I can understand this perspective. You're looking at it with healthy eyes.

But for fat people, the calculus looks different.

A decision to take semaglutides is a decision between the long-term negative effects of obesity *now*, or the possibility of long-term negative effects *later.*

Anecdotally, trans people have a similar calculus. Going unmedicated/unsupported brings significant mental health risk now[1], whereas going on hormone replacement may or may not cause complications much later in life (osteoperosis, hepotoxicity issues for some treatments, etc).

Either way, you gotta get to the "later in life" part before you can worry about the outlook there.

1: a CDC meta-review said that 26% of surveyed US trans students attempted suicide this year, N=20,103 surveyed, ~660 of which were trans. https://archive.ph/0H81G

> a huge swath of the population will be dealing with issues 30 years form now

We've got 20 years of data on this class of drug. Certainly there could be some long term issues that we're not aware of yet, but it's not likely that there are significant issues that affect a large percentage of users after 30 years that didn't affect the small sample of users that have been using it for 20 years or the massive number of users that have been using it for 10.

OR - there will be some long term positive consequence to using Ozempic et al, and I'm not getting any of the benefits because I'm not overweight

Who the fuck cares? If you're not overweight and are reasonably then you're already winning in physiological terms. If you can maintain a good quality of life into old age and then die, what more do you want? Going through life worrying about whether you're missing out on some marginal health benefit from the drug-of-the-moment is neurotic.

But consider the tradeoff: it's okay to have serious health issues in 30 years, if you were projected to die in 20 years without it.

I’m skeptical of the idea that across the general population we’d be healthier if we dialed up our insulin production. Serious question but has there ever been a case of humans benefitting from increasing a hormone like this? Since it’s an injection, It wouldn’t be a steady increase, but more likely have bursts of it. I don’t know how healthy that would be in the long run.

After what happened with OxyContin I think wed benefit from some skepticism when a new drug gets oversold.

Has there ever been a case where something like #2 has happened?

Don't think you need to worry about that one.

Going by the results around addiction, I'm betting on #2 with reduced alcohol consumption.

Medical FOMO? I wouldn’t worry too much about it, I mean, there are hypothetical upsides to countless decisions we haven’t made, right? We always miss some chances in life.

That's why I haven't taken it. I'm probably a guy who should. Overweight, with kidney disease person who, if I became diabetic, it would probably kill me.

I'm not, someone who doesn't really need it. For example, some average weight housewife who just wants to fit in a dress a little better.

And still, I won't use it even though I can afford it cause it's the long term consequences are not entirely understood.

There were several side effects related to pancreatic cancer associated with the precursors to GLP-1 drugs. The same companies promoting GLP-1s were responsible for driving up insulin prices. So I'm hedging my bets.

There's a really cool Modern MBA video [1] on this topic btw :)

[1]: https://www.youtube.com/watch?v=7sUoZVke_30

Keep in mind a lot of people who'd benefit from this may not last another 30 years due to age or health issues due to weight either.

> I'm not getting any of the benefits because I'm not overweight.

You’re already benefiting.

Well, the negative consequence on the value of willpower is pretty obvious. "In what measure" is the real question.

Yeah, once you start taking it, you can’t stop. It becomes a lifetime commitment.

For sure, the consequences at psychological level are dire.

People can't be bothered to take a walk or eat a salad instead of a pizza more often, but are willingly working multiple days per month to afford these drugs.

This is absurd.