Already my local newspaper has front page banner ads that say, "Have you taken Ozempic, Wegovy, Rybelsus, or Mounjaro and been hospitalized for gastroparesis, stomach paralysis, or gastric blockage?" That alone would scare me off! If the side effects are so bad that lawyers are already seeking litigants, it seems like things are bound to go south for the vanity weight-loss crowd.
Vanity?? 70% of Americans are too big-- and 60% are obese. MORBID OBESITY is our fastest growing category. Maybe some of those huge bodies should have had bariatric surgery where your stomach is reduced to s the size of a toddlers.
I'm sorry, I didn't mean to offend you. I have a friend who went on one of these drugs (obtained at a pop-up strip-mall clinic) to lose 20 lbs. That was what I meant by vanity. I know most Americans are overweight or obese but I don't think these drugs are necessarily the way to alter the landscape unless obesity/diabetes is more of a threat to one's life than gastroparesis, and I'm sure it sometimes is.
Why would I be offended other than I have spent 83 years looking at ugly bodies. In fact, Americans are so messed up because of their gluttony guilt -- one of the SEVEN deadly sins-- and their hatred of their appearance and their nonstop lying-- no dieting without lying-- so Trump is appealing. This issue is so much more than anyone knows. I have watched my entire life.
This is a very complex issue, for which, as with most complex issues, there is no silver bullet or single thing that fixes it. I do think these drugs have a place if they are dosed appropriately ( many problems may be attributed to a dose that is too high for the patient), and combined with an eating and movement/exercise/muscle building plan that is closely monitored by a trained professional. More drug is not better and there are no quick fixes, as we humans tend to fall prey to those ideas. Low doses and going slowly with increasing dose, and backing off the dose that creates side effects may be solutions for some.
I highly recommend readers check out Dr. Tyna Moore’s website and podcasts. She has a lot of very good information on these peptides as well as other topics. She is a fan of microdosing GLP-1s and using them as part of a comprehensive plan, not as a mono therapy.
My biggest concern is the cost of this drug (for someone’s lifetime, potentially) which ALL OF US will pay for as insurance companies just pass their costs on via increased premiums, coinsurance and copays…whether you use the drug or not. And let’s just consider what could be done with let’s say $1000/ month (which is what I hear these drugs cost…) to pay for high quality exercise programs, nutrition counseling and cooking education. But disease prevention isn’t what drives Wall Street or big pharma.
Odds are high that it will be more serious than that OR.
Move more eat less is the nonsensical solution to obesity.
I think obesity is high due to high consumption of polyunsaturated fats that have never been in our diet before. Seed oils lower metabolic rate and kill delicate beta cells, thymus, leydig cells and more. Processed foods are loaded with PUFA fats. All chicken and pork is loaded with it.
Drugs will always end up failing and there will be billions in settlements years from now when the managerial class has long since moved on to a different drug.
I would have mentioned added sugar as well. It's pretty incontrovertible that a diet with a high glycemic load will promote diabetes, CVD, and obesity. And the rate of added sugar and highly processed high glycemic carbs in our diets has vastly increased in the last 100 years or so. Our government even subsidize corn which makes corn syrup artificially cheap.
Actually it’s not that clear. Not at all. Sugar consumption has been declining on a per capita basis. It is far lower than it has been for many many years. At the same time, PUFA consumption has skyrocketed.
Sugar consumpsion does not correlate with type 2 diabetes either. Everyone believes a lot of nonsense about sugar and obesity. It is all wrong.
RESULTS—Compared with the lowest quintile of sugar intake, the RRs and 95% CIs for the highest quintiles were 0.84 (0.67–1.04) for sucrose, 0.96 (0.78–1.19) for fructose, 1.04 (0.85–1.28) for glucose, and 0.99 (0.80–1.22) for lactose, after adjustment for known risk factors for type 2 diabetes. Similar findings of no association were obtained in subgroup analyses stratified by BMI.
CONCLUSIONS—Intake of sugars does not appear to play a deleterious role in primary prevention of type 2 diabetes. These prospective data support the recent American Diabetes Association’s guideline that a moderate amount of sugar can be incorporated in a healthy diet.
Note however that your graph for PUFAs goes back to 1900 while your graph for sugar goes back only to 1961 (it's also not clear what "sugar" means there - is it just the industrial product that is a granular solid you purchase in bags, or does it include the other newer refined products like HFCS that are usually only present as additives in other foods?). For what it's worth the post-1961 drop is only modest on a percent basis.
