relatively painlessly, why on earth would I not?
This comes across to me like people who won't use painkillers - I should feel the pain, masking it is fake, there is virtue in suffering etc. Turns out those people often end up with secondary complications to (for example) muscle damage, because they've adapted their movements so much to avoid using the painful muscle that now everything else is tense, strained and locked up.
If people want to believe in "grit", they at the very least have to also believe in Undset's dictum: the hearts of men do not change, not in any age.
If it's an inherent quality, then there's no reason we should have any less of it than "the greatest generation", or whoever we should want to idolize. The difference has to be external, not internal.
Let's work on what we can change, the external. What you are might change, but you can't change it - that's the core realization behind both European pagan obsession with fate, and Christian obsession with sin.
Been on Mounjaro/Zepbound for the past 2 years. Lost around 80lbs, and my brain feels like I’m 25 again. Almost no urge for alcohol and have an opened bag of Halloween candy in the closet which isn’t calling my name. But the most surprising part hasn’t been that… it’s that my no limit poker game has gotten really quite good. I’ve played for 20 years, and been well above average, but after the glp-1, something just clicked. Maybe I no longer go on tilt or something? Played in the World Series of poker for the first time last year and placed in the money, in the top 10% after having not played since before Covid. I just started playing in a house game that I’d previously played in 10 years ago. Same people, and before I’d never placed in the money. I’ve now won in 3 of the last 5 games. Something’s different. Is playing poker pleasurable? Not in the least, but a good friend invited me, and played for the social aspect, but now I’m just stunned at how good I’ve suddenly become. Disliked the World Series so much last year, that I opted against playing again, even though I expected to place again. Maybe other poker players will adopt it.
One thing i noticed being on ozempic at first and then mounjaro after, while mounjaro is better for weight loss in general, ozempic was better at tampering my desire to drink throughout the week (although i wouldn't say i had AUD on either). I think the reason for this is the half life: ozempic is 7 days, (enough to get you until the next once a week dose), while mounjaro is only 5 days (which means by day 6/7 less than half the dose your took at the beginning of the week is still in your system). This also applies to food as well: my craving were less for sweets etc by the end of the week before the next dose on ozempic vs now on mounjaro. Although I think because mounjaro has 2 mechanisms of action vs just 1 for ozempic, I still end up losing more weight. But this is subjective based on my experience.
However, Ozempic will be generic early 2026 in Canada, and there's no way in hell I would pay 4-5x the difference (I'm guessing) for mounjaro as the benefit is relatively minor already given the half life difference (right now the price is almost the same).
I’m not diabetic, so my insurance doesn’t cover it, meaning I have to pay full price, which only went up after Eli Lilly switched from vials to pens in Canada. I genuinely hate Eli Lilly for : 1) their pricing, 2) for eliminating vials in favor of pens, and 3) for how they handled my situation. I reached out to their customer service honestly, admitting I wouldn’t qualify for a discount (even though I’d seen countless Reddit posts from people lying on the form and getting approved anyway and told them this). I reached out and requested in good faith and was flat-out denied, basically brushed off by their support team. This destroyed a lot of goodwill i had initially towards them because of better results and any future brand loyalty I might have had.
All I will say, is if/when you start noticing digestive issues, it's probably the GLP-1 even if it's after a year of taking the stuff... and woah boy, coming off the stuff is anything but fun.
What was your comedown like? After 6 months of taking subcutaneous semaglutide, I just stopped taking it one day and it was fine. Need a bit more effort to be mindful of snacking now, though.
EDIT: saw your other comment that you felt you were starving. that sucks. the whole thing experience sounds awful.
Started developing gastroparesis issues after about a year on Trulicity... over the pandemic, due to shortages I was switched to Ozempic for a few months which was less effective with my diabetes mgt. I didn't actually lose weight on the medication(s).
After seeing several doctors about the issue including a couple specialists, only one of about half a dozen medications tried actually worked to help the gastro issues, which included fecal vomiting, rotted fermented food coming up, both regularly. No actual blockages. The medication that did work wasn't covered by my insurance. After a couple years of suffering, I saw a news report about the Trulicity lawsuit related to gastroparesis issues. Over the same period, I started to develop retina issues, several retina bleeds and regular injections to treat it.
When I found out about the lawsuit, I stopped taking the medication going back to straight insulin injections (long and short) currently Lantis and Novalog. For close to a year after coming off, I experienced a feeling of starvation 24/8... didn't matter if I was physically full up to my throat, the ravenous feeling of hunger would not subside. I gained about 80# during this time (again, didn't lose weight on the meds).
