GLP-1 disruption

[Castanza]

The idea the humans are going to stop eating readily available junk food in large quantities because of some new weigh loss drug is beyond ridiculous. 

[3259]

The study data for GLP-1 weight loss is for weight loss. Not healthy, fat reduction. If you diet with a calorie deficit (especially at a large deficit), while monitoring body fat % you’ll note that you need to be quite diligent in monitoring your diet (mainly protein intake) and possibly exercise to ensure you’re actually losing fat and not lean mass. This becomes harder as you age and it’s much harder as we age to maintain and build muscle mass.

 

I suspect most people claiming weight loss due to GLP1s are not diligent with protein intake and exercise and that much of the weight loss is not healthy, fat loss. This may solve some problems but create others. If you’re past 40 and are losing a bunch of lean mass, while being sedentary and working a desk job and not making lifestyle changes, you may be making your life harder down the road.

 

If you’re not diligent with your diet/exercise after you stop taking the GLP1s, you will likely regain the weight you lost.
 

This is relevant to the question of what health problems GLP-1 weight loss solves and what treatments will be used less due to the weight loss (e.g. ortho implants, knee and hip replacements, reduction in other healthcare expenses).

[Spekulatius]

On 10/13/2023 at 1:55 PM, whatstheofficerproblem said:

Jeffries analyst says United Airline would save $80M/year due to GLP-1 if the average passenger weight falls by 10 pounds. Less weight and load leading to less fuel consumption.

As we all know, productivity growth and lower fuel cost never get competed away, the great business they are.

 

Also, $80M in savings for a $50B revenue business is a real game changer.

Edited October 15, 2023 by Spekulatius

[UK]

On 10/13/2023 at 8:07 AM, UK said:

 

More healthy teeth because of less sweets:)? 

 

Lets just hope these drugs will not also work to cure stupidity...

 

Based on current research, there may be a relationship between obesity and problem gambling, according to BofA, which estimates this kind of gambling represents 10%-30% of all gaming revenue. If weight loss drugs are prescribed to even more people, this could potentially lead to a decline in problem gambling, negatively impacting the industry.

 

[whatstheofficerproblem]

1 hour ago, UK said:

If weight loss drugs are prescribed to even more people, this could potentially lead to a decline in problem gambling, negatively impacting the industry.

 

I hope that this causes a steep decline in BYD and EVO, would love to pick them up at a nice discount.

[bizaro86]

On 10/13/2023 at 6:05 PM, Castanza said:

The idea the humans are going to stop eating readily available junk food in large quantities because of some new weigh loss drug is beyond ridiculous. 

 

Maybe. My mother has lost 60 lbs in 8 months on Ozempic. She's cut her spending on junk food in that time period by at least $100/month and probably $200. That might not be typical, but if you multiply that by a few million people I can imagine a world where you start to see deleveraging on your fixed costs...

[Castanza]

8 hours ago, bizaro86 said:

 

Maybe. My mother has lost 60 lbs in 8 months on Ozempic. She's cut her spending on junk food in that time period by at least $100/month and probably $200. That might not be typical, but if you multiply that by a few million people I can imagine a world where you start to see deleveraging on your fixed costs...

Largest demographic for junk food and fast food eaters are mid 20’s to late 30’s. People 55+ often already have diet restrictions etc. 

 

I just think people are touting this as a miracle drug and the cure all. Call me skeptical because it’s never happened before. Guess it could be the inflection point. I just think the argument of “because something is available it’s inevitable” is a bit lazy. But maybe I don’t fully understand the application of Ozempic and others drugs here. 

[CorpRaider]

On 10/13/2023 at 2:27 PM, Dinar said:

Keep in mind that for something like Remy Cointreau, profits are much higher than free cash flow because you are selling product that was set aside 10-40 years ago.  On a replacement cost basis, earnings would be 10-15% lower, and you can see free cash flow is about 20% lower than net income.  

Thank you.

[Spekulatius]

11 minutes ago, Castanza said:

Largest demographic for junk food and fast food eaters are mid 20’s to late 30’s. People 55+ often already have diet restrictions etc. 

