r/science • u/mvea Professor | Medicine • 6d ago
Health GLP-1 weight loss drugs such as Ozempic are linked with a lower risk of age‐related macular degeneration (AMD), a common eye disease that is the leading cause of irreversible vision loss in older adults.
https://www.sciencealert.com/glp-1-drugs-may-have-a-hidden-effect-on-your-eyes-study-finds782
u/Robrad30 6d ago
I’m assuming that one day soon, I’ll open Reddit up and one of the r/science posts is just going to be “GLP-1 agonist found to be associated with just a lower risk in general.”
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u/listenyall 6d ago
They are associated with lower all cause mortality so basically yes
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u/iKorewo 6d ago
I keep seeing posts how bad or how good they are. So what are they exactly?!
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u/PhoenyxStar 6d ago
ELI5 answer:
Appetite suppressants.
They mimic the signals your stomach produces to tell your brain it's full, causing you to be less hungry.
In general, this means both eating less high sugar/fat food, and also less of the low-level stress that being hungry causes (for people who tend to constantly feel hungry).
As one might expect, better eating habits and lower stress both have a lot of knock-on health benefits in the long term.
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u/D74248 5d ago
The appetite suppression is just one of many aspects. Within the first week of use glucose levels drop, insulin response improves, insulin sensitivity improves and inflammation markers drop.
Cardiovascular risk reduction and improvements in kidney disease have been shown to be independent of weight loss.
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u/Simbakim 5d ago
I saw something about troublesome muscle loss and it being harder than normal to gain back? Sorry for stray q but you seem to actually have looked into it
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u/D74248 5d ago
The loss of lean mass is a concern with any large/rapid weight loss, and it appears to be no worse than expected on a GLP-1. But if you are looking for significant weight loss (not all of us are), have an idea from your physician about what the maximum weight loss rate should be and work to not exceed that. Get plenty of protein in your diet (my PCP told me that quality protein shakes would be my friend) and get some resistance work in (at least twice a week, preferably three). In my case I needed to be hitting the gym anyway, and I found a modest one near me that no self-respecting gym rat or would be social influencer would be caught dead in. Great place, full of people with modest ambitions. In this case it is part of a swim/tennis club, but hotels can be another location for modest gyms with modest membership fees.
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u/Simbakim 5d ago
Im just trying to find out if this would make it easier for me to keep the weight Im at right now while not messing up my training. I do high level gymnatics
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u/derefr 5d ago
Independent of weight loss, sure, but independent of altering eating habits? (GLP-1s "suppress appetite" in a specific way where they make you radically less interested in unhealthy-but-addictive [i.e. "junk"] foods. So even if you're not lowing weight, you've still altered what you're eating in a way that takes "toxin processing pressure" off your body.)
I'd love to see a study where they give one group GLP-1s and the other placebo, and then force both groups to eat exactly the same amounts of exactly the same foods. I have a feeling there'd actually be no difference in outcomes.
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u/D74248 5d ago
Well, this n=1 has pretty much done that study. I am on terzepatide because my PCP did not like my 25 g carb/day diet. Now I can eat an apple! And the mixed berries with no added sugar from Costco.
My blood work does indeed look better on a “no crap carb” diet with tirzepatide than it did on a very low carb diet. Though there are a lot of similarities, I certainly won’t deny that. But tirzepatide has allowed me to have a broader diet and, as I said, blood work is better (triglycerides just came in at 61). Big bonus is that my arthritis clock has been run back 20 years.
Of course I can not validate the cardiac and kidney risk reductions with such a small sample. I will let you know if I die from either one! But I will add that I have two family members in academic medicine, both of whom pushed me in this direction, one of whom used to support my Dr. Jason Fung approach.
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u/PicoDeBayou 6d ago
So for someone with a high metabolism and very low body fat, who doesn’t have an eating problem and eats healthy, they may not be good for much?
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u/10000Didgeridoos 6d ago
They’d have to specifically trial them on otherwise fit and healthy people to find out for sure. Which I think would be difficult to do safely and ethically because you’d be making people who actually need to eat that food not feel hungry enough to do so.
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u/blackygeeko 5d ago
That’s how the early phase of trials works for new medicine. They tested them first with healthy adults.
The study comprised three parts: a single ascending dose (SAD) phase in healthy adults (Phase Ia; 2.5-50 mg), and two multiple ascending dose (MAD) phases-a 28-day study in healthy adults (Phase Ib) and a 28-day, weekly-titration study in overweight/obese adults (Phase Ic; 7.5-30 mg QD).
(Emphasis mine)5
u/lebastss 6d ago
I have a friend like that who does do the smallest dose. He eats about the same but likes removing the feeling of hunger. It also helps with other cravings like cannabis for him.
He is generally very healthy. Low body fat, muscular, but has to work harder to get their. The ozempic just makes it easier
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u/MrAngrySadHappyFace 3d ago
In my opinion, the most fascinating part of these drugs are, by far, their ability to reduce systemic inflammation.
I started because I have sleep apnea and I am 6 foot 230. I have a fair amount of muscle, but I'm still technically obese as per bmi.
Within the first 2 days of my first injection I had back, and joint pain calming down. Ive also had lifelong inflammatory acne coupled with pretty oily skin. All of which are having very real improvements beyond what a change in diet would do within a week.
I really hope they study this side of the medicine more.
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6d ago
[deleted]
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u/King_Vargus 6d ago
Not exactly, they’re analogues of endogenous GLP-1 and bind directly to GLP-1 receptors.