I'm a few years off and my digestion is inconsistent and unpredictable... sometimes I'll have a few days where things flow normally... others I'll be backed up for close to a week and have to take a heavy magnesium laxative to get things going again. I stay pretty close to carnivore as just about anything else can range from discomfort to pain. Not to mention legume allergies and really sensitive to wheat... I still cheat about once every other week, and I pay for it physically.
Because I was on more than the one medication, I cannot participate in either the Trulicity or the Ozempic class action lawsuits. These medications have kind of ruined my life. I'm now about half blind and using 45" monitors to work, and even then have to zoom text and lean in to be able to function.
Over the years, I've been on several drugs for diabetes that I'd built up a quick tolerance to, that may have had other negative effects... Byetta, Victoza and others... I've always had digestion sensitivities, these just turned it up to 11. When I started Trulicity, my insulin use was pretty minimal and I was already on a Keto diet and had been losing weight... I wish I'd stuck with that and never even heard of the stuff.
Some of the recollections are a bit jumbled, apologies for that, I'm just kind of writing as it comes to mind.
Aside: along with the medical issues has been some employment inconsistencies the past few years with a few contract roles spread a few months apart. I had hoped to maintain my income level as many available jobs were lower pay. Currently, my insurance is "emergency" coverage based, and doesn't even cover the 3 doctors I'm seeing regularly and doesn't help much with the medications I am still taking. Let alone the eye injections I haven't been able to get for about a year now ($7k/eye/injection). Tried working 2 jobs for a while, but couldn't keep up with the load after a few months. I'm depressed and angry. Prior to about 8 years ago, I never carried debt... now I'm maxed out and staring at bankruptcy.
As a beer enthusiast drinking unhealthy amounts rather too frequently, my drinking went way down when on Mounjaro.
(Maybe it wouldn't have made the same difference if I was into whisky instead of beer - with beer, I suspect it's the relatively large volume of drink involved that may have made it less appealing?)
Recently switched to Wegovy since the big Mounjaro price hikes here in the UK, and it seems rather less effective overall. Both beer and snacks are somewhat more appealing again :(
Side effects are generally rare, but it really depends on the person. I tried to start five times, and got massive side effects each time. The last time I started, I did my own protocol (started at 0.5mg every three days and increased a bit on every injection).
Now I'm up to 6mg and I'm not getting any side effects, but it also doesn't work for me! I lost 6kg at one point but the effects wore off and I gained the weight again.
None of my friends had this experience, for everyone else it's worked with no side effects. I really am cursed.
Be on the look out, I had really bad semaglutide side effects and had to stop. Thought microdosing would help, but the side effects just ramped up more slowly, culminating in what I assume was gastroparesis (my food just stopped digesting for over a day and I couldn’t eat despite being hungry and depleted, not to speak of the rest of the digestive process).
I also had drastically degraded (increased) resting heart rate, (decreased) heart rate variability, and exercise intolerance - a normal easy run started to make it feel like my heart would explode and gave me palpitations. Off it, I can run a 5K and beyond no problem, if my knees cooperate.
Food noise came into the picture much worse than baseline after I stopped, although it did eventually come down and I’ve been able to start losing weight again after a few months off. Berberine seems to help, at the expense of giving me nausea like semaglutide, but no other side effects.
> A more recent RCT showed that low-dose semaglutide reduced laboratory alcohol self-administration, as well as drinks per drinking days and craving, in people with AUD [72].
I think this quote is... wrong? Or at least extremely misleading? Here, citation 72 refers to a paper by Henderson et al. That paper did (sorta) reduced laboratory alcohol self-administration, but did not find any reduction in the amount that people drank. https://dynomight.net/glp-1/
> Semaglutide treatment did not affect average drinks per calendar day or number of drinking days, but significantly reduced drinks per drinking day (β, −0.41; 95% CI, −0.73 to −0.09; P = .04)
So they didn't find any reduction in (1) drinking, or (2) in the number of days that people drank, but they did technically find (3) a reduction in the number of drinks that people consumed on the days that they drank. So I guess what they said is technically correct... but I still think it's very odd not to mention the headline result that there was no actual reduction in drinking!
I don’t understand the math here. The average per calendar day didn’t go down, so the total drinking is the same. That total is distributed among the drinking days, which are also the same. So how can the drinks per drinking day have changed?
1. drinks/day declined in both groups and somewhat more in the treatment group but wasn't statistically significant
2. number of drinks/day basically wasn't different at all
3. drinks/drinking day didn't change in the placebo group but did decline in the treatment group
(These are all actually regression coefficients computed on non-random samples but nevermind.) Somehow it seems like what's happening is that 3 rises to statistical significance even though 1 doesn't.
I've noticed that when I'm on Zepbound 2.5mg, I don't have the strong urge to play video games and can focus on my projects. Even if I do play video games while on it, I lose interest after a maximum of half an hour.
