"And as Scott notes, if your group starts actually believing in literal demons, you start getting iatrogenic demons, which does not sound like a great thing to be conjuring into existence"
I actually think all demons are iatrogenic demons, because the official Talmudic advice is to be studiously oblivious. But in case someone needs empirical proof, and has a good IFS therapist to fix it afterwards....
One who seeks to know that the demons exist should place fine ashes around his bed, and in the morning the demons’ footprints appear like chickens’ footprints, in the ash. One who seeks to see them should take the afterbirth of a firstborn female black cat, born to a firstborn female black cat, burn it in the fire, grind it and place it in his eyes, and he will see them. He must then place the ashes in an iron tube sealed with an iron seal [gushpanka] lest the demons steal it from him, and then seal the opening so he will not be harmed. Rav Beivai bar Abaye performed this procedure, saw the demons, and was harmed. The Sages prayed for mercy on his behalf and he was healed.
"The main objection seems to be that obesity is a moral failure of our civilization and ourselves, so it would be wrong to fix it with a pill rather than correct the underlying issues like processed foods and lack of exercise.'
There's some concerning information in the approval studies for these drugs relating to muscle loss. I realize this sounds (often) like a silly concern, but long-term it might be a fairly serious issue if these drugs get you to 60+ lean-ish and then you're super frail, break a hip and die. OK, that's overstating the case, but for people considering them:
The approval studies I've seen document a level of muscle loss roughly commensurate-ish with "normal" weight loss. This isn't a quite as simple as comparing lean body mass over time and the data is very, very fuzzy. After looking at it over and over again I'm fully not claiming it is more/less than "normal" weight loss. However, based on anecdotal reports it seems a lot of people taking the new weight loss drugs are completely ignoring the "exercise" component (or attempting to put it off till they are lean).
This is a terribad idea, you NEED to lift on the way down to maintain mass/bone density in a caloric deficit. It's probably the most vital time to lift in terms of long term health concerns, and people are treating these drugs as a free pass to the "looking healthy" club, but not doing any of the lifestyle changes (unrelated to the drug) that would make this true. The rest of the results (impulse control, diet changes, decrease in metabolic disorders) probably will over-power this effect making, but you're leaving VERY EASY money/gains/QOL points on the table if you don't lift when going on these drugs and possibly risking long term problems.
Speaking as someone who totally lost a TON of weight while doing zero exercise, yes, it has its side effects. But in addition to that being about weight loss in general rather than GLP-1s, I am learning (1) that can be undone after, with work, if you want it and (2) I was infinitely better off after than I was before even without fixing it.
Muscle mass loss - if I made you carry a 50lb weight everywhere you went you’d gain muscle mass. If I no longer made you carry around that weight you’d lose that muscle mass. Are they saying that when people are no longer carrying around an extra 50lb of fat they lose muscle mass? And that’s some great indictment?
You can wind up in a position where you're 50 and have lower bone density and lower muscle mass than if you had stayed lean the entire time. It's incredibly confounded (like all exercise science/nutrition questions) by a pile of factors. But, it is something to watch out for given the health concerns associated with being "skinny fat" (simply put: healthy weight range/waist, but the visceral body fat associated with a much higher BMI/poorer health outcomes).
Putting it another way: we associate healthy weight range/waist ranges with, err, being healthy. But, a lot of that is the road walked to get there. We've snuck a shortcut and that's great, but people who take that shortcut would do well to avail themselves of some strength training and cardio before they discover they are skinny and unhealthy.
Ok how do the drugs impact that? Obviously someone who is 35 and 50lbs overweight (and lost that 50lbs) isn’t going to be as healthy as a 35 year old 3% body fat triathlete.
The issue is that they might not be as healthy as a 35 YO 20% BF normie with a dadbod. But, the probably think they are as healthy or healthier b/c they're (post-drugs) sitting at a respectable 10-15% BF.
