Most of the addiction literature I've read says that physical addiction is overestimated: even heroin addicts regularly go through physical addiction, either involuntarily because they can't get it, or voluntarily (through treatment efforts, or simply deciding to sober up for e.g. a wedding or other important event). What makes them addicts isn't that they can't stop, it's that they start up again.

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.

Idk I think the importance given to withdrawals is overrated. Dealing with withdrawals is just matter of gradually lowering the dose.

The lifelong craving is the bigger issue.

The distinction you're reaching for is addiction vs dependance.

How is a lack of dopamine different from "withdrawals"?

Metabolic dysfunction is the root of many diseases which addiction is one of them .

Do GLPs flood the body with broken down fat? I thought they just suppressed appetite and the like.

I do the work I probably should be doing, or side projects, or spend time with my kids, or go on a walk, or follow up on that thing I've been putting off, or any of the other million things that are more productive and fulfilling than video games are. It's embarrassing to admit that I was a grown man who would put off basic, important tasks just to play games but I did. Now I don't.

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.

Can't speak for OP but I largely spend it reading (and web). I bought a kindle recently because I found the ipad/iphone were too distracting to reliably avoid web surfing instead of a book. I view the switch to long form content as a form of information dieting in the same way as a switch to whole foods.

Not the person you asked but I have good data - I lost 32kg over 6 months on tirzepatide, 11kg of it was lean body mass, the rest was fat (based on DEXA scans).

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.

It’s available in powder form online through “research chemical” sites “not for human consumption”.

Anyone saying they’re taking retatrutide almost certainly obtained it this way. Quality and purity untested.

It's available at many clearnet peptide websites. Caveat emptor.

I think it depends. With tirzepatide (my first encounter with GLP1 meds) I got acute appetite suppression, perhaps too acute. I living comfortably on sometimes 1500 calories or less per day, and I track my calories religiously. We are talking maybe 1 cup of yogurt with frozen berries in the morning, and 1 whey protein shake around 3pm (Fairlife milk + 2 scoops whey) and I would be absolutely full until bed. No energy deficiencies to note. I worked out regularly 5 days a week.

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.

I hate to imagine what LOL is used to treat, let alone the side effects.

Definitely not GP, but I think it’s pretty clear that whatever grit there was to have, GP did not have it. “Die an early death due to being overweight or build the grit” is strictly worse than “lose the weight without building the grit, or build the grit”, and it’s even more so when you realize that “or build the grit” was never in the cards. Because then the choice becomes “die an early death or don’t“. Building the grit can be done on other, hopefully less lethal, projects.

What do you mean "grit"? Does doing something more efficiently mean you lose it? What's the difference, say, between someone using an LLM to help them code and someone else using a drug to help them diet? Is the coder using an LLM losing their "grit"? Do you walk to work in 30 inches of snow, uphill both ways, in the rain? Are you concerned about your loss of "grit" by not doing so? This argument continues to baffle me.

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.

Maybe if moral virtues can be purchased they were never moral virtues to begin with?

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?

Maybe "grit", like phlogiston, isn't real, and neurotransmitters are?

Not the GP, but do you think Serena Williams - world number 1 womens tennis player for 319 weeks, who trained for 5 hours per day at her peak - has insufficient grit?

Because she went on GLP-1 to lose weight.

Good god no.

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%.

Turns out that this attitude was bullgrit all along.

The idea that some people are overweight simply because they don't have grit, determination and self-discipline is asinine.

wet farting noise

I think this is a valid point, and the reason I haven’t tried these drugs and don’t plan to. There are huge benefits to developing the mental strength and discipline to lean into discomfort consistently and just do what needs to be done- and all types of addiction provide one of the hardest, and therefore most valuable and useful obstacles here. As Marcus Aurelius said “The impediment to action advances action. What stands in the way becomes the way.”

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.

I think a lot of drugs are like this though. When concerns and worries are removed, you have more mental capacity for the task at hand.

Small amount of psychoactive substances seem to help a lot of people get into "the zone".

Started developing gastroparesis issues after about a year on Trulicity... over the pandemic, due to shortages I was switched to Ozempic for a few months which was less effective with my diabetes mgt. I didn't actually lose weight on the medication(s).

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.

Yeah IIRC the current state of the addiction medicine model is that the drug use of addicts is maladaptive but that there is a real illness or suffering that at one point it gave relief from, or the user thought it would. So someone who gets addicted to opioids after knee surgery is in the same category, doing the same thing, as an alcoholic who started drinking so they wouldn't have nightmares about their abusive childhood. Or whatever. The addict may not always even know explicitly but there is a reason they initially started using in this way.

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.

Interesting that Moujourno helped more than other brands. Might give that a try ;)

Side effects are generally rare, but it really depends on the person. I tried to start five times, and got massive side effects each time. The last time I started, I did my own protocol (started at 0.5mg every three days and increased a bit on every injection).

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.

Yup, 20lbs effortlessly. But I’ve plateaued despite going up in dosage. So still stuck at 200lbs

I don’t understand the math here. The average per calendar day didn’t go down, so the total drinking is the same. That total is distributed among the drinking days, which are also the same. So how can the drinks per drinking day have changed?

> a reduction in the number of drinks that people consumed on the days that they drank

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.

i doubt it would help, their stock will probably go down as glp lose their patents globally in most countries and become generics

> As someone who doesn't really drink and never has alcohol at home, is it just that people buy beer/wine and drink on a daily basis for fun?

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.

Basically I think “a beer would be nice right now” and then I go to the store or local pub.

When drinking small quantities, it's more to relax/unwind at the end of the day than to 'have fun'. Sometimes it's self-medication for stress/depression.

But it can easily escalate into a rather unhealthy habit. And even fairly small amounts can disrupt sleep.

I don't know much about the drug, maybe you're talking about something else... but FWIW, I got sober from years as a practicing alcoholic the traditional way, I had lots of personality changes, some good some bad, but who I was when I was drinking all day every day and who I am today are quite different people.

Yeah I am reading through this thread and it does feel that things can go wrong here. With alcohol/drugs it is very likely to be an extremely positive change (at least for the majority), but some people shared videogames, and while they can totally be addicting, I personally place them on the same level as books/shows/movies, and losing interest in all of that is definitely a big change.

I don't think it's a personality change, at least insofar as personality is separate from neurochemistry. Ghrelin and dopamine are strongly linked, and dopamine is our central reward-seeking driver; GLP-1s generally reduce ghrelin production, which I suspect helps remove you from a state of being constantly primed for reward-seeking. I noticed this firsthand when I went hard keto for the first time, and could suddently for the first time tell a significant difference between "I want food because I'm hungry" and "I'm not hungry but want food because it's pleasurable".

I worry about it. I do tend to wonder if it can change your relationship with addictive and maybe risky behaviors, does it also potentially make you into a more conservative (not politically) person? Does creativity and risk tolerance go down as well?

Worry about a positive side effect? No.

It has definitely come up in books and podcasts I’ve listened to, but given general cultural values and biases I don’t think it gets much traction.

I'm not sure how true the stigma is for GLP-1 based drugs. There are lots of online options for getting it from major orgs in the UK including things like Asda who aren't really a well-known pharmacy brand here (https://onlinedoctor.asda.com/uk/weight-loss-treatment.html).

As to advertising, my perception is that it's wrapped in a "weight loss clinic" style presentation but you don't have to be on all the sites long before you get to the "buy $GLP-1" here :)