[ValarMorghulis]

A couple of days ago Nithin Kamath (one of the Zerodha brothers) wrote a blog on The Daily Brief speculating on the second order affects of GLP-1 drugs (colloquially known as weight loss drugs).

The obvious effect is that people can lose 15-20% of their weight, as long as they keep taking the drug. But I've also read that the drug can potentially reduce addictive tendencies and compulsive behaviors like alcoholism, smoking, gambling, and so on. There's some evidence to show that these drugs can reduce the risk of cardiovascular diseases, dementia, and Alzheimer's; improve mental health; and so on.

FMCG companies like Walmart are saying that these drugs are affecting purchasing behavior. What would happen if more people started taking these drugs? We'll have an across-the-board effect on every single industry.

People will eat less, smoke less, buy less, and live longer. They'll also trade less? 😬 Insurance premiums have to change, and annuity payouts in pensions will have to be readjusted.

While these might be considered a ranting of a billionaire, for these drugs are currently available at Rs. 3,500 a pop for 2.5 mg, and Rs. 4,375 a pop for 5 mg (~2lakh INR annual). But with the patents expiring in 2026, generics might flood the Indian market soon.

But if there was a drug available to you for, say Rs. 100 a week, that helped you overcome alcoholism, smoking, unhealthy snacking or compulsive shopping would you not go for it?

Then the commercial angle:
- FMCG shops would suffer. No more mindless midnight snacking.
- Sin companies would suffer. Fewer sales of booze bottles and smokes (will that not affect the government tax revenues?)

There might be a lot many secondary affects that might not have been covered so far, but it is an interesting premise.

So what do you think?
1. Would you take such a pill?
2. Do you think it'll bring substantial change in the spending habits and health of the people as a whole?



References:
Link to blog
Link on GLP-1 drugs improving mental health-1
Link on GLP-1 drugs improving mental health-2
Link on GLP-1 drugs improving Alzheimer's disease
Link on GLP-1 drugs improving Cardiovascular health-1
Link on GLP-1 drugs improving Cardiovascular health-2

[deathwalkr]

Oh man, that sure sounds extremely far fetched.

But then he is who he is because he can think far whereas I am who I am because I can't

[karikaalan]

Originally Posted by ValarMorghulis

A couple of days ago Nithin Kamath (one of the Zerodha brothers) wrote a blog on The Daily Brief speculating on the second order affects of GLP-1 drugs (colloquially known as weight loss drugs).

In today's world of Instagram "perfection" and the substantial pressure on teens and even adults to look thin an fit (without doing any workout of maintaining diet) means that the potential for abuse is heavy! Remember reading somewhere that the generic version of these drugs have potential to be a billions of dollars in value once the patents are open for the generic manufacturers.

There is no need to be sympathetic that stores will suffer, it is a dog eat dog world. Anyways corporates and home delivery is the leading cause of killing smaller stores, doubt if this magic pill will cause such a drastic difference. Besides, only long term usage will tell whether these are truly miracle drugs (remember Joule vape was initially introduced as a safer alternative to smoking before it brewed a shitstorm and increased vaping among teens today due to it's discreetness) or another PR nightmare in the making.

We learn from history that we do not learn from history - George Hegel

[Jeroen]

I think this whole idea of a pill or injection against overweight is ridiculous. From what I have read is your overweight will return once you stop taking the pills and or injections.

Irrespective, overweight is one of the very large, often underestimated problems of our world today. Overweight/obesity leads to a huge variety of health problems. cardiovascular disease, type 2 diabetes, hypertension and some cancers to name just a few. Which are becoming a real drain on the respective health systems around the world.

But these pills and injections mask reality. Which is an unhealthy diet and life style. Whereas the symptoms get addressed, it hides the reality issues.

Maybe there comes a time when we can just take a pill, without any side effects to stay healthy, trim, taut and so.

But till that time I think more effort is required to educate folks and help them maintain a healthy diet and lifestyle. The truth is, it’s relatively easy and cheap too. Without any underlying condition anybody can stay healthy by having fairly simple diet routines and suffice t exercise. You don’t even need to work out. But you do need to get of your butt!

[Divya Sharan]

There's no magic pill, never was and never will. (Hey, I rhymed!)

