Posted by PaulHoule 2 days ago
Once I started on tirzepatide, and then with retatrutide, the "urge" to swap over to my PC between meetings and load up a game is pretty much zeroed out.
Is this an "addiction" or a form of "abuse" similar to alcohol or other drugs? I would have said no some time ago, but now I'm not sure. I definitely feel like, looking back, I was more or less "addicted" to video games. I don't want to romanticize it as some sort of "escape", it just is what it was.
This was an unintended side effect (benefit?) of the drug for sure, in addition to acute weight loss of course.
Unlike many others, even after titrating down and coming off the GLP's, I have not felt the urge to binge food, video games, or anything else. I maintain a healthy, active lifestyle and have kept my weight exactly where I prefer it. My relationship with my body and my time has massively improved. I feel like I am at risk of sounding like a complete shill, obviously, but in my mind these drugs can be something that absolutely has the potential to turn life around for many, many people.
For people with normal executive function, the second category of problems should be fairly tractable to overcome, whereas the first is still quite difficult.
The second only really becomes an issue when you have a bit of executive dysfunction.
Maybe that distinction is important and one merits the term addiction while the other doesn't? Though both categories seem to be relatively treatable with drugs that massively improve executive function, so the parallels are pretty glaring.
Conversely, people hospitalized for something acutely painful often get addicting (or, withdrawal causing) painkillers in amounts and at purities street users can only dream of. And once it's over, they go through withdrawal, and it's deeply unpleasant, and they never want to do it again. People going through something like that aren't more likely to become opioid addicts than anyone else, according to old study results (I may be able to dig them up if you're interested).
It's of course different for chronic pain. But then, the reason for people wanting to start up again is pretty obvious.
It’s true that pharmaceutical purity is higher, but it’s very much incorrect to say that hospital patients routinely receive higher amounts or doses than street users.
The doses used by chronic opioid, benzo, and stimulant addicts can be absolutely insane compared to even high doses given in medical practice. Even more so after tolerance builds.
This can be a real problem for severe addicts who become hospitalized or end up in the ER because their tolerance is so high that even the high end of doses used in normal patients may do next to nothing in patients with severe addictions.
Addicts also have several factors contributing to the increased severity of their condition: Their route of administration is designed to maximize the ramp up of the dose, which leads to stronger effects, habituation, tolerance, and withdrawal dynamics.
Undergoing many cycles of habituation and withdrawal (missing doses, running out, or just abusing on weekends and trying to stay sober during the week) can actually sensitize addiction problems and exacerbate the problem, even if the doses are not extreme. This is not a problem in a hospital where doses are scheduled and regular.
Finally, the duration of exposure and area under the curve is dramatically different. An addict may be exposed to 100X or 1000X as much of a drug over years due to higher dosing and long term addiction relative to someone in the hospital who undergoes a procedure and then is tapered off.
It’s really misleading to compare opioids or benzos prescribed in a controlled hospital setting to the use by addicts. They are so dramatically different that you can’t compare the addiction and withdrawal dynamics at all.
As I said, the studies are old. With the rise of superpotent synthetic opioids in the illegal market, and probably more caution in hospital use - one of the reasons these studies were made, was probably that someone noticed "wow, they sure used a lot of opioids during the Vietnam War, I wonder if that led to a rise in street addicts?" It's possible that it's no longer true that patients get much higher doses than the typical street addict. But it used to be the case, at least, and we can still learn from what we observed back then.
I think there's still plenty of support for the conclusions, that addicts can beat physical addiction, but that they start again, and that the fear of withdrawal pains is not a big factor in what's keeping them as addicts.
The differences between street/illicit use and hospital use are so extreme even just from a physical point of view that it is unreasonable to compare the physical addiction/withdrawal they both cause.
That being said, physical addiction/withdrawal is definitely only one piece of the puzzle of why addiction happens and addicts don't stop their use. I think that using the data of hospitalized patients being able to push through it isn't as strong as an argument for that as you've made it out to be, but that doesn't mean it isn't true.
Addiction is a very hard problem, and I'm hopeful that we'll continue developing new treatments and support methods as a society, even if its semi by accident like with GLP-1s.
People with physical addictions can choose not to use drugs etc. Smokers can take 12 hour flights and they don't involuntarily take out a lighter and cigarette and smoke half way through. It is about self control.
These are just the people you notice and see because they don’t care that you see them that way.