When you're 20 you can walk past a kebab stand and look at a weight and put muscle on, this people often remember. The other side is you can also keep (a relatively high proportion) of the muscle on during some pretty extreme cuts. Once you're 40/50, less so. Certainly possible to do, especially with an eye towards efficient nutrition and appropriate training. But, based on web-reports people seem to treat these drugs as a magical "get out of obesity free card" and don't think past "lose weight".
Age related muscle/bone loss is a huge problem, and it's only going to get worse as more sedentary generations age (people not starting from a great place). I fear I may have failed to be communicate well.
Take the drugs, as appropriate, but you need train and do cardio as well. If your situation is such that this is difficult/very difficult at the start resolve to do it as soon as possible.
bit of a tangent but it seems to me quite difficult to ballpark how much really changes about exercise response at the 40s and 50s life stage — even on average, much less accounting for variance, which prima facie/intuitively seems likely meaningful. many exercise physiology studies are done either in 60-65+ or in young/fit for obvious reasons (trying to formulate a ‘clean’ experimental question, especially as such studies generally have limited n)
curious if Zvi or Gwern or anyone semi-comparable has happened to look into this yet. too young to be invested yet old enough to viscerally not want to focus on it? but also, good at foresight? maybe it’s time
Otherwise, from reading a lot of training logs and talking with people, what any older lifter will tell you is simple: Train consistently and you will see consistent progress. Depending on your training history this might be lifetime PRs, age related PRs, master's records or health/strength to do life as you age gains.
"Your periodic reminder that we went fast when we created the Covid vaccines, but could have gone much faster."
One of the ways we could have gone much faster, (And some researchers did this personally.) would have been to take the several coronavirus "common colds", and used them to create a live vaccine. We early on had substantial evidence that recent prior exposure to basically any coronavirus resulted in a Covid 19 infection being much more mild.
This was just a few months after they'd announced the pandemic, you notice.
"Which SARS-CoV-2 genes do you use to make the chimeric live virus"
You don't have to make a chimeric live virus, in this scenario: You could just distribute a cocktail of preexisting coronavirus "common cold" viruses, knowing that they only cause a very mild illness, and are protective. A number of researchers were privately doing this for themselves and their families, I'd heard at the time.
I think "allocate resources based on past decisions" means you can't do things like refuse medical care because someone is a smoker so contributed to their own illness. Or that a patient has previously had lots of treatment, so shouldn't get even more. It's a more narrow phrase than a literal reading.
from my pov it is an intensely ambiguous phrasing that desperately needs examples, preferably multiple, to mean anything. i have to assume that the bioethicist target audience is familiar enough with this phrasing to intuitively impute the right context and interpretation, just because *surely* no one would build an option that vague into an instrument like this if they were formulating options from scratch
You have two patients in desperate need of lung transplants and one is a lifelong smoker and one got their lungs wrecked by some horrible industrial accident, and you have one set of donor lungs available, who do you give them to?
I can see that some people would argue "the smoker did this to himself, no sympathy", and others view that statement as callous and inhumane.
The utilitarian view is a much simpler one - a past smoker is way more likely to be a future smoker, no matter how much they promise that they've quit, and thus the expected lifetime of their new lungs is lower, ceteris paribus.
Re: Hanson the issue is that he varies quite wildly across posts as to the strength of the healthcare claim he's making. The end claim of "the US spends way more than anymore else and has no better health outcome, maybe a lot of that is wasted" is perfectly sensible, but Hanson repeatedly makes much, much stronger claims than that in his blog, along the lines of medical treatments not even being net positive (I'll dig out the posts I'm thinking of and comment below).
> The FDA is considering black octagon warning labels on the front of packages of foods to warn of things like ‘excess’ fat, sodium, sugar or calories.
Israel does these. I've mostly found them occasionally helpful and not especially annoying.
In terms of UK versus US healthcare spending, part of it is less investment in experimental or explorative care.
Some of it is spending a lot less on luxuries like private rooms and good hospital food.
