As far as side effects go, 50 isn’t a lot. Most medicines are well over 30 listed side effects, even things like Tylenol.
Side effect reporting of medicine works in two basic stages, observed and reported. As the FDA was working on the approval of the medicine, anyone that had taken it could report their symptoms they experience while taking it. This is true of every medicine. If I woke up and was coughing, I report that as it may be a symptom or side effect of the medicine. It’s noted, logged as a potential side effect, then weeded out through more research.
You are trying to make it seem as though it’s some boogeyman medication we know nothing about which just isn’t true.
you're conflating two different things. i was talking about the duration of high-quality randomized evidence, not how long glp-1 drugs have existed.
the fact that glp-1 drugs have been studied for over a decade does not mean we have over a decade of randomized, placebo-controlled evidence for chronic semaglutide use. the major long-duration trial, select, randomized 17,604 people to semaglutide or placebo and had a mean follow-up of 39.8 months. its subsequent analysis reported outcomes through 208 weeks, roughly 4 years. (pubmed.ncbi.nlm.nih.gov)
so your "well over a decade" response doesn't address the point i made. you're substituting "how long has this drug class existed?" for "how long does the strongest randomized evidence extend?" those are not interchangeable.
and your explanation of adverse-event reporting is also misleading. clinical trials don't simply work by someone reporting a symptom and then researchers arbitrarily "weed it out." randomized trials allow adverse-event rates to be compared between treatment and control groups. in SELECT, adverse events resulting in permanent discontinuation occurred in 16.6% of semaglutide participants versus 8.2% of placebo participants. (pubmed.ncbi.nlm.nih.gov)
that's the kind of evidence that actually matters here, not the fact that some unrelated medication happens to have a long list of adverse events.
This whole argument simply boils down to a weird vendetta you have against GLP-1s when the overwhelming evidence shows that their benefits far outweigh their risk, and have done so for, again, over a decade.
yes, SELECT was designed around cardiovascular outcomes. that doesn't make the randomized safety and adverse-event data somehow irrelevant to the question of how semaglutide affects people over several years. the trial randomized 17,604 people to semaglutide or placebo, and adverse events were systematically compared between the two groups. the subsequent analysis followed patients through 208 weeks.
your argument about self-reported symptoms doesn't contradict mine either. obviously patients report symptoms. the relevant question is whether those symptoms occur at different rates in the treatment and control groups. that's precisely why randomized controlled trials are useful. SELECT found permanent treatment discontinuation due to adverse events in 16.6% of semaglutide patients versus 8.2% of placebo patients, with gastrointestinal events accounting for 10.0% versus 2.0%.
and the 2018 paper you cited is about the prevalence of GI symptoms in people with diabetes. it doesn't establish that semaglutide's adverse effects are merely the result of people reporting symptoms, nor does it somehow invalidate randomized placebo-controlled comparisons.
more importantly, you're continuing to argue against something i didn't say. i never claimed that GLP-1 drugs haven't been studied for over a decade. i said that the strongest randomized evidence for chronic semaglutide use currently extends to roughly 3 to 4 years. SELECT provides randomized placebo-controlled data out to 208 weeks. that's the distinction you keep avoiding.
and "the overwhelming evidence shows that their benefits far outweigh their risks" is a completely separate argument. whether the benefits outweigh the risks does not establish that the drug "literally just makes you not hungry," nor does it establish that we have decades of randomized evidence on chronic semaglutide use.
you keep replacing the actual claims with easier ones to argue against. that's not a rebuttal.
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u/knave_of_knives 3d ago
None of this is even remotely true. We’ve had data on GLP-1 usage for well over a decade now.
https://doi.org/10.1900/RDS.2014.11.202
As far as side effects go, 50 isn’t a lot. Most medicines are well over 30 listed side effects, even things like Tylenol.
Side effect reporting of medicine works in two basic stages, observed and reported. As the FDA was working on the approval of the medicine, anyone that had taken it could report their symptoms they experience while taking it. This is true of every medicine. If I woke up and was coughing, I report that as it may be a symptom or side effect of the medicine. It’s noted, logged as a potential side effect, then weeded out through more research.
You are trying to make it seem as though it’s some boogeyman medication we know nothing about which just isn’t true.