My friend worked in the rehab industry. The people who attended rehab came from all different walks of life. Many of them had everything going for them and great lives. It was common for people doing well in work and their social life to think that they could abuse drugs because they could handle it better than “those people” and they wouldn’t allow their use to get out of control.
The idea that addiction is only ever a response to life circumstances is a myth. Lots of people get tangled up with drugs simply because they’re seeking some extra recreational value or euphoria and don’t think the addiction part will apply to them.
In fact, I think the idea that addiction only happens to people who aren’t good members of society is a contributor to many of these people dabbling with drug abuse: They’ve heard so much about addiction only happening to people of poor morale character or who are victims of their circumstances that they think they’re not at risk for addiction because they don’t fit that description.
* A lot of people who have broadly good lives get into trouble because their particular blend of biology and mental health makes them vulnerable to addictive behaviors, but others use those same drugs without issues
* People with poor life circumstances (and certain mental health conditions like ADHD) are more susceptible to addiction because they have rough lives and anything that gives you dopamine, be it exercise, casual sex or drugs has the potential to cause addiction, and people in those circumstances utilize behaviors for dopamine release more frequently and readily, and also have a stronger lack of dopamine when they stop
It's a very complex subject that's still developing, but one thing I think we can say for certain is that stigmatizing addicts and addiction and treating the people struggling with it as criminals doesn't solve anything. The criminal penalties for drug use and sale have never once helped anyone. What does seem to reliably help people struggling with addiction, any addiction, is support and safe places/drugs to use. And if GLP-1s can enhance that, I'm all for it.
And, it wouldn't hurt to change our society somewhat so we have fewer people on the bottom rungs of it, barely getting by due to whatever circumstance, whom are then less likely to get in trouble with drugs broadly. And to legalize drugs, because making them illegal doesn't do anything apart from inflate police departments' budgets, and push people who want drugs into dangerous situations, addiction being among them but not the only one.
The lifelong craving is the bigger issue.
In fact, the side effects of certain drugs that directly increase dopamine levels (L-DOPA) or drugs that directly stimulate dopamine receptors (dopamine agonists like bromocriptine) include a risk of compulsive gambling, shopping, and risky behaviors.
Ironically it’s more accurate to simply say “withdrawals” than to try to inject reductionist neurotransmitter speak.
It's not even really about choosing not to, either... it really does feel fundamentally like I cannot even derive a dopamine response to video games at all anymore, period. Same could probably be said about doom scrolling social media or whatever else. I just get no false positive feedback loop from the act.
I suppose if you just play the same game day in and day out and it has no real substance (which admittedly is probably the largest gaming segment) it might be a good thing to get rid of the habit. But some games are masterpieces and they often hit very different than other mediums because you are the protagonist making choices. In my opinion some of the best stories come in the form of games and I find it a real shame there's a portion of the population who think they're a complete waste of time.
I think there's also something to be said here about being addicted to work. I know such people and it's just as sad even if it's what society expects of them.
In general, lean body mass loss is more of a result of rapid weight loss (I certainly consider mine very rapid), than result of the medication itself. If I was able to lose the same weight in the same period of time without the medication, and kept my protein and resistance training the same, I'd expect a similar ratio of muscle/fat loss.
Overall extremely happy with the outcome, very grateful that these drugs exist and that I was able to access them.
Is it possible that video games were your escape from a world in which you were obese, with all that it can entail, and losing the weight removed the need to escape?
Anyone saying they’re taking retatrutide almost certainly obtained it this way. Quality and purity untested.
Not true for everyone, or perhaps even most playing in this space.
Every batch friends of mine have ordered has been independently tested for purity and dosing. Random batches also tested for sterility.
Plenty of folks yolo it, but it’s not like it was a couple years ago. Lots of group buys being done that order a large batch and then do random sampling for lab testing.
Where are they getting it tested?
Janoshik is a longtime name in this space, originally catering to bodybuilders buying anabolic steroids and HGH.
> Not true for everyone, or perhaps even most playing in this space.
> Every batch friends of mine have ordered has been independently tested for purity and dosing. Random batches also tested for sterility.
Yes, you have to test it because the quality and purity what you get isn’t tested.
When someone sells something and they make a statement about the product (e.g. “tested”), they don’t mean the customer has to test it.
Sure, you might be given a "batch number" that matches up with what they said was tested, but that's putting a whole lot of trust in the seller.
