Chapter 1: What are GLP-1s and how did they change weight management?
Hey there, welcome to Chasing Life. You know, when Ozempic first hit the market in 2017, it was the start of a revolution. The medication approved to treat type 2 diabetes was also helping people lose weight. Sometimes a lot of it. And that fact did not go unnoticed. The drug seemed to usher in a paradigm shift in the field of weight management.
Other GLP receptor agonists, as they are called, soon followed. Magovi, Manjaro, Zepbound. They helped millions of people do what they had been unable to do before, lose weight, seemingly without effort. So demand for them surged, no surprise. And since they're widespread use, so has our understanding of them.
The landscape has changed a lot since we first reported on these drugs on Chasing Life. So today we're bringing back my friend and colleague Meg Terrell, who has been covering them since the start. She's going to update us on what is new, what's on the horizon. And let me tell you, there's a lot to talk about. I'm CNN Chief Medical Correspondent Dr. Sanjay Gupta, and this is Chasing Life.
Welcome back to Chasing Life. Thank you for having me. My favorite guest. You and I, we know each other so well. We work together, but I just so respect your reporting. And I don't know if you realize this, but the last time we talked about GLP drugs was more than two years ago.
The last time we talked on the podcast, you and I talk about them constantly.
We talk about it all the time, yes. We have a lot of conversations, Meg and I. But yeah, for the podcast, for our audience two years ago, and there's a lot that has changed since then, and I want to really focus on that. But I'm just curious, overall, just the headline here. I think it was 2017 or so when Ozempic hit the market. How big a deal really are these GLP drugs now in the market? Yeah.
In terms of medicines, drugs, these are some of the biggest drugs of all time.
You're talking about in terms of money spent on them?
In terms of money spent, but also the number of people who are taking these. I mean, millions of people are now on GLP-1 drugs, most of them for weight loss, also for diabetes. And increasingly, they're getting approved for other indications. They're showing they work
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Chapter 2: What new indications are being explored for GLP-1 medications?
So they found these cells in the liver that essentially, when stimulated by GLP-1, tamp down on inflammation in the liver, regardless of whether the mites lost any weight. And so they're finding that these completely weight independent effects of these medicines and they're still trying to understand what is happening and why this is happening.
Inflammation does seem to be a big hypothesis of what is going on. But then, of course, there's other things like addiction. I mean, and that, of course, is probably totally unrelated to inflammation, most likely. I mean, it has to do with what's going on with the food noise and that kind of getting quieted down that we hear from a lot of people.
You know, we try and be very careful on this podcast not to be prescriptive about things, you know, or even making recommendations. But it is interesting to hear about all the known benefits now beyond just weight loss of these things and potential benefits in the future. Let me commingle two things which are in the news a lot lately. One is just peptides in general. I know.
And two is off-label use. So first of all, GLP, the P is peptide. It is a peptide. Insulin is a peptide. These are peptides. I don't know how much you think about this aspect of things, but there's a lot of other peptides that people are talking about in the wellness community. And friends of mine who say, yeah, I'm definitely taking these now. It helps me.
They're injecting themselves with these peptides. Have you learned anything about these?
It totally freaks me out. I just can't believe that this is so widespread and that these things are not widely tested. We haven't done the safety testing. I hear so much about people who are like, we still don't know if GLP-1s are safe. It's like these have been through clinical trials and tests. Tens of thousands of people. They've been looked at so closely.
Regulators are studying them in the real world all the time. And yet all these folks are taking these peptides that are completely unregulated. You don't know exactly how they're made, who's making them, what the conditions are, whether they're doing anything, whether they're what they say they are. Even if they are what they say they are, what are the safety risks of that?
I mean, I just, I can't believe that people are doing this.
I mean, one of these people who I'm talking about, one of my friends said, oh, yeah, I had a really bad reaction to taking it. They had to keep me in the office a lot longer, take my blood pressure. I felt very faint, like I was going to pass out. And I'm thinking, isn't this part of the problem? You know, like there can be significant side effects.
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Chapter 3: How do GLP-1s impact long-term weight management?
Thankfully, it's been approved.
Now it has a brand name, Foundeo. And so that just got approved. And we haven't seen yet how many people are taking it. But with the Wagovi pill, it was the fastest drug launch of all time. I mean, hundreds of thousands of people, if you believe these Wall Street estimates, which have been coming out, are taking the Wagovi pill already.
So I'm really interested to see how quickly the Foundeo pill gets taken out as well.
Calling it the Wegovy pill for a second, how does it compare to the injection in terms of how well it works and side effects?
It's actually pretty similar in terms of, I think, both of those things. We'll have to see how it actually shakes out in the real world, but it doesn't appear to be significantly different. When you look at the Lilly pill, Foundeo, it is not as effective, at least in clinical trials, certainly not as Terzepatide, which is a Zep-bound pill.