Just a single datapoint here. About 8 months after starting on semaglutide I took a month off alcohol and by the time the month was over had lost all interest for alcohol.
Almost 2 years now. I'm not religious about it and will occasionally drink the celebratory glass of bubbles or a beer (alcohol free if available) when it's hot outside.
As someone who doesn't really drink and never has alcohol at home, is it just that people buy beer/wine and drink on a daily basis for fun? The wine I feel like you can pair with food and feel classy as an excuse but beer that ain't the case.
I realize how completely dumb this question might sound.
> As someone who doesn't really drink and never has alcohol at home, is it just that people buy beer/wine and drink on a daily basis for fun?
Yes, anything from a couple of drinks a night with dinner / tv to getting blackout drunk multiple times a week, alone, with your significant other, or with friends / roommates.
In the case of people in my social circle (late 30s early 40s) it's primarily still for fun, as well as just a large amount of momentum from your teenage years, 20s, 30s, etc. For a lot of people I know, the association between drinking and good times / relaxation has been deeply engrained since high school.
I've recently taken an extended break for my health, as I'm fully aware that it takes a toll on me, but I still love grabbing some drinks whether I'm relaxing alone in the evening or going out with friends and family.
While it's certainly true that many people get into a dark place with drinking and let it spiral into a self-destructive, depressive pursuit, I don't think it's quite the rule it's made out to be.
I have a good amount of family who live idyllic, full, happy, social lives, drinking heavily multiple times a week with their friends and family into their 70s/80s until death.
I think the calorific content of alcohol and general habituation are under-looked. I also basically never drink any more (and am on zep), but when I do occasionally have a craving, an alcohol-free beer 100% hits the spot for me.
I'm not trying to pick on you because I've seen this anecdote on many occasions; however, it strikes me that people are quite willing to walk past "personality changes" as a side effect of a drug.
Does anyone else feel a slight sense of worry about this?
I don't know much about the drug, maybe you're talking about something else... but FWIW, I got sober from years as a practicing alcoholic the traditional way, I had lots of personality changes, some good some bad, but who I was when I was drinking all day every day and who I am today are quite different people.
I don't think it's a personality change, at least insofar as personality is separate from neurochemistry. Ghrelin and dopamine are strongly linked, and dopamine is our central reward-seeking driver; GLP-1s generally reduce ghrelin production, which I suspect helps remove you from a state of being constantly primed for reward-seeking. I noticed this firsthand when I went hard keto for the first time, and could suddently for the first time tell a significant difference between "I want food because I'm hungry" and "I'm not hungry but want food because it's pleasurable".
I worry about it. I do tend to wonder if it can change your relationship with addictive and maybe risky behaviors, does it also potentially make you into a more conservative (not politically) person? Does creativity and risk tolerance go down as well?
I hate these articles so much. The title should be: “Speculation on how GLP-1a drugs could theoretically reduce alcoholism while waiting for any real evidence”.
99% of promising mice studies does not result in clinical practical application in humans. And theoretical associations and mechanisms of action should not be promoted without huge asterisk to contextualize how often such speculation are wrong.
If you complain about AI slop and don’t see how this is just as bad science slop, please go listen to Sabine Hossenfelder. This is just as bad, and create just as much useless noise as AI content does on the nett.
Once-Weekly Semaglutide in Adults With Alcohol Use Disorder
Results
Forty-eight participants (34 [71%] female; mean [SD] age, 39.9 [10.6] years) were randomized. Low-dose semaglutide reduced the amount of alcohol consumed during a posttreatment laboratory self-administration task, with evidence of medium to large effect sizes for grams of alcohol consumed (β, −0.48; 95% CI, −0.85 to −0.11; P = .01) and peak breath alcohol concentration (β, −0.46; 95% CI, −0.87 to −0.06; P = .03). Semaglutide treatment did not affect average drinks per calendar day or number of drinking days, but significantly reduced drinks per drinking day (β, −0.41; 95% CI, −0.73 to −0.09; P = .04) and weekly alcohol craving (β, −0.39; 95% CI, −0.73 to −0.06; P = .01), also predicting greater reductions in heavy drinking over time relative to placebo (β, 0.84; 95% CI, 0.71 to 0.99; P = .04). A significant treatment-by-time interaction indicated that semaglutide treatment predicted greater relative reductions in cigarettes per day in a subsample of individuals with current cigarette use (β, −0.10; 95% CI, −0.16 to −0.03; P = .005).
One breakthrough and then a WHOLE BUNCH OF NEW STUFF happens all at once now that this new idea or new pathway is created.
mRNA vaccines break away and now they're testing them in everything. GLP-1 showing signs of use in obesity and now it's being tested for a whole gamut of other things. All very exciting!
