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I’ve been on Mounjaro since August. Down almost 60lbs, and it’s been a life changer. Have I had some gastrointestinal issues, sure, but expected. I feel great and my brain seems to be functioning as well as when I was in my 20’s. Now, when I go to the bar with friends, I end up having maybe 2 beers and although enjoyable, I don’t feel that light switch turning on which encourages me to drink more. Can I force myself to keep drinking, say if my good friends are in town and we’re going out all night? Sure, but there’s some reward center that’s no longer lighting up. I just get drunker, but it’s not more pleasurable. I was never a big drinker at home by myself. Maybe a glass of wine or two with dinner if my in-laws are coming over. Now I’ve literally had zero drinks at home by myself. Seems to have started changing about 3 month in.
Work also seems more interesting, but my untreated ADHD seems to be getting worse.
>I feel great and my brain seems to be functioning as well as when I was in my 20’s
>but my untreated ADHD seems to be getting worse.
I had very similar results after taking ketamine for treatment-resistant depression. It eliminated all my compulsive tendencies for getting cheap dopamine hits (food, doomscrolling, etc), reset my tolerance to everything (caffeine, ADHD meds, alcohol), and made my ADHD worse while improving throughput and ability to Get Shit Done.
I wonder if they affect the same parts of the brain in a roundabout way? Ketamine is also used to treat addiction (opioids, primarily).
Do you experience any anhedonia while using Mounjaro? Did your overall pleasure response get blunted?
I started taking it in November and I’m down 30 pounds and my retina has detached 2x for no apparent reason since then. My drinking is unchanged, except I get full sooner and drink slower. Because of the discomfort.
> but there’s some reward center that’s no longer lighting up.
Do you find other pleasures (non food and drink) as enjoyable? Interesting to hear if it’s selective or dampens everything.
Good job, nice to see it works on reducing alcohol consumption too. I do not need this drug but it's nice knowing the option exists it need be. It gives hope to others too.
Based on what you've said it sounds like the drug may have an effect on release of dopamine, though I'm sure the trials would have caught that if so.
I heard Mounjaro is even more effective than Semaglutide.
I heard that 2/3 of the weight loss is muscle, do you find that to be the case?
If you're interested - not pushing an agenda. Here's what worked for this weird dude to not drink and stay fit.
I used to lift and be real fit till about 40. Like bulky-lean looking, bench 400 10x with a 6pack. Had a lot to do with being on the road for work all over the world, and you sit at the gym at the hotel for an hour every night because of nothing else to do, and there are girls there also on business who you'll never see again. I drank A Lot, ate anything I wanted, and did lots of blo on weekends.
It was getting out of control, so I did months of google-foo, went to a pharmacy in eastern europe, got like a thousand 150mg disulfiram pills under the counter for fifty bucks, and took one pill every morning for 2 years. You don't drink, you can't drink or you die, you forget drinking exists and after a couple of months don't even think about it, yet still do all the same stuff you used to - like dancing and clubs if that's your thing. And it's even more fun. There were no side effects.
Then things changed with age, testosterone went to crap, joints hurt. I got married and settled down. Can't work out too much now - just a couple of hours per week, and no heavy weights. Within 2 years I couldn't fit into my clothes and had high blood pressure and high cholesterol.
I realized I don't eat because I'm hungry, but because it keeps away sadness. So I changed my diet so I could eat however much I want. I now have a 4-pack instead of 6, fit into my pants, and eat however much I want.
I cut out fat completely. No oil when I cook besides a light spray on the frying pan. No nuts. Tuna - not salmon. Real expensive lean filet if I want cow in my mouth. Only white meat from birds. All the pasta, rice, and potatoes I want, but zero sugar added to anything. Lots of splenda and sweet n low. Fat free fairlife milk (lactose filtered out = less sugar calories). I eat normal sized meals.
Then, I have fruit and berries, and I eat as much of that as I want. I'm stuffing my face the whole day. Today, I had a pint of blueberries, 5 medium apples, 2 mangoes, and a pound of grapes.
Speaking of gastrointestinal issues, my poo is now soft and gentle, and smells delicious.
the most surprising thing to me is how you’re describing normal behavior that I can relate to all my life, but the community of strugglers is so big that this is a whole testimonial people feel comfortable and exalted to share
like thats not something I’m deriding its just news to me
makes me wonder what this drug actually does, flush gut bacteria? just the right ones?
I’m glad people are enjoying Ozempic. My experience from seeing a family member on it, is I would not touch it if I were a 500-pound alcoholic smoking two packs of cigarettes a day. That’s an exaggeration since it probably outweighs the health issues there, but only slightly.
The person I know taking Ozempic has only lost weight (35 lbs) due to the fact that eating now makes her sick. She has been sapped of all energy and has developed issues with her bladder, circulatory system, joints, thyroid, and digestive system since starting Ozempic. I’m not saying it’s due to Ozempic, but I am saying all these issues have cropped up in the few months since she started taking it, and she never had any chronic health issues prior. At least she lost some weight, I guess.
