I would assume we’d also see a reduction in cardiovascular disease?
I’m with you on health and change for improving their life. There are a lot of non-weight loss benefits that may even exceed the weight loss ones, particularly in mental health and engagement with the outside world.
Still, the evidence is out that GLP-1s WITHOUT EXERCISE promote effective weight loss that persists as long as you keep taking them - and lots of downstream major health benefits like reversing a lot of type 2 diabetes, reduced deaths from cardiac disease, and a lot more that are being actively studied. Exercise has played no factor in these improvements in the studies, as the participants were not instructed nor did they start new exercise programs to complicate the analyses.
Promote exercise and fitness for what it is - a great part of life and living, with real quality of life improvements. But don’t try and insinuate that exercise is required for GLP-1 effects - they are absolutely not required. Obese people who are in bed all day can take GLP-1s and will most likley lose 15-25% of body weight - while lying in bed just as before, because the GLPs remove their cravings for food.
I’ve never said exercise was required for them to work, but they will work better,ie you lose more weight, if you also adjust your lifestyle.
And as I reiterate - the exercise is NOT making the GLPs ‘work better’. The GLPs are doing ALL the heavy lifting.
Exercise might give you an extra slight weight loss and other quality of life benefits I mentioned, but none of those have to do with the GLP, nor do they synergize or work with the GLP, as far as we know now.
I know you hate that people get this magic bullet for weight loss that doesn’t hold the accountable to the hard work of diet discipline and regular exercise, but it’s exactly what this drug is proving to be thus far.
(FWIW, I’m not on it nor plan on being on it, but I won’t say never, as I do believe we live in a super addictive food environment, and we have very little chance against it especially in the much older ages where high activity is near impossible and the body just wants to keep increasing weight in most people.)
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I think you guys might be missing the real reason that stipulation is put on the label – to reduce legal liability when overweight people have all manner of injury from using the drug to essentially starve themselves to near death without engaging in any physical exercise.
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Do you argue for a living? You just agreed to my point that you will lose more weight with diet and exercise. That’s all I’ve said. I know the GLP’s do ALL the heavy lifting. As we like to say, they build the cake, and diet and exercise are just icing it. They are not like anabolic steroids where you actually have to lift the weights to add muscle mass.
Anyway, I think we both have basically the same thoughts on these drugs.
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Ha, I do like arguing on slowtwitch, you called it right there! Actually, I’m not really into the ‘arguing’ part as much, but it usually ends up that way after I point out exactly what people posted before contrary to their ensuing claims.
This is what you posted first, which set off our entire back and forth:
Retail pharmacist here, so deal with these meds on a daily basis. Wegovy and Zepbound are approved for weight loss AS AN ADJUNCT TO DIET AND EXERCISE, ie, you need stop eating crap and get your ass to the gym or do some cardio.
That part about “you need stop eating crap and get your ass to the gym or do some cardio” pretty clearly implies that you think the gym/cardio is an important part of the GLP-1 weight loss. Don’t blame me, that’s exactly your words, and they’re not exactly subtle.
Glad to see we’re on the same page after all though, as shown by the followup comments.
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And diabetes, and kidney and lower risk of dementia and on and on…..
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I can understand why you may think that. But that’s not how drug labeling and FDA approvals work.
Exercise and proper diet are on the label because that’s what was studied during the trials. The FDA approves drugs based on the trial conditions.
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This thread is actually making me want to go sign up for some.
IMO retatrutide should certainly be banned. Not sure about the others.
Banned in sport? Or banned for public use?
Some info I found while reading the news the other day :
France has officially, about a week ago, approved the reimbursment of these medicines, in specific cases. So to be clear, before that, you could still take them but they had to be prescribed and you had to pay for them yourself (which in France is pretty rare for someone to pay for their medicine themselves, and is about 300 euros per month, which is absolutely huge for French patients, so not many must have been taking them).
They will be reimbursed only for certain people : that is obese people categorized as “massive obesity” or “severe obesity with comorbidity”. A quick look shows that means people with at least 35kg/m2 body mass index. In addition, only certain practicians which work in clinics specialized in obesity will be able to prescribe them, and that will have to be in addition to hypocaloric regime and activity increase. The government claims it will be closely monitoring as they are aware there is high risk of misusage of the drugs (pretty obviously).