Once I started on tirzepatide, and then with retatrutide, the "urge" to swap over to my PC between meetings and load up a game is pretty much zeroed out.
Is this an "addiction" or a form of "abuse" similar to alcohol or other drugs? I would have said no some time ago, but now I'm not sure. I definitely feel like, looking back, I was more or less "addicted" to video games. I don't want to romanticize it as some sort of "escape", it just is what it was.
This was an unintended side effect (benefit?) of the drug for sure, in addition to acute weight loss of course.
Unlike many others, even after titrating down and coming off the GLP's, I have not felt the urge to binge food, video games, or anything else. I maintain a healthy, active lifestyle and have kept my weight exactly where I prefer it. My relationship with my body and my time has massively improved. I feel like I am at risk of sounding like a complete shill, obviously, but in my mind these drugs can be something that absolutely has the potential to turn life around for many, many people.
For people with normal executive function, the second category of problems should be fairly tractable to overcome, whereas the first is still quite difficult.
The second only really becomes an issue when you have a bit of executive dysfunction.
Maybe that distinction is important and one merits the term addiction while the other doesn't? Though both categories seem to be relatively treatable with drugs that massively improve executive function, so the parallels are pretty glaring.
Conversely, people hospitalized for something acutely painful often get addicting (or, withdrawal causing) painkillers in amounts and at purities street users can only dream of. And once it's over, they go through withdrawal, and it's deeply unpleasant, and they never want to do it again. People going through something like that aren't more likely to become opioid addicts than anyone else, according to old study results (I may be able to dig them up if you're interested).
It's of course different for chronic pain. But then, the reason for people wanting to start up again is pretty obvious.
People with physical addictions can choose not to use drugs etc. Smokers can take 12 hour flights and they don't involuntarily take out a lighter and cigarette and smoke half way through. It is about self control.
The lifelong craving is the bigger issue.
It's not even really about choosing not to, either... it really does feel fundamentally like I cannot even derive a dopamine response to video games at all anymore, period. Same could probably be said about doom scrolling social media or whatever else. I just get no false positive feedback loop from the act.
I suppose if you just play the same game day in and day out and it has no real substance (which admittedly is probably the largest gaming segment) it might be a good thing to get rid of the habit. But some games are masterpieces and they often hit very different than other mediums because you are the protagonist making choices. In my opinion some of the best stories come in the form of games and I find it a real shame there's a portion of the population who think they're a complete waste of time.
I think there's also something to be said here about being addicted to work. I know such people and it's just as sad even if it's what society expects of them.
Pill popping.
Is it possible that video games were your escape from a world in which you were obese, with all that it can entail, and losing the weight removed the need to escape?
Anyone saying they’re taking retatrutide almost certainly obtained it this way. Quality and purity untested.
Not true for everyone, or perhaps even most playing in this space.
Every batch friends of mine have ordered has been independently tested for purity and dosing. Random batches also tested for sterility.
Plenty of folks yolo it, but it’s not like it was a couple years ago. Lots of group buys being done that order a large batch and then do random sampling for lab testing.
> Not true for everyone, or perhaps even most playing in this space.
> Every batch friends of mine have ordered has been independently tested for purity and dosing. Random batches also tested for sterility.
Yes, you have to test it because the quality and purity what you get isn’t tested.
When someone sells something and they make a statement about the product (e.g. “tested”), they don’t mean the customer has to test it.
This caused rapid weight loss. A side effect of this rapid weight loss and lack of food intake I also attribute to my thinning hair and dry, splotchy skin outbreaks. Any sort of overeating on tirzepatide (for me) caused severe sickness, or nausea.
Retatrutide, by contrast, causes far less pure appetite suppression (my dosage is also lower) and has another mechanism which helps me maintain leanness while also eating extra calories. I think I prefer the reta, but if I ever felt the need to very simply destroy my appetite again I wouldn't hesitate to use tirzepatide again.
I procured both tirzepatide and retatrutide through the peptide "grey markets" so one was not harder to come by than the other.
League of Legends is “used” by a lot of people as medicine. Nobody hides away to play Stanley Parable. Lots of games, lots of genres, difficult to generalize.
Because she went on GLP-1 to lose weight.
There's probably generally a bit of correlation. But just because someone can be very focused and go to extreme lengths in one aspect of their life doesn't mean they can consistently do it in every aspect of their life.
Because that has nothing to with grit, that's just business.
I didn't take the GLP to help me with addictive behavior traits beyond my diet, but I observed tertiary benefits of the drug.
As I've titrated my dose down to zero, I've retained those habits and my weight. I'm in the best shape of my life and mentally healthier than I've been in over a decade.