Some of it is less training and paying people less. For instance children in the UK see GPs and specially trained nurses (health visitors) for routine healthcare, not paediatricians. GYNs don't do cervical screening or regular exams here, either. Nurses do that. Medical school is an undergraduate degree, not a graduate one. Etc.
Public health developments are what led to the big increase in life expectancy last century. Victorians did most of the medical breakthroughs and yet life expectancy didn’t increase until the vaccines.
I really wanna see ozempic in healthy normals. Like is there a dose you can take to reduce your levels of hunger or addiction so you basically never make poor eating choices
It doesn't work like that. Yes, it will reduce your level of hunger, but it doesn't do squat to bias your eating choices in a healthy direction, you need to do that part yourself, consciously.
If you were habitually eating Skittles and instant ramen at every meal, take this stuff and you'll eat fewer Skittles and instant ramen, you won't suddenly develop an urge to eat salad and tuna.
You’re confusing different types of poor eating choices. Ozempic changes the quantity, not quality that you eat so the poor eating choices you mentioned wouldn’t apply
Bad take on the warning labels. If this information is not prominently displayed, then consumers aren't going to pay attention to it, and imagining otherwise is wishful thinking. If I'm staring at a shelf of options, am I really supposed to pick out each product one by one and look at each's nutrition facts? Not realistic.
Often these food products have insanely bad nutritional characteristics, and it's hard to know in advance. I remember that after NYC added high-sodium warnings to restaurant menus (with a ridiculously high threshold — single items over 2.3g of sodium), it turned out that at some restaurants, everything on the menu had an icon. Was this information theoretically available previously? Yes. Was it intentionally obfuscated to make it minimally salient? Also yes.
Could AI help with this? Maybe! I can imagine in the future pointing my smartphone at a retail display and getting back some nutritionally-appropriate suggestions. We are not there yet, however.
once you’re looking at a rack full of chips with intent, you have probably already deprioritized nutritional optimization for the moment. *maybe* a big splashy icon is going to get through where the regular labeling on the back isn’t, but it seems questionable at best
There are some food products that are bad in surprising ways that labelling could help with though. I remember being surprised to find instant noodles have a ton of saturated fat - I knew they weren't *good* food, but I'd assumed they were just bad in the 'nutritionally void, high-carb' manner, I didn't know they were flash-fried and retained a load of sat fat from it.
Also, I've seen quite a few vegetarian products with poor nutritional profiles that are not immediately obvious.
I think the 'traffic light' system we have in the UK is pretty good, it's not overbearing but is easy to see.
I think there are three reasons to think there's more to the story than that:
1. There are plenty of chips that are marketed as "healthy". Sun Chips come to mind, for example. Are they actually though? Warning labels could help. And if consumers really didn't care about nutrition, then it wouldn't be necessary to market them as healthy.
2. We see in other places that have done this, that it has affected consumers' choices. So I think the burden of proof is on those that think this won't have an effect.
3. If this really didn't matter, we wouldn't see so much push-back from manufacturers.
Common failure mode from rats I see is thinking that more information = better decisions (for most people). People aren't eating poorly because they're unaware of the nutritional value, (with some rare exceptions like juice). People are eating crap because they like eating crap.
If that's true, then why do we see that these labels have effects on consumers' choices in other places where they've been tried?
The way I see it, "more information" does not necessarily lead to better decisions (indeed, it can lead to worse decisions); however "more salient information" can indeed improve decisions. That's the main difference between prominent front-of-label warnings and nutrition facts found on the back.
"We can largely do this by shifting more of the costs for marginal care onto the patients. They will mostly make reasonable decisions on which things to keep."
Are you saying patients will make reasonable decisions on what to keep, or doctors will? If it's the former, I'm pretty skeptical of the validity of that assumption.
> Early results from a study show the GLP-1 drug liraglutide could reduce cravings in people with opioid use disorder by 40% compared with a placebo.
