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Started By
Message
re: GLP-1 (Ozempic/Mounjaro) vs TRT / Testosterone Stigma
Posted on 6/27/24 at 7:21 am to lsu777
Posted on 6/27/24 at 7:21 am to lsu777
While I agree that Pharma companies are putting out bad info, that is the nature of the beast. Unless something changes, we are going to wind up with 40 year old frail folks that look way older than they are. Muscle mass is linked to longevity. On the flip side, obesity is also linked to longevity. There is a gray area.
How do we fix this? During the college world series I saw that stupid commercial from Wegovy almost every single commercial break. Doctors and Pharma need to do better.
I know two ladies that are told by their doctors they need to be weight training and actually perform DEXA scans each visit to ensure they aren't losing too much muscle. It's funny that those two are the two that actually need the drug. The rest (about 8) that I know are using it for vanity and when I bring up the need to preserve muscle, they'll tell me that their doc hasn't mentioned anything about it and continue going down that path.
I realize that the Pharma companies are to blame but they aren't going to change. I fear that a vast majority of folks using the drug are losing tons of longevity due to their ignorance.
I also worry about the financial burden this may create due to how expensive and in demand it is. At some point GLP-1s are going to be covered by medicaid for weight loss (if they aren't already). Once that happens, the costs are going to go wild. Testosterone, on the other hand, is currently extremely hard to get covered by insurance while achieving levels desired.
How do we fix this? During the college world series I saw that stupid commercial from Wegovy almost every single commercial break. Doctors and Pharma need to do better.
I know two ladies that are told by their doctors they need to be weight training and actually perform DEXA scans each visit to ensure they aren't losing too much muscle. It's funny that those two are the two that actually need the drug. The rest (about 8) that I know are using it for vanity and when I bring up the need to preserve muscle, they'll tell me that their doc hasn't mentioned anything about it and continue going down that path.
I realize that the Pharma companies are to blame but they aren't going to change. I fear that a vast majority of folks using the drug are losing tons of longevity due to their ignorance.
I also worry about the financial burden this may create due to how expensive and in demand it is. At some point GLP-1s are going to be covered by medicaid for weight loss (if they aren't already). Once that happens, the costs are going to go wild. Testosterone, on the other hand, is currently extremely hard to get covered by insurance while achieving levels desired.
This post was edited on 6/27/24 at 7:27 am
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Posted on 6/27/24 at 8:15 am to MemphisGuy
quote:
Don't you think the companies that developed these drugs would best know how to use them?
well its not that they are wrong or bad info but it is info for people who dont really want to do anything aka morbidly obese. i mean i guess for them it is ok advice as far as dosing but should be way more coaching involved if you get the script. should be required by insurance to get a nutritionist and a trainer to be approved
and im all for the medicine. i just cant believe the dosages people are using.
Posted on 6/28/24 at 5:58 am to caro81
quote:
Ozempic is treating laziness and lack of willpower. Anyone can put a fork down.
100% factually wrong. This mindset is still very common and shows a complete lack of understanding about what drives obesity for the majority. It’s a hormone deficiency, not a choice. GLP-1 agonists treat a deficiency in GLP-1. The exact same way TRT treats a deficiency of naturally occurring testosterone. Almost a 1:1 analogy. It’s not a lack of willpower for the vast majority. It’s a lack of naturally occurring GLP-1.
With that said, there shouldn’t be any stigma around TRT. It has gotten much better, but still exists. GLP-1 agonists and TRT are both medical treatments for hormone deficiencies. Both get abused by people that should not be on them, but that does not change what they are and their potential benefit to the many that need them. Both should be better understood and accepted by all.
Posted on 6/28/24 at 6:15 am to lsu777
quote:
Also ramping up the dose way to fast. For many 2.5 mg of mounjaro is plenty to take the food noise away. Then it’s all about staying strict. Instead they ramp the dose so much they literally control calories by forgetting to eat all together. Wild West shite show and the medicines are getting the blame cause the pharma companies are putting out bad info imo
It absolutely is the Wild West. This is why anyone considering GLP-1 agonists should see a specialist whom is trained and understands the full scope of issues surrounding obesity and weight loss treatments. The absolute best credentials to look for behind the MD are DABOM(Diplomate of American Board of Obesity Medicine) and ASMBS(American Society for Metabolic and Bariatric Surgery). This is as specialized as it gets for obesity specialists in the world. Surgery is largely being overlooked now because of the meds. Surgery is often a better option(and costs less long term). Most don’t understand bariatric surgery either. Most think it just shrinks the stomach. It changes the hormonal balance, and that is the larger driver of weight loss following bariatric surgery. Insurance coverage is a common issue with both types of treatments. Senate Bill 106 was just passed in Louisiana, and we are quite excited about this massive change in access for patient care.