True health, both inside and out, comes from maintaining proper nutrition and engaging in regular exercise tailored to individual needs and preferences, sustained over a long term.

Most other methods are just fads that often do more harm than good.
Rapid weight loss, for example, "will" lead to inevitable muscle mass loss, weakened bone structure, and reduced strength.
Anything unnatural, like rapid weight gain or loss, can have more severe side effects than long-term obesity/anorexia.

Both approaches are detrimental and can lead to drastic consequences, it's not fair to compare the two evils directly.

[shankar.balan]

I think it would just be sensible to eat right, try and eat home food, eat on time, walk nicely for exercise, sleep early and rest well. Play some sport. And drop all the stuff that is proven to be bad and anyway doesn’t suit most of our genetic makeup. Like Alcohol and Tobacco.

Just because an Italian or a French person can drink wine at every meal doesn’t automatically mean that our ‘Indian’ bodies are also conditioned for it. Don’t follow fads. Change the mind set, make a start on the good path and start feeling better about yourself. Thats the first step.

[SS-Traveller]

Originally Posted by ValarMorghulis

So what do you think?
1. Would you take such a pill?
2. Do you think it'll bring substantial change in the spending habits and health of the people as a whole?

What do I think?
How I wish lay people without a basic understanding of human physiology, pharmacology & pathology, will stop discussing, recommending, supporting & deciding on the future of mankind by the use of new drug inventions. You don't have the foresight or knowledge about how drugs work, their side effects - both known & unknown - and recognizing & testing for the onset of problems (such as kidney failure in this case), yet you claim on social media that the drug will change entire human behaviour & make saints out of sinners.

Would you take such a pill?
Not unless closely monitored & supervised by my physician, and only to cure a problem that is unmanageable by established drugs.

Do you think it'll bring substantial change in the spending habits and health of the people as a whole?
There's no harm in dreaming while asleep that there will be no more war, strife, theft & lies amongst mankind once everybody takes a certain drug; but please don't let those dreams govern your action of swallowing pills or taking injections as recommended by non-expert billionaires, while you are awake.

[am1m]

Originally Posted by SS-Traveller

...as recommended by non-expert billionaires, while you are awake.

Used to be clueless movie stars talking about world affairs and sport celebrities giving their opinions on everything. Now we have CEOs talking about everything other than the business/industry they are in and getting media time!

The clicks work for them, works for the media house, but we should be smarter and take them as seriously as we would a bollywood star talking about medicine!

[DigitalOne]

Originally Posted by ValarMorghulis

But with the patents expiring in 2026, generics might flood the Indian market soon.

Small correction. The core patents are set to expire next year, but there are secondary patents which could keep generics out till 2030.

The core patents for semaglutide expire next year, but secondary patents that protect other aspects surrounding the drug could keep generic semaglutide out of the U.S. market until the early 2030s.

The dangerous aspect is that India will have cheap fakes in the market

Originally Posted by SS-Traveller

What do I think?
How I wish lay people without a basic understanding of human physiology, pharmacology & pathology, will stop discussing, recommending, supporting & deciding on the future of mankind by the use of new drug inventions. You don't have the foresight or knowledge about how drugs work, their side effects...
....but please don't let those dreams govern your action of swallowing pills or taking injections as recommended by non-expert billionaires, while you are awake.

Did you read the blog? He has not done any of those things (i.e recommending, supporting, deciding... ). All he has done is provided research studies, of reputed journals like The Lancet etc. He has also admitted that this can all be a part of the hype cycle.

When a drug, touted as a miracle treatment against Obesity/diabetes, enters the market it is better to be well-informed. Also, this class of GLP-1 drugs have been in the US market for last 3 years. There were reports earlier that many well-to-to Indians were making frequent trips to UAE to get these.

So, whether one likes it or not, we are going to be confronted with a difficult choice in near future . Thanks for @ValarMorghulis for this thread.

[SS-Traveller]

Originally Posted by DigitalOne

Did you read the blog? He has not done any of those things (i.e recommending, supporting, deciding... ). All he has done is provided research studies, of reputed journals like The Lancet etc. He has also admitted that this can all be a part of the hype cycle.