Or you test a vial from your own kit. Expensive but still cheaper than compounded GLP-1.
Or you roll the dice and assume that everything ahipped out about the same time with the same cap color is the same batch.
Or you buy from nexaph.
Everyone has to decide their own comfort zone.
This caused rapid weight loss. A side effect of this rapid weight loss and lack of food intake I also attribute to my thinning hair and dry, splotchy skin outbreaks. Any sort of overeating on tirzepatide (for me) caused severe sickness, or nausea.
Retatrutide, by contrast, causes far less pure appetite suppression (my dosage is also lower) and has another mechanism which helps me maintain leanness while also eating extra calories. I think I prefer the reta, but if I ever felt the need to very simply destroy my appetite again I wouldn't hesitate to use tirzepatide again.
I procured both tirzepatide and retatrutide through the peptide "grey markets" so one was not harder to come by than the other.
League of Legends is “used” by a lot of people as medicine. Nobody hides away to play Stanley Parable. Lots of games, lots of genres, difficult to generalize.
This is certainly worse for the individual, but at society scale, the cost being the obvious devaluation of willpower is way too high. Way too high because everything good in that society was built almost exclusively by driven and strong-willed individuals.
Many moral vices naturally decline with age as physical senses and hormones dull and life loses novelty. It may be a comforting fantasy that we can somehow link our inevitable physical decline to a story of moral progress and assume that our accumulated wisdom would protect us from the folly of youth if we were somehow thrust again into our younger bodies.
But what if instead moral progress is about finding the right way of living? About spending more time with your kid than with a screen.
Maybe the virtue wasn’t in getting over the wall but finding yourself on the other side and choosing it because it is better? Society puts up walls all the time to prevent people from finding themselves on the wrong side of the wall. Nobody ever talks about the “grit” of the addict persistently dodging law enforcement to score their next fix.
Maybe the problem is society putting walls in the wrong place. If that’s true, does it really matter how you get over the wall?
I didn't take the GLP to help me with addictive behavior traits beyond my diet, but I observed tertiary benefits of the drug.
As I've titrated my dose down to zero, I've retained those habits and my weight. I'm in the best shape of my life and mentally healthier than I've been in over a decade.
My understanding is that that GLP1 drugs don't actually have this effect, as much as we know so far.
Because she went on GLP-1 to lose weight.
There's probably generally a bit of correlation. But just because someone can be very focused and go to extreme lengths in one aspect of their life doesn't mean they can consistently do it in every aspect of their life.
Because that has nothing to with grit, that's just business.
If I can change my behaviour and achieve good health outcomes, relatively painlessly, why on earth would I not?
This comes across to me like people who won't use painkillers - I should feel the pain, masking it is fake, there is virtue in suffering etc. Turns out those people often end up with secondary complications to (for example) muscle damage, because they've adapted their movements so much to avoid using the painful muscle that now everything else is tense, strained and locked up.
Better living through chemistry, 100%.
If it's an inherent quality, then there's no reason we should have any less of it than "the greatest generation", or whoever we should want to idolize. The difference has to be external, not internal.
Let's work on what we can change, the external. What you are might change, but you can't change it - that's the core realization behind both European pagan obsession with fate, and Christian obsession with sin.
People today are fat and lazy for many reasons but one of those is that society allows them to get away with being fat and lazy. It gets worse every year: now not only can you work from home and "e-date" but you can get anything you ever need delivered to the door. Never get off the couch!
Circumstance, including other people, can change it for better or worse, but you can't change it on your own. You are exactly what you are. Without input from outside, you'll never turn into anything that isn't already implicitly there.
To explain it in computer science terms, since this is HN: suppose you have a method which takes no input. Even if it's self-modifying code, can it change into something else? Can it "improve"? No. Whatever it will turn into after overwriting its own code is essentially already there.
You have all the "character", "grit", whatever, that you started off with. If you get some or lose some throughout your life, it's from outside yourself: it can go either way, and you can't take credit for it anyway. This is something that all sorts of pagans, and Christians, have understood for thousands of years, but the modern Horatio Alger "conservative" doesn't understand it.
That is not a Christian view as I understand their philosophy. I am not one myself.
I think a better analogy would be self-modifying non-deterministic code. You cannot say in advance what the result will be. The state before execution is not equivalent to the eventual result, because different results are not equivalent to each other and equivalence is transitive. So it can indeed improve. Or get worse.