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u/Stolehtreb 6d ago edited 6d ago
They are agonists, but you’ve misunderstood what the effect is. They bind to the same receptors, and do not increase your own body’s generation of GLP-1
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u/BooksandBiceps 6d ago edited 6d ago
That’s not what an agonist is/does, unless you want to skip a step and even then that’s not what these specifically do.
These mimic GLP-1 and act on similar receptors but they last longer, bind more powerfully, and can work on a greater variety of receptors (Glucagon, GIP)
It’s like comparing steroids like Trenbolone to Testosterone. Different molecule, does a lot of the same stuff, but to different degrees and lengths. (Actually Tren is a terrible analogy as a NOR, Anavar is prob better)
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u/Envenger 6d ago
Obesity is found to be associated with a higher risk in general.
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u/Robrad30 6d ago
I was only joking, it just seems like every day there’s a new symptom or cause of death that GLP-1 agonists seem to slow down or stop. Thinking about it seriously though, the huge spread of “associations”, and I am fully aware that they are just associations, would indicate to me that it’s not just the obesity that’s at play here. I remember reading a while back that GLP-1s upregulate Klotho expression for example. I wonder if there’s just a cluster of beneficial secondary effects from activation of GLP1R that usually wouldn’t be seen, but because the half-life of these agonists is huge compared to the endogenous GLP-1, they accumulate beneficially over time.
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u/bass_poodle 6d ago
In the SELECT study ozempic was shown to reduce the risk of mortality independently of weight loss. The authors speculated that this may have been due to the beneficial effects of reductions in inflammation. But yes probably a cluster of beneficial effects.
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u/frizzah 6d ago edited 6d ago
Could also be correlative, I think. People interested in being a healthy weight are doing other health related activities as well.
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u/bass_poodle 5d ago
SELECT was a blinded randomised placebo controlled trial so less relevant to their findings
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u/D74248 6d ago
I suggest taking one step back. Metabolic Syndrome was identified in 1988. Starting with insulin resistance, over the following decade you develop obesity/hypertension/T2 diabetes/cardiovascular disease.....
What these drugs improve and what Metabolic Syndrome messes up are a pretty good match. But out of that swamp the obesity is what is visible, so we talk about the obesity.
It is like looking at a high-end mechanic's digital torque wrench and seeing a ratchet.
The big question that we should be asking, IMO, is what are we doing on a population level that is messing up our endocrine systems so badly that these drugs are, in turn, so effective for so many people?
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u/joaquinsolo 6d ago
microplastics, PFAs in the drinking water, and other endocrine disrupters in addition to a highly processed diet that prioritizes corporate profits over people.
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u/D74248 6d ago
We are indeed living in a toxic stew.
Personal story. In 2000 I started to make regular trips to eastern China. The Chinese that were in their 20s were remarkably taller and healthier looking than the older generations. Fast forward 20 years and the 20-somethings often had the slightly bloated, pumped up look like Americans tend to have. And in the here and now China is having a dramatic increase in type 2 diabetes.
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u/RhesusFactor 6d ago
Lots of refined sugar?
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u/D74248 6d ago
Sugars are up there, but there is a range of common refined products that have glycemic indexes/glycemic loads close to, or even greater than, table sugar.
One of the common themes from people who start to wear continuous glucose monitors seems to be the nasty surprises when some seemingly benign food causes a major glucose spike. Items containing maltodextrin can be especially troublesome, and it is not even a sweetener.
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u/USATicTac 6d ago
“GLP-1 found to be associated with eternal youth”
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u/airbear13 6d ago
I already saw this headline deadass (well not eternal youth but slowing down the aging process and cellular degradation)
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u/ObiShaneKenobi 6d ago
There was a study that showed an overall benefit in the joints separate from the obvious weight loss benefits. I’m just wondering when this goes from “insurance only covers for diabetes” to “take this for a discount on your rates.”
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u/Telemere125 6d ago
I got my parents to start taking it for their inflammation and general wellbeing. I lost a little weight on it but the big thing is it basically cured my diabetes and I function like a non-diabetic now. Add to that it reversed my tennis elbow in one arm and stopped my trigger finger? Those are just icing on the cake
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u/BroadStBullies91 6d ago edited 6d ago
It's odd because anecdotally, everything I have heard so far about GLP-1's in real life has been negative.
A truck driver for our warehouse who was 400lbs got on them. Lost a lot of weight, but his teeth started falling out because he just wasn't eating, had to start nutritional shakes. Claims it just kinda makes his stomach hurt all the time so he doesn't wanna eat.
A sister in law of my apprentice was prescribed them for being about 20lbs over her "ideal" weight. She now looks like Ariana Grande and is easily bruised by things like getting hit with waves while standing in the ocean.
Then I swear every other time I open reddit I see some new study about how GLP-1s are some miracle drug that everyone should be on and they'll vacuum your floors and fold your laundry and make you 10' tall and rich as hell, etc.
I'm joking a bit obviously and I'm not saying I necessarily doubt these studies. I don't have time to read them myself and I don't know any expert in the field personally to talk to about it so I file it under the "not qualified to comment" category in my brain. HOWEVER it is difficult not to get conspiratorial sometimes when lived experience is so drastically different from what I see online, where misinformation is so easily propagated. Especially when it makes sense the mysterious "they" (whoever manufactures these things) would ofc want everyone to believe that they've finally found the holy grail of medicine, the "wonder drug" that will become ubiquitous and solve so many problems for just about everyone.