I’ve found that the general act of leaning into challenges and mild physical discomfort has a ripple effect on my mind, and all types of addiction and dopamine seeking behaviors become automatically less interesting- almost exactly like what people report on these drugs. If I take a cold shower or work out every morning even when I don’t feel like it- pretty soon I’m eating healthier and limiting my alcohol, caffeine, and screen time without even really trying to.
That said, it only works if you manage to actually do it. It’s much better to get over addiction with a drug than to continue suffering from the addiction, and be unable to escape, especially something that causes as much damage as alcohol can.
One idea I had was to set a deadline for overcoming an addiction, and to just use the drug if you reach the deadline and the mental approach is still unsuccessful.
As so many boxers (and many athletes for that matter) he was addicted to drugs and alcohol for many years. Probably sexual abuse he suffered as a kid had something to do with it. He was able to quit, but I think cold shower and a run in the morning was not quite enough to do it.
Nobody just starts abusing their body with chemicals. It is not difficult to quit, you can stay off your Jones for months, but if you do nothing to the demons that made you enter the 36th chamber in the first place, you are going to slip sooner or later. It takes more than a splash of cold water on the face.
Marcus Aurelius was literally a god and the emperor of the world. He prob had little bit more resources to help gim other than stoism. Similarly if you have loving family and friends, a good therapist and some sort of medication,you canmaybe wim the fight with the devil that gets you to use. Training and getting used to being uncomfortable surely helps, but you won’t kick anything for long only with them.
Therefore these drugs won’t be a solution either. Are you going to use them rest of your life? Whatever it is that makes you want to drink, smoke, shoot, gamble or whatever is still going to be there. Bit used together with therapy and loving environment might help. Of course, most addicts have no access to any of these resources.
CBT and ACT are modern therapy methods based on stoic methods, very widely used, and very effective for regular people that aren't emperors.
I do think you need tremendous mental effort, or grit, even to fight serious addiction. But it is only a start.
Peoples' neurochemistry differs enormously. One person's positive reinforcing experience is another's nociceptive hell. (source: Ph.D. neurophysiologist here)
Arguments like yours presuppose humans have free will, that it's widely distributed, and if $whoever would just get on it, they'd progress.
More and more, it appears what we have is the perception of free will, not the real thing - whatever that actually might be.
The basic idea seems to be at the core of both a lot of modern self help gurus advice that seems to actually work for a huge fraction of the people that really commit to them (David Goggins, Wim Hof, etc.) as well as modern psychotherapy systems like CBT and ACT that are proven clinically effective.
How many people are really trying this approach, and it not working for them? More often, I see people saying it sounds like it royally sucks (which is true and basically the entire point), and never trying it- which is valid, but doesn't really demonstrate that it wouldn't work for them.
It absolutely is a "nociceptive hell" at first for everyone that tries it, but when you connect that with intention, purpose, and meaning it eventually transforms into something almost enjoyable. Becoming strong enough to meet discomfort or pain feels amazing, especially for someone that usually experiences the opposite of that.
I also have ADHD, which is explained in part as a developmental disability of executive control, but I find this approach to be extremely effective for regaining executive control, even to levels that people without ADHD lack. Basically, I suspect ADHD isn't a loss of executive control at all, but the executive control is being blocked by something like the feeling of pain or drug withdrawal, and that once you are okay with just having that bad feeling all of the time, you get your executive control back. I'm curious if GLP-1 drugs also help with ADHD? My prediction is that they would.
Can you define huge fraction and really commit? And cite evidence?
I disagree the basic idea of CBT or ACT is leaning into discomfort. In the senses articles suggest David Goggins and Wim Hof advise even less.
CBT and ACT work for many patients and don't work for many patients.
Some people liked intense exercise their whole lives. Some people hated it when they started but liked it eventually. Some people exercised daily since decades and hated every minute. Do you not believe the 1st and 3rd groups?
Pushing through bad feelings is a form of executive control. And ADHD impairments are not limited to impulse control. People who have ADHD who do not take medication have significantly higher rates of driving accidents than people who do not have ADHD or take ADHD medication. Proprioception, internal time perception, and working memory impairments are common.
I am somewhat baffled by your statement, as I feel it is largely self evident being familiar with, and having tried both therapy methods with professional therapists, and both Goggins and Hof's advice for years. I think a simple wikipedia level explanation of what those things actually are would suffice to answer your question, so I have nothing major to add, unless I am misunderstanding you. Goggins whole shtick in particular is just this one basic point, make yourself as mentally tough as possible by intentionally always doing whatever is difficult. Hof is also just literally getting into very cold water consistently, which is really not easy- and he has no real philosophy or theory, he just has you do it and see what happens.
