Maybe I'm just an aging cynic, but I'm waiting for the other shoe to drop when it comes to GLP-1s. There have been so many claims of positive benefits that it almost seems too good to be true. With them being so expensive, the producers have every incentive to upsell using any study they can get their hands or money on.
I am sort of in your boat in seeing what may come. There are a few very rare conditions but the benefits seem to out weigh (ha, I will take the pun!) The down sides.
While it might mean the incident rare of some things goes up, those that it reduces are far more impactful and where far more likely to have mortality issues. Sort of like how Chemotherapy is poisonous but potential has better long term odds, only chemo is far more extreme than GPL1.
Time will tell but so far it is looking kind of good with a few lesser issues.
> Maybe I'm just an aging cynic, but I'm waiting for the other shoe to drop when it comes to GLP-1s. There have been so many claims of positive benefits that it almost seems too good to be true.
Well, read up the testimony of those who stopped taking it for adverse effects, such as nonexistent intestinal transit and -yuck- sulfur burps.
I was in that boat too but with NAFLD and now liver fibrosis despite not eating all that much sugar and having a BMI that is high but partially due to muscle I finally gave in to see if semaglutide will help.
Only on week 3 but it's been a rollercoaster. It seems to have quite a broad spectrum of effects. I'm still not sure I'll be able to stay on it but losing 10 pounds is a nice counterpoint to the side-effects.
Right. This is what we heard about the COVID therapies. And we all know how that turned out to be little more effective than placebo for healthy non-comorbid people.
Basically, the gastro-intestinal side effects are the biggest issue, along with CVS (not the store) and possibly eye problems.
That said, the negative side effects look to be incredibly rare and manageable (including via stopping treatment) -- and the positives are quite tremendous.
It's not a magic drug, but it is the first of it's kind with such a skew to the positive on side effects.
Like others have mentioned, liraglutide already exists as a generic! It's not as good as Semaglutide or Tirzepatide, but.
Also, a lot of people are still getting compounded GLP1, to the chagrin of Eli Lilly and Novo Nordisk.
Separately, 2026 is about to completely change the pricing of this stuff, not even taking into account the Trump administration's recent efforts. The price of injected GLP1 is going to implode due to patents lapsing in Canada and other places -- and for the pill forms that come out soon it looks like the Trump administration is keen on keeping prices for that low as well.
> However, the study authors emphasize that more research is needed to confirm these mechanisms and determine whether the survival benefit observed in this real-world analysis represents a direct anti-cancer effect or an indirect result of improved metabolic health
Given it’s an observational study, I would bet on the latter. It’s really hard to know you’ve controlled for all confounding factors, and there’s a strong null hypothesis because we know that losing weight can have huge and wide-ranging health benefits.
Interesting that GLP-1s might have different effects on cancer _incidence_ vs. cancer _survival_.
A different study "GLP-1 Receptor Agonists and the Risk of Thyroid Cancer" was published in the Diabates Care journal in February 2023*
The conclusion of the 2023 study: "we found increased risk of all thyroid cancer and medullary thyroid cancer with use of GLP-1 RA, in particular after 1–3 years of treatment."
I wonder what the mechanistic hypothesis could be for GLP-1s increasing thyroid cancer _incidence_ (the probability of thyroid cancer occurring in patients taking GLP-1s) but increasing colon cancer _survival_ (the probability of surviving in patients taking GLP-1s who have colon cancer).
Of course there are numerous important differences across the studies (cancer type, France vs. USA data, etc.), I'm just curious about a why this might be the case.
The article also says that the effects persist after adjusting for BMI:
> After adjusting for age, body mass index (BMI), disease severity and other health factors, GLP-1 users still showed significantly lower odds of death, suggesting a strong and independent protective effect.
The observed reduction in mortality is also quite large:
> Health sites, researchers found that those taking glucagon-like peptide-1 (GLP-1) medications were less than half as likely to die within five years compared to those who weren’t on the drugs (15.5% vs. 37.1%).
More research is needed, but if I were diagnosed with colon cancer I would definitely be asking my doctor about the risks vs. potential benefits of getting on GLP-1 meds based on this study alone.