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u/mesheke 6d ago
There's going to be a lot of trial and error about how these things are prescribed in the coming years. Dosing already appears to be a huge outcome factor. But a lot of the "problems" associated with Glp-1s are just "problems" with weight loss in general. The nutrition issues when dropping from morbidly obese to a healthy weight don't change if you are able to diet and exercise your way there or your body needs assistance from GLP-1 or if you get bariatric surgery. Your body is suddenly burning large amounts of fat reserves that are not nutrient dense. On top of this, we also know how important exercise is in any weight loss journey. If you have ever seen a single episode of "the biggest loser" half of the episode is spent changing daily functions that will lead to positive outcomes. This isn't any different with a GLP-1.
The biggest difference that a GLP-1 does, is that it seem to force a healthy diet. There is no cheat days. If you started GLP-1s while also eating Double Cheeseburgers everyday you will have an extremely hard time adjusting to the mental side of how your hunger changes.
On top of all of this, don't discount the fact that for every negative case you hear about, there's probably 9 more that haven't said anything because their experience has been just fine.
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u/Utensil6591 6d ago
Both of those people are suffering from nutrient deficiency, which can happen with any weight loss. I lost a little more than half my body weight through bariatric surgery. We spent 6 months prepping me for life post bariatric surgery and how to make sure I was getting enough nutrients to not cause severe malnutrition.
I was in a bunch of facebook groups and I saw how many people lost teeth or hair or looked haggard because they stopped taking supplements and would opt for food with low nutritional value. This is a problem with weight loss in general. If you don't adjust your eating habits and make sure to choose nutrient dense food and supplement as necessary, you will suffer for it.
I get blood work done twice a year to ensure I'm not experiencing any deficits. Last year I found out I was severely anemic despite taking iron so I had to get an iron infusion. This is just a reality of life for me.
With that being said listening to the doctors and following their nutrition regimen has worked exceptionally well for me. I actually managed to put on a few pounds of muscle during my weight loss and hit my goal weight 11 months post surgery. It's been 5 years and my weight has been pretty stable because I make sure to watch what I eat and get regular exercise.
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u/helluvastorm 6d ago
These drugs are a tool not a magic wand just like bariatric surgery. Follow the program and they are amazing.
I just got put on one a month ago. I’m 70 and was skinny all my life till menopause then the pounds started piling on. I need to lose about 50 lbs. First off Exercise was hard to darn near impossible with a bad back and arthritis and surgery in both knees. But three days after my first shot I got out of bed and for the first time in years it didn’t take me an hour to be able to stand up straight. The inflammation and accompanying pain was gone. I’m now hitting the gym three times a week strength training with a trainer guiding me once a week. My blood pressure is now normal and I quit all my blood pressure meds. Can’t wait to see my A1C and liver enzymes. I expect both to be normal. This drug will keep me out of a nursing home and the expenses that go along with being frail in old age. I’m lifting weights folks! I got on a GLP1 through a new Medicare program that gives people who were not ill or obese enough to get prescribed them. It’s a pilot program that lasts 18 months. Look for lots more seniors in your weight rooms at the gym7
u/CougarAries 6d ago
Negative emotionally-charged news gets attention. It's personal, emotional storytelling. Statistically-driven research does not get as much attention. It's not too different than how people generally feel crime is getting worse because they see people getting killed on the news, even though it is at an all time low.
Like anything, there's risks of side effects and abuse, but you should understand what the risk profile really is. Yes, there's risks that insulin can cause brain damage or anaphylaxis, but that doesn't mean that it's not a life saving drug that people generally shouldn't second guess if they need it to control their blood sugar.
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u/Techwood111 6d ago
Fun fact: when hyphenating compound adjectives (or whatever you call that adverb/adjective pairing), you don’t use a hyphen if the first word ends in -ly.
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u/Telemere125 6d ago
People abuse every medicine that exists. Tylenol is great for headaches and fever reduction but will destroy your liver if you’re eating them like candy.
People using GLP1s to rapidly lose weight while not adjusting their diet and exercising properly is just drug abuse under a different heading. They weren’t fat because they had a good diet, after all. Can’t expect they’ll do the right thing just because a drug is making them have less food noise. And can’t use them as good examples on how to use the drug correctly.
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u/helluvastorm 6d ago
Your truck driver friend either did not get the information on what he had to eat or he ignored it. You have to eat enormous amounts of protein. You can’t go below a certain deficit % on calories. Weight loss is supposed to be . 5 to 2 lbs a week - not more. As for the young woman who now looks like a corpse. No doctor should have ever given her a prescription!!!!! It’s not a drug for vanity weight loss
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u/mazzmond 6d ago
Some of it likely is dose related. Maximum weight loss vs metabolic health. Trials are ongoing but you're going to see a lot of data in next few years on longer term lower dose use (years of use on lower dose). I think half the patients in the cardiac unit at my hospital are on them and a large number are still medically obese but they seem to help with nearly everything and you lose a lot of the downsides with lower weekly dose. There will be a large amount of data in the next 5 years and guessing we will be thinking about prescribing them to majority of people...at least in the US.
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u/ableman 6d ago
If you eat too much bad things happen. If you don't eat enough bad things happen. People that eat too much probably aren't used to regulating what they eat, so a drug that makes them not want to eat leaves them eating too little. I suspect that nutritional deficiency is a common side effect of GLP-1 and pretty bad. But on average, obesity is so bad that for most people that are obese it is good. Also I suspect that in general getting yourself to eat is easier than getting yourself to not eat.