The total cost is estimated at 100 million euros per year. And the article claims France is the first country in Europe to reimburse the drugs. To add, they will be reimbursed 65%, with the 35% left picked up in most cases by private health insurance which most people in France have, or if they don’t by the patient himself. Although in this case, many will get 100% by the government if they are on a “long term illness” list which I think severe obesity is.
Here is the article for those interested (in French) : Les traitements contre l’obésité Wegovy et Mounjaro remboursés dès la mi-juin en France, dans un cadre contrôlé
So at least in France, it seems we’re not on the USA level use of these drugs (I read another article which stated 1 in 8 americans take these drugs !), and probably use by (amateur) athletes is not a thing, and authorities want the drugs used as an alternative to last resort surgeries for obese people, not a way for overweight people to bring their weight down (or at least in this case without the government paying for it). I would imagine the plan is to see how that goes and if there is benefit maybe increasing use little by little to larger parts of the population if needed.
Seems like a reasonable way to go about it in my opinion.
My good friend Dr. Jeff Sankoff with a new article addreressing this subject today in Triathlete Magazine Online. Jeff also has a terrific weekly podcast called the TriDoc podcast where he discusses medical and supplement issues of endurance athletes.
I like that he couched his assumption with the fact that there are severely obese folks that showed this tiny, tiny possible side affect. This is going to be the problem for awhile, our cohort is the exact opposite of the group that all the results are coming in from. If I hear that they make you lose muscle mass one more time, well I suppose anyone on the con side will cherry pick all kinds of things to poo poo them. Of course you lose muscle mass, you are 100+ lbs overweight and noting you could/wwould do would just lose you fat!!!
But for folks in the 30lbs or less category who do triathlons and have been stuck there for a decade+, trying all the conventional methods and failing, this could be their ticket. I have a very good friend right down the road from you who has been doing triathlons for 30+ years, carrying at least 40lbs+ his entire career, he is the perfect candidate for something like this. Trains everyday of his life, but now in a very dangerous area with his age and weight of having something very bad happening.
It will take some time, but eventually we will get studies of people that actually train and eat right. And I have a sneaking suspicion that the dynamic of going off and gaining all the weight back will be different too. I can see a possible micro dose at some point for athletes who have the discipline to go out and train everyday, and not the total couch potato’s that lose a 100lbs but never get off that couch..
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I’m a physician that prescribes these.
Like any medication there are possible adverse effects but the benefits are incredible. That said, it’s not a ‘get out of jail free’ card for discipline and my patients are required to eat a minimum amount of protein and exercise (ideally resistance training, weight lifting) each day. If they lose muscle mass I won’t prescribe them.
For athletes, it could augment health, but for competitive athletes, I’d be really angry if a triathlete beat me to a KQ on a GLP1 / GIP. Triathlon is about strength vs weight and being on one would be cheating with a performance enhancing substance just like an anabolic or “TRT.”
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Prepare then to be very very disappointed as this will definitely become a widespread method of ‘legal’ doping in the near future if not already happening.
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Your friend can do these 2 tasks, instead of just one (exercise) , without needing the glp1
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We actually don’t need this study. GLPs cause weight loss across the population unmatched by any other treatment except gastric surgery. It’s more reliable for weight loss when looking at the entire population results than any other nonsurgical treatment. It works whether exercise or don’t, or even if you choose to continue to eat foods that are considered ‘bad’ for you - you just end up eating so much less of that bad food that you still lose a lot of weight.
On the other hand, as you mentioned, in the 50+ (or even 40+) population, there are tons of people, possibly the large majority especially in various ethnic groups, that are prone to obesity or at least overweightness no matter how much they exercise and how well they eat, even if they were thin as rails up to their mid 20s. A lot of these folks eat right and train right, but it still happens. I’m aging up into this category, and it’s happening to me as well - the weight keeps coming on at 1lbs per year even if I train year round at close to 15hrs/wk, and eat a pretty good diet. I’m now 25lbs heavier than I was at age 30, and yet I train nearly 2x as much (and equally as hard if not harder) than I did back then. I still don’t have really any visible body fat but at the current rate I’m going, I’ll be full-out obese weight at age 60+, and may become a candidate for GLPs as much as I’m trying to not rely on a drug.
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I’m still waiting for someone to explain to me as a competitive athlete why you would in any way want to use something that reduces/slows gastric emptying (disaster for triathlon) and also stops the liver from releasing glycogen (key energy source on race day)
Heck maybe i should be pushing this crap more to help sabotage my competitors.
WADA isn’t considering banning GLP1s because they make athletes worse.
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