I think if you look back further you will see trends for both. I agree BTW that PUFAs are a problem and personally I try to avoid them.
Obesity is the result of over consumption. People own 20 pairs of sneakers and they are sneaker "obese" but the only drawback is credit card debt unless they are rich. Our entire economy is built on overconsumption of cheap goods. We can't get quality food while we produce twice the amount we need. Cant' make 100,000 good dresses or millions of good peaches. Just bit into one I bought at Whole Foods and it is tasteless. YET all the pols talk about inflation and "the American family can't put food on the table"-- but we don't need too much food since we have overeaten for decades. WE have eaten future meals. 70% of the population is too big and since we NEVER connect the dots, we cannot admit that Expensive food in small quantities is better for us and won't hurt the economy. Most Americans have no idea why we fattened up.
Because of the pretty wellness word, most don't even know they are fat. 35 inch waistline is obese. Ozempic is our only solution to this current issue even if it has issues in the future. NO ONE needs to stay on the drug forever. They just need 80 BITES
This is entirely incorrect. Obese people do not necessarily over consume and in fact, when they cut calories, they do not lose body fat because their bodies are adapted to a very low metabolic rate and low calorie drops their metabolic rate even further.
The true reason is probably due to high PUFA fats int the diet. Of course, medicine is only willing to indict omega 6 fatty acids. Omega 3 are supposedly benevolent, and ratios are supposedly everything.
I hate to cite review articles and meta studies, but this is a highly charged political topic and difficult to find well structured studies.
Prospective studies clearly show an increase in the risk of obesity as the level of omega-6 fatty acids and the omega-6/omega-3 ratio increase in red blood cell (RBC)
Maximal weight loss observed in low-calorie diet (LCD) studies tends to be small, and the mechanisms leading to this low treatment efficacy have not been clarified. Less-than-expected weight loss with LCDs can arise from an increase in fractional energy absorption (FEA), adaptations in energy expenditure, or incomplete patient diet adherence.
Don't forget that dietary fat has been an evil word for the last couple of decades. Which is why sugar is added to everything to make it taste good. So you combined highly processed, sugar laden diets, with low-quality foods, and it's a recipe for disaster.
Joan's right about this " Expensive food in small quantities is better for us." One avocado would be a better meal than 2 Big macs.
Why don't you think about the ONE BILLION who are actually starving and another billion who need food. STOP PLAYING WITH FOOD. If you had taste, you would understand that reducing QUANTITY doesn't mean reducing calories. Think about your beloved avocado. YOU FOOD NUTS HAVE LOST. Everyone will eat less of everything which is the sophisticated way to eat before people became gluttons thinking they could get away with it if they ate the"right " foods. Diets and exercise made people FAT. Before that they were slim and some just chubby. YOU have no idea why we got fat.
I found the statement "The solution is a magic pill" (may not be verbatim) to be laughable. EVERYONE knows why Americans are so obese. Don't we? Come on... Don't we? Have you dined out in the last 30 years? Have you looked at the process food being sold? The mega caloric fast foods? The ENDLESS aisles of chocolates, chips, cookies?
Do you know what they DON'T do in Korea? In Japan, In Vietnam's of the world? They don't serve an ungodly amount of food as a plate for one. Nor do they expect to eat it all. Most people eat a well balanced food cooked by moms who don't use artificial everything and serve titanosaur portions.
We've stopped talking about obesity as a problem. Body positivity movement went off the deep end - Marinas Trench level deep end - and told people "it's not your fault you shove 18 hotdogs down your throat" It's not fat shaming. It's the opposite. It's fat glorification that got us here. Take a look at any photo from the 50's. Nary a fat person in the picture. The eating habits, what we eat, when we eat, how we cook and what people cook at home has been hijacked. We go from Sugar, to fat, to poly saturated fat, the salt to FILL=in-the-boogieman as escape goats.
But hey, I"m sure the Ozempics of the world are "safe and effective..." Huh. Where have I heard that before?
The post is spot on. Imagine if we had this platform (and Vinay was a doctor!) in the 90’s when the opioid epidemic was starting. OxyContin was going to save the chronic pain sufferers - a miracle drug! We see what happened there. Any time I hear “miracle drug” I get that sinking feeling. Any condition that can be managed with proper diet and exercise should be managed no other way.
