[fiftyfifty]

The biggest problem with semaglutide is once you stop taking it things like blood sugar and body weight start to go back to where they were before. On average people gain back 70% of the weight they lost on the drug within the first year when they stop taking it. It seems likely this is going to be true with other addictions as well such as alcohol. While the effects are impressive, without addressing the underlying causes such as psychological factors that cause people to overeat or abuse other substances like alcohol it seems like we are just replacing one form of chemical dependance with another, albeit a healthier one.

https://www.healthline.com/health/semaglutide-withdrawal-sym...

[futureshock]

While this is oft repeated, it’s not very relevant. First of all, some weight is kept off, which is a huge win. Secondly, the drug can be taken again. Thirdly, it will be a second chance for millions at a heather lifestyle. Once you get so fat, it becomes a doom spiral of low physical activity and low body image. Personal willpower and choice can have a huge impact but its very hard to start exercising when you can barely walk down the street.

[fiftyfifty]

It's not just that the weight is gained back but the rate that it's gained back. Imagine someone loosing 100 pounds on semaglutide and then gaining 70 pounds of it back in 1 year when they stop taking it. That's over 1 pound a week of weight gain, likely much faster than that individual gained the 100 pounds originally. That type of rapid weight gain is associated with even worse health effects than carrying the extra 100 pounds probably was, and that's just at 1 year, where will this individual be in 2 years, 3 years etc? Will they really keep that other 30% weight off? We don't have the data yet, but it doesn't seem likely they will. I'm not saying we shouldn't use these drugs, just that we need to understand that they are only the first step to a much longer strategy to improved health.

[JumpCrisscross]

> it seems likely this is going to be true with other addictions as well such as alcohol

Why? We need to eat. We don't need to drink.

Removing alcohol for a year or more could allow both the body and environment to be adapted to a point where it is no longer presented in the same way.

[ewoodrich]

Agreed, speaking from experience taking a long break from alcohol does wonders to reset the brain’s idea of what’s “normal” plus the simple act of just disrupting an engrained habit.

Won’t be the case for everyone but I think even taking it for a limited amount of time could do a lot for a certain type of excessive drinker.

[bigyikes]

i’m not sure whether there’s any physiological basis for this, but subjectively having an addiction feels a lot like having an additional need in the same vein as hunger and thirst. The addict’s mind is convinced it does “need” the substance.

[cobbernicusrex]

How is this any different than treatments for high blood pressure and other chronic illnesses? I hear this refrain often, which diminishes the incredible achievement and benefit of these new drugs.

[sunshowers]

I think there are two kinds of people, those for whom taking medications for the rest of their lives is unthinkable, and those for whom it's completely normal. I'm definitely in the latter camp but the cultures colliding can be a real surprise.

[EA-3167]

Just... keep taking it then? What's the downside of taking a drug that has a number of beneficial effects, especially the reduction of addictions (food, alcohol) that have high fatality rates?

[sunshowers]

I'm not on Ozempic, but I am on plenty of medications that I'll be taking for the rest of my life.

[alexb_]

Yes, this is how medicine usually works

[akira2501]

Well then maybe we shouldn't use it unless the consequences are severe enough to warrant them. In particular we shouldn't use them without trying behavior modification first.

[baxtr]

Nah… there is also the type of medicine where you take the pills and the disease is gone, and then you won’t need those pills no more.