 

I just think people are touting this as a miracle drug and the cure all. Call me skeptical because it’s never happened before. Guess it could be the inflection point. I just think the argument of “because something is available it’s inevitable” is a bit lazy. But maybe I don’t fully understand the application of Ozempic and others drugs here. 

I think it is also lazy to think that something can't happen because it hasn't happened before, especially if there is strong evidence to the contrary.  For example you read comments like "people should eat less instead of taking X drug" Funny though that GPT-1 just does that - they make people to eat less and in addition control diabetes.

 

We can argue that some takes are overplayed but I think the ripple effects from this are quite real. now the question is how large this can be, but I think there is a strong possibility that the number of people who take this class of drugs is higher than single digits, especially of these drugs get cheaper after they come off patent in about 2032 ( at earliest) that assume that no LT side effects are found that make it unsuitable for LT weight loss use.

[Castanza]

1 hour ago, Spekulatius said:

I think it is also lazy to think that something can't happen because it hasn't happened before, especially if there is strong evidence to the contrary.  For example you read comments like "people should eat less instead of taking X drug" Funny though that GPT-1 just does that - they make people to eat less and in addition control diabetes.

 

We can argue that some takes are overplayed but I think the ripple effects from this are quite real. now the question is how large this can be, but I think there is a strong possibility that the number of people who take this class of drugs is higher than single digits, especially of these drugs get cheaper after they come off patent in about 2032 ( at earliest) that assume that no LT side effects are found that make it unsuitable for LT weight loss use.

I hear you on the it could happen

How much more effective is Ozempic vs the multitude of other pharma drugs people take? SSRI, ADHD meds all reduce appetite and cause weight loss. Yet obesity has continued to clone in tandem with those drug uses.

[bizaro86]

1 hour ago, Castanza said:

I hear you on the it could happen

How much more effective is Ozempic vs the multitude of other pharma drugs people take? SSRI, ADHD meds all reduce appetite and cause weight loss. Yet obesity has continued to clone in tandem with those drug uses.

 

My general impression is "more effective". N=1, but my mom has tried all sorts of stuff and has been way overweight for decades. Interestingly, she wasn't able to get the full size pens this month (4 doses of 1mg) and Costco Pharmacy sold her the 4 doses of 0.5 mg pen (she was annoyed because it was the same price). She's already had many of the consequences (eg both knees already replaced) but even if there are long term side effects it seems probable that the lower stress on her heart/kidneys/knees/everything else would outweigh them. 

[Castanza]

16 minutes ago, bizaro86 said:

 

My general impression is "more effective". N=1, but my mom has tried all sorts of stuff and has been way overweight for decades. Interestingly, she wasn't able to get the full size pens this month (4 doses of 1mg) and Costco Pharmacy sold her the 4 doses of 0.5 mg pen (she was annoyed because it was the same price). She's already had many of the consequences (eg both knees already replaced) but even if there are long term side effects it seems probable that the lower stress on her heart/kidneys/knees/everything else would outweigh them. 

Interesting stuff for sure. Glad it worked out for your mom. You very well could be right! I was reading through the potential longterm side effects. 5% rate for the basket doesn’t seem too bad vs the likelihood of diabetes, and other heart conditions caused by obesity. 
 

https://vial.com/blog/articles/what-clinical-research-says-about-the-long-term-safety-of-ozempic/
 

Investment wise, snacks isn’t something I’m interested in, and pharma is also not an area I like. One is too attached to dads and has little growth while the other constantly is one bad drug away from lawsuit mania. Just not something I like to risk. 
 

Im just stubborn and don’t think the vast majority of people will stop eating junk food. For humanities sake I hope they do! 2 out of 3 adults being obese is a piss poor statistic. I’m also very much personally against drug pushing over lifestyle changes. But that’s just me. 
 

Hope you guys make a killing! 

