Santa’s Got Pancreatitis?
So, are the GLP-1 receptor agonists the Holy Grail for weight loss? Even the 2022 American Diabetes Association recommends GLP-1 agonists as a first-line therapy for type 2 diabetes, specifically in patients with atherosclerotic cardiovascular disease or obesity. I have been retired for three years but in my whole career, I never saw a weight loss medication without MAJOR side effects. Could these drugs be the first? I have heard rumors of pancreatitis, pancreatic cancer, and on and on but I have to say, these are just anecdotes. And these drugs have been used for quite a while though I don’t think there is long-term data on them. I believe Oprah even is on one.
My concerns are:
- Cost
- I don’t trust Big Pharma with their data
- It looks like a forever drug as people gain their weight back when they come off
- It looks like a lot of muscle mass is lost by patients
What are your thoughts?
(BTW: every celebrity with newfound weight loss is a GLP1 user until proven otherwise).
I was more uneasy about GLP-1 and GIP for weight loss, until I considered the high cost of obesity related comorbidities: I care for amputees and most of them are dysvascular: diabetes, HTN, neuropathy. The cost to insurance is easily in the tens of thousands for each prosthesis, and new ones are needed every 5-10 years. So the downstream cost for obesity-diabetes-neuropathy-non-healing wounds-amputation surgery-prostheses is STAGGERING, and I feel good about meds that can work the front end of this problem, because prostheses aren’t getting any cheaper.
I take Mounjaro but then again I have diabetes. It has worked wonders for me. I prescribe these drugs and have yet to see any major side effects (esp. pancreatitis). The biggest problems I have seen is ridiculous cost and nausea. I think this is the best class of medication for diabetes control to come along in years.
Sadly, it does work. Sadly, people and doctors will abuse it. Long term side effect? We’ll see. Expensive? YES! But you can find compounding pharmacies that sell it for less.
On the “approved authority” side, I wonder if any ADA grants come from shell corporations for Big Pharma?
On the patient side, it will be like phentermine, et al. You can negotiate with a patient for short time use combined with lifestyle change goals. They won’t even attempt the lifestyle changes, and will be pissed when you cut them off.
And so on the physician side, we will again become the non-paid salesmen for Big Pharma, subordinating their agenda to clinical judgment and professional ethics. I’d rather this shit was just over-the-counter.
But we will blame doctors for increasing medical costs and cut reimbursement. Better yet replace them with NPs who won’t know what pancreatitis is.
Weight Watchers wants to quit the game that works and put in prescriber-bots to write for the magic drugs, you can look it up.