There are side effects, but the risk profile is known (is my understanding). It is (at this time) believed to be a forever drug, just like diet and exercise stop working if you stop them. A longer term fix is likely gene therapy (Fractyl Health has a clinical trial in progress, REMAIN-1) vs chronic maintenance.
GLP-1s allow us to poke at the human to see what happens. Gene therapy will, hopefully, allow us to implement a permanent fix vs a hotfix (once the risk profile of such a genetic modification is better understood).
AFAIK Fractyl's "drug" is not gene therapy but a surgery where they remove part of the lining of your colon. It is not currently possible (nor will it likely be) to use gene therapy for obesity treatments. The technology is not suitable for this kind of medical application.
Wasn't my understanding from the contact I spoke to at Fractyl and associated docs. Noted to follow up with a ___domain expert, appreciate the context. Are you available for a paid 30-60 min conversation on the topic? Attempting to fill knowledge gaps, as I am not an expert.
> just like diet and exercise stop working if you stop them
I suppose, but that assumes you are viewing them as temporary weight loss interventions rather than lifestyle.
The key is to want to be healthy, and to arrive at a sustainable balance of nutrition and exercise level that works for you to stay at a healthy weight. Fad diets where you are denying yourself pleasures, or going hungry are not sustainable, nor is any extreme exercise regime that you find unpleasant or does not comfortably fit in with your routine.
Diet and exercise don't have negative side effects and they are free. Exercise is social too and has lots of side effect benefits beyond the obvious fitness ones
> Diet and exercise don't have negative side effects and they are free
They're absolutely not free. They fail at a high rate, which incurs medical costs. And when they work, they require--in practice--a lot of follow-up and coaching.
It's fairy-tale level mindblowing that we can look at the status quo where nearly half of the industrialised world is obese and get haughty about a drug that medically, demonstrably improves patient outcomes.
Tell me how much does it cost to do push ups? How much does it cost to do squats? Failing at doing any of these does not incur medical costs. And yes, it takes effort and willpower (like anything worthwile in this life). But none of those cost money.
It's fairy-tale level mindblowing that we can look at the status quo where nearly half of the industrialised world is obese and get haughty about a free method (see physical exercise) that medically, demonstrably improves patient outcomes with no negative side effects.
That drug is the medical equivalent of a goldberg machine.
Exercising your willpower will have more benefits than physical exercise alone: mental health, cardiovascular and strength fitness and you could go on. And it is free. No big farma making money from you
> It takes time and induces brain fog for at least some time after exercise
Are you serious? How is "taking time" meaning that is not free? And you can't possible use that as a side effect. Brain fog is not even a common side effect. In fact, doing exercise is actually one of the recommended ways to tackle brain fog.
Obesity is primarily a US problem. It's not the same in Europe, where people walk a lot more, and where portion sizes are normal. A ham and cheese sandwich in the UK would have a slice of ham and of cheese. In the US a deli sandwich is a monstrosity with about 1/4 pound of meat in it.
No no no. Obesity is very high in the US, but it's a big problem for lots of the world. It's a hard one to compare because different places use different cut-offs, but bringing this back to the UK: "64.0% of adults aged 18 years and over in England were estimated to be overweight or living with obesity [of which 40% are obese]"[0].
Thing is the US is the world's superpower and it extends its influence everywhere. That includes its language, tech, culture and food habits (however unhealthy) too
If no one does them, their risk profile is immaterial. GLP-1s can be manufactured for $5/month. Cheaper than trying to coax the monkey brain into doing things you can't make it do. I cannot speak to the gene therapy cost; balance against lifetime cost of "Western disease" if not provided.
Engineer for the way the world is, not the way we wish it was. From your comments, you appear to operate under the belief that people can free will their way to success ("The better option seems to be face the appetite head on rather than putting it on a temporal cage"). That is not what the evidence shows, and I wouldn't ask anyone with a brain chemistry imbalance or dysfunction to attempt to will the condition away when proven interventions are readily and inexpensively available.
TLDR We are improving agency in humans using bioengineering, broadly speaking.
I find your language usage curious. "trying to coax the monkey brain into doing things you can't make it do", "the way the world is", "people can free will their way to success", "anyone with a brain chemistry imbalance or dysfunction".
You seem to imply that people have no self-control and are unable to power through difficulties. Because this is what is all about at the end of the day: self-control, one of the main things that separate us from the rest of the animal kingdom. It is the ability to regulate one's emotions, behaviors, and impulses in the face of temptations and urges.
What your parents taught you, your teachers taught you all those years during compulsory education lies on a solid foundation of self-control. Civilisation as we know is built upon it. Depends on it.
Yet your language implies that this is not the case. That humans are effectively, like toddlers, unable to use their self regulating powers to reign upon their emotions for the sake of a much better outcome in the long term. Fully unable to choose healthier foods or foods with lower calories. Fully unable to engage in free physical activities such as walking, jogging or running.
Truly makes you wonder how civilisations exist at all.
The idea that you can improve an individual's agency by having to temporarily disable a part of their brain is nonsensical. Surely, you can temporarily improve a specific decision making outcome (do I eat now?) by doing this. But you are not improving their agency anymore than you can by putting a gun on their head. In both cases, there is an external force temporarily suppressing a part of their normal decision making so they decide not to eat.
The underlying problem: lack of self-control is still there. You just tackled a symptom. There are others (deciding not to engage in physical activity for example).
A better solution would tackle the lack of self-control rather than some of the symptom. There is already some research on this area and some potential suggestions that if further investigated could help provide a better solution. But unfortunately, the solutions are virtually free and don't involve a lifetime subscription (could very well end up like diabetes medication which is arguably more critical for affected people yet with companies endlessly increasing the patents Disney style) to a drug.
GLP-1s allow us to poke at the human to see what happens. Gene therapy will, hopefully, allow us to implement a permanent fix vs a hotfix (once the risk profile of such a genetic modification is better understood).
https://www.remain1study.com/remain-1-study/