[bizaro86]

1 minute ago, Castanza said:

Interesting stuff for sure. Glad it worked out for your mom. You very well could be right! I was reading through the potential longterm side effects. 5% rate for the basket doesn’t seem too bad vs the likelihood of diabetes, and other heart conditions caused by obesity. 
 

https://vial.com/blog/articles/what-clinical-research-says-about-the-long-term-safety-of-ozempic/
 

Investment wise, snacks isn’t something I’m interested in, and pharma is also not an area I like. One is too attached to dads and has little growth while the other constantly is one bad drug away from lawsuit mania. Just not something I like to risk. 
 

Im just stubborn and don’t think the vast majority of people will stop eating junk food. For humanities sake I hope they do! 2 out of 3 adults being obese is a piss poor statistic. I’m also very much personally against drug pushing over lifestyle changes. But that’s just me. 
 

Hope you guys make a killing! 

 

Should probably be clear I have no position here. The current multiple plus potential competition plus patent expiry puts it in the too hard pile for me.

 

I've put snack companies in the "avoid" bucket as well based on the potential for loss of customers. 

[Spekulatius]

1 hour ago, Castanza said:

I hear you on the it could happen

How much more effective is Ozempic vs the multitude of other pharma drugs people take? SSRI, ADHD meds all reduce appetite and cause weight loss. Yet obesity has continued to clone in tandem with those drug uses.

Well, it's quite simple - these drugs are not approved for weight loss. ADHD drugs have obvious side effects that make them unsuitable unless you have severe ADHD as well. So yes, Ozempic/ Semaglutide is different.

[formthirteen]

Sounds like Ozempic lowers anxiety. Tobacco, fast food, drugs, sex, rock 'n' roll finally have a competitor. It's probably addicting too, but that's fine as it's approved by the government. Tobbacco investors watch out.

[UK]

https://www.bloomberg.com/news/articles/2023-10-20/ozempic-maker-is-testing-weight-loss-drugs-for-kids?srnd=premium-europe&leadSource=uverify wall

[John Hjorth]

To me personally, this has gone totally overboard in the MSM, and likely much of it highly speculative, simply because the speculations are undocumented and not founded in realia.

 

- - - o 0 o - - -

 

Here is one of the latest ones :

 

Bloomberg BusinessWeek [October 18^th 2023] : The Ozempic Effect Is Coming for Everything From Kidney to Heart Disease Treatments.

 

It appears and looks realiable and trustworthy on surface, and contains a lot of links to 'socalled sources'. These sources are - most of them [- I haven't checked them all, so can't say for sure it's all of them - ] are other Bloomberg articles, released earlier on the matter or about adjacent topics. Then you can check the sources in the underlying 'source'-articles, and you find other yet earlier Bloomberg articles as sources, that also do not contain any factual news or information about it from an outside Bloomberg source with some professional credibility. Then you start scratching the top of your head, asking your self : "Where did it actually come from?", going back / returning to article that linked to that particular place, and you realize that there aren't any links to or specific guide to basis for the written statements in the article for its central statements, generating the  actual headline of the article.  [<- Translation : WTF?!]

 

Journalism at its finest.

 

- - - o 0 o - - -

 

The article is partly subscription protected, and contains this [, which I don't know what to think about - also thinking Novo Nordisk and Eli Lilly should focus on ramping up on production capacity and on work for approval, instead of 'chasing everything']  :

 

 

 

Edited October 22, 2023 by John Hjorth

[Spekulatius]

Interesting story here - the surge in GPT-1 drug could really benefits PBM (or insurers with PBM’s)

https://www.wsj.com/health/healthcare/ozempic-boom-is-an-opportunity-for-health-insurers-26ea9a42?mod=finance_lead_pos1

 

Could be good for CVS and CI specifically. ELV also has Carelon as their own native PBM but it’s still small.

Edited October 22, 2023 by Spekulatius

[Red Lion]

On 10/15/2023 at 9:05 PM, bizaro86 said:

 

Maybe. My mother has lost 60 lbs in 8 months on Ozempic. She's cut her spending on junk food in that time period by at least $100/month and probably $200. That might not be typical, but if you multiply that by a few million people I can imagine a world where you start to see deleveraging on your fixed costs...

