For a lot of people in my life, the main reason they aren't using these things is that you can't buy them at Target. Seriously I have no idea what you mean by "sourced the correct way", it seems like you have to do some kind of complicated grey market backdoor stuff to get these things or sift through sketchy websites that may or may not ship you what you think you're buying. Most people in the US are used to having a certain kind of institutional background approval for what they put in their bodies that the kind of thing you're talking about just doesn't have.

Related, many of these are controlled substances.

I am skinny and conscientious.

I hear that the real benefits come from double jaw surgery, limb lengthening surgery, testosterone for gains, and meth for leanness.

I don't understand why everyone doesn't do all of the above, to get ahead.

Not everyone wants to lose weight. Not everyone wants to maximise productivity. Even people who do have those goals might prefer to do so by cultivating personal discipline or as part of a socialisation activity etc.

I’m glad the drugs are working for you but there’s a lot of assumptions baked into your question.

Side effects. You appear to be fortunate in not having them. Stimulants: many people can’t tolerate strong stimulants, and even the ones who can take them for a bit often experience anxiety and insomnia that are eventually bad enough to make them stop. GLP-1s: people experience gastrointestinal side effects (serious diarrhea or constipation, nausea, vomiting), low blood sugar episodes, and there’s several kinds of long-term organ damage risks. These risks may be worth it if you really need the med for health reasons, but make it not worth it in an otherwise healthy adult who doesn’t especially need it.

The reason I don't take certain kinds of stimulants is it feels like they reduce creativity, but I don't know if this applies to glp1 meds

If sourced in a correct way? Where do you live?

I felt sick as hell on GLP-1s. I would have loved the help but it just wasn't worth feeling nauseous every day to lose a few pounds.

Methylphenidate is Ritalin which is known to boost performance like Adderall at some cost of addiction and a large cost of needing to be able to source it.

How's the tradeoff between that and modafinal?

As for bio hacking in general you might ask why :

People don't take a stack of metformin, sirolimus, a stimulant, a GLP-1 (they seem to reduce biomarkers for aging), and whatever random shit Bryan Johnson sells.

The answer is :

A.  Cost and hassle

B.  Each of the things I mentioned there are lots of papers showing they all have incredible effects....in rats, or in less than gold standard trials, or other causes for doubt.  Bryan Johnson's shit may not work at all and his great biomarkers may be from his exercise and sleep routine and hyperbaric chamber usage. (Or the biomarkers may not measure the right things)

C.  In addition each has a risk.  Metformin may cause dementia.  Sirolimus may cause cancer or prevent it more than it causes it.  Stimulants have heavy addiction risk and tolerance buildup.  GLP-1s may cause thyroid cancer.  

So that's why.  Can you get ahead of doing nothing but exercise and sleep?  

Expected value wise, I think so.  Doing the above puts you ahead average case I suspect even with incomplete evidence.  But if you're unlucky you die of one of the rare negative effects.

...to be honest I just swallowed a handful of pills that has everything above and I injected tirzapide Monday.  I am gambling on the EV.

What happens when you come off?

I don’t take any drug on a regular schedule, even coffee, because I don’t want to shift my baseline functioning. If I had a health condition that required a medication, sure I’d take it, but as is I’m healthy and doing well in life (thankfully) so I don’t want to risk becoming reliant on anything.

I don’t know anything about GLP-1s/ozempic really, so if they cause no dependency at all and you can come off them and feel just the same as before, that’s great. I’d consider taking them then. However, I doubt that that’s the case.

Edit: also I’m not interested in losing weight. In fact I want to gain weight … I went down a rabbit hole before and unfortunately there’s not really anything you can take for that 

why isn't everyone taking random drugs? really? how is that even a serious question.

I think most people are not aware that GLP-1s can be attained, "amazingly cheap if sourced the correct way." Many people are not even aware of compounding pharmacies which are much cheaper, but still not amazingly cheap. Even fewer people are aware of the option of purchasing from research compounding laboratories, and a good number of those who are are uncomfortable with trusting themselves to properly dose and administer a product meant for use by professional researchers, not the average joe. And if your sourcing is even cheaper than that, I also don't know how you're getting it.

Side effects, tolerance, and/or not needing them.

I'm a healthy weight, so why would I take a GLP-1?