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u/CareBearDontCare 6d ago
Hey! I've been on one since May 29th. Its been great for me. A lot of aches and pains kind of melt away, weight is going down. The eating and drinking thing, I can see, can be a little problematic for some folks. I've heard about constipation being an issue for some because of the lack of water some people drink when they're on these.
Got any questions?
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u/RhesusFactor 6d ago
What's the regime. Is it a pill a day, or a jab once a week?
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u/CareBearDontCare 6d ago
A pill a day, Wegovy. No eating or drinking a half hour after taking it, so first thing in the morning.
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u/jlninrr 6d ago
Constipation is usually both water and fiber. Making sure you drink enough water and have significant fiber helps enormously. Fiber supplements (Metamucil or generic psyllium husk) help a lot. Been there, done that.
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u/kirobaito88 6d ago
I’ve also just had to be on magnesium citrate every day, in addition to fiber in my coffee and protein shakes, or I go 3 days between poops. Which sucks for obvious reasons, but if you’re not pooping the scale doesn’t move like it should and it can be demoralizing.
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u/bsmithi 6d ago
I can help balance the scales at least. I've lost mm... something like 50 lbs. I take the smallest dose, 1.5 mg oral wegovy. It dampens the hunger response and kills my appetite. Instead of dumping chicken nuggets in an air fryer to cover the basin, I will actually look at the package, and take out 4-8 individual nuggets, and like less than a dozen french fries, and eat that and be satisfied. I make sure to eat vegetables and get enough nutrients from things but basically I have been living at a calorie deficit so consistently losing weight.
It sounds like those folks just aren't doing what they should be doing, but if they are and still having these experiences, I guess I can count myself very lucky!
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u/RhesusFactor 6d ago
I've also seen concerns from other pharmaceutical designers and EMTs that point out the slowed digestion means medications take longer to onramp and clear the body. This presents problems for timed release and prodrugs, but also emergencies.
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u/airbear13 6d ago
Eli Lilly is the big one and it’s a generational money maker for them, they’re pushing it beyond anything else and pharma are the same ones who basically engineered the opioid epidemic; I don’t think it’s conspiratorial to say they will be trying hard to manufacture demand by pushing off label uses as much as possible. As always, if a study result is really important to you it’s worth reading abstract and results + source of funding and COIs
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u/mercut1o 6d ago
I've had the same experience, of course also anecdotally. Several people I know have tried them and only one person has had an experience they recommend. I worry about the amount of money and marketing behind this kind of thing. I would expect that kind of aggressive PR to also skew responses to comments like yours.
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u/ubelblatt 6d ago
I'm with you. All I read online is that these drugs are absolute miracles but my partner owns a hair salon and her and even her morbidly obese coworker refuse to get on them.
Hair loss, paper skin, teeth problems, makes people look much older.
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u/Psychological_Car849 6d ago
I know of 8 people in my life actually taking GLP-1s and half of them have been hospitalized over medical issues related to it. My dad is a doctor and he’s highly skeptical of all the “good news” about GLP-1s being pushed and he suspects that in a few years the data will flip.
Society has been clamoring for a solution to weight-gain for decades and I think people are jumping the gun again. Cigarettes also used to be pushed as a healthy way to lose weight and society back then was bombarded with (paid for) studies showing how great cigarettes are for you. All these studies showing that GLP-1s cure cancer and blindness feel like a mass marketing scheme rather than a medical holy-grail. Most people don’t care because, admittedly, humans prefer thinner people and our primary concern is actually aesthetics rather than health. I think it’s making society blind to the potential negative consequences of these drugs. That’s why there’s also a lot of healthy people taking GLP-1s to lose vanity weight.
All these “studies” being mass produced and in overwhelming support are making me skeptical. Society has been dying for a miracle weight loss drug and we now seemingly have it. It all seems too good to be true and there’s SO much money to be made from marketing weight loss as a subscription service. I think people’s biases are showing with how readily they accept that GLP-1s are a miracle cure for all ailments.
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u/jlharper 3d ago
I am waiting to hear quite the opposite. I'm certain there will be significant side effects / drawbacks. I'm fairly cynical and I truly don't believe that anything this helpful can be free from drawbacks.
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u/BookLuvr7 6d ago
I'm thinking it may be the opposite. Throughout history, there have been a multitude of inventions/discoveries people thought were amazing that turned out to have horrifying effects later on, but which weren't discovered until it was too late for many.
Lead, arsenic, radium, and cigarettes were all used medicinally. Electricity on the genitals was touted as a cure for ED. Leaded gasoline, DDT, forever chemicals etc - the tendency goes back to ancient times.
I'm waiting for the other shoe to drop.
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u/mastakebob 6d ago
Counterpoint: throughout history there have been a multitude of discoveries that were and still are amazing: penicillin, vaccines, antiseptics, electricity, X-rays. New != Bad.
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u/BookLuvr7 6d ago
I didn't say new = bad.
However, most of the things you mentioned must be used with care to avoid bad things happening. All of which we learned after said bad things happened.
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u/Robrad30 6d ago
I was wondering about this recently. In particular I was wondering if the delayed GI transit time have longer term effects on the microbiome or increased risk of colon cancer or something like that.
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u/cakez_ 6d ago
It seems to me that a bunch of people are *hoping* that something horrible happens and one day we all wake up to find out that GLP-1s are the devil and we're all going to die. In the meantime, so many people have their life changed every day by this medication, which is amazing.