I’ve heard a lot of stories like this. I’m personally on mounjaro, and while I was essentially on a low carb paleo type diet for much of the last 15 years, I’ve found that the medication has completely taken away cravings for certain types of food. Personally, this has manifested more as an aversion to greasy foods. I used to eat a ton of grass fed beef, and now I’ve become almost completely pescatarian.
 

I’m actually spending quite a lot more on food, but that’s because I’m privileged to just buy $25/lb fish instead of $10-$15 meat. 
 

I’m also eating the most carbs I’ve eaten in the last 15 years. And that’s been amazing. But stuff like legumes, whole grains, fresh fruits (mango’s, pineapples)and starchy vegetables that I couldn’t used to handle without killing my blood glucose numbers. 
 

I’d say my cravings for sweet junk food have subsided. I have avoided eating these foods for a long time, but it’s become noticeably less significant, maybe it’s because I’m getting more healthy carbs in my diet. 
 

Anyway I’ve actually reduced the fat in my diet, increased carbs, probably kept protein similar on the seafood front (I might need to watch the mercury.) 

 

All this to say, I 100% believe junk food companies will be hurt on volumes if there is wide glp adoption. Having experienced the benefits of these drugs I’m a believer that there will eventually be widespread adoption, but it seems very uncertain if that would occur before the patents start expiring on trulicity or Ozempic.  

With all this said I can still eat a piece of candy, or garbage from Taco Bell, or potato chips but I tend not to eat a ton. 

Edited October 23, 2023 by RedLion

[Guest]

9 hours ago, RedLion said:

I’ve heard a lot of stories like this. I’m personally on mounjaro, and while I was essentially on a low carb paleo type diet for much of the last 15 years, I’ve found that the medication has completely taken away cravings for certain types of food. Personally, this has manifested more as an aversion to greasy foods. I used to eat a ton of grass fed beef, and now I’ve become almost completely pescatarian.
 

I’m actually spending quite a lot more on food, but that’s because I’m privileged to just buy $25/lb fish instead of $10-$15 meat. 
 

I’m also eating the most carbs I’ve eaten in the last 15 years. And that’s been amazing. But stuff like legumes, whole grains, fresh fruits (mango’s, pineapples)and starchy vegetables that I couldn’t used to handle without killing my blood glucose numbers. 
 

I’d say my cravings for sweet junk food have subsided. I have avoided eating these foods for a long time, but it’s become noticeably less significant, maybe it’s because I’m getting more healthy carbs in my diet. 
 

Anyway I’ve actually reduced the fat in my diet, increased carbs, probably kept protein similar on the seafood front (I might need to watch the mercury.) 

 

All this to say, I 100% believe junk food companies will be hurt on volumes if there is wide glp adoption. Having experienced the benefits of these drugs I’m a believer that there will eventually be widespread adoption, but it seems very uncertain if that would occur before the patents start expiring on trulicity or Ozempic.  

With all this said I can still eat a piece of candy, or garbage from Taco Bell, or potato chips but I tend not to eat a ton. 

 

Why did you go from paleo to taking medication? Seems kind of crazy to do that to me. 

[Red Lion]

49 minutes ago, stahleyp said:

 

Why did you go from paleo to taking medication? Seems kind of crazy to do that to me. 

Because paleo quit working years ago? I’ve been diabetic for 20 years. This is after several years of fully controlling diabetes with an A1c below 6.5 with zero medication with paleo plus exercise. 
 

Then even flirting with a 25 bmi, I had to add metformin about 8 years ago. Then I had to add victoza, up to the max dose around 5 years ago. Then last year when on the max dose of victoza, still eating a paleo diet, my A1c hit 11 and I caused serious damage to my eyes, now I have prescription glasses. I went on insulin until I could find a supply of the new glp drugs, because everyone in the goddamn country wants them for weight loss. 

 

And I literally just explained it in my post if you bothered to read.
 

And now I basically eat paleo plus legumes and whole grains with way more fish than before.  
 

Anyway, this type of post demonstrates some extremely typical ignorance from people who don’t understand that paleo doesn’t actually cure fucked up genetics. But it DID help for many years. 
 

