- Swiss Re’s optimistic scenario estimates GLP-1 drugs could lead to a reduction in cumulative all-cause mortality in the US general population of 6.4% over the next 20 years
- For the UK, Swiss Re’s optimistic scenario forecasts a 5.1% cumulative reduction in all-cause mortality in the general population, over the same time horizon
- Achieving the full potential of GLP-1 drugs is strongly dependent on availability, adoption rates, lifestyle and nutritional changes
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A 4% drop would be 805.6 to 773.4. That might add a few years to life expectancy. A step in the right direction.
Age-Adjusted Death Rate
deaths per 100,000
805.6 United States
1083.6 Mississippi
585.8 Hawaii
All Races (includes Hispanic/Latino), Both Sexes, All Ages, 2019-2023
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Read an article the other day about people trying to get off GLP-1s. Within a year, most had regained 25-75% of their previous weight loss.
Too much unknowns to still be addressed. Primarily, did they ever change their diet and exercise habits or solely depend on the drug for weight loss. The other big unknown, which won’t be known for years/decades, what is the long term effect.
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Well that’s about the same effect size that I imagine happens when folk on restrictive diets plans decide to go back to regular eating habits. They usually gain weight back…..not infrequently more than they actually lost.
To the usual scary warning of unknown long term side effects….. we do have plenty of evidence of long term effects of continued overweight/obesity/T2D. Doesn’t strike me that those known problems are likely to be preferable to the results of weight management etc with GLP-1 receptor antagonists ….. which have actually been around for a couple of decades, now.
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Still, they’re off the drug and still maintain 25-75% of the loss. A decent result.
DB2
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This study was only for a year, so not enough time. I compare it to all the various gastric bypass surgeries of the past. Knew several people that had them and almost all of them eventually put all the weight back on eventually. Might have taken 2-5 years but they never bothered to change any other habits so doomed from the start.
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Maybe these medications should be studied for efficacy (in assisting withbehaviour change) earlier in the weight gain continuum….as in at the point of what’s disparagingly called “vanity pounds” as opposed to, well, whatever you want to call the opposite extreme. By the time someone has reached the poundage necessary to qualify for “legitimate” use/third party financial assistance, the habits of overeating have become well and truly ingrained by then…..not to mention the damage done by the accompanying metabolic dysfunction etc.
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Between 1980 and 2019, U.S. mortality dropped by 33% for ages 45 to 64, and by 25% for ages over 65. Mostly from drops in deaths from heart disease. Life expectancy at birth increased from 73.7 years in 1980, to 78.7 in 2010, to 78.8 in 2019. (The FDA approved the first U.S. statin (lovastatin) in 1987.)
| Cause 45 to 64 years | year 1980 | rate per 100k | Cause | year 2019 | rate per 100k | change | chgPct | ||
|---|---|---|---|---|---|---|---|---|---|
| All causes | 425,338 | 956 | All causes | 535,330 | 642 | -314 | -33% | ||
| Diseases of heart | 148,322 | 333 | Diseases of heart | 111,975 | 134 | -199 | -60% | ||
| Malignant neoplasms | 135,675 | 305 | Malignant neoplasms | 147,352 | 177 | -128 | -42% | ||
| Cerebrovascular diseases | 19,909 | 45 | Cerebrovascular diseases | 18,084 | 22 | -23 | -52% | ||
| Chronic liver disease and cirrhosis | 16,089 | 36 | Chronic liver disease and cirrhosis | 22,483 | 27 | -9 | -25% | ||
| Chronic obstructive pulmonary diseases | 11,514 | 26 | Chronic lower respiratory diseases | 22,335 | 27 | 1 | 4% | ||
| Suicide | 7,079 | 16 | Suicide | 16,250 | 19 | 4 | 23% | ||
| Diabetes mellitus | 7,977 | 18 | Diabetes mellitus | 21,856 | 26 | 8 | 46% | ||
| Unintentional injuries | 18,140 | 41 | Unintentional injuries | 48,251 | 58 | 17 | 42% | ||
| Pneumonia and influenza | 5,804 | 13 | Nephritis, nephrotic syndrome and nephrosis | 8,126 | 10 | ||||
| Homicide | 4,019 | 9 | Septicemia | 7,848 | 9 | ||||
| population | 44,511,000 | 83,400,000 |
========================