So what did he mean when he said...

But all that said, what’s entering India right now is still a medical marvel. It goes far beyond weight loss — it can help Indians with a suite of problems that, for all of human history, were considered impossible to cure. And that’s something worth being excited about.

[DigitalOne]

Originally Posted by DigitalOne

There were reports earlier that many well-to-to Indians were making frequent trips to UAE to get these.

Apologies for back-to-back posts. Source for the above are this May 2024 report in India Today.

An investigation by India Today has exposed concerning trend about the import of drugs such as Ozempic from Denmark's Novo Nordisk and Mounjaro from America's Eli Lilly illicitly and without any regulatory checks.

A surge in demand among affluent Indians for weight-loss medications touted in showbiz circles has led to a concerning trend -- drugs like Ozempic from Denmark’s Novo Nordisk and Mounjaro from America’s Eli Lilly are illicitly entering Indian pharmacies, sidestepping regulatory checks, an India Today investigation has found.

And this from last week:

Ozempic, the weight loss injectable drug that took the world by storm last year, has many takers in Bengaluru though it is yet to officially enter the Indian market.

Originally Posted by SS-Traveller

So what did he mean when he said...

He has linked studies to US government's NIH studies, and other reputed journals, on the so-called benefits. He has also linked to side-effects and cautioned against buying into the hype.

To me, the article seems quite balanced. If you feel otherwise, let's agree to disagree.

But let's also not focus on the messenger (Nikhil Kamath) and lose sight of the message. Something big is happening, whether good or bad, only time will tell.

[am1m]

Originally Posted by DigitalOne

But let's also not focus on the messenger (Nikhil Kamath)...

No, that is the point. The whole point of a reputed media house should be to bring us information from several qualified sources on several topics. For personal articles, there are blogs and forums/social media.

If you google this guy's name you will see there is an effort to keep him and his company name in the news. The media know that given the rising interest in retail investing, anything with 'Zerodha' in the headline is going to grab eyeballs. Till now most of the articles dealt with his business or topics tangential to his business, so at least it made sense.

But now that he seems to be branching out into areas that he is not qualified in (however well-researched) why should I make his PR agency's job easier? (By reposting/consuming.)

For anything related to medicine, I'd much rather listen to qualified doctors in the field and seek their interpretation of the various studies quoted. Interpreting even reputed medical studies is not something everyone can do, however intelligent or qualified in another area/field. In fact, the risk is misinterpreting such studies and drawing the wrong conclusions.

It is sad that the media have been reduced to this. Instead of taking the effort to talk to several qualified doctors, scientists, pharma execs and giving us a complete picture so we can make informed decisions, they promote what is essentially an 'influencer' view, from his personal blog.

[DigitalOne]

Originally Posted by am1m

No, that is the point.

I agree with all of what you said. However, I question the applicability in this case . He has written the blog on the Zerodha's Blog platform "The Daily Brief". It is his company's blog. Since Zerodha is not publicly owned company, one can't even claim that he is using the company's name for personal benefit .

[am1m]

Originally Posted by DigitalOne

It is his company's blog. Since Zerodha is not publicly owned company, one can't even claim that he is using the company's name for personal benefit .

Yes, yes, I am not blaming him. He has every right to use his company's blog to post whatever. I'm saying we should not be like sheep re-posting and pushing his posts on topics that he is not really an authority on. Or worse, following medical advice from non-medical professionals.

And I am lamenting on the state of all the mainstream media outlets that pushed his blog post as news.

[ValarMorghulis]

Originally Posted by am1m

No, that is the point. The whole point of a reputed media house should be to bring us information from several qualified sources on several topics. For personal articles, there are blogs and forums/social media...

@am1m: He mentioned the aspects. I have given multiple references to Lancet and other reputed journals. What he is talking about (the medical aspects) at least, for now, is backed by research. Is it 100%? I don't think so. But there is something really new brewing up.

@Everyone: Forget the hype usage of the medicines for now. Just imagine if this drug could help someone get rid of their smoking habits? Or alcoholism or drug usage? We have a whole thread dedicated to motivating smokers on quitting.

If this drug helps folks kick their harmful habits, don't you think it is great?