If we could find a drug that got rid of cravings for _all_ forms of distractions, I'd bet we could get a few years of 10% GDP growth here in the US without AGI. Just imagine all the hours wasted on TV shows, Instagram, TikTok, etc, being put into productive work. It's a shame that we're not spending at least 0.1% of GDP on trying to find such a drug (and, no, Adderall's not even close).
Covid was real…but the biggest factor for a population’s death rate that avoided the initial wave was % below poverty level. So America is old and unhealthy and the only state in which age can be identified as a factor is Utah which has an anomalously low median age. Poverty prematurely ages Americans via unhealthy habits and poverty means less access to health care and it also means less education and all of that is a deadly combination.
If Ozempic's use becomes widespread and people eat (say) 1-2% less in aggregate, how much do we collectively save in terms of water, farmland, laborer hours, and other agricultural inputs?
This seems yet another insufficiently-explored social benefit of the drug class.
On the margin, I expect people to cut the cheapest calories first. So not a large impact. All the resources you mention are only scarce because we use vast quantities on non-essential food items that are 10x less efficient than staple crops.
"And as Scott notes, if your group starts actually believing in literal demons, you start getting iatrogenic demons, which does not sound like a great thing to be conjuring into existence"
I actually think all demons are iatrogenic demons, because the official Talmudic advice is to be studiously oblivious. But in case someone needs empirical proof, and has a good IFS therapist to fix it afterwards....
https://www.chabad.org/torah-texts/5299475/The-Talmud/Berachot/Chapter-1/6a
One who seeks to know that the demons exist should place fine ashes around his bed, and in the morning the demons’ footprints appear like chickens’ footprints, in the ash. One who seeks to see them should take the afterbirth of a firstborn female black cat, born to a firstborn female black cat, burn it in the fire, grind it and place it in his eyes, and he will see them. He must then place the ashes in an iron tube sealed with an iron seal [gushpanka] lest the demons steal it from him, and then seal the opening so he will not be harmed. Rav Beivai bar Abaye performed this procedure, saw the demons, and was harmed. The Sages prayed for mercy on his behalf and he was healed.
Sometimes I like to spin around and think of 11k demons being forced to keep up.
"The main objection seems to be that obesity is a moral failure of our civilization and ourselves, so it would be wrong to fix it with a pill rather than correct the underlying issues like processed foods and lack of exercise.'
There's some concerning information in the approval studies for these drugs relating to muscle loss. I realize this sounds (often) like a silly concern, but long-term it might be a fairly serious issue if these drugs get you to 60+ lean-ish and then you're super frail, break a hip and die. OK, that's overstating the case, but for people considering them:
The approval studies I've seen document a level of muscle loss roughly commensurate-ish with "normal" weight loss. This isn't a quite as simple as comparing lean body mass over time and the data is very, very fuzzy. After looking at it over and over again I'm fully not claiming it is more/less than "normal" weight loss. However, based on anecdotal reports it seems a lot of people taking the new weight loss drugs are completely ignoring the "exercise" component (or attempting to put it off till they are lean).
This is a terribad idea, you NEED to lift on the way down to maintain mass/bone density in a caloric deficit. It's probably the most vital time to lift in terms of long term health concerns, and people are treating these drugs as a free pass to the "looking healthy" club, but not doing any of the lifestyle changes (unrelated to the drug) that would make this true. The rest of the results (impulse control, diet changes, decrease in metabolic disorders) probably will over-power this effect making, but you're leaving VERY EASY money/gains/QOL points on the table if you don't lift when going on these drugs and possibly risking long term problems.
Speaking as someone who totally lost a TON of weight while doing zero exercise, yes, it has its side effects. But in addition to that being about weight loss in general rather than GLP-1s, I am learning (1) that can be undone after, with work, if you want it and (2) I was infinitely better off after than I was before even without fixing it.
Makes sense, especially if you lose enough that exercise is substantially more enjoyable after.