| Cause 65 years and over | year 1980 | rate per 100k | Cause | year 2019 | rate per 100k | change | chgPct | ||
|---|---|---|---|---|---|---|---|---|---|
| Diseases of heart | 595,406 | 2,330 | Diseases of heart | 531,583 | 983 | (1,348) | -58% | ||
| All causes | 1,341,848 | 5,252 | All causes | 2,117,332 | 3,914 | (1,338) | -25% | ||
| Cerebrovascular diseases | 146,417 | 573 | Cerebrovascular diseases | 129,193 | 239 | (334) | -58% | ||
| Malignant neoplasms | 258,389 | 1,011 | Malignant neoplasms | 435,462 | 805 | (206) | -20% | ||
| Pneumonia and influenza | 45,512 | 178 | Influenza and pneumonia | 40,399 | 75 | (103) | -58% | ||
| Unintentional injuries | 24,844 | 97 | Unintentional injuries | 60,527 | 112 | 15 | 15% | ||
| Diabetes mellitus | 25,216 | 99 | Diabetes mellitus | 62,397 | 115 | 17 | 17% | ||
| Nephritis, nephrotic syndrome and nephrosis | 12,968 | 51 | Nephritis, nephrotic syndrome and nephrosis | 42,230 | 78 | 27 | 54% | ||
| Chronic obstructive pulmonary diseases | 43,587 | 171 | Chronic lower respiratory diseases | 133,246 | 246 | 76 | 44% | ||
| Atherosclerosis | 28,081 | 110 | Alzheimer’s disease | 120,090 | 222 | 112 | |||
| Chronic liver disease and cirrhosis | 9,519 | 37 | Parkinson’s disease | 34,435 | 64 | 26 | |||
| population | 25,550,000 | 54,100,000 |
======================
data from https://www.cdc.gov/nchs/data/hus/2020-2021/LCODAge.pdf
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I checked my math with AI, and got a similar conclusion.
Question: How much have statins lowered the mortality rate in the U.S. for ages 65 and over? The FDA approved the first U.S. statin in 1987.
AI answer: "Statins have been associated with a significant reduction in all-cause mortality and cardiovascular mortality for individuals aged 65 and over, with studies showing relative risk reductions ranging from approximately 14% to over 50%, depending on the population studied and whether they were used for primary or secondary prevention. … A separate 2021 meta-analysis of observational studies found a 14% lower risk of all-cause mortality and a 20% lower risk of cardiovascular death in older people (ages ≥65) without prior cardiovascular disease.
At a population level in the U.S., the introduction and widespread use of statins since 1987 is estimated to have made a substantial contribution to increased life expectancy. One analysis suggests that through 2010, statins were responsible for:
74% of the total increase in life expectancy at age 70.
57% of the total increase in life expectancy at age 75.
Overall, due to medical advancements (including statins) and public health campaigns since 1970, the total heart disease death rate has decreased by 66%"
Re earlier intervention woth GLP-1 receptor agonists: this might well be an idea whose time has come. Back when I was recovering from my first lapiplasty……so end of 2021…..as part of my retail therapy I spent a few hundred bucks on a certification course aimed primarily at training post menopausal women. Obviously I didn’t need the CE credits but it was primarily for personal benefit. There was access to an online study group as part of the deal.
Well, at one point someone asked if anyone had experience with training clients who were on GLP-1 receptor agonists. Not so much experience with in evidence but a superabundance of opinions on how folk should be showing a bit more moral fiber (or whatever it is that divides the fat from the lean) One woman came along and announced that she wouldn’t even consider training anyone taking these drugs…..especially since her husband “needed” to be on them and couldn’t get insurance coverage.
I felt the need to point out the incongruity of accepting that her husband (presumably a fat bloke) was deserving, but that someone who was trying NOT to be in his position…..and at their own expense (meds AND personal training) come to that……should be discriminated against. I also opined that getting a handle on how to manage clients might be something worth undertaking because such folk are likely to be more common in the near future.
The folk offering this certification have just added coursework on…..training post menopausal clients who are GLP-1 receptor agonist users
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I read recently that people taking GLP-1 meds for obesity found that their uncontrollable, obsessive, constant thoughts about food declined.
https://www.apa.org/monitor/2025/07-08/weight-loss-drugs-mental-health
That would put the GLP-1 med in the category of a psychoactive drug (e.g. SSRIs for OCD) rather than one which adjusted a physical process such as glucose metabolism.