Sadly, we continue to fight the disease of obesity as well as the stigma and perpetuating bad mindsets that inhibit social acceptance of obesity for what it truly is. The good fight continues.
Posted on 6/28/24 at 7:33 am to BawtHouse
Agree with everything but the surgery. Not big on it, due to some of the issues I have seen with it, much rather see them use glp1 than have the surgery, just my opinion
I do agree with poster above that decay should be used each visit to monitor muscle loss or atleast a really nice in body scan.
I fear one the issues is many times these drugs are being issued out by cosmetic clinics who zero understanding of nutrition or muscle and coukdnt advise clients even if they wanted to.
Complete wild west
I do agree with poster above that decay should be used each visit to monitor muscle loss or atleast a really nice in body scan.
I fear one the issues is many times these drugs are being issued out by cosmetic clinics who zero understanding of nutrition or muscle and coukdnt advise clients even if they wanted to.
Complete wild west
Posted on 6/28/24 at 7:37 am to BawtHouse
quote:
This mindset is still very common and shows a complete lack of understanding about what drives obesity for the majority. It’s a hormone deficiency, not a choice.
I'm not disagreeing with you, but broadly speaking.. Why are so many more people nowadays obese compared to the 70's and 80's? What changed? If it's simply hormones, why weren't their hormones altered? Is it food? Oil? Lifestyle? I have a hard time blaming our hormones on this. Yes, our hormones may be thrown off because of another thing, but I don'y buy that it's not due to what we are eating or something else. It's hard to put what I'm thinking into words so I apologize if this is confusing.
Posted on 6/28/24 at 7:43 am to BawtHouse
quote:
It’s a hormone deficiency, not a choice
Crazy how that deficiency affects some countries and cultures more than most.
You're right though, I'm sure obesity isn't more related to lifestyle choices.
Posted on 6/28/24 at 7:57 am to BawtHouse
quote:
lack of understanding about what drives obesity for the majority.
This is 'feel good' nonsense and part of the normalization of obesity in this country that is:
Not normal
Detrimental
Delusional
Destructive
People are obese because they are lazy have no willpower and a gluttons. There's a small 1% that have actual deficiencies causing it. We should be fat shaming the shite out of these lazy obese slobs and maybe they will get enough self respect to do something about it. They just need to cut back on portions and move around. Nobody says they have to even go to a 'gym'. Eat less and go on a 30 minute walk a day. Thats it. It is that simple. Move around. It has absolutely nothing to do with any deficiency in 99% of Americans. It is pure unadulterated laziness and gluttony and its not normal it is disgusting and sick behavior.
Posted on 6/28/24 at 8:03 am to ronricks
quote:
People are obese because they are lazy have no willpower and a gluttons.
You'll get downvoted but it's true. I'm one of those people. I can't lose weight because I hate being hungry. I lift 5x a week on a difficult plan, get 10k steps and still don't lose. I eat THAT much. It's shameful.
Example of how bad I am...I've lost 5lbs the last couple of weeks just so I can gain it all back next week while on vacation. So, I can do it, I just choose not too.
Posted on 6/28/24 at 8:14 am to bamaguy17
quote:
You'll get downvoted but it's true. I'm one of those people. I can't lose weight because I hate being hungry. I lift 5x a week on a difficult plan, get 10k steps and still don't lose. I eat THAT much. It's shameful.
Brother the first step is acknowledging the problem. There are people in my gym who kill themselves 5 or 6 days a week. Workout real hard. But - they leave the gym and hit up a Zaxby's or McDonald's drive thru and undue all the hard work they just put in in about 5 minutes once they gobble it down. I know this because they have told me. I try to help them and tell them that weight loss is:
#1 mental
#2 85% diet/lifestyle
The gym is good but it is but a small piece of this puzzle. The diet and lifestyle trumps all. This idea that imbalances or deficiencies are responsible for obesity in America is laughable and an insult to us that know better. Its past time to drop all the 'feel good' bullshite and get to the root of the problem and fix it and oftentimes that requires some tough love and sometimes tough conversations. We are a sickly nation and its only getting worse. The time to play 'nice' and make believe so we don't hurt feelings is out the window at this point. We are at crisis levels for obesity, diabetes, amount of people on prescription medications etc.