If the source of that non-determinism (or at least some of it) is our choices then yes of course those choices are constrained or sometimes determined by circumstances or our current past-determined states but that does not mean we do not have the ability to influence our future states.
We have the power to better ourselves even if we don't have the power to directly determine our internal states.
Nondeterminism changes nothing for the argument, in fact I mentioned it explicitly already.
Life is more complicated than that. We all know that.
I’ve found that the general act of leaning into challenges and mild physical discomfort has a ripple effect on my mind, and all types of addiction and dopamine seeking behaviors become automatically less interesting- almost exactly like what people report on these drugs. If I take a cold shower or work out every morning even when I don’t feel like it- pretty soon I’m eating healthier and limiting my alcohol, caffeine, and screen time without even really trying to.
That said, it only works if you manage to actually do it. It’s much better to get over addiction with a drug than to continue suffering from the addiction, and be unable to escape, especially something that causes as much damage as alcohol can.
One idea I had was to set a deadline for overcoming an addiction, and to just use the drug if you reach the deadline and the mental approach is still unsuccessful.
As so many boxers (and many athletes for that matter) he was addicted to drugs and alcohol for many years. Probably sexual abuse he suffered as a kid had something to do with it. He was able to quit, but I think cold shower and a run in the morning was not quite enough to do it.
Nobody just starts abusing their body with chemicals. It is not difficult to quit, you can stay off your Jones for months, but if you do nothing to the demons that made you enter the 36th chamber in the first place, you are going to slip sooner or later. It takes more than a splash of cold water on the face.
Marcus Aurelius was literally a god and the emperor of the world. He prob had little bit more resources to help gim other than stoism. Similarly if you have loving family and friends, a good therapist and some sort of medication,you canmaybe wim the fight with the devil that gets you to use. Training and getting used to being uncomfortable surely helps, but you won’t kick anything for long only with them.
Therefore these drugs won’t be a solution either. Are you going to use them rest of your life? Whatever it is that makes you want to drink, smoke, shoot, gamble or whatever is still going to be there. Bit used together with therapy and loving environment might help. Of course, most addicts have no access to any of these resources.
CBT and ACT are modern therapy methods based on stoic methods, very widely used, and very effective for regular people that aren't emperors.
I do think you need tremendous mental effort, or grit, even to fight serious addiction. But it is only a start.
Peoples' neurochemistry differs enormously. One person's positive reinforcing experience is another's nociceptive hell. (source: Ph.D. neurophysiologist here)
Arguments like yours presuppose humans have free will, that it's widely distributed, and if $whoever would just get on it, they'd progress.
More and more, it appears what we have is the perception of free will, not the real thing - whatever that actually might be.
The basic idea seems to be at the core of both a lot of modern self help gurus advice that seems to actually work for a huge fraction of the people that really commit to them (David Goggins, Wim Hof, etc.) as well as modern psychotherapy systems like CBT and ACT that are proven clinically effective.
How many people are really trying this approach, and it not working for them? More often, I see people saying it sounds like it royally sucks (which is true and basically the entire point), and never trying it- which is valid, but doesn't really demonstrate that it wouldn't work for them.
It absolutely is a "nociceptive hell" at first for everyone that tries it, but when you connect that with intention, purpose, and meaning it eventually transforms into something almost enjoyable. Becoming strong enough to meet discomfort or pain feels amazing, especially for someone that usually experiences the opposite of that.
I also have ADHD, which is explained in part as a developmental disability of executive control, but I find this approach to be extremely effective for regaining executive control, even to levels that people without ADHD lack. Basically, I suspect ADHD isn't a loss of executive control at all, but the executive control is being blocked by something like the feeling of pain or drug withdrawal, and that once you are okay with just having that bad feeling all of the time, you get your executive control back. I'm curious if GLP-1 drugs also help with ADHD? My prediction is that they would.
Can you define huge fraction and really commit? And cite evidence?
I disagree the basic idea of CBT or ACT is leaning into discomfort. In the senses articles suggest David Goggins and Wim Hof advise even less.
CBT and ACT work for many patients and don't work for many patients.
Some people liked intense exercise their whole lives. Some people hated it when they started but liked it eventually. Some people exercised daily since decades and hated every minute. Do you not believe the 1st and 3rd groups?
