This is also an extremely rare vision problem. So absolute numbers are very tiny. The absolute numbers for diabetes, weight related problems, etc far dwarf this.

Right. On the whole I think these things are incredible.. looking to try myself after reading here in HN the other day about it working for all sorts of distractions. Just wanted to point out it's not all sunshine and rainbows which would certainly be suspicious.

Literally too much water or aspirin can kill you. Some people are allergic to avocados. Driving kills huge numbers of people daily. Everything is about risk/reward, and looking at the macro picture. And right now the comorbidities for obesity are terrible in huge absolute numbers… something that GLP-1’s can take down in significant magnitude. Unless we learn that the majority of users end up with something worse than obesity, they’re a huge win for public health.

A large drop in HbA1c does cause early worsening of diabetic retinopathy. Regardless of how it's achieved. So expect some noise in generalized data.

Personally, I went from mild background retinopathy to PDR and getting laser treatment in about 3 months. My ophthalmologist (who has an academic background) didn't really know if this diagnosis had the same "quality" of someone who "naturally" progresses to PDR, but some studies say it's transient.

A lot of the issues are hydration-related, and I wouldn’t be surprised if the eye ones are, too. Some water intake is from food, so if you eat less, you need to drink more. If you also tend to drink with food, and you’re eating less, you may drink less instead of the more that you need to be. Add in a generally dulled “I crave something” sense and you’ve got a recipe for not just going all day without eating, but also without drinking.

I’m not a doctor but iirc water consumed along with a meal is absorbed slower and therefore results in longer-lasting hydration - than just a bare glass of water on an empty stomach. Of course, eating might add more material that encourages dehydrating, so I don’t know if you’d get a net benefit from a bag of teriyaki beef jerky say.

It's a little suspicious... 68x risk with semaglutide, no significant risk with tirzepatide. Case-control studies that merely search these databases are only really useful for hypothesis generation.