I'm a big semaglutide proponent after being on it for a year. I know research says it helps with inflammation, arthritis (separately from weight reduction), and all sorts of magical things.

I lost 40 pounds in a year(230 to 190) at age 50. Great! I also went from being active and fat(weightlifting with some cardio) to basically having no energy. In the last year I've had arthritis appear in several joints. I'm awake several times a night to pee(yeah, prostate is acting up but I still void completely. The semaglutide is like a diuretic for me at night.). I get waves of hypoglycemia like feelings where I feel weak and spaced out. I'm afraid to get off of it because now my joints can't handle the extra weight. My doc recommended going to every other week now that my BMI is normal but as far as I can tell that advice isn't backed up by any research. Anyway, it's a powerful drug that works well but is not without side effects.

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zulux 7 hours ago | parent | next [-]

I'm on the pill version, which allows me to adjust the dosage on a more day-to-day level. It also doesn't need a fridge, so it allows me to travel more easily. There's a level that works best for me long-term, and it's quite a bit less than typical.

	▲	apparent 6 hours ago \| parent [-]
		I thought the half-life was long enough that skipping a pill or taking a lower dose wouldn't make much of a difference? Also, do you cut pills? I had looked into this and only found info saying that it ruins the delivery mechanism. I was skeptical of this because it would benefit the pill makers to convince people that these special pills cannot be cut, even though they do not require extended delivery (quite the opposite).

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hattmall 7 hours ago | parent | prev | next [-]

You are a proponent, but your outcomes seem worse?

	▲	Juvination 7 hours ago \| parent \| next [-]
		Losing 40 pounds where sometimes it feels like this weight is impossible to lose. That's what makes it worth it.
	▲	exhilaration 5 hours ago \| parent \| prev [-]
		For a lot of people, the alternative to GLP-1's is dying of a heart attack in their 50s, or taking decades off their lives by developing type 2 diabetes, or any number of complications from weight-related diseases.

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turbocon 4 hours ago | parent | prev | next [-]

I'm younger than you and only loss a about 25 lbs. I've now gone to a maintenance dose and seen my energy recover substantially, I do still think (anecdotally) that when I got off for a week I got even more energy but it's hard to judge.

	▲	mchusma 4 hours ago \| parent [-]
		I also had low energy but that was really mostly when I was losing weight, which made sense. As I slowed weight loss and reduced dose, energy improved.

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6 hours ago | parent | prev | next [-]

[deleted]

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amrrs 7 hours ago | parent | prev | next [-]

Is it kind of the stuff where the benefits outweigh the side effects? I'm just scared of the unknowns with the drug with such overwhelming positive research. Maybe, I'm a paranoid person but I'm unable to believe that such a powerful drug isn't without any side effect, clinically proven.

	▲	wavemode 6 hours ago \| parent \| next [-]
		The principal side effect is that you eat less. Eating less can have positive effects (losing weight), but can also make you feel like shit (in a wide variety of ways), as your body is running on less energy intake than it has been accustomed to. Depending on your activity level and the makeup of your diet, eating less can also lead to muscle loss and nutrient deficiencies.
	▲	ThrowawayTestr 4 hours ago \| parent \| prev [-]
		The drug has been in use for 20 years. The only side effect I've had is nausea and it passes after a few minutes.

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kccqzy 6 hours ago | parent | prev | next [-]

I’m also active and fat. And to me being active is more important than losing weight; I’d rather continue to do those long 2000kcal bike rides on weekends than having a healthier BMI. I’ve heard stories of my own friends bonking during a ride and I decided that I wanted to err on the side of overeating. So semaglutide doesn’t interest me. You aren’t the only one I’ve heard who started to have no energy after being on semaglutide.

That said the dementia benefit mentioned in the article still intrigues me.

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eapressoandcats 5 hours ago | parent | next [-]

I know people for whom GLP-1s made them lose weight, have a better relationship with food, and reduce their intrusive thoughts, and left them far more able to be active.

I feel like we’ll eventually find out that how well GLPs work is going to depend on the “why” someone has extra weight.

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NorthSouthNorth 3 hours ago | parent | prev | next [-]

People bonk because they're not eating enough DURING the ride. I'll eat (actually mostly drink) like 120-200g carbs on longer rides. Record is 700g during a 200km ride. I've seen big guys bonk too. It has very little to do with your BF% (although this is nuanced based on power zones and training 'durability' etc, etc).

	▲	01100011 2 hours ago \| parent [-]
		Going back to my endurance days, I think people bonk because they aren't adapted. After a year or so of pushing through the bonk, and growing up with hypoglycemia if I didn't eat frequently, I got to where I could start out at 5am on an empty stomach and not eat until noon or later. If I did bonk, I'd sip V-8(yeah, really) and instantly recover.

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loeg 5 hours ago | parent | prev | next [-]

I'm on tirzepatide, a competitive athlete, and have no idea what GP is talking about.

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01100011 5 hours ago | parent | next [-]

Being a competitive athlete is probably why you have no idea what I'm talking about (and maybe you're not in your 50s). You have a reason to keep your momentum and you are likely more regularly active than I was. Sure I lifted weights, but it was only 2-3 days a week for maybe 6 hours total.

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loeg 5 hours ago | parent [-]

Maybe start lifting weights again? 50 isn't a death sentence; I know a lot of competitive 50s-year-olds.

	▲	01100011 2 hours ago \| parent [-]
		I'm trying but I've got a toddler and now it seems like every joint hurts. No time to get to a gym and no room for a decent home gym. I did start to do back day again at the Y when we go on the weekend for the pool. We'll see...

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mathgeek 5 hours ago | parent | prev [-]

People who eat well below their maintenance calories tend to have lower energy levels. That's the most likely explanation.

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anon291 4 hours ago | parent | prev | next [-]

Being active is great but fat is still dangerous. Let's not lie to ourselves.

> decided that I wanted to err on the side of overeating

The reason you bonk is because you've run out of sugar in your muscles not fat

	▲	kccqzy an hour ago \| parent [-]
		True, but sugar can be converted to fat in the body. If you eat too much sugar before/during a ride, the extra sugar becomes fat.

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paulpauper 4 hours ago | parent | prev [-]

There are so many active overweight or obese guys, whether it's cycling, swimming or hiking .This myth that inactivity = obesity or that activity fixes obesity or being overweight, need to die. It's not that simple. Hunger signals and how the body partitions/uses food is only orthogonal to activity.

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matthewdgreen 4 hours ago | parent | prev | next [-]

Try Tirzepatide or one of the other drugs. They each have their own side effect profile.

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borski 6 hours ago | parent | prev [-]

What dose? Have you considered lowering it?

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01100011 5 hours ago | parent [-]

2.4mg for over 6 months. I'm considering dropping back a level(1.7mg?).

	▲	borski 5 hours ago \| parent [-]
		You’re on too high a dose. The highest dose made me a vegetable, with no energy, and so on. That is not the way. Lower the dose (with your doctor, of course). For me, the “middle” dose was the sweet spot of positive effects with minimal side effects. You are likely a “hyper-responder” to GLP-1s. Also, tirzepatide had far fewer side effects for me, fwiw. YMMV, of course.