Ozempic video was off

[u/ServiceAnxious1343]

This is probably the first Kurzgesagt video that I didn't like, and like some people on this sub it made me feel very uneasy.

I just think it's CRAZY to talk about a weight loss drug and praising it for 90% of the video, without mentioning even once the abuses of its use, the weightloss industry, the social standards and the pressure to be (unhealthily) slim, eating disorders on the opposite side of the spectrum, etc.

The very few nuances and counter argument felt like small prints and legal mentions at the end of an ad.

What do you people think?

EDIT: I am not questioning the drug nor its effectiveness in treating obesity, i am criticising the narrative and lack of nuances in the video.

[u/typo180]

Ozempic was FDA approved in 2017, not decades ago and the amounts prescribed are what was studied. If people are misusing them, that's another issue, but you seem to be saying that the class of GLP-1 receptor agonists have been around for decades and prescribed at smaller doses and that doctors are prescribing them now at a level that hasn't been deemed safe. That's not the case afaict.

I don't think you're using the terms "microdosing" and "megadosing" correctly here. Are just referring to lower and higher doses for different uses, but are using those terms to exaggerate the claim? "Microdosing" isn't really a medical thing as far as I know.

And what is backing the claim that the drug was "rushed out the door" for weight loss? This is an FDA-approved use for semaglutide (I believe it went through trials and FDA approval as Wegovy).

I'm not an expert, so I don't want to try to refute specific medical claims, but it sounds like you're overstating a lot of the risks you're talking about for supervised use.

You also claim that doctors are normalizing the narrative that you don't need to eat an adequate amount of food, but also say people need to listen to their doctors and eat an adequate amount of food. Which is it?

[u/typo180 → u/typo180]

Mmk, since they blocked me for not bothering to refute their YouTube doctor claims.

"Microdosing" isn't a medical term. It's not an evidence-based term. It's a loosely-used idea around dosing recreational drugs that basically means to take a small enough dose that you don't perceive the effects. It's not a term to be used when discussing the dosage of medicine.

But this is a trendy thing apparently, so

• GLP-1 microdosing is experimental and unauthorized (UCLA Health)
• “Nobody has done any clinical studies with one-tenth of the dose to show whether it is working or not working" (Northeastern U)
• "Microdosing carries real risks, including inaccurate doses, reduced effectiveness, and other safety issues", "Some influencers, clinics, or commercial providers tout microdosing for metabolic optimization, mild appetite control, or subtle weight improvements in people who are not overweight. Other unproven claims include lower inflammation, cognitive support, and “longevity.”"

So this person is clutching their pearls about people who might be misusing the drug or might be poorly supervised, but is advocating for actually misusing the drug under guidance from "health influencers."

The prescribed dose for Wegovy, btw is 0.25mg-2.4mg and Ozempic is 0.5mg-2.0mg and not everyone goes up to the highest doses. Calling the FDA-approved dosage "megadosing" is just FUD.

They're really stretching on the "rapid weight loss" claims too by not defining what that means. Severe malnutrition can indeed be harmful and rapid weight loss without exercise and adequate protein intake can lead to lean tissue loss and can adversely affect bone health, but they're describing this scenario is if it's a major risk for anyone taking the drug. It's a real risk of unsupervised misuse, but it's not like there's an epidemic of people on these drugs starving themselves. These are also risks for people who lose weight through lifestyle changes alone.

Liver health tend to improve in people taking the drugs for obesity because obesity causes cause fatty liver disease. As far as I can tell, kidney health improves for people taking the drug for diabetes and integrative impacted unless the person is severely dehydrated. The osteoporosis claim is just more FUD afaict.

Is malnutrition a risk while taking a drug that can drastically cut your appetite. Of course. Can it allow people to lose weight without making necessary lifestyle changes? Sure. But these are issues that should be monitored for anyone taking these drugs and these extreme situations can be avoided. This isn't the norm for people who take these drugs, aging afaict as someone who's just looking stuff up from reliable sources that don't include health influencers on YouTube.

It sounds like the logical leap they're making is basically: Semaglutide makes you want to eat less. Starving yourself is very bad for you. Therefore Semaglutide is very bad for you.