I have taken all the stimulants for narcolepsy, but I always develop a tolerance to daily use to where the active benefit is gone. Literally gone--I was taking the epworth sleepiness scale and after two years of adderall use and multiple dose increases, my scores started getting WORSE than my unmedicated baseline. So all I had was side effects (anxiety, gut issues) and no benefit.

I think people vastly underestimate how many people will develop a tolerance to Adderall. It's really easy to slide slowly back to your baseline without even realizing it, and to think that withdrawal effects when quitting are evidence that the medicine is still "working," when really you're now in a position where you need the drug to maintain what used to be your unmedicated baseline.

I'm not fat, and I don't actually want to be productive. I do my job for the paycheck, how much actual work I get done and how useful it is my employer's problem, not mine. I don't see any reason to take drugs in order to make someone else more money.

I haven't dug into it much, but most GLP-1 agonist medications are contraindicated for those with a family history of thyroid cancer. On the surface, that means they're not for me. I need to look into all of the different versions to see if any are safe for me. I also need to verify which thyroid cancer was in the family; maybe it wasn't the kind that is a problem with GLP-1s.

For me, methylphenidate gives me around four hours of useful effect, then two to four hours of crash, and then another two to four hours before it stops interfering with my sleep. The crash and sleep issues were never quite worth it. And, you know, the hassles of dealing with a prescription for a controlled substance.

I'm already healthy and conscientious, I'm not interested in unpleasant side-effects for high cost and little to gain.

Glp-1s out of pocket are expensive right? And many people would like them but aren’t overweight enough for insurance to cover it? Or is there a workaround?

Tirzepatide took 48 hours to produce in me a) raging insomnia, b) diarrhea every 15 minutes or so, and c) horrible heartburn. Oh—and I didn’t have much of an appetite, but that could have been a byproduct of a), b) and c). I gave it two weeks and then waved the white flag. Everyone’s mileage varies, clearly.

are any of the things in your post over the counter and cheap? if not your question is kind of dumb

The short answer, for me, is that for a lot of people, these medications are not neutral tools with only an upside once you step outside of populations they were actually studied for.

From the pancreas community side, which is where my opinion generates, GLP-1 agonists (including tirzepatide) are one of the most common medication-associated triggers we see for new-onset acute pancreatitis and for progression to chronic disease. That isn’t theoretical or rare in patient spaces. Many of us can point to a very clear “before GLP-1 / after GLP-1” line in our medical history, and for some people the damage didn’t reverse when the drug was stopped.

Clinical trials excluded people with pancreatic risk factors, prior GI disease, gallbladder issues, or early/subclinical pancreatic dysfunction. Post-marketing surveillance is where these complications show up and it’s largely patient reports that are driving the concern. That’s why regulatory agencies and manufacturers still list a history of pancreatitis as a contraindication or strong precaution, even if individual prescribers are increasingly dismissive of that risk.

The “anti-inflammatory” effect you’re describing is also complicated. Appetite suppression, reduced caloric intake, and weight loss can feel anti-inflammatory systemically, but in some patients GLP-1s slow gastric emptying, alter bile flow, and increase pancreatic enzyme stimulation in ways that actually increase pancreatic stress. People don’t experience that until they do and when it happens, it can be severe.

As for “why isn’t everyone taking them,” a big reason is that a lot of people are balancing tradeoffs that aren’t visible from the outside. Losing weight faster or improving executive function is meaningful, but not if the cost is permanent GI injury, chronic pain, enzyme dependence, diabetes, or repeated hospitalizations. Once you’ve watched people go from healthy to disabled over the course of a year because of a medication that was supposed to be benign, the risk calculation looks very different.

None of that negates that these meds can be useful for some people, or that your experience has been positive. It just explains why broad “why not everyone?” framing doesn’t land well in patient communities that are dealing with the long tail of adverse outcomes. The benefits are real — so are the harms — and the latter are disproportionately carried by people who were never the target population in the first place.

That’s the part that tends to get lost when these discussions stay theoretical instead of patient-centered.

Family Guy, of all things, shows some of the side effects of ADHD meds surprisingly accurately.

Glp-1 meds can fuck you up

The reason I don't take this stuff is mainly because I'd need to get the doctor to approve it. My BMI is 26. So just in the overweight category. I'd like to nudge that down but I've found that hard what with the not snacking and all. Like I do quite a bit of exercise but I like to eat as well. I don't think I'll be able to get a doctor in Australia to OK me for a script at BMI 26.