Pushing through bad feelings is a form of executive control. And ADHD impairments are not limited to impulse control. People who have ADHD who do not take medication have significantly higher rates of driving accidents than people who do not have ADHD or take ADHD medication. Proprioception, internal time perception, and working memory impairments are common.
I am somewhat baffled by your statement, as I feel it is largely self evident being familiar with, and having tried both therapy methods with professional therapists, and both Goggins and Hof's advice for years. I think a simple wikipedia level explanation of what those things actually are would suffice to answer your question, so I have nothing major to add, unless I am misunderstanding you. Goggins whole shtick in particular is just this one basic point, make yourself as mentally tough as possible by intentionally always doing whatever is difficult. Hof is also just literally getting into very cold water consistently, which is really not easy- and he has no real philosophy or theory, he just has you do it and see what happens.
Perhaps the therapy methods are less clear, but reframing things or deciding on clear values and purpose, are in my view, psychological tools to make the difficult endurable, or in some cases even enjoyable. This makes more sense if you're seeing the methods in the context of how the ancient stoics used the same techniques that inspired those therapies- especially Epictetus.
> Can you define huge fraction and really commit? And cite evidence?
Not really, it's just firsthand experience from doing them, and having widely sought out and read the experiences of others that did online.
You are effectively implying that firsthand experience and expertise are completely worthless, and people can only learn information from large scientific studies, which is nonsense- it would invalidate virtually everything humans know that allows them to effectively navigate the world. I'm a working academic scientist that often designs and executes large studies, and I only ever see these arguments and line of thinking from non-scientists that don't actually understand the limitations of scientific methods, but have turned it into some sort of pseudo-religion.
These are effectively yoga/meditation like techniques that are taught in communities I am part of, and that I have taught to friends and family. I'm not under some delusion that there isn't bias there, I have seen it not work for people, and account for that in my thinking about it. It's been life changing for me, and so I am happy to share info about it in case it might be for others, but I'm not under some delusion that it is the solution to everything.
Correct me if I'm wrong, but I get the impression that your comment isn't really about what I am actually saying, but a general anger towards anything that looks like "pulling yourself up by your own bootstraps"- an anger you can see in other comments in this thread as well. This toxic line of thinking comes from an old fashioned moral argument, that basically derives ones moral standing and worth as a person from the state of being helpless and persecuted, which requires one to actively fight against anything that might be an effective tool to overcome adversity.
I don't agree that using techniques that can help people overcome adversity in any way diminishes the challenges people face, or diminishes things like systematic injustice and addiction that certainly can be due to factors outside of one's control, and hard or impossible to overcome.
Having tools and methods that can, even sometimes, empower people to overcome, survive, and thrive, even if they don't work every time doesn't invalidate those problems, it is just one way to fight them.
That may be the aspect of this line of thinking that’s not clear then: it doesn’t work for anyone. At least, in so far as the free will is illusory, it is a hallucination that such people have that they made such decisions, and stuck to them. It’s the demon hand syndrome, the person hallucinating a rationale for its motion.
Perhaps beforehand it was somehow "pre-determined" which of these attitudes and paths you would take, but that is completely irrelevant for the individual just living life, they have no way to know that one way or another, or any reason to actually care, as they still need to act exactly like they have free will and made the right choice to actually play out a future as the type of person pre-determined to have a desirable outcome.
It doesn't actually feel any easier or less painful to accomplish something difficult, even if free will is some sort of illusion when looked at from the outside perspective. You still experience, e.g. trying and failing over and over and never giving up until you succeed.
I can buy that, for example perhaps there is something outside our control that decides if you are capable of never giving up, but you still cannot know until you decide to never give up and try it- so it literally does not matter except as a philosophical curiosity.
I think a more interesting biological (and philosophical) question is why and how exactly do these GLP-1 drugs work, and why exactly are they so shockingly effective? Maybe they do somehow act on the brain to offer exactly the same psychological benefits as the stoic approach I am talking about, by the same or related underlying mechanism, and they're essentially interchangeable but work more often?
“Leaning into discomfort” for personal change may well work for much more than a miniscule fraction of people. It may be that such success is made more likely by some structural predisposition – an attenuated neuronal response to negative reinforcement, or some other precondition that allows its “carrier” to keep plugging to a successful outcome.
But clearly, there’s also a more than miniscule fraction of people for whom that doesn’t work. Their preconditions may deflect them from even trying that particular path, or cause them to give up along the way. I really don’t know, but that fraction seems at least as significant as the fraction for whom uncomfortable personal development paths lead to success.