As a counter-counter-point I've read most (~90%) of the papers that come out of trials registered at http://clinicaltrials.gov/ for all GLP-1 agonists, including ones that haven't been approved. The vast, vast, vast majority of secondary outcomes, for things like
- blood pressure
- lipids (HDL, LDL)
- insulin sensitivity
- blood glucose
- strokes
- cardiovascular events + deaths
- myocardial infarctions
- hemoglobin A1C,
- revascularization,
- etc, etc, etc
are literally all affected positively (to the benefit of the imaginary "mean" patient) in bulk.
Note though, that doesn't mean 100% of patients are have positive results, just that each of these are, in bulk, positive across the tested subjects when averaged together. There's little in the data to suggest that cases like your family member aren't happening or couldn't happen.
There's also evidence that GLP-1 agonists increase the rate of glucose use in the brain, accelerating learning rates. (The brain accounts for 2% of body weight but up to 25% of glucose consumption, it really is fueled by glucose)
https://clinicaltrials.gov/ct2/show/NCT00256256?term=stroke&...
Your relative’s sad story reminds me of a short story I read a few years ago about a miracle pill that leaves about 90% of its takers perfectly slim and able to stay that way eating anything, after a few truly disgusting initial days of elimination, but kills the other 10% gruesomely.
Because it’s so wonderfully effective for the majority, there ends up being a ton of social and economic pressure for anyone even slightly overweight to take it, despite said 10% risk of death.
(Edited to add):
“The Pill,” by Meg Elison
https://escapepod.org/2022/11/03/escape-pod-861-the-pill-par...
https://escapepod.org/2022/11/10/escape-pod-862-the-pill-par...
It’s interesting to me how much of the hostility to this drug has a moral dimension. I am quite fit for my middle age. It’s a relative superpower which confers a degree of status in this world. It’s not why I originally became fit 5 or so years ago but it’s something I increasingly notice or to be clear others notice and comment on.
I think the “fit” of the world get inherently uncomfortable that our relative social currency is being “devalued” if everyone can be like us with an “unearned” pill. And it comes out as hostility and skepticism.
I admit haven’t done much research on this particular topic. History should caution us that serious medication like this often has serious side effects which are not apparent early on. I get that. But unlike many others I don’t “hope” that happens like some kind of moral balancing. I get that reaction. In my gut I have that “I did it with willpower and lifestyle and sweat and these people shouldn’t just get it at CVS.” But that’s just the primate status brain talking.
Not that it impacts the outcome but I sincerely hope these drugs can improve people’s lives without significant negative problems. I can find my relative status elsewhere or better yet try to grow up past such impulses.
Yes. On a compounded semaglutide. I can finally control my hunger and a nice unexpected effect has been losing a desire to drink large quantities of alcohol. I don’t drink during the week anyway, but it seems to be the volume that turns me off to drinking. Thus a few cocktails are all I can tolerate. For context, Im 30, male, would be defined as a binge drinker on weekends. Oh, and I’ve given up nicotine entirely. I can’t tell if the drug is helping or it was just a point in my life that I finally decided I accept it makes me feel ill most of the time.
A drug that promotes weight loss, lessens the desire to smoke, drink, etc...sounds too good to be true?
From what I have heard, all of these issues come back as soon as someone comes off the drug. So either a person is committing to a lifetime of being dependent on this drug, or a person is committing to some period of time of ideal living, followed by a possible time of depression after reverting to the status quo.
What happens when you reach your target weight with drugs like this?
After having learned potentionally nothing about nutrition, exercise, and self-control, are you stuck on these meds for life out of fear of binge-eating back to your original weight?
FWIW I'm on a hundred-pound roller coaster ride from 300lbs to 200lbs; currently ~215. I've learned a lot about discipline and sustainable habits along the way.
I'm surprised Ozempic gets all the press. Supposedly Mounjaro is all that and more.
The wonderful Paul Ford has the best writeup I've seen that discusses these more meta levels, the post-human implications of a drug we can genuinely widescalely reprogram ourselves with. Paul's so great. https://www.wired.com/story/new-drug-switched-off-appetite-m... https://news.ycombinator.com/item?id=34660232
How long is the research info ozempic and other hormonal weight loss drugs? Remember the last miracle drug that went to the market for weight loss had to be retracted for killing people or damaging their hearts to the tune of over 10 billion dollars in damages paid out.
I tried Ozempic for two months but wasn't able to continue - the gastrointestinal side effects are unbearable. I can confirm lack of desire to eat and drink alcohol. The hunger didn't go away but after a few bites of anything it quickly evaporated. After dropping the drug the hunger steeply increased, even higher than before, that was hard to contain.
the genetics of obesity are amazing.
we all have a unique combination of genes, and epigenic features that influece the endocrine and neuronal pathways that drive the desire to eat, these different genotypes affect our behaviour. Ozempic is putting a thumb on the scales of this pathway, but this pathway is balanced differently in all of us.