There are "miracle drugs" which produce miracle profits, but not too many drugs which produce miracle therapeutic benefits . . . Okay Antibiotics, Insulin, Advil, Latonoprost--not too many others.
There are many people smarter than I am that can answer that. I think in my own field of pain and addiction with regard to opioids that there were/are many good ones that in the wrong hands and off label that became vilified. The drugs themselves are not bad; the way pharma and well paid experts said to use them are. But I’ll let smarter folks add to that pile. Not dodging you, just telling you that I’m pretty limited on personal knowledge.
“ There is some chance that as time goes on some adverse effect of ozempic will be discovered. This can happen when a drug is administered to young people for years on end even if not known at product launch.” Dr., why didn’t the so called experts take this point into consideration with the CV-19 vax? Why couldn’t they seem to understand that people would be hesitant to take a new drug that had not been thoroughly tested for years, especially for young people?!
Could not agree more. This is an expensive new poop on the wall solution in medicine that is not any different than Pheterimine or any of the other diet pills that have been used over the years. In the long run it still comes down to what we put into our bodies and how we treat the amazing vessel that makes us who we are. For DM, it is a good adjunct to treatment at this time but as to weight loss the actual benefit remains to be seen.
This is the classic "something for nothing" silver bullet solution we Americans love. We are hard wired to find the most efficient solution, but it haunts us so often. It is so rare that we get the magic bullet solution, everything really is a trade off and Ozempic seems to have big ones: stomach paralysis, equal loss of fat and muscle, and hospitalization (YIKES to all!). I think your team will confirm that this is not the solution many hope and will make many trial attorneys rich e.g. Fen-Phen.
I have the impression that a fairly high percentage of people who used these drugs were successful in reducing their weight. I also have the impression that a nontrivial percentage of them gained back the weight they had lost after stopping the drugs - so the a person using the drug to manage his/her weight should expect to be on the drug indefinitely.
Are there any studies comparing the health outcomes of longer duration use to simply remaining overweight? I'm not exactly sure how long these drugs have been in use, so there may not yet be any good studies of "long duration" use. Obviously it is better to drop weight by diet and exercise if possible, but I guess the question remains as to which is more dangerous (excess pounds or long duration use of these drugs).
This so what the realist in me says as well. Starving oneself was never an effective, long term weight loss plan. I was speaking with a friend yesterday about his wife in ozempic who told me her food choices have bit improved but she has lost 40 pounds.
She isn’t hungry often, but when she does eat, she tends to reach for junk food. So she is malnourished and losing weight. This should turn out well.
Let’s keep in mind that the mechanism of action is not fully understood and that many reports suggest it’s essentially an anti-craving drug. People that lose weight report not craving food as do people that drink too much alcohol, and even compulsive gamblers! The societal question is what makes our society crave stuff, not just food.
Please invite addiction medicine specialist like Dr. Judson Brewer to Sensible Medicine. I don’t choose to be fat. I’m a fucking addict. Ozempic could be one of the tools that I could add to the nine tools given to me by Overeaters Anonymous. everybody loses weight on a hunger strike. If it was only about knowledge, we wouldn’t have people continue smoking after their lung cancer diagnosis. Continue to drink after their skin becomes jaundiced. Continue to gamble after they’ve lost their families money. Continue obsessive/anxious thoughtsv despite the fact that they’re not able to function without drugs. Long-term freedom from any addiction is possible there are hundreds of 12 step programs. This is one of the most incredible things that the United States has produced. Thank you, Bill Wilson.
Already my local newspaper has front page banner ads that say, "Have you taken Ozempic, Wegovy, Rybelsus, or Mounjaro and been hospitalized for gastroparesis, stomach paralysis, or gastric blockage?" That alone would scare me off! If the side effects are so bad that lawyers are already seeking litigants, it seems like things are bound to go south for the vanity weight-loss crowd.
Vanity?? 70% of Americans are too big-- and 60% are obese. MORBID OBESITY is our fastest growing category. Maybe some of those huge bodies should have had bariatric surgery where your stomach is reduced to s the size of a toddlers.
I'm sorry, I didn't mean to offend you. I have a friend who went on one of these drugs (obtained at a pop-up strip-mall clinic) to lose 20 lbs. That was what I meant by vanity. I know most Americans are overweight or obese but I don't think these drugs are necessarily the way to alter the landscape unless obesity/diabetes is more of a threat to one's life than gastroparesis, and I'm sure it sometimes is.