Perhaps the therapy methods are less clear, but reframing things or deciding on clear values and purpose, are in my view, psychological tools to make the difficult endurable, or in some cases even enjoyable. This makes more sense if you're seeing the methods in the context of how the ancient stoics used the same techniques that inspired those therapies- especially Epictetus.
> Can you define huge fraction and really commit? And cite evidence?
Not really, it's just firsthand experience from doing them, and having widely sought out and read the experiences of others that did online.
That may be the aspect of this line of thinking that’s not clear then: it doesn’t work for anyone. At least, in so far as the free will is illusory, it is a hallucination that such people have that they made such decisions, and stuck to them. It’s the demon hand syndrome, the person hallucinating a rationale for its motion.
Perhaps beforehand it was somehow "pre-determined" which of these attitudes and paths you would take, but that is completely irrelevant for the individual just living life, they have no way to know that one way or another, or any reason to actually care, as they still need to act exactly like they have free will and made the right choice to actually play out a future as the type of person pre-determined to have a desirable outcome.
It doesn't actually feel any easier or less painful to accomplish something difficult, even if free will is some sort of illusion when looked at from the outside perspective. You still experience, e.g. trying and failing over and over and never giving up until you succeed.
I can buy that, for example perhaps there is something outside our control that decides if you are capable of never giving up, but you still cannot know until you decide to never give up and try it- so it literally does not matter except as a philosophical curiosity.
I think a more interesting biological (and philosophical) question is why and how exactly do these GLP-1 drugs work, and why exactly are they so shockingly effective? Maybe they do somehow act on the brain to offer exactly the same psychological benefits as the stoic approach I am talking about, by the same or related underlying mechanism, and they're essentially interchangeable but work more often?
“Leaning into discomfort” for personal change may well work for much more than a miniscule fraction of people. It may be that such success is made more likely by some structural predisposition – an attenuated neuronal response to negative reinforcement, or some other precondition that allows its “carrier” to keep plugging to a successful outcome.
But clearly, there’s also a more than miniscule fraction of people for whom that doesn’t work. Their preconditions may deflect them from even trying that particular path, or cause them to give up along the way. I really don’t know, but that fraction seems at least as significant as the fraction for whom uncomfortable personal development paths lead to success.
Early in my career, I strongly believed in free will. I mean, I had it, right? And I didn’t regard my consciousness as all that different from my fellow hominids, so they’re probably all similarly endowed, right? Except...
Over time, research with small molecules like epinephrine and the psychedelics showed that perception/decisions/will could be profoundly influenced by neurochemistry. Ditto for various neuronal illnesses that are associated with profound personality changes.
I regard the GLP-1 results as a further demonstration that “free will”, whatever that is, is fundamentally mechanistic. There are few, maybe no, organismic drives stronger than hunger. A weekly injection of a GLP-1 agonist turns that drive way, way down in most of those who try it. This commonly exhibits itself in profound behavioral modification: if you were an inveterate snacker, suddenly you’re not interested in snacks. You pass them by in your pantry and at the grocery store. Your cognition around snacking changes, to the extent that not only aren’t you snacking, but you might find yourself setting a reminder that it’s time to have lunch. Given the strength of the hunger drive, that’s a very big deal, and revelatory about how we work.
I used to think I understood “free will”. Lately, I find it increasingly hard to define. I’m moving more in the direction of Robert Sapolsky as more research results come in. It feels to me a bit like the “God of the gaps” phenomenon, in which the space available for faith in the supernatural grows smaller with every scientific discovery.
It’s a remarkable time to be alive and have the luxury of considering these questions.
I think it's obvious that we don't have "free will" in that sense, it had never really occurred to me to consider otherwise- people are definitely quite driven by instincts, neurochemicals, etc. they they can't consciously choose.
However, I think my comment in the other thread still applies- that for an individual, it doesn't really matter one way or another- your firsthand experience is still going to be one of exercising your will to increase the odds of getting outcomes you want in life, or choosing not to, and definitely not getting them.
But there is some biological clue here about who we are, and how our brains work that is fascinating, when you consider the breadth of human health problems and challenges that these GLP-1 agonists influence. I can't wait to see what more is learned about this in the future.
After I started committing, really committing to consistently working out, a lot of other things fell into place more or less automatically. I stopped drinking, started eating very cleanly (I became ravenously hungry; junk food and sweets aren't appealing anymore), and stopped spending as much time on gaming. I know your broader point is about leaning into discomfort, but specifically leaning into exercise seems to bring extra benefits. Exercise is medicine, as they say.
Addiction is also common(ism) amongst those who suffer from NDP. In this case, is it truly addiction, or simply another tool in their NPD cache of weapons.
I don’t disagree with you. But it’s also important to be aware of some of the nuances and finer points. I also recommend reading “The Courage to be Disliked”. Not that it / Adler speak to addiction but it’s a thought provoking alternative to the Freudian paradigm.