This post was edited on 6/28/24 at 8:20 am
Posted on 6/28/24 at 11:14 am to lsu777
Surgery should be done by a qualified specialist. There are plenty of surgeons doing bari that shouldn’t be. There should also be a properly designed program to help the patient comply with post surgery needs both short and long term. Surgery is not a golden bullet. It requires a lot of effort and compliance. Meds are closer to a golden bullet than surgery, but these also should be accompanied by a program that structures diet and exercise as critical components. Surgery is absolutely the better option for some, but not most.
Posted on 6/28/24 at 11:26 am to Rendlo
Great question. Obesity is an extremely complex disease. Anyone trying to oversimplify it to the point of “it’s easy you just eat less and move more” or “it’s easy you just take this injection” lacks the fundamental knowledge of the disease.
Without question, compounding issues are plentiful. Our food supply here in the US is a big problem. They have a very powerful lobby. Big food is real. Technology has also created a growing percentage of our job market that doesn’t require much caloric output. That’s another big problem. “Normal” daily activities don’t use calories like they used to. It requires specific effort by most to burn the needed calories daily. Fat shaming culture is another big problem we have. Anyone that thinks fat shaming will help people “see the light and change” is an idiot. Fat shaming culture has been going on for many decades. If it worked, the obesity epidemic wouldn’t exist today. But it does, because fat shaming has the opposite effect. It takes a psychological toll on those with the disease of obesity and is counterproductive to their chances of success in fighting the disease. It makes them give up hope that they can and will change. They have tried many times a million different ways to lose way without success. “Move more eat less” simply doesn’t work by itself for the vast majority of people. Period.
The root cause issue is a lack of naturally occurring GLP-1. GLP-1 agonists fix that, which is why there is huge success with them EVEN in the USA where we have all these other compounding issues related to the disease.
Without question, compounding issues are plentiful. Our food supply here in the US is a big problem. They have a very powerful lobby. Big food is real. Technology has also created a growing percentage of our job market that doesn’t require much caloric output. That’s another big problem. “Normal” daily activities don’t use calories like they used to. It requires specific effort by most to burn the needed calories daily. Fat shaming culture is another big problem we have. Anyone that thinks fat shaming will help people “see the light and change” is an idiot. Fat shaming culture has been going on for many decades. If it worked, the obesity epidemic wouldn’t exist today. But it does, because fat shaming has the opposite effect. It takes a psychological toll on those with the disease of obesity and is counterproductive to their chances of success in fighting the disease. It makes them give up hope that they can and will change. They have tried many times a million different ways to lose way without success. “Move more eat less” simply doesn’t work by itself for the vast majority of people. Period.
The root cause issue is a lack of naturally occurring GLP-1. GLP-1 agonists fix that, which is why there is huge success with them EVEN in the USA where we have all these other compounding issues related to the disease.
Posted on 6/28/24 at 12:16 pm to ronricks
quote:
Its past time to drop all the 'feel good' bullshite and get to the root of the problem and fix it and oftentimes that requires some tough love and sometimes tough conversations. We are a sickly nation and its only getting worse. The time to play 'nice' and make believe so we don't hurt feelings is out the window at this point. We are at crisis levels for obesity, diabetes, amount of people on prescription medications etc.
This is ignorant. We are beyond the time of guessing. We know, factually, that GLP-1 inadequacy is the main driver of obesity. There is nothing to argue about with that. It’s a fact. Shaming people has the opposite effect you claim to desire. If you want to help people, get them to see a professional that is trained in this specialty.
For the record, I do not condone crappy lifestyles. Quite the opposite is true. There are cases where TRT was the only recommended medical intervention. Those patients were then able to eat healthier and work out more productively, lose weight, and improve psychological issues like depression. These same patients were previously fat shamed for decades by people like you. It hurt them and made it harder for them to seek help. They report this in evaluations.
You are arguing that lifestyles and behaviors are driven by choices and willpower and nothing else. That is simply inaccurate for the vast majority. Lifestyles and behaviors and vastly driven by the chemical makeup in our bodies. In many cases, these chemical makeup’s get worse as a result of the lifestyles and behaviors they created in the first place. And the cycle continues.
Never forget that what works for one doesn’t mean it will work for all. Evaluate large sample sizes to get accurate information. Facts are not on your side with this Mr. Ricks
Posted on 6/28/24 at 12:24 pm to bamaguy17
Don’t listen to ronricks if you want to improve your situation. Go see an MD with DABOM credentials. You have a desire to lose weight. No matter how much you desire to lose weight, the feelings of hunger are more powerful. That’s called food noise. Food noise is caused by a deficiency in GLP-1. Sounds like you are a perfect candidate for GLP-1 agonist medication(this is not to be considered medical advise).