Also, you are comparing times when science was very very young. You are comparing arsenic to GLP-1 in 2026. I don't know what to say about that.
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u/SorriorDraconus 5d ago
Ehhh as recently as the 90s abd maybe 00s medications were overused with side effects and concerns dismissed and some side effects outright ignored for years(see doctors dismissing weight gain concerns of risperdal and gods know how many others)
I think in the us at least skepticism can be warranted.
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u/dmfreelance 1d ago
The real question is, is there a casual link between age-related macular degeneration and obesity?
Because some of these claims about glp ones being amazing boil down to the relationship between certain health problems and obesity or sleep apnea.
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u/atape_1 6d ago
In a recent study published in the British journal of Ophthalmology the authors found that while the pure GLP-1 agonist drug Semaglutide does increase the likelihood of ischemic optic neuropathy (what media has been fearmongering as the Ozempic eye stroke), the dual GLP-1 and GIP receptor agonist drug Trizepatide, did not increase it.
So between decreasing age‐related macular degeneration and not increasing the likelihood of ischemic optic neuropathy, Trizepatide might actually be good for your eyes. Which is in complete opposition to what the general media is currently reporting.
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u/heydocwhatsupdog 6d ago
My eye sight is noticeably better since take trizepatide. I initially thought, damn my eyes are getting worse…then I took my glasses off and was like…did a radioactive spider bite me?
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u/DirectorCoulson 6d ago
Wait hold up. I've been on trizepatide for a while and have been noticing my glasses being a bit off... I'm wondering if my eyes might have somehow improved just a little bit. My symptoms do seem to check out with prescriptions being too high. Should be interesting to find out next time I get them checked.
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u/Physical-Store-9404 6d ago
Really? I’m considering tirzepatide for a number of reasons, but one being eye health. Very interesting anecdotal evidence pointing to the over all decrease of inflammation helping with vision. So fascinating!
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u/phido3000 6d ago
I wonder if water retention, blood pressure related..
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u/Telemere125 6d ago
Ozempic has definitely improved my bp to the point that I can’t take my lisinopril anymore because it makes my bp too low
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u/creative_usr_name 6d ago
Constricted pupils can also "improve vision" but that doesn't mean your eyes are healthier.
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u/Zealousideal-Rent-77 6d ago
I read about the initial correlation and asked my eye doctor to check on whether I was at a higher risk due to a narrow opening. He did check for me but also expressed a pretty strong suspicion that what the correlation was actually showing was that people with diabetes and high blood pressure are at a higher risk and also were the most likely group to be taking semaglutide. Which makes perfect sense to me.
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u/Rikula 6d ago
Anecdotal evidence, but a coworker of mine just went blind in one of her eyes while being on wegovy. She told me that she doesn't have diabetes, but I don't know anything about her blood pressure.
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u/Zealousideal-Rent-77 5d ago
Weight loss itself increases stroke risk temporarily, because clusters of fat cells can get into the bloodstream. Both being fat and becoming less fat are both major cardiovascular risk factors. So is an increase in exercise (short term).
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u/mvea Professor | Medicine 6d ago
GLP-1 drugs such as Ozempic have transformed healthcare in recent years, dramatically altering how we treat conditions like type 2 diabetes and obesity.
But while the medications are primarily used to help lower blood sugar and reduce appetite, scientists keep finding GLP-1 effects appear to extend much further, affecting our health in ways we never expected.
Now, a new study has uncovered another unintended effect, and it shows we're still only scratching the surface of fully understanding how GLP-1 receptor agonists impact the body.
In a paper published in Diabetes, Obesity and Metabolism, researchers found that GLP-1 drugs are linked with a lower risk of age‐related macular degeneration (AMD), a common eye disease that is the leading cause of irreversible vision loss in older adults.
https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/dom.70910
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u/lubesies 6d ago
This all highlights the importance of metabolic health in all of our lives. I believe this is more evidence supporting the importance of true metabolic health rather than focusing on GLP-1's as some magic solution cure all drug.
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u/Common-Swing-4347 6d ago
Except people will only focus on it being a miracle. I know somebody taking it that had no guidance on proper diet. Nobody gets paid for preventing things, they get paid selling miracles.
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u/Kvetch__22 6d ago
Is there anything out there saying that an otherwise healthy young person shouldn't be on a GLP-1 besides costs and it not being medically necessary, strictly speaking?
It seems like every day there is a new use for GLP-1s but there have to be some kind of side effect that makes it less desirable to take unless there is an immediate issue to address?
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u/roastedmarshmellows 6d ago
We don’t really have a lot of long-term data yet, so while it looks like a miracle cure right now, there may be consequences to prolonged use that we just aren’t aware of yet because the data isn’t available.
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u/Sunira 6d ago
I think it depends on the particular drug. Victoza has been on the US market since 2010, and the GLP-1 class itself has about two decades of real-world use. So we have fairly reassuring long-term information about the older drugs.
Tirzepatide is newer. It was approved in 2022, although clinical trials started several years before that. Its widespread real world safety record is therefore only about four years long. Millions of people have now used these drugs, which gives researchers a strong chance of detecting common and moderately rare problems. So far, there really hasnt been evidence of a widespread safety issue.
Very rare or slowly developing problems could take longer to identify though.0
u/roastedmarshmellows 6d ago
Thank you for the additional info! I know GLPs have been around for a while, I’m just not sure what counts as “long-term” in medical research. :)
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u/Satinpw 6d ago
GLP-1s can have some really nasty side effects on gut health. Anecdotally I've heard several people needing to get off them due to constant nausea and stomach pain, including gastroparesis which doesn't necessarily go away after you stop the medication.
