Dr. Ben Bikman

But always using these very, very low doses, not for weight loss, but for changing habits.

Yeah, and I think that's because they're not framing, I think a part of it's the narrative or the story, which is let's frame the conversation in the context of helping you change your dietary habits.

Rather than this is just a magic bullet and you're going to lose weight.

I think in that instance, the person's changed the way they're eating, but maybe they're not.

I know I'm kind of getting into this hokey pseudo area of science perhaps, but when the conversation is focused on the habit, I think it helps change habits.

Yeah, I haven't seen it either.

Yeah, but it does beg the question, is the use of – so it's very real.

The evidence is very real showing one of the best-looked papers in the New England Journal of Medicine about two, three years ago found that about almost 40% of the weight loss –

that a person was losing was fat-free mass.

Now that is itself a big pool, but some of it would be muscle and bone mass.

But I have not seen data that has determined whether it is a direct effect of the semaglutide.

In other words, is the drug actually harming muscle and bone, or is it just an artifact of the poor nutrition?

It might be a little bit of both, but it also might matter in the dose where I've heard reports.

In fact, my lab is doing a muscle cell culture now looking at varying doses of the drug.

Where it's possible at a lower dose, it's facilitative, and at a higher dose, it may be more catabolic when it comes to muscle mass and the dynamics of muscle protein synthesis.

But even still, as far as I'm aware, it's unknown.

Is it a direct effect of the drug, or is it an artifact of just poor nutrition because the person's not eating, and what they are eating, they're not absorbing very well?

point here and that is like glp-1 receptors and i mean they're all over many different organs the muscle has them and so does bone yeah right yeah so that is that is an neurons do yeah i mean and it also starts to touch on the broader use of glp-1 drugs where you and i both know people are using them uh well beyond the as much as i bemoan the fact that it's now an obesity drug where it was once just a diabetic drug now people are saying well it's a blood pressure drug it's an

I just don't know.

In fact, as far as I am aware, there's very few studies to touch on that broader on the mechanism.