I did look into an online site (mosh) that would do an "online consultation". They quoted $400 a month which is a lot. So there is the money side as well. If I was obese it would be worth it but I'm just a little over.

The main issue for me is getting legit access to the stuff.

I want to lose weight but don't think GLP-1s are the answer because you have to come off them at some point, and it seems that everyone just regains the weight. So I don't believe they're a sustainable solution.

Cost, side-effects, tolerance, variable effects - all 4 factors (especially the last 3) are HIGHLY individual, unpredictable and variable. You are still in a stimulant honeymoon

I'm assuming that any weight loss I might experience would be reversed by going off the drug, so I'd be committing to staying on it for the foreseeable future. That's not something I'd do lightly. I'm about 15lbs over my ideal weight (currently at 205lbs at 6'3''. I'd be happy with 190lbs) and I think that the willpower to lose weight is also attainable and the willpower to make positive life changes is good.

OTOH, I have mild psoriatic arthritis and it seems like that would benefit. The combination of "helps you lose weight" and "helps with arthritis" is attractive...

I have no intention of buying from the black market or grey market. I don't trust the source enough (not that big pharma is a bastion of safety, but if I'm ordering a drug I'd like a high level of confidence that it doesn't contain lead).

Someone told me long ago that "there is no biological free lunch". The price might be low and worth it, but nothing is for free. I don't need GLP-1 to manage my weight and my conscientiousness is fine to the point where I don't want to inject something for some "maybe" results.

It doesn't work the same way for everyone. I tried Concerta, Adderall, and Vyvanse at different times (partially because of the shortage in 2023) and none of them drastically increased my attention, but did spike my heart rate and reduced my ability to consume coffee which was a bummer for me.

It works really well for my brother but the side effects messed him up more as well, so he has not taken them since college.

To me: dependence and unknown long-term side effects.

I'm exactly the same weight I've been since 18 and am not overweight.

I've weaned off stimulants after deciding they weren't really working to make me more productive. My job changed from a series of discrete tasks that could be planned on then executed, to more interpersonal interaction. Stimulants harm your social skills IMO.

Sometimes stimulants cause people to diligently do dumb things; the effect can be very dramatic in drug abusers using extremely high doses of stimulants, but therapeutic doses don't seem entirely without problems:

This effect has turned up in a number of studies over the years, but there are two relatively recent ones that illustrate it well. One was published in 2023 by Elizabeth Bowman, an Australian neuroscientist, and David Coghill, a British psychiatrist. They recruited 40 young adults in Australia, gave some of them stimulant A.D.H.D. medications and others a placebo and then asked them to solve a series of complex tests called knapsack-optimization problems. Knapsack problems are well-known puzzles in economics and computer science. You’re given a virtual backpack and a series of items of different weights and prices, and you need to figure out the assortment of items that will maximize the dollar value of your load. 

The subjects who were given stimulants worked more quickly and intensely than the ones who took the placebo. They dutifully packed and repacked their virtual backpacks, pulling items in and out, trying various combinations. In the end, though, their scores on the knapsack test were no better than the placebo group. The reason? Their strategies for choosing items became significantly worse under the medication. Their choices didn’t make much sense — they just kept pulling random items in and out of the backpack. To an observer, they appeared to be focused, well behaved, on task. But in fact, they weren’t accomplishing anything of much value.

Source.

Cost. Gatekeeping.

What do you mean you get a false sense of productivity from Vyvanse? can you explain further

Tangentially related but I find it interesting how different the quality of many medicine-related discussions are had on this sub as opposed to on “mainstream” subs like r/biohackers or r/nootropics. This sub sometimes functions as a refuge for half-informed, open-minded thought on topics that have become too mainstreamed on their dedicated subs.

Personally because I have a low IQ rule that I don't like to take drugs unless I absolutely need to.

If I want a productivity boost, I use caffeine. It's extremely effective for me. I just don't do it every day so that I don't build tolerance. If I want to lose weight, I stop eating ice cream. I just lost 4 pounds in 2 weeks by eating no ice cream.

Why do you think I would benefit from these meds?

But also, this is the first I've heard about the consciousness medication you take. So, maybe people just don't know about it?

Im into second month of tirzapeptide and it seems almost like magic. I can eat at a large calorie deficit and am just not hungry. Previous weight loss efforts have been hard to keep up consistently. I just need to make sure i get enough protein. Ive also taken the chance to clean up my nutrition rather than just eat less of the bad stuff. Limited side effects for me. Downside is its very expensive here in Australia unless you have diabetes which i dont.