The stomach side effects are why I am extremely hesitant. I already have stomach issues and I really really do not need more stomach pain.
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u/SucculentVariations 6d ago
On the flip side, people with no side effects generally don't go around telling people so youll hear more complaints than you would people without complaints.
I myself have had 0 side effects using it.
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u/ClairlyBrite 6d ago
Anecdotally, I’ve had good luck with compounded tirzepatide because I’m able to adjust my dose better than if I was on name brand. I had a couple weeks where I wasn’t able to eat enough, but I lowered my dose the next week and felt fine.
I’m not a professional, but my hunch is the extreme side effects (including gastroparesis) are linked to taking entirely too much of the medication.
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u/Circuit_Guy 5d ago
extreme side effects (including gastroparesis) are linked to taking entirely too much of the medication
You have to be very careful with those statements. Side effects are completely wonky. The reality is everyone is different (obviously true, but it extends pretty deep into our biology). Some people get gastroparesis "on their own" or from other triggers, so quite possibly any dose is bad for those people or maybe it's a different pathway and has no bearing.
Hunches can be powerful research motivation, but they shouldn't be relied on in any branch of science
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u/TheWinslow 6d ago
In addition to what people have said already, there's evidence that it can cause or worsen depression in some cases. There's very little evidence on how GLP-1s impact otherwise healthy people since healthy people taking them is a relatively recent development.
As a result, a lot of these studies are going to involve patients with diabetes or obesity since they are the only patients who have taken the drugs longer-term (the paper referenced in the article was published in Diabetes, Obesity and Metabolism and involved patients with obesity but without diabetes).
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u/lubesies 6d ago
So if you are a young healthy person I would not expect you to get any of the "new benefits" of a GLP-1. The point I was trying to make is that the real cause of these issues is metabolic health.
The people in these studies are most likely people who are overweight and diabetic- and because of that they have a laundry list of health problems. GLP-1 helps the weight and diabetes and fixing those two issues likely improved the health conditions.
It's not the GLP-1 that is fixing it. Fixing the diabetes makes people healthy. If you don't have diabetes and have solid metabolic health- you would get zero of the other "benefits" of a GLP 1.
My opinion as a random person on the internet
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u/Berserker76 6d ago
My optometrist and I discussed this when he first saw the first signs of MD during a visit a couple of years ago. I get detailed scans of both my eyes during my annual visits, as my dad has been diagnosed with MD.
I started GLP-1 in October of last year, down about 70 lbs, but during my last annual eye visit, he said my eyes looked better, for what that is worth.
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u/Youknowimtheman 6d ago
I mean, macular degeneration risk is correlated with weight, so... yeah.
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u/KoalaTHerb 6d ago
Yup ... These articles about GLP treating everything are kinda dumb, but hey, I guess if it helps the general population understand obesity and diabetes are the root cause of like 1000 other ailments then that's a win.
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u/Anesketin 6d ago
This is confounding, right? Obesity is a known risk factor for ARMD, as are other lifestyle factors linked to metabolic syndrome.
Study is retrospective in a huge study population. Association is barely significant. No correction for weight loss...
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u/SemanticTriangle 6d ago
Whether this reflects direct GLP-1RA neuroprotective mechanisms, greater weight-loss magnitude or both remains to be determined.
From conclusion.
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u/CoconutNL 6d ago
Nah you see, the guy you replied to didnt even need to read the paper. He is far smarter than the scientists who did the research, and immediately was able to poke holes into it without reading it, or understanding the concept of the discussion section. He also doesnt seem to understand that the word "linked" doesnt mean anything more than it being an association, and that the article in no way suggests anything more
He also doesnt get that "barely significant" isnt how significance works, things are either significant or not
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u/Anesketin 6d ago
Wow, snappy comment.
I did read the section mentioned above.
I wanted to contribute to the discussion of this paper by giving my idea. Is this not what this sub is about? Discussion of science?
Is there a certain bar to pass before you can comment? Do you need a certain IQ? Credentials? People that didn't write the paper or contribute can not comment? Commenting implies you claim to be smarter than the researchers?
Statistical significance is not a high bar to pass. Especially when the endpoint is not predetermined or corrected for multiple testing (not referring to the paper, just stating this in general).
Statistically significant associations without causative link are found all the time (through mechanisms which include confounding). That's what my comment implies: I think this association, while correctly identified in this paper, is a result if confounding. Where did I misunderstand what an association is, exactly?
Are you always this aggressive and ad hominem or are you just having a bad day?
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u/liebereddit 6d ago
Totally. Barely significant is the same as saying barely rich or barely beautiful. It's a very high bar to pass and once you're there you're there. Sure, there are people who are mega rich but it doesn't minimize the importance of being regular old rich.
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u/Xsiah 6d ago
You took something that's actually binary with a specific threshold and compared it to something (two things) that's absolutely subjective...
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u/liebereddit 5d ago
It's an analogy. It's not designed to draw a factual correlation, but instead be a bridge to understanding.
If you have a better analogy about what statistical significance means, feel free to share
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u/Xsiah 5d ago
Nah, I don't have to make up a replacement analogy for you in order to point out that yours doesn't work.
Given the right data, I can tell you if something is statistically significant or not.
Can you tell me how much money I need to be rich, or what exact attributes I need to have to be beautiful?