If I can change my behaviour and achieve good health outcomes, relatively painlessly, why on earth would I not?
This comes across to me like people who won't use painkillers - I should feel the pain, masking it is fake, there is virtue in suffering etc. Turns out those people often end up with secondary complications to (for example) muscle damage, because they've adapted their movements so much to avoid using the painful muscle that now everything else is tense, strained and locked up.
Better living through chemistry, 100%.
If it's an inherent quality, then there's no reason we should have any less of it than "the greatest generation", or whoever we should want to idolize. The difference has to be external, not internal.
Let's work on what we can change, the external. What you are might change, but you can't change it - that's the core realization behind both European pagan obsession with fate, and Christian obsession with sin.
Life is more complicated than that. We all know that.
However, Ozempic will be generic early 2026 in Canada, and there's no way in hell I would pay 4-5x the difference (I'm guessing) for mounjaro as the benefit is relatively minor already given the half life difference (right now the price is almost the same).
I’m not diabetic, so my insurance doesn’t cover it, meaning I have to pay full price, which only went up after Eli Lilly switched from vials to pens in Canada. I genuinely hate Eli Lilly for : 1) their pricing, 2) for eliminating vials in favor of pens, and 3) for how they handled my situation. I reached out to their customer service honestly, admitting I wouldn’t qualify for a discount (even though I’d seen countless Reddit posts from people lying on the form and getting approved anyway and told them this). I reached out and requested in good faith and was flat-out denied, basically brushed off by their support team. This destroyed a lot of goodwill i had initially towards them because of better results and any future brand loyalty I might have had.
EDIT: saw your other comment that you felt you were starving. that sucks. the whole thing experience sounds awful.
After seeing several doctors about the issue including a couple specialists, only one of about half a dozen medications tried actually worked to help the gastro issues, which included fecal vomiting, rotted fermented food coming up, both regularly. No actual blockages. The medication that did work wasn't covered by my insurance. After a couple years of suffering, I saw a news report about the Trulicity lawsuit related to gastroparesis issues. Over the same period, I started to develop retina issues, several retina bleeds and regular injections to treat it.
When I found out about the lawsuit, I stopped taking the medication going back to straight insulin injections (long and short) currently Lantis and Novalog. For close to a year after coming off, I experienced a feeling of starvation 24/8... didn't matter if I was physically full up to my throat, the ravenous feeling of hunger would not subside. I gained about 80# during this time (again, didn't lose weight on the meds).
I'm a few years off and my digestion is inconsistent and unpredictable... sometimes I'll have a few days where things flow normally... others I'll be backed up for close to a week and have to take a heavy magnesium laxative to get things going again. I stay pretty close to carnivore as just about anything else can range from discomfort to pain. Not to mention legume allergies and really sensitive to wheat... I still cheat about once every other week, and I pay for it physically.
Because I was on more than the one medication, I cannot participate in either the Trulicity or the Ozempic class action lawsuits. These medications have kind of ruined my life. I'm now about half blind and using 45" monitors to work, and even then have to zoom text and lean in to be able to function.
Over the years, I've been on several drugs for diabetes that I'd built up a quick tolerance to, that may have had other negative effects... Byetta, Victoza and others... I've always had digestion sensitivities, these just turned it up to 11. When I started Trulicity, my insulin use was pretty minimal and I was already on a Keto diet and had been losing weight... I wish I'd stuck with that and never even heard of the stuff.
Some of the recollections are a bit jumbled, apologies for that, I'm just kind of writing as it comes to mind.
Aside: along with the medical issues has been some employment inconsistencies the past few years with a few contract roles spread a few months apart. I had hoped to maintain my income level as many available jobs were lower pay. Currently, my insurance is "emergency" coverage based, and doesn't even cover the 3 doctors I'm seeing regularly and doesn't help much with the medications I am still taking. Let alone the eye injections I haven't been able to get for about a year now ($7k/eye/injection). Tried working 2 jobs for a while, but couldn't keep up with the load after a few months. I'm depressed and angry. Prior to about 8 years ago, I never carried debt... now I'm maxed out and staring at bankruptcy.
(Maybe it wouldn't have made the same difference if I was into whisky instead of beer - with beer, I suspect it's the relatively large volume of drink involved that may have made it less appealing?)
Recently switched to Wegovy since the big Mounjaro price hikes here in the UK, and it seems rather less effective overall. Both beer and snacks are somewhat more appealing again :(
It used to be the case that 1-2 drinks would make me feel good, and introduce a craving for more (a "just one more will get me right" feeling).
But that's gone now. It's an amazing side effect.
Now I'm up to 6mg and I'm not getting any side effects, but it also doesn't work for me! I lost 6kg at one point but the effects wore off and I gained the weight again.