 

Edited October 23, 2023 by RedLion

[Guest]

13 minutes ago, RedLion said:

Because paleo quit working years ago? I’ve been diabetic for 20 years. This is after several years of fully controlling diabetes with an A1c below 6.5 with zero medication with paleo plus exercise. 
 

Then even flirting with a 25 bmi, I had to add metformin about 8 years ago. Then I had to add victoza, up to the max dose around 5 years ago. Then last year when on the max dose of victoza, still eating a paleo diet, my A1c hit 11 and I caused serious damage to my eyes, now I have prescription glasses. I went on insulin until I could find a supply of the new glp drugs, because everyone in the goddamn country wants them for weight loss. 

 

And I literally just explained it in my post if you bothered to read.
 

And now I basically eat paleo plus legumes and whole grains with way more fish than before.  
 

Anyway, this type of post demonstrates some extremely typical ignorance from people who don’t understand that paleo doesn’t actually cure fucked up genetics. But it DID help for many years. 
 

 

 

I was on paleo and was in the best shape of my life. That's why I thought it was odd. Usually taking medication is not the way to go but sometimes it might be. That's why I asked. Sorry dude, didn't mean to offend. 

[Red Lion]

1 minute ago, stahleyp said:

 

I was on paleo and was in the best shape of my life. That's why I thought it was odd. Usually taking medication is not the way to go but sometimes it might be. That's why I asked. Sorry dude, didn't mean to offend. 

Sorry if my post was worded offensively. Paleo is awesome and like I said, it actually did work without medication at first. I still eat super clean 95% of the time. I think most people don’t develop t2d until they’re in their 50s or 60s after decades of garbage diet, and I think paleo might be sufficient alone for these folks. 
 

I’m just so lucky that I have these drugs at a young age. My grandmother and great grandmother both were on insulin younger than me (39) and died young too. Hoping I avoid this fate, and hopefully they come out with something better. 
 

[Guest]

3 minutes ago, RedLion said:

Sorry if my post was worded offensively. Paleo is awesome and like I said, it actually did work without medication at first. I still eat super clean 95% of the time. I think most people don’t develop t2d until they’re in their 50s or 60s after decades of garbage diet, and I think paleo might be sufficient alone for these folks. 
 

I’m just so lucky that I have these drugs at a young age. My grandmother and great grandmother both were on insulin younger than me (39) and died young too. Hoping I avoid this fate, and hopefully they come out with something better. 
 

 

Sorry to hear man. Yeah, that sucks and I too hope medication improves. Keep working hard though and do the best you can!

[changegonnacome]

https://www.marketwatch.com/story/junk-food-is-as-addictive-as-alcohol-and-cigarettes-report-92aebe6e

 

"Junk food is as addictive as alcohol and cigarettes - new report"

 

In some respects it's a great triumph of food science to modify a product so much that it gets to be as addictive as alcohol & cigarettes.......and given the statistics on health outcomes.....the medical costs to society over time of being addicted to doritos is perhaps worse in aggregate than the smaller number of those being addicted to cigarettes.......cigarette use is falling and the users of cigarettes get 'taken out' early and often......Doritos "users" not so much......junk food addicts tend to set themselves up for a lifetime of myriad health problems - numerous and debilitating..........with trickle down & follow-on health issues that come out of insulin insensitivity & various metabolic syndromes.

 

Dr.Peter Attia spoke recently around a number of drugs similar to the GLP-1 class that are currently in trial and that have been shown to be even better at preserving lean tissue inside a calories deficit than Ozempic. I'm curious if anyone here knows what drugs they might be and by what companies.

 

The data I've seen on Ozempic does show significant reductions in weight - which for some is just a slam dunk outcome - but I've also seen how much of that weight is also coming from lean tissue.

 

https://fortune.com/well/2023/09/27/weight-loss-drugs-ozempic-wegovy-risks-for-people-over-65/

 

This sub-group trial showing the participants losing nearly equal weight fat & muscle is not a great outcome period....but even more so in older adults where loss of lean tissue sets one up frailty, mobility and falls in older age.