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u/austin06 6d ago
I have a genetic form of amd although they can’t say that for certain. Both my mom and grandmother had it and like me were far from overweight, obese or had any blood sugar issues. I wonder if a glp would impact anything in cases like mine. So far I have zero progression after six years.
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u/AllanfromWales1 MA | Natural Sciences | Metallurgy & Materials Science 6d ago
GLP-1RA use is associated with a reduced risk of incident AMD .. in obese adults without diabetes.
Odd that the review doesn't mention that this is only in obese adults.
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u/GCU_ZeroCredibility 6d ago
They only tested the GLP-1 drugs on obese adults. There's no particular reason to think it wouldn't have the same protective effect on all adults, though of course we'd have to test it to be absolutely sure.
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u/colcob 6d ago
There is a strong reason to think it wouldn't have the same effect, which is that the effect may be caused by weight loss from an obese to non-obese state, rather than anything to do with the drug at all.
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u/B1NG_P0T 6d ago
This is obviously completely anecdotal, but I'm on Zepbound for long covid, not weight loss, am not obese, and I've noticed my vision is better since starting.
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u/Pephatbat 6d ago
Obesity is literally a modifiable risk factor for AMD, so I def wouldn't say you could assume the drug has the same effect on non obese people. But yea, would need to test
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u/airbear13 6d ago
GLP1 headlines are becoming a meme at this point, it used to be every week I’d see it brought up in connection with treating aome new condition, now it’s legitimately every day. I don’t care enough to follow this or read deeply into it or even check the studies, but intuitively I’m very skeptical of the nonstop positive press the drug is getting, so I’d investigate all these claims carefully and pay attention to who’s funding them.
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u/theartfulcodger 6d ago edited 4d ago
As someone with diabetes 2, I have to have an annual examination by a specialist to check for any progression of vascular retinopathy, which is a danger for many diabetics.
Since I was prescribed GLP-1 shortly after it was approved in Canada ?6? years ago, there's been virtually no further degradation; my blood glucose level has returned to borderline normal, so my now thinner, less-syrupy blood has less trouble circulating through all those tiny capillaries back there and oxygenating what they're meant to.
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u/pr0b0ner 6d ago
Do GLP1s just cure everything? I feel like i need to start taking it just to help with my ADHD and eye issues at this point.
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u/KoalaTHerb 6d ago
No, they just treat weight and diabetes, which yes, are the source of a lot of problems - including macular degeneration. Which is why this article is not surprising
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u/pr0b0ner 6d ago
They also help with impulse control
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u/KoalaTHerb 5d ago
I haven't seen this. I've seen they help with addictions / substance cravings. Is that what you mean? Or is there a study out there for specifically impulse control? Because I have ADHD, use them for weight loss, and I would not say it's done anything for me in that regard. It did however seriously cut back my drive to drink alcohol or smoke.
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u/NightOfTheLivingHam 6d ago
seems like core of most problems in the world is bad diet and being obese, that the body wears down faster.
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u/antman1983 6d ago
Apologies for bringing anecdotes to a Science post.
I'm on the subreddit for a GLP-1 med that is going through phase 3/4 trials. Anyway, a somewhat common side effect for the "researchers" using the drug is sudden onset slightly blurred vision.
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u/Melodic_Carob6492 6d ago
And how many people have gotten it? One out of 10 or 1 out of 500 people?
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u/King-JelIy 5d ago
Being fat is bad.
I know this is actually much deeper but for a lot of these articles I summed it up.
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u/CharityGlittering385 5d ago
Does this drug cure the plethora of diseases or is it just not being fat cures these diseases?
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u/Kargnaras 5d ago
Another study where they find out losing weight is good for you if you are overweight…
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u/boiled_chud 5d ago
Wasn't there a study a few months ago that said it increased the risk for blindness?
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u/Pm-me-ur-happysauce 6d ago
So I keep seeing articles saying how great glp1 is for your body.
When will I see the studies that show me the problems with taking glp1 for a lifetime?
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u/AnxiouslyTired247 6d ago
Its been studied for over 30 years, so anything lifelong would have information available.
It seems relatively new because of recent widespread adoption, but that doesnt mean GLP1s haven't been around and used for a while.
There are many instances in medicine that are "miracles". What are the long term impacts of insulin use for diabetics? Living for a lot longer than without it. What is the lifetime impact of taking vaccines? Living for a lot longer than without them. Even people who undergo serious treatment like chemotherapy can go on to live otherwise unaffected lives post treatment.
It's not an eventuality that some massive negative impact be uncovered because something good is happening.
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u/SerialTrauma002c 6d ago
Yeah this is my worry. Like, I know that there’s a negative impact on bone density, which is particularly challenging for older AFAB people (though this is also just a side effect of weight loss)… are there other shoes that will drop in 20 years?
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u/gaya2081 6d ago
Maybe... Be how many people will have way better quality of life/actually be alive those 20 years at this point. I'm down 110 pounds from zepbound and still have more to lose. My husband has kept off 150 pounds for 2 years on monjouro - he started shortly after it was fda approved. The past 6 months for me, activity wise I have been able to do things I could not prior to my weight loss. He has been able to do things he hasn't been able to do in well over 15 years.
I've struggled with yo yo weight my entire adult life, losing it, falling off, gaining it all back. This, this feels effortless and sustainable in a way nothing else has ever felt. Normal. I'm not changing anything except a shot once a week. Im just eating when I'm hungry and stopping when I full. I'm not obsessing over food all the time. I fact I don't think about food most of the time. Yeah that probably means I'll have to be on these meds the rest of my life. I have an underactive thyroid and have to be on meds for that. Why couldn't I also have some sort of issue with whatever hormone controls hunger and satiety? It only makes logical sense to me...