But it also seems not to be as effective if you just compare. And it's not apples to apples because they weren't head on compared in a clinical trial together. But it doesn't look like it's as effective as the Wagovi pill in terms of its clinical trial results. And we're going to have to see what the side effect profile ends up being for it.
And we'll have much more on the evolving landscape of GLPs with my colleague Meg Terrell right after this short break. Let's talk about cost. And even before comparing the pill to the injection, we heard about the President Trump plan to reduce costs. How has that sort of played out for the average consumer?
That actually did something. Often these things come out of different administrations and you're sort of like, what's this really gonna do? And in general, the TrumpRx idea, they have this new website where you can buy drugs directly from drug companies and TrumpRx sort of lists them on its website. They're not selling drugs, but they say they have a role in negotiating the discounts.
There are questions about how broadly helpful that is going to be for drugs generally, but for the GLP-1 drug class, it actually has played a part in bringing costs down really significantly. And there may have been a price war anyway, because when you've got two companies that are competing so directly, sometimes you do see costs come down in this way.
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Chapter 4: What are the potential side effects of GLP-1 medications?
Huh. Right? Yeah. It's fascinating. And the whole reason this has gotten a lot of attention recently is because they're thinking about this for NASA. Like, could humans hibernate as they're going towards Mars? Whoa. It solves a lot of problems. One is that you're hibernating so you don't get bored. Boredom and isolation is a big concern.
Two is you don't have to take as much food and water up because they're not eating or drinking anything at the time that they're hibernating. And three is this issue of... Humans, if you don't move for even a few days, you lose muscle mass. They may be sort of in that state for months where they're not moving much. Hibernation could solve a lot of problems.
So it's gotten all this funding recently. But then she said it could be actually something beneficial for people who are taking GLP drugs as well. This has been one of the big questions. I want to lose weight. I don't want to lose muscle.
Right. Oh, I think that is so fascinating. I didn't know that about the NASA going to Mars. I mean, it's like Austin Powers. I know, right?
Well, yeah. And then even back here on Earth, the idea, like you're saying, like I want to lose weight, but I don't want to lose muscle mass. I don't want to lose bone density and things like that. By the way, I'm getting my bone density checked again. I think we talked about this last time. It's been about a year. So I'll let you know how that turns out.
Last time we talked about this topic, I wrote this down, you made sort of an interesting comment related to the stigma associated with taking these pills, or taking these injections at that time, now pills. People being sort of criticized for like, you're just using a shortcut here. There's non-medication ways, non-expensive medication ways to achieve these.
Where do you think we are culturally now compared to a couple years ago?
I think there are still a lot of folks who feel that way. I mean, we just did a video this week about some findings on these medicines, and I was looking at some of the comments. And, you know, there were a number of people who were just like, well, just eat right, avoid ultra-processed foods, and, you know. And so I think there is still a lot of that.
But I do think, I mean, there's also a growing... appreciation for what these medicines can do. And so I think that is changing. But I still think, I mean, people love to speculate. Who's taking a GLP-1? Why did their body change so much? And it's something that, you know, we all do it. We're all gossipy. It's like how we are as humans.
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Chapter 5: How do costs of GLP-1 drugs affect accessibility?
They know that they can do it while they're doing it. I think that's really great. Other people I've heard even just by themselves, they wanted to take these medicines and they're like, I'm going to start weight training before I take the medicines so that I establish that sort of pattern and I know that I can do it. And I think that's so healthy and great.
Like, I mean, I even think about it for myself. I'm like, these medicines have so many different benefits. Should I be microdosing a GLP-1?
And what do you think?
I don't know. But I also think like my diet isn't perfect. My exercise isn't perfect. Not that it needs to be perfect. But I also think like I need to take a page out of those folks' books and get to a point where I'm really consistent with those kinds of things and assess where I am. And if I still feel like I need help or I could benefit in some way, like talk to a doctor about it, you know.
Yeah, I'm the same way. And it's funny, I think a lot of people just sort of look at the cardiovascular benefits. I have a strong family history of heart disease. I worry about dementia. I have dementia in my family. And so I'm not taking these medications, but there's a part of me that wonders if I'm missing out now.
because of these, well, I look back 10 years from now and say, gosh, I could have maybe helped, if not prevent, at least stall the onset of some of these diseases. I feel like that's an increasingly big part of the conversation.
Yeah, and the problem is we don't know until we know. Right. And even though these drugs have been around for a long time, they're pretty well understood, You know, it doesn't mean that they're completely benign. And, you know, would we find if a certain population is taking them that, you know, something could something bad happen if you were taking it? So it's not like only one direction.
You know, there is a risk benefit.
And so, you know, two years from now, what do you think this market looks like?
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