Why would I be offended other than I have spent 83 years looking at ugly bodies. In fact, Americans are so messed up because of their gluttony guilt -- one of the SEVEN deadly sins-- and their hatred of their appearance and their nonstop lying-- no dieting without lying-- so Trump is appealing. This issue is so much more than anyone knows. I have watched my entire life.
This is a very complex issue, for which, as with most complex issues, there is no silver bullet or single thing that fixes it. I do think these drugs have a place if they are dosed appropriately ( many problems may be attributed to a dose that is too high for the patient), and combined with an eating and movement/exercise/muscle building plan that is closely monitored by a trained professional. More drug is not better and there are no quick fixes, as we humans tend to fall prey to those ideas. Low doses and going slowly with increasing dose, and backing off the dose that creates side effects may be solutions for some.
I highly recommend readers check out Dr. Tyna Moore’s website and podcasts. She has a lot of very good information on these peptides as well as other topics. She is a fan of microdosing GLP-1s and using them as part of a comprehensive plan, not as a mono therapy.
My biggest concern is the cost of this drug (for someone’s lifetime, potentially) which ALL OF US will pay for as insurance companies just pass their costs on via increased premiums, coinsurance and copays…whether you use the drug or not. And let’s just consider what could be done with let’s say $1000/ month (which is what I hear these drugs cost…) to pay for high quality exercise programs, nutrition counseling and cooking education. But disease prevention isn’t what drives Wall Street or big pharma.
Carrying excess pounds is associated with a lot of expensive health conditions.
Depending on how much the drugs cost, it could actually reduce health care costs.
Odds are high that it will be more serious than that OR.
Move more eat less is the nonsensical solution to obesity.
I think obesity is high due to high consumption of polyunsaturated fats that have never been in our diet before. Seed oils lower metabolic rate and kill delicate beta cells, thymus, leydig cells and more. Processed foods are loaded with PUFA fats. All chicken and pork is loaded with it.
Drugs will always end up failing and there will be billions in settlements years from now when the managerial class has long since moved on to a different drug.
I would have mentioned added sugar as well. It's pretty incontrovertible that a diet with a high glycemic load will promote diabetes, CVD, and obesity. And the rate of added sugar and highly processed high glycemic carbs in our diets has vastly increased in the last 100 years or so. Our government even subsidize corn which makes corn syrup artificially cheap.
Actually it’s not that clear. Not at all. Sugar consumption has been declining on a per capita basis. It is far lower than it has been for many many years. At the same time, PUFA consumption has skyrocketed.
Sugar consumpsion does not correlate with type 2 diabetes either. Everyone believes a lot of nonsense about sugar and obesity. It is all wrong.
https://diabetesjournals.org/care/article/26/4/1008/23749/A-Prospective-Study-of-Sugar-Intake-and-Risk-of
RESULTS—Compared with the lowest quintile of sugar intake, the RRs and 95% CIs for the highest quintiles were 0.84 (0.67–1.04) for sucrose, 0.96 (0.78–1.19) for fructose, 1.04 (0.85–1.28) for glucose, and 0.99 (0.80–1.22) for lactose, after adjustment for known risk factors for type 2 diabetes. Similar findings of no association were obtained in subgroup analyses stratified by BMI.
CONCLUSIONS—Intake of sugars does not appear to play a deleterious role in primary prevention of type 2 diabetes. These prospective data support the recent American Diabetes Association’s guideline that a moderate amount of sugar can be incorporated in a healthy diet.
https://www.helgilibrary.com/indicators/sugar-consumption-per-capita/usa/
https://www.dailymedicaldiscoveries.com/wp-content/uploads/PUFA-Consumption-610x463.png
Interesting. Thanks for the info.
Note however that your graph for PUFAs goes back to 1900 while your graph for sugar goes back only to 1961 (it's also not clear what "sugar" means there - is it just the industrial product that is a granular solid you purchase in bags, or does it include the other newer refined products like HFCS that are usually only present as additives in other foods?). For what it's worth the post-1961 drop is only modest on a percent basis.
I think if you look back further you will see trends for both. I agree BTW that PUFAs are a problem and personally I try to avoid them.