Early in my career, I strongly believed in free will. I mean, I had it, right? And I didn’t regard my consciousness as all that different from my fellow hominids, so they’re probably all similarly endowed, right? Except...
Over time, research with small molecules like epinephrine and the psychedelics showed that perception/decisions/will could be profoundly influenced by neurochemistry. Ditto for various neuronal illnesses that are associated with profound personality changes.
I regard the GLP-1 results as a further demonstration that “free will”, whatever that is, is fundamentally mechanistic. There are few, maybe no, organismic drives stronger than hunger. A weekly injection of a GLP-1 agonist turns that drive way, way down in most of those who try it. This commonly exhibits itself in profound behavioral modification: if you were an inveterate snacker, suddenly you’re not interested in snacks. You pass them by in your pantry and at the grocery store. Your cognition around snacking changes, to the extent that not only aren’t you snacking, but you might find yourself setting a reminder that it’s time to have lunch. Given the strength of the hunger drive, that’s a very big deal, and revelatory about how we work.
I used to think I understood “free will”. Lately, I find it increasingly hard to define. I’m moving more in the direction of Robert Sapolsky as more research results come in. It feels to me a bit like the “God of the gaps” phenomenon, in which the space available for faith in the supernatural grows smaller with every scientific discovery.
It’s a remarkable time to be alive and have the luxury of considering these questions.
I think it's obvious that we don't have "free will" in that sense, it had never really occurred to me to consider otherwise- people are definitely quite driven by instincts, neurochemicals, etc. they they can't consciously choose.
However, I think my comment in the other thread still applies- that for an individual, it doesn't really matter one way or another- your firsthand experience is still going to be one of exercising your will to increase the odds of getting outcomes you want in life, or choosing not to, and definitely not getting them.
But there is some biological clue here about who we are, and how our brains work that is fascinating, when you consider the breadth of human health problems and challenges that these GLP-1 agonists influence. I can't wait to see what more is learned about this in the future.
After I started committing, really committing to consistently working out, a lot of other things fell into place more or less automatically. I stopped drinking, started eating very cleanly (I became ravenously hungry; junk food and sweets aren't appealing anymore), and stopped spending as much time on gaming. I know your broader point is about leaning into discomfort, but specifically leaning into exercise seems to bring extra benefits. Exercise is medicine, as they say.
Don't fall into 'I can do it, therefore everyone should be able to do it' trap.
Addiction is also common(ism) amongst those who suffer from NDP. In this case, is it truly addiction, or simply another tool in their NPD cache of weapons.
I don’t disagree with you. But it’s also important to be aware of some of the nuances and finer points. I also recommend reading “The Courage to be Disliked”. Not that it / Adler speak to addiction but it’s a thought provoking alternative to the Freudian paradigm.
Small amount of psychoactive substances seem to help a lot of people get into "the zone".
It’d be interesting if these meds help with weight and addiction or just even overdoing it regularly.
EDIT: saw your other comment that you felt you were starving. that sucks. the whole thing experience sounds awful.
After seeing several doctors about the issue including a couple specialists, only one of about half a dozen medications tried actually worked to help the gastro issues, which included fecal vomiting, rotted fermented food coming up, both regularly. No actual blockages. The medication that did work wasn't covered by my insurance. After a couple years of suffering, I saw a news report about the Trulicity lawsuit related to gastroparesis issues. Over the same period, I started to develop retina issues, several retina bleeds and regular injections to treat it.
When I found out about the lawsuit, I stopped taking the medication going back to straight insulin injections (long and short) currently Lantis and Novalog. For close to a year after coming off, I experienced a feeling of starvation 24/8... didn't matter if I was physically full up to my throat, the ravenous feeling of hunger would not subside. I gained about 80# during this time (again, didn't lose weight on the meds).
I'm a few years off and my digestion is inconsistent and unpredictable... sometimes I'll have a few days where things flow normally... others I'll be backed up for close to a week and have to take a heavy magnesium laxative to get things going again. I stay pretty close to carnivore as just about anything else can range from discomfort to pain. Not to mention legume allergies and really sensitive to wheat... I still cheat about once every other week, and I pay for it physically.
Because I was on more than the one medication, I cannot participate in either the Trulicity or the Ozempic class action lawsuits. These medications have kind of ruined my life. I'm now about half blind and using 45" monitors to work, and even then have to zoom text and lean in to be able to function.