Muscle mass loss - if I made you carry a 50lb weight everywhere you went you’d gain muscle mass. If I no longer made you carry around that weight you’d lose that muscle mass. Are they saying that when people are no longer carrying around an extra 50lb of fat they lose muscle mass? And that’s some great indictment?
Surely that can’t be it.
You can wind up in a position where you're 50 and have lower bone density and lower muscle mass than if you had stayed lean the entire time. It's incredibly confounded (like all exercise science/nutrition questions) by a pile of factors. But, it is something to watch out for given the health concerns associated with being "skinny fat" (simply put: healthy weight range/waist, but the visceral body fat associated with a much higher BMI/poorer health outcomes).
Putting it another way: we associate healthy weight range/waist ranges with, err, being healthy. But, a lot of that is the road walked to get there. We've snuck a shortcut and that's great, but people who take that shortcut would do well to avail themselves of some strength training and cardio before they discover they are skinny and unhealthy.
Ok how do the drugs impact that? Obviously someone who is 35 and 50lbs overweight (and lost that 50lbs) isn’t going to be as healthy as a 35 year old 3% body fat triathlete.
The issue is that they might not be as healthy as a 35 YO 20% BF normie with a dadbod. But, the probably think they are as healthy or healthier b/c they're (post-drugs) sitting at a respectable 10-15% BF.
When you're 20 you can walk past a kebab stand and look at a weight and put muscle on, this people often remember. The other side is you can also keep (a relatively high proportion) of the muscle on during some pretty extreme cuts. Once you're 40/50, less so. Certainly possible to do, especially with an eye towards efficient nutrition and appropriate training. But, based on web-reports people seem to treat these drugs as a magical "get out of obesity free card" and don't think past "lose weight".
Age related muscle/bone loss is a huge problem, and it's only going to get worse as more sedentary generations age (people not starting from a great place). I fear I may have failed to be communicate well.
Take the drugs, as appropriate, but you need train and do cardio as well. If your situation is such that this is difficult/very difficult at the start resolve to do it as soon as possible.
bit of a tangent but it seems to me quite difficult to ballpark how much really changes about exercise response at the 40s and 50s life stage — even on average, much less accounting for variance, which prima facie/intuitively seems likely meaningful. many exercise physiology studies are done either in 60-65+ or in young/fit for obvious reasons (trying to formulate a ‘clean’ experimental question, especially as such studies generally have limited n)
curious if Zvi or Gwern or anyone semi-comparable has happened to look into this yet. too young to be invested yet old enough to viscerally not want to focus on it? but also, good at foresight? maybe it’s time
https://www.strongerbyscience.com/predict-strength-gains/
Age section is pretty good.
Otherwise, from reading a lot of training logs and talking with people, what any older lifter will tell you is simple: Train consistently and you will see consistent progress. Depending on your training history this might be lifetime PRs, age related PRs, master's records or health/strength to do life as you age gains.
Of course, joy gains are possible:
https://www.youtube.com/watch?v=2N2eSsIWtNI
Podcast episode for this post:
https://askwhocastsai.substack.com/p/medical-roundup-3-by-zvi-mowshowitz
"Your periodic reminder that we went fast when we created the Covid vaccines, but could have gone much faster."
One of the ways we could have gone much faster, (And some researchers did this personally.) would have been to take the several coronavirus "common colds", and used them to create a live vaccine. We early on had substantial evidence that recent prior exposure to basically any coronavirus resulted in a Covid 19 infection being much more mild.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7773392/
This was something that could have been done almost instantly, with a known and fairly low risk profile.
That was just a quick example confirming the finding. If you want something from before the vaccine was available, https://www.science.org/content/article/t-cells-found-covid-19-patients-bode-well-long-term-immunity
This was just a few months after they'd announced the pandemic, you notice.
"Which SARS-CoV-2 genes do you use to make the chimeric live virus"
You don't have to make a chimeric live virus, in this scenario: You could just distribute a cocktail of preexisting coronavirus "common cold" viruses, knowing that they only cause a very mild illness, and are protective. A number of researchers were privately doing this for themselves and their families, I'd heard at the time.
