Dhruv Khullar

There have been reports, not a lot of great research yet, but at least reports that people feel kind of a blunted mood or even anhedonia.

They're not interested in doing the things that they used to do.

And of course, that is potentially quite concerning if people aren't interested in kind of living the life that they want to be living.

You know, that's something that needs to be followed very closely.

You know, the cost is still a huge issue.

The sticker price can still be $1,000 or $1,300 a month.

And so, as you can imagine, not a lot of people are going to be able to afford that.

And finally, I would say GI side effects.

In clinical trials, they seem to be pretty well tolerated.

So maybe 5% or 10% of people have significant enough GI side effects to come off them.

But that is potentially higher in the real world and one reason that people are coming off the medications.

Well, one of the things that happens when you're on a GLP-1 is that often people are losing a lot of weight.

And with that weight is going to be part loss of fat, but also loss of muscle.

And losing a lot of muscle very quickly can be concerning for all sorts of reasons, but one of which is it can lead to frailty.

And people might be at higher risk for

falls and other problems.

And so the recommendation really is not just to take the GLP-1 in isolation, but to do it along with a diet and exercise regimen.

The diet should be a high protein diet that allows you to preserve as much muscle as possible.

And of course, the exercise regimen should involve high levels of strength training so that people, when they're losing the weight, can preserve as much muscle as possible.

That's possible.