None of my friends had this experience, for everyone else it's worked with no side effects. I really am cursed.
I also had drastically degraded (increased) resting heart rate, (decreased) heart rate variability, and exercise intolerance - a normal easy run started to make it feel like my heart would explode and gave me palpitations. Off it, I can run a 5K and beyond no problem, if my knees cooperate.
Food noise came into the picture much worse than baseline after I stopped, although it did eventually come down and I’ve been able to start losing weight again after a few months off. Berberine seems to help, at the expense of giving me nausea like semaglutide, but no other side effects.
I think this quote is... wrong? Or at least extremely misleading? Here, citation 72 refers to a paper by Henderson et al. That paper did (sorta) reduced laboratory alcohol self-administration, but did not find any reduction in the amount that people drank. https://dynomight.net/glp-1/
> Semaglutide treatment did not affect average drinks per calendar day or number of drinking days, but significantly reduced drinks per drinking day (β, −0.41; 95% CI, −0.73 to −0.09; P = .04)
So they didn't find any reduction in (1) drinking, or (2) in the number of days that people drank, but they did technically find (3) a reduction in the number of drinks that people consumed on the days that they drank. So I guess what they said is technically correct... but I still think it's very odd not to mention the headline result that there was no actual reduction in drinking!
This is as in the abstract:
1. drinks/day declined in both groups and somewhat more in the treatment group but wasn't statistically significant 2. number of drinks/day basically wasn't different at all 3. drinks/drinking day didn't change in the placebo group but did decline in the treatment group
(These are all actually regression coefficients computed on non-random samples but nevermind.) Somehow it seems like what's happening is that 3 rises to statistical significance even though 1 doesn't.
It seems it doesn't block dopamine generally, but does seem to act on dopamine spikes?
Almost 2 years now. I'm not religious about it and will occasionally drink the celebratory glass of bubbles or a beer (alcohol free if available) when it's hot outside.
Very interesting how it has worked.
I realize how completely dumb this question might sound.
Yes, anything from a couple of drinks a night with dinner / tv to getting blackout drunk multiple times a week, alone, with your significant other, or with friends / roommates.
In the case of people in my social circle (late 30s early 40s) it's primarily still for fun, as well as just a large amount of momentum from your teenage years, 20s, 30s, etc. For a lot of people I know, the association between drinking and good times / relaxation has been deeply engrained since high school.
I've recently taken an extended break for my health, as I'm fully aware that it takes a toll on me, but I still love grabbing some drinks whether I'm relaxing alone in the evening or going out with friends and family.
While it's certainly true that many people get into a dark place with drinking and let it spiral into a self-destructive, depressive pursuit, I don't think it's quite the rule it's made out to be.
I have a good amount of family who live idyllic, full, happy, social lives, drinking heavily multiple times a week with their friends and family into their 70s/80s until death.
Does anyone else feel a slight sense of worry about this?
99% of promising mice studies does not result in clinical practical application in humans. And theoretical associations and mechanisms of action should not be promoted without huge asterisk to contextualize how often such speculation are wrong.
If you complain about AI slop and don’t see how this is just as bad science slop, please go listen to Sabine Hossenfelder. This is just as bad, and create just as much useless noise as AI content does on the nett.
Once-Weekly Semaglutide in Adults With Alcohol Use Disorder
Results
Forty-eight participants (34 [71%] female; mean [SD] age, 39.9 [10.6] years) were randomized. Low-dose semaglutide reduced the amount of alcohol consumed during a posttreatment laboratory self-administration task, with evidence of medium to large effect sizes for grams of alcohol consumed (β, −0.48; 95% CI, −0.85 to −0.11; P = .01) and peak breath alcohol concentration (β, −0.46; 95% CI, −0.87 to −0.06; P = .03). Semaglutide treatment did not affect average drinks per calendar day or number of drinking days, but significantly reduced drinks per drinking day (β, −0.41; 95% CI, −0.73 to −0.09; P = .04) and weekly alcohol craving (β, −0.39; 95% CI, −0.73 to −0.06; P = .01), also predicting greater reductions in heavy drinking over time relative to placebo (β, 0.84; 95% CI, 0.71 to 0.99; P = .04). A significant treatment-by-time interaction indicated that semaglutide treatment predicted greater relative reductions in cigarettes per day in a subsample of individuals with current cigarette use (β, −0.10; 95% CI, −0.16 to −0.03; P = .005).
One breakthrough and then a WHOLE BUNCH OF NEW STUFF happens all at once now that this new idea or new pathway is created.
mRNA vaccines break away and now they're testing them in everything. GLP-1 showing signs of use in obesity and now it's being tested for a whole gamut of other things. All very exciting!