Here's a graph with more historical context:
https://www.cureamd.org/wp-content/uploads/2018/10/U.S.-Sugar-Consumption-Historically.jpg
Also, what do you make of studies that indicate reversal of type 2 diabetes with carbohydrate restricted diets? These are interventional studies, not merely observational. For example here's a summary of a recent one: https://www.medicalnewstoday.com/articles/low-carb-diet-reverses-type-2-diabetes-in-51-of-participants-to-new-study
Obesity is the result of over consumption. People own 20 pairs of sneakers and they are sneaker "obese" but the only drawback is credit card debt unless they are rich. Our entire economy is built on overconsumption of cheap goods. We can't get quality food while we produce twice the amount we need. Cant' make 100,000 good dresses or millions of good peaches. Just bit into one I bought at Whole Foods and it is tasteless. YET all the pols talk about inflation and "the American family can't put food on the table"-- but we don't need too much food since we have overeaten for decades. WE have eaten future meals. 70% of the population is too big and since we NEVER connect the dots, we cannot admit that Expensive food in small quantities is better for us and won't hurt the economy. Most Americans have no idea why we fattened up.
Because of the pretty wellness word, most don't even know they are fat. 35 inch waistline is obese. Ozempic is our only solution to this current issue even if it has issues in the future. NO ONE needs to stay on the drug forever. They just need 80 BITES
This is entirely incorrect. Obese people do not necessarily over consume and in fact, when they cut calories, they do not lose body fat because their bodies are adapted to a very low metabolic rate and low calorie drops their metabolic rate even further.
The true reason is probably due to high PUFA fats int the diet. Of course, medicine is only willing to indict omega 6 fatty acids. Omega 3 are supposedly benevolent, and ratios are supposedly everything.
I hate to cite review articles and meta studies, but this is a highly charged political topic and difficult to find well structured studies.
https://www.mdpi.com/2072-6643/8/3/128
Prospective studies clearly show an increase in the risk of obesity as the level of omega-6 fatty acids and the omega-6/omega-3 ratio increase in red blood cell (RBC)
https://www.sciencedirect.com/science/article/pii/S0002916523279186
Maximal weight loss observed in low-calorie diet (LCD) studies tends to be small, and the mechanisms leading to this low treatment efficacy have not been clarified. Less-than-expected weight loss with LCDs can arise from an increase in fractional energy absorption (FEA), adaptations in energy expenditure, or incomplete patient diet adherence.
Don't forget that dietary fat has been an evil word for the last couple of decades. Which is why sugar is added to everything to make it taste good. So you combined highly processed, sugar laden diets, with low-quality foods, and it's a recipe for disaster.
Joan's right about this " Expensive food in small quantities is better for us." One avocado would be a better meal than 2 Big macs.
Why don't you think about the ONE BILLION who are actually starving and another billion who need food. STOP PLAYING WITH FOOD. If you had taste, you would understand that reducing QUANTITY doesn't mean reducing calories. Think about your beloved avocado. YOU FOOD NUTS HAVE LOST. Everyone will eat less of everything which is the sophisticated way to eat before people became gluttons thinking they could get away with it if they ate the"right " foods. Diets and exercise made people FAT. Before that they were slim and some just chubby. YOU have no idea why we got fat.
I found the statement "The solution is a magic pill" (may not be verbatim) to be laughable. EVERYONE knows why Americans are so obese. Don't we? Come on... Don't we? Have you dined out in the last 30 years? Have you looked at the process food being sold? The mega caloric fast foods? The ENDLESS aisles of chocolates, chips, cookies?
Do you know what they DON'T do in Korea? In Japan, In Vietnam's of the world? They don't serve an ungodly amount of food as a plate for one. Nor do they expect to eat it all. Most people eat a well balanced food cooked by moms who don't use artificial everything and serve titanosaur portions.
We've stopped talking about obesity as a problem. Body positivity movement went off the deep end - Marinas Trench level deep end - and told people "it's not your fault you shove 18 hotdogs down your throat" It's not fat shaming. It's the opposite. It's fat glorification that got us here. Take a look at any photo from the 50's. Nary a fat person in the picture. The eating habits, what we eat, when we eat, how we cook and what people cook at home has been hijacked. We go from Sugar, to fat, to poly saturated fat, the salt to FILL=in-the-boogieman as escape goats.
But hey, I"m sure the Ozempics of the world are "safe and effective..." Huh. Where have I heard that before?
