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epistasistoday at 1:31 AM2 repliesview on HN

> An injection to cure obesity is a small price to ask, as any person that has been obese will tell you. They could have determined this from a simple survey.

You're missing the primary point: GLP-1 was investigated as another me-too diabetes drug, for which there were many injectable drugs available.

It wasn't until much much later that it was discovered to be an obesity drug. It was a completely coincidental and accidental discovery.

It turns out that most science is like that. We make the most important discoveries unexpectedly and by chance. Which is why you should always distrust the politicians that mock and ridicule science for sounding ordinary or obvious. That's where the real magic happens.


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wombatpmtoday at 4:49 AM

You should always distrust politicians on science issues. Even if they come from a science background. Being a successful politician is orthogonal to being a brilliant scientist.

DannyBeetoday at 2:02 AM

"It wasn't until much much later that it was discovered to be an obesity drug. It was a completely coincidental and accidental discovery."

Define "much much later"

It was known by the early 1990s that GLP-1 slowed stomach emptying, with a key study in 1993 demonstrating its effects on gastrointestinal functions like gastric emptying, leading to longer feelings of fullness, which is the central mechanism at work here. See, e.g., https://pubmed.ncbi.nlm.nih.gov/35635627/

It just took eons for someone to decide that therefore maybe it was worth thinking about for weight loss.

That part is due to lack of exec vision - the fact that weight loss was not commonly treated with drugs (amphetamines work, but ...) meant they never thought really that hard about it.

To be fair, that lackof vision is not unreasonable in the sense that they have both plenty of high value targets, and plenty of arrows to shoot at them. Most of the arrows miss of course, but that's okay.

There is not always tremendous incentive to try new targets until they start missing the target too much, or the value of existing targets drops.

They almost certainly give up on, or ignore/drop/whatever, a near infinite number of things that may have turned into life saving drugs, billion dollar blockbusters, you name it.

At least right now, that's how this kind of thing works, for better or worse.

However, this is quite separate from when x was discovered to be a y, as it is here.

FWIW - I'll offer another lack of vision in the same vein - by slowing stomach emptying significantly, GLP-1 also causes the same amount of alcohol to do significantly less damage, because it enters your small intestine in much smaller amounts and over a much longer period of time. So much so that is a very effective treatment for alcoholism because it both reduces alcohol craving, and causes significant amounts of alcohol to do less damage. See, e.g., newly published studies like https://pubmed.ncbi.nlm.nih.gov/37192005/ and https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...

Again, this should have been somewhat obvious to study a long time ago, but it wasn't started until 2 years ago.

It also turns out to reduce drug cravings, which is more unexpected, but would have been discovered much earlier with better vision.

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