What you are saying is EXTREMELY common. You can lose weight for short periods of time, but it doesn’t last. The fact that you are already working out 5x per week is awesome. Food choices(both quantity and quality) become so much easier when the feelings of hunger are not so strong. GLP-1 agonists are extremely safe and quiet that food noise. AND…you don’t have to feel like you are starving and torturing yourself constantly to lose weight and get healthier. Good luck to you.
What you are saying is EXTREMELY common. You can lose weight for short periods of time, but it doesn’t last. The fact that you are already working out 5x per week is awesome. Food choices(both quantity and quality) become so much easier when the feelings of hunger are not so strong. GLP-1 agonists are extremely safe and quiet that food noise. AND…you don’t have to feel like you are starving and torturing yourself constantly to lose weight and get healthier. Good luck to you.
Posted on 6/28/24 at 12:39 pm to BawtHouse
quote:
You can lose weight for short periods of time, but it doesn’t last.
Started at 304 February 28,2023. Today, I weight 230. This is not a short period of time and I will never go back to that.
Posted on 6/28/24 at 12:41 pm to Rendlo
One of my biggest concerns about all of this is that work hard, build muscle, and lose weight message will go out the window and EVERYONE will be told it's not their fault. We are already seeing it with Weight Watchers. They went from if you eat right you can lose weight to saying it's never anyone fault, here's a shot.
Once medicaid covers GLP-1, we are going to have a huge huge budget issue in this country.
Once medicaid covers GLP-1, we are going to have a huge huge budget issue in this country.
Posted on 6/28/24 at 1:41 pm to Rendlo
quote:
One of my biggest concerns about all of this is that work hard, build muscle, and lose weight message will go out the window and EVERYONE will be told it's not their fault.
Understandable, but an unfounded, fear. This is why it is absolutely critical to push people in need to see a specialist. The messaging is so important. Meds and surgery both should not be seen as silver bullets. Patients must understand the meds are a tool that unlocks one’s ability to to live a healthier lifestyle and make healthier choices. Imagine how much easier it would be if you only got half as hungry as you do now? Imagine feeling hunger half as often as you do now and the intensity of that sensation was only 30-50% of the intensity you feel now. Now try to imagine how much easier it would be to plan and prep healthier foods, wait until you get home to eat instead of stopping at fast food, and so on.
Regarding the cost…lol. Consider it an investment. Invest $10,000,000,000 treating obesity to return $50,000,000,000 in NOT treating diabetes, heart disease, psychological issues, liver disease, kidney disease, and so on. It’s way more than 5x by the way. And then wrap your head around the economic impact it would have through increased productivity in the workplace, less people on welfare and disability, etc. You start getting into silly multiples.
There are two major issues facing this change.
1. Societal stigma and cultural norms(fat shaming and assigning blame to people for a disease they have). It is hard for some to understand that we can stop blaming people for the disease AND still hold people accountable for taking action to make change(see a specialist and follow the entire care plan).
2. Access to care. Policy changes are needed badly so that the people that need these treatments can get them. Insurance coverage blocks access to care frequently.
This post was edited on 6/28/24 at 1:46 pm
Posted on 6/28/24 at 2:53 pm to BawtHouse
It’s easy to say that people need to go to qualified providers. Impossible to actually achieve as it’s already grossly overprescribed. The drug makers couldn’t care less if you go to a worthwhile provider or not as long as their drug is being pushed. (See Oxycontin makers).
Posted on 6/29/24 at 12:26 pm to ronricks
So you are back to ignoring Glp-1 deficiency is a really thing? Something we can measure?
I’m not saying I don’t agree with you to some extent because I do but glp deficiency is a real thing and makes it much harder for some. No different than someone with extreme low test not being able to easily put on muscle. Would you ridicule them for getting on trt after multiple failed attempts to put on muscle? What about steroids to add muscle?
I mean that’s what you did. According to you, you took the lazy way out
I’m not saying I don’t agree with you to some extent because I do but glp deficiency is a real thing and makes it much harder for some. No different than someone with extreme low test not being able to easily put on muscle. Would you ridicule them for getting on trt after multiple failed attempts to put on muscle? What about steroids to add muscle?
I mean that’s what you did. According to you, you took the lazy way out
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