If the root cause of weight gain in a specific patient was intrusive, uncontrollable thoughts about food it would make sense to intervene as early in the process as possible. It wouldn’t make sense to delay mental health treatment for obesity any more than it would to delay treatment for depression until the patient was on the brink of suicide.
The federal government has passed a law mandating mental health treatment parity with physical health treatment. The mind-body link has not yet been fully absorbed by doctors but GLP-1 meds may be an example.
Wendy
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My PA & cardiologist got me started last June on Mounjaro, primarily to drop my A1C back to pre-diabetic levels, but also the weight loss, I’m down a fair amount, 40ish, but will likely go ahead and bump the dosage on my next Rv after the new Year, to keep it going.. Holidays are tough, pizza irritable, etc… But no side affects, soI’m also reading what I can find on the topic… And at Thanksgiving, it turned out my Son inlaw & his Dad are also on GLP-1’s, more recent so not as noticable yet, but surprisingly more common than I expected… Add in cutting carbs, salt, red meats, it all seems to be helping… I don’t see the food thoughts changing, but sugars, chocolate, still grab my eye… Will be interesting to see what the new year brings…
weco
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These meds are apparently well recognised for controlling a lot of compulsive behaviours….eating, drinking, smoking etc. In the year or so before my daughter and the albatross split up at the start of last year, she’d started to gain weight from stress eating and drinking for the first time ever. Nothing compulsive….a glass or two of wine at the end of a horrible day etc. Interestingly, a wonderfully “healthy” diet…..but for the amount and she just couldn’t seem to feel satisfied or even full. Her migraine was also almost uncontrollable and the medication she was taking was strongly associated with this lack of satiety (unknown to her)
As it happened, she was working seriously hard with a trainer…and I guess unknowingly building a lot of muscle concurrently. As the stress levels diminished, migraine improved and meds reduced etc, she managed a bit of weight loss….but still couldn’t shift what I guesstimated to be about 20 lbs of lard that’d taken up residence…..especially around her middle. Start of the summer, she asked my husband to prescribe Ozempic….but not to tell me. I was a bit miffed because yes, as she said, I am a bit judgemental but I also recognise that not everyone has my self discipline and, more importantly, I have a take on the pharmacology of these meds and can see the value in the pleiotropic effects.
Let me tell you.…..nothing short of miraculous
Within a few days of the lowest, introductory dose, she was no longer thinking about food (she hadn’t been aware of the degree of food noise she was experiencing) and, as she joyfully announced, she felt like her normal self….and could self regulate her eating. She wasn’t finding it hard to eat…..just easier to “diet”.
In all, she’s lost about 25-30lbs. From appearance, body composition analysis, and continuing strength gains I’d say it’s mostly fat. I’m just a bit disappointed we didn’t treat it like a proper “study” with, say, DEXA scan and lipid/metabolic panel etc prior to starting because I’m 99.999 % certain that she was probably headed down the path to metabolic syndrome etc.
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Additionally, her neurologist (migraine) and her gynecologist are super supportive and interested. GYN happened to mention that she has personally started to recommend that peri menopausal women who’ve experienced associated issues with weight management for the first time consider these meds. Not many takers as it would be on their own dollar so a person REALLY has to want it to do it right.
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The US population has been moving south and west for more than half a century. Since cold kills more people than heat, the movement to warmer climates has contributed to greater longevity. Deschenes and Moretti estimate that between 1970 and 2000, 4% to 7% of the total gains in life expectancy over that period were attributable to the mobility.
Extreme Weather Events, Mortality, and Migration
https://direct.mit.edu/rest/article-abstract/91/4/659/57810/Extreme-Weather-Events-Mortality-and-Migration
DB2
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No drugs I lost 50 pounds in 2021.
Since then a good estimate is 7 pounds of muscle gained and 10 pounds of fat.
My sugar has stayed around 90 while fasting.
The last 7 pound gain has to be 4 pounds of muscle in leg workouts. I am hoping my sugar has not risen.
I am finding emotional ways to lose weight again. The habits need to be met by how to manage strong feelings when approaching and leaving food.