Are dipeptidyl peptidase 4 (DPP-4) inhibitors [like sitagliptin and Linagliptin] similar at all to semaglutide? Do they reduce appetite/are they ever worth it?

It’s “less effective” but it’s WAY easier to get.

A 2018 meta-analysis found no favorable effect of DPP-4 inhibitors on all-cause mortality, cardiovascular mortality, myocardial infarction or stroke in patients with type 2 diabetes.[5]

A 2018 meta analysis showed that use of DPP-4 inhibitors was associated with a 58% increased risk of developing acute pancreatitis compared with placebo or no treatment.[22]

A 2018 observational study suggested an elevated risk of developing inflammatory bowel disease (specifically, ulcerative colitis), reaching a peak after three to four years of use and decreasing after more than four years of use.[23]

A 2020 Cochrane systematic review did not find enough evidence of reduction of all-cause mortality, serious adverse events, cardiovascular mortality, non-fatal myocardial infarction, non-fatal stroke or end-stage renal disease when comparing metformin monotherapy to dipeptidyl peptidase-4 inhibitors for the treatment of type 2 diabetes.[24]

FWIW EVEN FOR NON-LONGEVITY REASONS, it is sometimes nice to have an easy appetite-killing pill around just in case one gets explosively hungry at the wrong time (eg when all the local food is expensive or it’s after midnight or it makes you tempted to eat your roommate’s food).

[that said, emergency acarbose can sometimes be enough if the only options left are rice/bread. Rice is actually less “disgusting” than bread (it’s far less messy for one)]

ugh I really should try potassium salts. They taste nasty by themselves, but beans/rice are so delicious that they make them tolerable.