I do not like the framing. GLP-1 drugs help people lose weight, and it is the weight loss that lowers death rates in colon cancer[1]. This is making it sound like the drug itself is reducing cancer.
Whether or not this is the case for this particular study, I wouldn't be surprised if they end up being miracle drugs that reduce everything from heart disease to liver disease to cancer through weight loss and reduced alcohol consumption.
I am on GLP-1 (very low dose), and I’ve found that it seems to help me moderate my alcohol consumption as well. Maybe some thing like that could also be contributing to the effect.
Same here. There's less wanting it but also, if I do indulge even one small glass of wine, the side effects are awful: broken sleep, acid reflux and a hangover the next day. It really slaps you in the face for indulging
I am 100% a layman here so apologies if this is a stupid analysis. But I have read that fasting can improve odds and improve side effects during chemo. Would GLP-1 stabilising blood sugar be having the same effect?
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[ 2.5 ms ] story [ 54.8 ms ] threadIf it's all upside, then I'm happy to be wrong.
While it might mean the incident rare of some things goes up, those that it reduces are far more impactful and where far more likely to have mortality issues. Sort of like how Chemotherapy is poisonous but potential has better long term odds, only chemo is far more extreme than GPL1.
Time will tell but so far it is looking kind of good with a few lesser issues.
Well, read up the testimony of those who stopped taking it for adverse effects, such as nonexistent intestinal transit and -yuck- sulfur burps.
Only on week 3 but it's been a rollercoaster. It seems to have quite a broad spectrum of effects. I'm still not sure I'll be able to stay on it but losing 10 pounds is a nice counterpoint to the side-effects.
That said, the negative side effects look to be incredibly rare and manageable (including via stopping treatment) -- and the positives are quite tremendous.
It's not a magic drug, but it is the first of it's kind with such a skew to the positive on side effects.
lots of people will miss out on benefits, like oh preventing death
our drug system is weird
(This refers to the U.S. Some other countries have more generics available.)
Also, a lot of people are still getting compounded GLP1, to the chagrin of Eli Lilly and Novo Nordisk.
Separately, 2026 is about to completely change the pricing of this stuff, not even taking into account the Trump administration's recent efforts. The price of injected GLP1 is going to implode due to patents lapsing in Canada and other places -- and for the pill forms that come out soon it looks like the Trump administration is keen on keeping prices for that low as well.
Given it’s an observational study, I would bet on the latter. It’s really hard to know you’ve controlled for all confounding factors, and there’s a strong null hypothesis because we know that losing weight can have huge and wide-ranging health benefits.
A different study "GLP-1 Receptor Agonists and the Risk of Thyroid Cancer" was published in the Diabates Care journal in February 2023*
The conclusion of the 2023 study: "we found increased risk of all thyroid cancer and medullary thyroid cancer with use of GLP-1 RA, in particular after 1–3 years of treatment."
I wonder what the mechanistic hypothesis could be for GLP-1s increasing thyroid cancer _incidence_ (the probability of thyroid cancer occurring in patients taking GLP-1s) but increasing colon cancer _survival_ (the probability of surviving in patients taking GLP-1s who have colon cancer).
Of course there are numerous important differences across the studies (cancer type, France vs. USA data, etc.), I'm just curious about a why this might be the case.
*https://diabetesjournals.org/care/article-abstract/46/2/384/...
> After adjusting for age, body mass index (BMI), disease severity and other health factors, GLP-1 users still showed significantly lower odds of death, suggesting a strong and independent protective effect.
The observed reduction in mortality is also quite large:
> Health sites, researchers found that those taking glucagon-like peptide-1 (GLP-1) medications were less than half as likely to die within five years compared to those who weren’t on the drugs (15.5% vs. 37.1%).
More research is needed, but if I were diagnosed with colon cancer I would definitely be asking my doctor about the risks vs. potential benefits of getting on GLP-1 meds based on this study alone.
https://www.merriam-webster.com/dictionary/truthiness
[1] https://link.springer.com/article/10.1007/s12672-025-03902-4