Here's another early discussion of using those cold viruses as a vaccine, or as the basis for one: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732292/
I think "allocate resources based on past decisions" means you can't do things like refuse medical care because someone is a smoker so contributed to their own illness. Or that a patient has previously had lots of treatment, so shouldn't get even more. It's a more narrow phrase than a literal reading.
from my pov it is an intensely ambiguous phrasing that desperately needs examples, preferably multiple, to mean anything. i have to assume that the bioethicist target audience is familiar enough with this phrasing to intuitively impute the right context and interpretation, just because *surely* no one would build an option that vague into an instrument like this if they were formulating options from scratch
Right, a classic toy example would be:
You have two patients in desperate need of lung transplants and one is a lifelong smoker and one got their lungs wrecked by some horrible industrial accident, and you have one set of donor lungs available, who do you give them to?
I can see that some people would argue "the smoker did this to himself, no sympathy", and others view that statement as callous and inhumane.
The utilitarian view is a much simpler one - a past smoker is way more likely to be a future smoker, no matter how much they promise that they've quit, and thus the expected lifetime of their new lungs is lower, ceteris paribus.
Re: Hanson the issue is that he varies quite wildly across posts as to the strength of the healthcare claim he's making. The end claim of "the US spends way more than anymore else and has no better health outcome, maybe a lot of that is wasted" is perfectly sensible, but Hanson repeatedly makes much, much stronger claims than that in his blog, along the lines of medical treatments not even being net positive (I'll dig out the posts I'm thinking of and comment below).
"Net zero benefit" to medicine claim: https://www.overcomingbias.com/p/medicine_as_scahtml?utm_campaign=post&utm_medium=web, https://www.overcomingbias.com/p/how-med-harmshtml?utm_campaign=post&utm_medium=web
He jumps back and forth between the "marginal American medicine is useless" and "the harms of medicine broadly outweigh the benefits".
> The FDA is considering black octagon warning labels on the front of packages of foods to warn of things like ‘excess’ fat, sodium, sugar or calories.
Israel does these. I've mostly found them occasionally helpful and not especially annoying.
In terms of UK versus US healthcare spending, part of it is less investment in experimental or explorative care.
Some of it is spending a lot less on luxuries like private rooms and good hospital food.
Some of it is less training and paying people less. For instance children in the UK see GPs and specially trained nurses (health visitors) for routine healthcare, not paediatricians. GYNs don't do cervical screening or regular exams here, either. Nurses do that. Medical school is an undergraduate degree, not a graduate one. Etc.
Public health developments are what led to the big increase in life expectancy last century. Victorians did most of the medical breakthroughs and yet life expectancy didn’t increase until the vaccines.
I really wanna see ozempic in healthy normals. Like is there a dose you can take to reduce your levels of hunger or addiction so you basically never make poor eating choices
It doesn't work like that. Yes, it will reduce your level of hunger, but it doesn't do squat to bias your eating choices in a healthy direction, you need to do that part yourself, consciously.
If you were habitually eating Skittles and instant ramen at every meal, take this stuff and you'll eat fewer Skittles and instant ramen, you won't suddenly develop an urge to eat salad and tuna.
You’re confusing different types of poor eating choices. Ozempic changes the quantity, not quality that you eat so the poor eating choices you mentioned wouldn’t apply
It does change food preferences: https://x.com/DKThomp/status/1735678039218937893
"The case that GLP-1s can be sued against all addictions at scale." Confusing typo: sued -> used
Bad take on the warning labels. If this information is not prominently displayed, then consumers aren't going to pay attention to it, and imagining otherwise is wishful thinking. If I'm staring at a shelf of options, am I really supposed to pick out each product one by one and look at each's nutrition facts? Not realistic.
Often these food products have insanely bad nutritional characteristics, and it's hard to know in advance. I remember that after NYC added high-sodium warnings to restaurant menus (with a ridiculously high threshold — single items over 2.3g of sodium), it turned out that at some restaurants, everything on the menu had an icon. Was this information theoretically available previously? Yes. Was it intentionally obfuscated to make it minimally salient? Also yes.