What anti inflammatory effects did you notice? Elaborate please

And what will happen when you stop using GLP-1?

You clearly put a very large emphasis on your physique. Not many people do, and for all the ones that do, few think it is worth the costs.

That is why.

How do you know these drugs are harmless? There’s certainly cases of people believing a substance was safe and finding out the hard way it was not.

We don’t all have money coming out of our ears and doctors eager to write scripts for whatever we ask for after appointments that took less than a month to get.

My Father taught me his belief, instilled most likely from my Grammy: There is a little poison in every medicine.

I find it immature binary thinking, the idea there are only unalloyed good/bad things in the universe. Is good health built upon the current influencer fad synthetic chemicals or is it simple old school ideas, sensibly eating a spectrum of fairly natural foods and engaging in sensible old school exercise?

People make their living—and sometimes make bank—being 'an influencer.' Is it healthy for us to follow their influencing campaign? Do they have the best intentions to promote products and activities which improve our health and livelihood? Are the products or activities they're paid to promote actually 'the better way to live?' Or is this influencing just a clever marketing campaign part of someone's business plan?

There's a KPI Dashboard on that influencer, is there a KPI dashboard on your health? Are there unbiased indicators used in that KPI Dashboard?

My elderly parents didn't partake in such things, and they're 85 and 90 ... my mom is 85 and walks three miles a couple times a week, that's a pretty good KPI right there.

Am Asian. Most of us are already thin and conscientious. Many of my folks would probably benefit from gaining a bit of weight (muscle mass) and being less conscientious (more spontaneous and risk taking)

tl;dr of this whole conversation -

Huh, people are different.

Who knew??

I also wonder this. Speaking personally, one of my close friends is obese and inquired about GLP-1s but his insurance didn't cover it, if I'm not mistaking.

So my guess is cost, but I'm open to being more educated on the matter.

I would be using methylphenidate if I could. My country has had "shortages" for over 2 years now. And by "shortages", I mean the warehouses are empty and haven't gotten a single delivery.
I've heard some Americans talk about getting these types of drugs directly from China but I don't think that's a thing outside the US.

I've taken MPH before. It was useful for getting me out of short term slumps, but I hated the effects it had on my digestive system.

I'm hesitant to drop a lot of money on GLP-1 meds because money is tight.

Well, I have the problem that semaglutide and tirzepatide cause me to gain weight rapidly.

i'm already too thin for my own good, dont have much money to spare, nor do I know how to source them "correctly." also, don't love needles.

Methylphenidate benefits you describe are wow specific to yourself, where you deficiencies (ADHD?) alongside your modus operandi fully fit to make it the magic drug.

Unlike glp1 which is great for most humans, this one is fast from this

the best part is the certainty that taking drugs is "improving" - we used to smoke weed and say, "dude, we drive better - more focused." all from this rational community...just describing their emotions in a rational language to seem logical

More people should be on glp-1s agreed, they are nearly a free lunch for most people, but adhd drugs are from being one. I can’t sleep properly on adhd drugs and it fucks everything up as a result. I also become more addict prone above baseline without serious lifestyle design with adderall. And it reduces my creativity a tad although it’s not that bad. There is some dopamine state rebound that is akin to like depression if I take it for too long too many days in a row as well. But they do work well if you don’t have the side effects and definitely have changed alot of lives for the better. 

Basically if there was an adderall that didn’t make me have less rem sleep and insomnia on occasion, and didn’t have a dopamine rebound after a couple weeks of taking it daily that makes me depressed, I would take it daily. 

You seem to have an unusually good reaction to methylphenidate. Many people feel robotic, or dead, or uncreative, or unable to socialize, and get awful crashes. Other people find it doesn't make them more productive, just kind of on edge and too wired to work. Typically, stimulants are presented as a u-shaped curve - there's an optimal level of stimulation, if you usually run too low then stimulants will make you feel better, but if you usually run exactly right or too high, they'll make you feel worse.

I think most people, if they tried many stimulants at many doses, would find something that seems useful to them sometimes. But a lot of the time it would be coffee, and they already drink coffee. For other people, it's not worth the trouble of getting a controlled substance.

I think GLP-1s are more likely to work for most people, but some people aren't fat, or get really unpleasant side effects, or find it doesn't work for them.