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.
EDIT: saw your other comment that you felt you were starving. that sucks. the whole thing experience sounds awful.
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.
(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 :(
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.
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.
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.
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.
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.
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?
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.
“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 that we might not- 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.
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.
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.
Because she went on GLP-1 to lose weight.
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%.
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.
Anyone saying they’re taking retatrutide almost certainly obtained it this way. Quality and purity untested.
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.
99% of promising mice studies does not result in clinical practical application in humans. And theoretical associations and mechanisms of action should not be promoted without huge asterisk to contextualize how often such speculation are wrong.
If you complain about AI slop and don’t see how this is just as bad science slop, please go listen to Sabine Hossenfelder. This is just as bad, and create just as much useless noise as AI content does on the nett.
Once-Weekly Semaglutide in Adults With Alcohol Use Disorder
Results
Forty-eight participants (34 [71%] female; mean [SD] age, 39.9 [10.6] years) were randomized. Low-dose semaglutide reduced the amount of alcohol consumed during a posttreatment laboratory self-administration task, with evidence of medium to large effect sizes for grams of alcohol consumed (β, −0.48; 95% CI, −0.85 to −0.11; P = .01) and peak breath alcohol concentration (β, −0.46; 95% CI, −0.87 to −0.06; P = .03). 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) and weekly alcohol craving (β, −0.39; 95% CI, −0.73 to −0.06; P = .01), also predicting greater reductions in heavy drinking over time relative to placebo (β, 0.84; 95% CI, 0.71 to 0.99; P = .04). A significant treatment-by-time interaction indicated that semaglutide treatment predicted greater relative reductions in cigarettes per day in a subsample of individuals with current cigarette use (β, −0.10; 95% CI, −0.16 to −0.03; P = .005).
Almost 2 years now. I'm not religious about it and will occasionally drink the celebratory glass of bubbles or a beer (alcohol free if available) when it's hot outside.
Very interesting how it has worked.
Does anyone else feel a slight sense of worry about this?
I realize how completely dumb this question might sound.
Yes, anything from a couple of drinks a night with dinner / tv to getting blackout drunk multiple times a week, alone, with your significant other, or with friends / roommates.
In the case of people in my social circle (late 30s early 40s) it's primarily still for fun, as well as just a large amount of momentum from your teenage years, 20s, 30s, etc. For a lot of people I know, the association between drinking and good times / relaxation has been deeply engrained since high school.
I've recently taken an extended break for my health, as I'm fully aware that it takes a toll on me, but I still love grabbing some drinks whether I'm relaxing alone in the evening or going out with friends and family.
While it's certainly true that many people get into a dark place with drinking and let it spiral into a self-destructive, depressive pursuit, I don't think it's quite the rule it's made out to be.
I have a good amount of family who live idyllic, full, happy, social lives, drinking heavily multiple times a week with their friends and family into their 70s/80s until death.
It seems it doesn't block dopamine generally, but does seem to act on dopamine spikes?
t-writescode•1d ago
One breakthrough and then a WHOLE BUNCH OF NEW STUFF happens all at once now that this new idea or new pathway is created.
mRNA vaccines break away and now they're testing them in everything. GLP-1 showing signs of use in obesity and now it's being tested for a whole gamut of other things. All very exciting!
fullshark•6h ago