Over the years, I've been on several drugs for diabetes that I'd built up a quick tolerance to, that may have had other negative effects... Byetta, Victoza and others... I've always had digestion sensitivities, these just turned it up to 11. When I started Trulicity, my insulin use was pretty minimal and I was already on a Keto diet and had been losing weight... I wish I'd stuck with that and never even heard of the stuff.
Some of the recollections are a bit jumbled, apologies for that, I'm just kind of writing as it comes to mind.
Aside: along with the medical issues has been some employment inconsistencies the past few years with a few contract roles spread a few months apart. I had hoped to maintain my income level as many available jobs were lower pay. Currently, my insurance is "emergency" coverage based, and doesn't even cover the 3 doctors I'm seeing regularly and doesn't help much with the medications I am still taking. Let alone the eye injections I haven't been able to get for about a year now ($7k/eye/injection). Tried working 2 jobs for a while, but couldn't keep up with the load after a few months. I'm depressed and angry. Prior to about 8 years ago, I never carried debt... now I'm maxed out and staring at bankruptcy.
If you get someone off their normal drug, they a) have none of the other tools or coping mechanisms to deal with the initial problem, having failed to develop them during the years of using drugs instead and b) are grappling with the full and unattenuated experience of whatever caused them to start using in the first place.
People newly detoxed from a long addiction are particularly vulnerable to new addictions and need a lot of support and resolve to develop the intrapersonal emotional skills they've been neglecting. And in some cases picking up a new addiction is the less harmful option. I'm not particularly a fan of AA (but not anti either) but it turns out there was wisdom in their common advice for newly dry alcoholics to not worry about their cigarette or coffee or candy intake. Smoking won't kill you this week but drinking might, you can deal with the nicotine addiction next year.
(Maybe it wouldn't have made the same difference if I was into whisky instead of beer - with beer, I suspect it's the relatively large volume of drink involved that may have made it less appealing?)
Recently switched to Wegovy since the big Mounjaro price hikes here in the UK, and it seems rather less effective overall. Both beer and snacks are somewhat more appealing again :(
Wegovy/Ozempic are semaglutide.
It used to be the case that 1-2 drinks would make me feel good, and introduce a craving for more (a "just one more will get me right" feeling).
But that's gone now. It's an amazing side effect.
Now I'm up to 6mg and I'm not getting any side effects, but it also doesn't work for me! I lost 6kg at one point but the effects wore off and I gained the weight again.
None of my friends had this experience, for everyone else it's worked with no side effects. I really am cursed.
I also had drastically degraded (increased) resting heart rate, (decreased) heart rate variability, and exercise intolerance - a normal easy run started to make it feel like my heart would explode and gave me palpitations. Off it, I can run a 5K and beyond no problem, if my knees cooperate.
Food noise came into the picture much worse than baseline after I stopped, although it did eventually come down and I’ve been able to start losing weight again after a few months off. Berberine seems to help, at the expense of giving me nausea like semaglutide, but no other side effects.
I think this quote is... wrong? Or at least extremely misleading? Here, citation 72 refers to a paper by Henderson et al. That paper did (sorta) reduced laboratory alcohol self-administration, but did not find any reduction in the amount that people drank. https://dynomight.net/glp-1/
> Semaglutide treatment did not affect average drinks per calendar day or number of drinking days, but significantly reduced drinks per drinking day (β, −0.41; 95% CI, −0.73 to −0.09; P = .04)
So they didn't find any reduction in (1) drinking, or (2) in the number of days that people drank, but they did technically find (3) a reduction in the number of drinks that people consumed on the days that they drank. So I guess what they said is technically correct... but I still think it's very odd not to mention the headline result that there was no actual reduction in drinking!
This is as in the abstract:
1. drinks/day declined in both groups and somewhat more in the treatment group but wasn't statistically significant 2. number of drinks/day basically wasn't different at all 3. drinks/drinking day didn't change in the placebo group but did decline in the treatment group
(These are all actually regression coefficients computed on non-random samples but nevermind.) Somehow it seems like what's happening is that 3 rises to statistical significance even though 1 doesn't.
I can attest to this myself. I used to be called an "occasional binge drinker" by my endocrinologist. Now I'm just an "occasional drinker". It definitely has cut back my consumption, I'd say by more than half, if not more.