Could AI help with this? Maybe! I can imagine in the future pointing my smartphone at a retail display and getting back some nutritionally-appropriate suggestions. We are not there yet, however.
once you’re looking at a rack full of chips with intent, you have probably already deprioritized nutritional optimization for the moment. *maybe* a big splashy icon is going to get through where the regular labeling on the back isn’t, but it seems questionable at best
There are some food products that are bad in surprising ways that labelling could help with though. I remember being surprised to find instant noodles have a ton of saturated fat - I knew they weren't *good* food, but I'd assumed they were just bad in the 'nutritionally void, high-carb' manner, I didn't know they were flash-fried and retained a load of sat fat from it.
Also, I've seen quite a few vegetarian products with poor nutritional profiles that are not immediately obvious.
I think the 'traffic light' system we have in the UK is pretty good, it's not overbearing but is easy to see.
I think there are three reasons to think there's more to the story than that:
1. There are plenty of chips that are marketed as "healthy". Sun Chips come to mind, for example. Are they actually though? Warning labels could help. And if consumers really didn't care about nutrition, then it wouldn't be necessary to market them as healthy.
2. We see in other places that have done this, that it has affected consumers' choices. So I think the burden of proof is on those that think this won't have an effect.
3. If this really didn't matter, we wouldn't see so much push-back from manufacturers.
Common failure mode from rats I see is thinking that more information = better decisions (for most people). People aren't eating poorly because they're unaware of the nutritional value, (with some rare exceptions like juice). People are eating crap because they like eating crap.
If that's true, then why do we see that these labels have effects on consumers' choices in other places where they've been tried?
The way I see it, "more information" does not necessarily lead to better decisions (indeed, it can lead to worse decisions); however "more salient information" can indeed improve decisions. That's the main difference between prominent front-of-label warnings and nutrition facts found on the back.
"We can largely do this by shifting more of the costs for marginal care onto the patients. They will mostly make reasonable decisions on which things to keep."
Are you saying patients will make reasonable decisions on what to keep, or doctors will? If it's the former, I'm pretty skeptical of the validity of that assumption.
"Your periodic reminder that we went fast when we created the Covid vaccines, but could have gone much faster."
This same sentence should be applicable to the sections about mRNA and other personalized vaccines, except we didn't even go (that) fast. If we'd displayed a bit more urgency in that domain, I might still have a tongue and life expectancy of decades rather than months: https://jakeseliger.com/2024/04/12/moderna-mrna-4157-v90-news-for-head-and-neck-cancer-patients-like-me/
> Early results from a study show the GLP-1 drug liraglutide could reduce cravings in people with opioid use disorder by 40% compared with a placebo.
If we could find a drug that got rid of cravings for _all_ forms of distractions, I'd bet we could get a few years of 10% GDP growth here in the US without AGI. Just imagine all the hours wasted on TV shows, Instagram, TikTok, etc, being put into productive work. It's a shame that we're not spending at least 0.1% of GDP on trying to find such a drug (and, no, Adderall's not even close).
Commenting on the internet.
Covid was real…but the biggest factor for a population’s death rate that avoided the initial wave was % below poverty level. So America is old and unhealthy and the only state in which age can be identified as a factor is Utah which has an anomalously low median age. Poverty prematurely ages Americans via unhealthy habits and poverty means less access to health care and it also means less education and all of that is a deadly combination.
If Ozempic's use becomes widespread and people eat (say) 1-2% less in aggregate, how much do we collectively save in terms of water, farmland, laborer hours, and other agricultural inputs?
This seems yet another insufficiently-explored social benefit of the drug class.
On the margin, I expect people to cut the cheapest calories first. So not a large impact. All the resources you mention are only scarce because we use vast quantities on non-essential food items that are 10x less efficient than staple crops.