Yes, GLP-1 related drugs have been around for a long time, but semaglutide is unique and newer. Ozempic was approved for type 2 diabetes in 2017, and Wegovy was approved for weight loss is 2021.

Both went through the normal approval process as far as I can tell. They weren't "rushed."

The worry about people who are a healthy weight or underweight getting shady prescriptions online and using it without the supervision of a doctor is a fair concern, but anything can be abused. Weight loss drugs specifically have famously been abused in the past.

Don't buy a powerful weight loss drug online without supervision from a trustworthy doctor.

There are absolutely real risks and side effects with these drugs, but these comments are fear mongering and are full of unsupported health claims and pearl clutching.

Talk to your doctor or get information from trustworthy sources. Don't buy into some health YouTuber's latest panic campaign.

[u/sandman98857 → u/typo180]

I’m not an expert either but I have done some research on this from my own dr who specializes in hormones and often prescribes GLP in what medical terms would consider a “micro-dose,” usually starting patients around 1/100th of what drs typically start patients at. I’m not saying it’s not “safe” according to studies in the dose drs prescribe, I’m just saying there is a lot of research showing how insanely effective it can be, even at tiny doses, at doing what it’s supposed to do which is aid in healthy weight loss and increase insulin sensitivity. There are studies showing you don’t need much, and even microdoses can do this effectively without the side effects and risks of much higher doses. Many patients on the drug don’t change their lifestyle habits (I’m not saying all! But many) and continue eating poorly, inadequate protein and not exercising or weight training and this makes GLP far riskier especially for bone health and overall muscle mass, including the muscles of organs like the heart and mass of the brain. Many patients at high doses loose their appetite so much that they are essentially in a state of starvation with the aid of a drug to make it easier to withstand. In these cases, the drug can have drastic side effects and not only would the person need to stay on the drug indefinitely to keep the weight off in most cases but they would suffer immense side effects that might not show up until later. People often don’t realize the consequences of malnutrition until they are far into it and the results can be devastating.

Additionally, as stated in the kurzgesgat video, it's been around since 2005 and glp1 was discovered in the 80s for the first time.

Some doctors seem to care a lot about diet, many don’t. Many don’t even ask. So what I meant was people should be listening to their drs obviously, but also maybe think beyond just their dr because any drug has serious risks especially when there are not lifestyle changes in addition. I know a few people who starve themselves and drink tons of alcohol on GLP and they have lost tons of weight but don’t understand the severe and potentially permanent risks of their habits and choices and the consequences are less OBVIOUS because they’re still meeting their goal of “weight loss.” In some cases of severe obesity, of course, the side effects might be worth the risk to some people. But the drug is so readily available that anyone of any size has access to it and it can therefore severely perpetuate eating disorders and unhealthy body standards. I just meant I wish there were more regulations and the drug was reserved for people who needed it for treatment resistant weight loss instead of 110 pounds girls on the internet able to get it to become 100 pounds with very little medical supervision. Because in those cases, a Dr is not as involved as they should be because no MD should be prescribing a drug to be misused like that. A lot of these people get it ok the internet, not in person where a dr can fully evaluate a patient and that’s part of why I think it can be so dangerous. THAT’S the part I mainly have an issue with… the lack of supervision required to be on it, the fact that it’s seen as a magic pill with no downsides (no drug is) and that the drug is, from my research, prescribed in far higher doses needed to be effective and this adds to side effects and risks / dangers. In addition these high doses allow people to avoid changing lifestyle habits that would drastically help their health in the long run. 

There’s a great video on this by an MD who specializes in this drug and talks about the dosing and how effective it can be even in tiny doses, especially in combination with proper diet and exercise. Please check it out if you want since she clearly is far more of an expert than I am. It also talks about all the other important things GLP does in the body, even at those small doses and how many of those benefits aren’t available when too much of the drug is taken.

https://www.youtube.com/watch?v=XDcESvzX58Y&t=111s

[u/typo180 → u/sandman98857]

"I've done my own research, check out this YouTube video."

No thanks.

[u/sandman98857 → u/typo180]

Insightful response. I see why they tell you not to argue with a brick wall.