The post is spot on. Imagine if we had this platform (and Vinay was a doctor!) in the 90’s when the opioid epidemic was starting. OxyContin was going to save the chronic pain sufferers - a miracle drug! We see what happened there. Any time I hear “miracle drug” I get that sinking feeling. Any condition that can be managed with proper diet and exercise should be managed no other way.
There are "miracle drugs" which produce miracle profits, but not too many drugs which produce miracle therapeutic benefits . . . Okay Antibiotics, Insulin, Advil, Latonoprost--not too many others.
And I will add that - many ARE great drugs when used short term as intended
Can you list those great drugs for us? I'm not being sarcastic--I'm compiling a list.
There are many people smarter than I am that can answer that. I think in my own field of pain and addiction with regard to opioids that there were/are many good ones that in the wrong hands and off label that became vilified. The drugs themselves are not bad; the way pharma and well paid experts said to use them are. But I’ll let smarter folks add to that pile. Not dodging you, just telling you that I’m pretty limited on personal knowledge.
“ There is some chance that as time goes on some adverse effect of ozempic will be discovered. This can happen when a drug is administered to young people for years on end even if not known at product launch.” Dr., why didn’t the so called experts take this point into consideration with the CV-19 vax? Why couldn’t they seem to understand that people would be hesitant to take a new drug that had not been thoroughly tested for years, especially for young people?!
We should be discovering why so many people have developed obesity in the last 40 years and fix that instead of enriching pharmaceutical companies.
Could not agree more. This is an expensive new poop on the wall solution in medicine that is not any different than Pheterimine or any of the other diet pills that have been used over the years. In the long run it still comes down to what we put into our bodies and how we treat the amazing vessel that makes us who we are. For DM, it is a good adjunct to treatment at this time but as to weight loss the actual benefit remains to be seen.
This is the classic "something for nothing" silver bullet solution we Americans love. We are hard wired to find the most efficient solution, but it haunts us so often. It is so rare that we get the magic bullet solution, everything really is a trade off and Ozempic seems to have big ones: stomach paralysis, equal loss of fat and muscle, and hospitalization (YIKES to all!). I think your team will confirm that this is not the solution many hope and will make many trial attorneys rich e.g. Fen-Phen.
A sugar tax based on content like a carbon tax to offset the health care costs .
I have the impression that a fairly high percentage of people who used these drugs were successful in reducing their weight. I also have the impression that a nontrivial percentage of them gained back the weight they had lost after stopping the drugs - so the a person using the drug to manage his/her weight should expect to be on the drug indefinitely.
Are there any studies comparing the health outcomes of longer duration use to simply remaining overweight? I'm not exactly sure how long these drugs have been in use, so there may not yet be any good studies of "long duration" use. Obviously it is better to drop weight by diet and exercise if possible, but I guess the question remains as to which is more dangerous (excess pounds or long duration use of these drugs).
Studies? Laughable. Who has time for studies when there are billions to be made right now?
This so what the realist in me says as well. Starving oneself was never an effective, long term weight loss plan. I was speaking with a friend yesterday about his wife in ozempic who told me her food choices have bit improved but she has lost 40 pounds.
She isn’t hungry often, but when she does eat, she tends to reach for junk food. So she is malnourished and losing weight. This should turn out well.
Yep, weight loss on these drugs is mostly lean tissue (muscle) not adipose.
Let’s keep in mind that the mechanism of action is not fully understood and that many reports suggest it’s essentially an anti-craving drug. People that lose weight report not craving food as do people that drink too much alcohol, and even compulsive gamblers! The societal question is what makes our society crave stuff, not just food.
Please invite addiction medicine specialist like Dr. Judson Brewer to Sensible Medicine. I don’t choose to be fat. I’m a fucking addict. Ozempic could be one of the tools that I could add to the nine tools given to me by Overeaters Anonymous. everybody loses weight on a hunger strike. If it was only about knowledge, we wouldn’t have people continue smoking after their lung cancer diagnosis. Continue to drink after their skin becomes jaundiced. Continue to gamble after they’ve lost their families money. Continue obsessive/anxious thoughtsv despite the fact that they’re not able to function without drugs. Long-term freedom from any addiction is possible there are hundreds of 12 step programs. This is one of the most incredible things that the United States has produced. Thank you, Bill Wilson.