Do you have the same concerns about water or food? Why does it matter that it stops benefitting you if you stop taking it?

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jollyllama a day ago | parent | next [-]

It's possible to secure those independently in a wide variety of scenarios. It's harder to DIY your own GLPs.

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dd8601fn a day ago | parent | prev | next [-]

Oh god… if only I could quit food, too.

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estearum a day ago | parent [-]

No but like... why is it a concern? Money?

The health problems that GLPs produce help people avoid are way more costly than the drugs will ever be. Especially now that the market is so competitive and will only get moreso.

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treis a day ago | parent | next [-]

For me, historically drugs like this for ADHD or depression or gastric bypass or whatever tend to lose effectiveness over time as the body adjusts. Not for everyone but for enough where you've got a short term gain that ultimately compounds the original problem.

Medication can be a slippery slope into side effects and rotating dosages/medicines. Especially for behavioral medicines.

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astrange a day ago | parent [-]

ADHD medications do not lose effectiveness over time. That's magnesium deficiency.

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disgruntledphd2 14 hours ago | parent [-]

> ADHD medications do not lose effectiveness over time.

I mean, they're mostly stimulants, which definitely lose effectiveness over time. It would be really weird if they didn't as that's basically how our bodies work in general.

Note: I have been prescribed said medication, but have not started taking them yet so I might be entirely wrong in the practicalities (and how would one disentangle the psychological impact of medication from the physiological impact?).

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estearum 10 hours ago | parent [-]

I had the same intuition as you but I looked it up in light of GP's comment and it actually seems not so clear that's how it works. Apparently the physiological effects of prescription ADHD meds will tend to still be ~same intensity for years and years. Patients often report weakened cognitive/psychological effectiveness, but obviously that's very hard to compare...

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disgruntledphd2 9 hours ago | parent | next [-]

> Apparently the physiological effects of prescription ADHD meds will tend to still be ~same intensity for years and years.

I'm not sure how one would even measure this. Like, back in the halcyon days of my youth I took a bunch of stimulants, and experentially there was definitely less impact over time (habituation is a thing).

And given that ADHD is predominantly a psychological issue, then the only measure that matters is that of the patients themselves.

Do you have some of the sources you mentioned available, I'd be interested to understand the details?

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treis 8 hours ago | parent | prev [-]

Practical experience is that people cycle through ADHD and depression meds. I agree that it's hard to tell what that means because we don't generally do long term double blind placebo studies.

	▲	estearum 7 hours ago \| parent [-]
		The issue here is more complicated than just a lack of long term RCTs. It's that we're talking about psychological acclimation within individuals. Given that people's lives change so much, even within an RCT design it's not clear how you get an actual comparison of "effectiveness" from year 0 to year 4.

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dd8601fn a day ago | parent | prev [-]

Yeah, money, and just signing up to regularly inject a thing forever.

Anything that’s “starting tomorrow and until the day you die” just seems like a thing I shouldn’t take lightly.

Also I’m not badly, badly overweight. So it’s not like “it’s this or cardiac arrest in a year or two”, for me. I should probably be dealing with my issues the old timey way.

The stakes look very different for other people, obviously.

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logicchains a day ago | parent | prev [-]

Water and food have a milder risk profile. The FDA (https://glp-1.health/blog/glp1-obesity-eligibility-bmi-chart...) recommends "GLP-1 weight loss medications (Wegovy, Zepbound) if your BMI is 30 or higher, or if your BMI is 27 or higher with at least one weight-related health condition such as high blood pressure, type 2 diabetes, or sleep apnea". This is because there are side effects such that GLP-1 meds have not been shown to produce a net positive benefit-to-risk ratio for people who are only mildly overweight.

	▲	estearum a day ago \| parent [-]
		> This is because there are side effects such that GLP-1 meds have not been shown to produce a net positive benefit-to-risk ratio for people who are only mildly overweight. Importantly, this is different from "GLP-1 meds have been shown not to produce a net positive benefit-to-risk ratio" Anyway nearly all of the side effects for these drugs are just discomfort. Not even really obvious they should be called "risks." Meanwhile, the vast majority of Americans who are not already diabetic or have HTN will soon, and it would be quite a surprise to learn these drugs don't have protective effect.