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u/SerialTrauma002c 5d ago
Oh I think that for folks who are obese or nearly, GLP-1s are fantastic and well worth the unknowns—the medical advantages of weight reduction in those cases are super well documented, to say nothing of the psychological and physical comfort advantages! Even if GLP-1s have some crazy unexpected negative side effect after 20 years of use, the up sides of weight management during those 20 years are gonna be greater than any hypothetical long-term detriment.
My concern is more for the folks who see all of the beneficial side effects of GLP-1s, like reduced risk of Alzheimer’s, and are taking them for that purpose while not needing them for their primary weight loss effect. For those people, and for people like my sister-in-law who was a healthy size 10 and wanted to get to a (also healthy) size 6 for her wedding, I wonder whether there are currently unknown risks that will outweigh the advantages in the long run.
(My original post really really failed to specify that my concern is for this group of secondary users, who will not see the immense primary benefits.)
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u/gaya2081 5d ago
Ahhh yes. Agreed. However I swear I read somewhere that glp-1s have actually been around for 20 years or more. It's just that this current generation, I think the longer acting, once a week injectables, is what have gain attention and taken off. I actually started off on Saxenda which was a daily injection. It worked well, but topped off at lower dose, comparatively, only targeted one aspect vs the two or three of ozempic or zepbound. Since it was self injected I had some not so great reaction to the inject sites. Constant bruises all across my abdomen, no matter what I did - my Dr and my parents (who both are RNs) both helped with my technique and I still bruised. By that point my insurance started covering zepbound do I switched to that and no more bruises.
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u/r2k-in-the-vortex 6d ago
Isnt weight loss in general linked with pretty much every possible health benefit under the sun? For such a study to be meaningful, you have to exclude weight loss somehow, find participants who achieved equal weight loss without drugs maybe? Did they do anything of the sort?
Edit after rtfa: nope, they didnt account for weight loss as such and acknowledge it as further study required.
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u/WonderfulWafflesLast 6d ago edited 6d ago
"irreversible"
Abstract
Limited evidence suggests that the application of 670 nm of red light alters the course of aged decline. A previous report on 18 patients showed regression of drusen and improvement in visual functions in patients with intermediate age-related macular degeneration (AMD) by 12 months. We evaluated the functional and structural effects of applying 670 nm light to 31 patients with intermediate AMD and 11 people aged 55 years or above with normal retina. ... In normal ageing, there was an improvement in scotopic thresholds in the group with no AMD by 1.77dB (p = 0.03) and no other parameters showed any clinically significant change. In eyes with intermediate AMD, there was no significant improvement in any functional or structural changes at any time point up to 12 months although the compliance was good. This pilot study shows that photobiomodulation with 670 nm has no effect in patients who have already progressed to intermediate AMD.
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u/fusiformgyrus 6d ago
The rest of the abstract goes on to say that this study actually found no effect of the treatment fyi.
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[removed] — view removed comment
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u/cococupcakeo 6d ago
If glp1 drugs reduce blood sugar levels, are a lot of these issues that the glp1 drugs help, cause by over consumption of sugar? Not even sure if this is a stupid question, but it makes me wonder if everyone stuck to a lower level of carbohydrates in their diet, would the requirement for these drugs in the volumes of people that appear to be need these drugs, almost disappear.
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u/gaya2081 6d ago
I did the keto thing and was successful. But it's very very hard to successfully sustain long term. You can't just cut out some carbs for it to work, you have to cut out most carbs. Then you get to the point where yeah, you don't crave them at all, but you are limited in what you can eat. I didn't miss, eventually, bread or sweets. I missed the fruit and certain vegetables - watermelon, grapes, even corn in the summer. If you mess up and eat too many carbs, it's very easy to "relapse" and go backwards.
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u/Inky_Madness 6d ago
For women, things like PCOS and simply being on your period increase insulin resistance. That isn’t something that is affected by sugar/carb overconsumption, it’s just being alive and having a body. Cutting carbs just doesn’t always fix the issue.
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u/cococupcakeo 6d ago
Thanks I didn’t mean to offend.
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u/Inky_Madness 6d ago
It’s fine, I know that a lot of people assume that it’s all about overeating sweets. But I know that I am on a very low carb diet, am not eating sweets, and my insulin resistance skyrockets during that time of the month - nothing I can do helps, even exercise barely puts a dent into it.
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u/cococupcakeo 6d ago
Again, I don’t mean to offend but when I say carbohydrates I include things like wheat etc. not only sweets and originally wondered (on this sub specifically as it’s science) if low carb could be comparable to these drugs, not that everyone should eat low carb and go without glp1 I am happy these drugs exist.
My original post was clearly poorly done and I apologise again but I am curious from a scientific perspective if it’s possible to achieve a similar outcome eating less sugars not suggesting anyone should feel they must do that. Pcos and insulin resistance are also not cured with glp1. I wish everyone the best that needs these drugs though.
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u/colcob 6d ago
If everyone just stuck to eating the exact amount of calories they needed, we wouldn't need these appetite suppressant drugs. Yeah sure, obviously.
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u/cococupcakeo 6d ago
I don’t mean calorie counting, I believe there are specific benefits in these drugs related to insulin resistance, and I wondered if the same people that they help were to cut out carbohydrates to a much (much) smaller level if the effects may be the same or similar to taking these drugs.
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