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27 thoughts on “Factoid of the day: Semaglutide use in America”

    1. Brett

      It kills me that Novo Nordisk and Lilly are still having issues getting an adequate supply out there for their drugs, such that people are turning to sometimes dangerous compound semaglutide doses. It's been nearly two years since the drug truly "took off" in popular awareness.

      1. rick_jones

        I suppose if manufacturing certified/approved/inspected/whatnot pharmaceuticals were easy, many more companies would be doing so.

  4. D_Ohrk_E1

    Isn't anyone going to bring up the conservative hypocrisy of trying to roll back mifepristone even while looking the other way at the off-label use of Ozempic? No long-term studies, after all.

    3. iamr4man

      Do anti-vaxxers take Ozempic? Are there conspiracy theories that it was invented by the government to control people’s minds, sheds cooties, and kills perfectly healthy people when “overweight” is actually good for you? Just wondering.

      1. cld

        That is it!

        Bill Gates is putting microchips in the Ozempic so he can steal your fat.

        Because he hates Jesus and your guns! Love me, love my fat, and obviously Bill Gates doesn't. Where was he when I needed bail money?

        And, -- if you're not fat you'll have to pay more for heating in the winter, so it's the oil companies Democrats, who are the Deep State, who want you to stop eating, so you become accustomized to starvation, so they can steal your money. That you would be otherwise saving by not eating so much, that you could be using for yourself, but now you're forced to buy their chipped Ozempic and they're giving all your hard earned fat bucks, that you've worked for, stealing it, and giving it to illegal immigrants, for free, who hate Jesus and have abortions.

        And you end up looking like a death camp victim.

        Ozempic and chips. It all comes together.

  5. Talphon

    I tried to get it, but my insurance doesn't cover it and its too much without. I ended up dieting with Phentermine instead. Down about 85lbs so far over six months, but its a slog.

  6. Jasper_in_Boston

    Been on Ozempic since mid January. $300 month for the full 2mg monthly dose here in Beijing. It's not a magic bullet—you still have to be conscious of what you eat (at least I do). But I'm glad they invented it.

  7. jimshapiro

    Two points. If 10 million people each pay $1,000 a month, that's 10 billion dollars for semaglutide every month. Ouch!

    Also, why aren't people in Japan overweight?

    2. Chondrite23

      I lived there 9 years. As a guess I’d say that 1) People in Japan walk a lot. It is not unusual to walk 20 minutes each way from home to the train station or bus stop, then another 20 minutes to work or shopping. Same idea if you are going out to meet friends. Even if you have a car, it is common to leave the car home because there is no place to park and the roads aren’t that great.
      2) The usual Japanese meal has smaller portions than in the US.
      That’s my unscientific take on it.

      1. roboto

        The Japanese and other Asians also drink just 1/10th the amount of soda as Americans. Portions at restaurants are much smaller and most Japanese don't snack that much. Ergo, 4% obesity in Japan, 42% in America.

    3. Austin

      The walking thing is real. I didn’t own a car and walked everywhere when I lived in Chicago and weighed a lot less than I do now living in northern Virginia with a car that I use for 80-90% of trips. Nothing else changed: I still sit at a computer all day, eat out most of my meals, drink a few times a week and get almost no real exercise but the walking… and I’ve gained 25 lbs. Simply moving your body on your own 2 legs for 80-90% of your trips does help keep your weight down.

      1. Austin

        And before I hear “so why are there fat people in Chicago or NYC?” I will say that walking is necessary but not sufficient to keep yourself from being overweight. (So many pedants thrive online to poke holes in everything people say as generalities.)

      2. rick_jones

        How much older are you now compared with when you were in Chicago? Modulo that, simply getting older is likely (also) a factor.

  9. sonofthereturnofaptidude

    The addition of weight-loss drugs to the marketplace completes a virtuous circle by which the federal government creates the market conditions that create obesity (cheap food that's not very nutritious, transportation infrastructure that promotes a sedentary citizenry, etc) and then creates market conditions to allow profiting from the obesity.

    That 40% of Americans are overweight enough to desire weight-loss drugs doesn't result intentionally from what conservatives like to refer as "the free market system," but the profit-making from it certainly does.

  10. KayInMD

    I used to take Victoza for type 2 diabetes. Then this spring it was taken off the market temporarily so my doc put me on Ozempic as the only alternative that was readily available at the time. It turned out the co-pay is much less - ~$20 for 90 days of Ozempic vs $45 for Victoza. Now, I'm not taking a weight loss dose. I'm only taking the lowest dose. I may have lost a pound or two in the few months I've taken it, but that's likely more to do with some other health issues I've had, but I'll take them.

    My insurance carrier (Medicare) doesn't cover Ozempic for weight loss.

  11. Art Eclectic

    My husband has lost around 55 pounds on it, he is/was diabetic so fully covered.

    What he's now worried about, and rightly, is what happens when you come off it. If you can't stick to the lower calorie intake, you'll just gain the weight back. Managing calorie intake is the key to everything and it is not easy or fun. Everything in our lives encourages us to eat more than we need, and drink more as well. Commercial food is a carefully designed drug to get you to eat more - at the highest possible profit for the maker.

    For people who naturally maintain a trim body, it seems to be less of an issue. Three of my husband's kids eat whatever they want and don't seem to gain. But if you have the genetic tendency, you'll fight the weight for your entire life if you can't manage calorie intake. My husband I both have the tendency and committed to supporting each other by not keeping snacks and junk in the house, only eating at restaurants sparingly, and almost never eating fast food.

    It's a choice and you have to commit to making the healthy choice - especially if you want to reach your old age without needing 30 medications and a wheelchair.

  12. golack

    There were some write ups saying that when the brand name Semaglutide drugs get too expensive, patients (some) could be switched over to older weight loss drugs for maintenance.
    https://www.theatlantic.com/health/archive/2024/03/topiramate-glp1-ozempic-alternatives/677884/

    Semaglutide is harder to make (relatively high costs and low yields) than typical small molecule drugs. They're basically making a short peptide one amino acid at a time. Not as bad as a biologic, but still expensive and not easily scaled. And the "shortage" means better pricing for the manufacturer. It will take years to implement more easily scalable processes and get approval for those.
    https://pubmed.ncbi.nlm.nih.gov/38527576/

    One other thing to note, we don't know how these drugs work, though are getting a better understanding. They were designed to mimic a hormone, but their mechanism of action seems to be in the brain and not the gut where the hormone of interest works. No zombie side effect...yet.

  14. kaleberg

    I wonder if we'll see a "surprising" reduction in mortality. I remember that in the 1980s there was a big fuss about the "surprising" drop in heart disease mortality among older people. There were a few articles about a little known government program, Medicare, that provided heavily subsidized medical treatment for older people. You've heard of it? Wow, what a surprise.

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