Think of the most hungry you have ever been, in some people this never stops, in others it's dialed up or down.
there are some great papers on fat labradors that hint at how these different genotypes are linked to our desire to eat and how that shifts our behaiour. Guide dogs are highly selected for trainability, and positive reinforcement with food reward plays an important role in their training. I think it was Yeo, found 22% of pet Labradors and 80% of Labrador guide dogs sampled carried a 14 BP deletion in the POMC gene, which forms part of this pathway.
https://doi.org/10.1007/s00125-016-4187-x https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4873617/
Some people really love to moralize and cite anecdotes about Ozempic.
I was always of the opinion that being fat was a moral failing. Trying the drug really changed that.
Normies have it so easy. They take one bite and feel full. My brain would scream at me continuously to try and make me eat and would never be satisfied.
I was about to get on semaglutide and after extensive research I thought "wait, the results won't be much better than the periods of IF I've had in the past, and the reported benefits are similar", and without side effects. Dropping 30 pounds in 3 months? easy to achieve with the Warrior Diet or OMAD versions of IF.
The results are exactly the same... you fill full eating less quantity, cravings disappear after 1-2 weeks, increased focus and enhanced mental state. But yeah, you need some self-discipline, tons of coffee/matcha and water.
I've concluded that semaglutide is not for me. Just like self-discipline in pills, with potential side effects. So better to give IF another go... I'm in the 4th week and dropped 10lbs already.
I am taking Contrave to lose weight. Lost 30 lbs in 4 months. It is a drug that's composed of an anti-depressant and an opioid antagonist. Together they have a synergistic effect that represses binging envy and cuts appetite.
It also has a repressive effect on drinking and smoke, to my great surprise. And it also has had an effect on my addiction to video games.
Drugs companies get a lot of slack (most of the time deserving) but sometimes they create miracles pills.
Now if only it didn’t cost so damn much every month even under insurance =(
it's funny in that a few years ago we were (and still are) excited by the potential cellular protective properties of GLP1 agonists, not just in the pancreas but in brain glial cells or whatnot. So much so that it seems to be the most neuroprotective of recent candidates for Parkinson's disease disease-modifying-therapies (DMTs).
to whit, (like botox), all the initial promises of the stuff have been waaaay overshadowed by...cosmetic value.
(I'm oversimplifying a bit...for those who are morbidly obese, yes, the weight loss really helps, but then they also have diabetes most likely which is the primary indication of the drug)
Exercise is free and the side effects are you get stronger, more energetic, and better looking.
Ozempic costs money and its side effects include cancer, kidney failure, and ruining your eyes.
https://www.ozempic.com/faqs.html
edit: many point out calorie intake is the real problem, it's true: buy a kitchen scale, weigh your food, count your calories, and you will lose weight. Exercise is optional compared to that. Still, both are free and have more benefits.
I was on ozempic for a bit but it raised my resting pulse from 65ish to 95ish just sitting at my computer so I had to stop taking it.
From my experience of addiction, suppressing the sensation of pleasure derived, is only the start.
People who are addicted will repeat the behaviour even without the neurochemical response. Consider the ritual of the addiction as a form of self-soothing.
You have to treat the patterns we've trod in our own minds, as well as removing that biological reinforcement.
So, instead is suppressing the desire to eat, how about inventing a drug that blocks the absorption or breakdown of carbohydrates in the gut? Or maybe control the gut biome so that growth of bacteria that breaks down high calorie food is minimized.
Is this faster-than-light-like impossible daydream or is there any plausible path to it?
Wasn’t this the plot of the Firefly movie? It didn’t work out well for them.
Psilocybin too.
Is this mostly a US drug? I never heard about it in France.
I can't believe people love it so much without thinking about the actual source of their problem.
Just a heads up “weight loss” is a poor metric if it comes at the cost of lean muscle mass. It seems that 39% of weight loss associated with Ozempic comes from lean muscle mass which isn’t great.
https://peterattiamd.com/the-downside-of-glp-1-receptor-agon...
Ozempic did nothing for me
Congrats, you're now a lifetime subscriber to big pharma
maybe useful to treat drug addiction ?
"Semaglutide does not dull all pleasure, people taking the drug for weight loss told me. They could still enjoy a few bites of food or revel in finding the perfect dress; they just no longer went overboard. Anhedonia, or a general diminished ability to experience pleasure, also hasn’t shown up in cohorts of people who take the drug for diabetes, says Elisabet Jerlhag Holm, an addiction researcher at the University of Gothenburg."
So it doesn't dull all pleasure just almost all so it's not technically anhedonia...
I dunno, still seem pretty fucking bleak to me.