GLP-1 Agonists

“Yeah. Interesting. What are they going to do there? What are the diet? And it says diet. What are they? That's the GLPs, right? No, no, no. GLPs are that's a peptide. That's an injectable. No, but what are their pills now?”

“Okay, there you go. Loads of meat. Okay, what it does is for some of them, they, you know, like the GLP1s, they essentially slow down your digestive tract. You kind of paralyze your stomach and they kill your appetite.”

“on in 30 days. And I tested Dexascan 30 days in between. Now, couple things that were why I knew I could was this was right after I ran the first GLP1 experiment. I went all the way down to 199 pounds.”

“That's it. Enjoy the rest of the show. As of the recording of this podcast, one out of 10 Americans is on a GLP, and that number is growing rapidly. In fact, for the first time in recorded history, the obesity epidemic is actually declining.”

“However, they don't come without caveats, one of them being muscle loss. So today's episode, we're going to talk about how you can lose weight on a GLP and keep your muscle. Let's get to it. That's the main goal. And I want to start because this is top of mind for me because I had this conversation this weekend.”

“Now, obviously, there's some people that we're going to go over this up and that maybe they didn't know this, maybe, but I'd say a good percentage of people that have been around GLP ones now or been on one long enough, they've heard that you can lose muscle. And the way that Reda is being marketed is as this one that's like this, the miracle one at all of them that you don't lose muscle.”

“But no, it also caught it. You also saw muscle loss in the trials. So I do want to be clear that GLP peptides or medications don't cause muscle loss. So it's not that the GLPs themselves have this deleterious effect on muscle.”

“The majority of what's happening on a GLP that is causing the weight loss is the fact that it severely limits your appetite. Yeah. Okay. So when you go on a GLP, and if you're on one now, you know exactly what I'm talking about.”

“The weight loss that you see with GLPs looks like about 30, depending on the study, 30 to 40% of the weight is lean body mass, meaning the rest of the weight is body fat, but everything else that's being lost is non-body fat weight, which they refer to as lean body mass.”

“care. They just, by all means, means necessary, crush the appetite with the GLP one and let it fall off. They find themselves, and we get, by the way, we've helped and coached so many of these people. I mean, we took a trial group last year, over 50 people in that group that we did personally.”

“There are clients, there are people in their 30s and 40s who lost weight through a GLP, didn't do anything to try to keep the muscle. They just want to lose weight, ended up with osteopenia as a result.”

“Okay, I'm going to also be very clear. In my lifetime, there has not been a non-surgical medical intervention that comes anywhere close to the power of a GLP. Nothing comes close as like, this is as close as you can get to a miracle drug, but it must be used properly.”

“keep the muscle, you will get miraculous results. It can be very beneficial for you. That's right. If you just use the GLP and rely on the appetite suppression alone and change nothing else and just eat low calories, you are robbing Peter to PayPal. You will end up with another issue, which is having low mobility, having fatigue, and a metabolism that's just crawling.”

“I think so. It's been two years ago. It's been two years. I think two years ago was when I tested the GLP one. And the idea, for those that don't know, was obviously they were getting super popular. I'm like, I want to take this thing. I I want to take the medical dose that they prescribe.”

“So I just wanted to share that because I know there's going to be people listening to this that are on a GLP one that may not be taking all the advice you're about to give right now and still doesn't care because they're like, I'm not happy they lost the weight. Yeah, I'm not fat. I'm not fat as I was a month ago. So who cares?”

“eat and change things while on a GLP. You also set yourself up for a potential future where you don't have to live on a GLP for the rest of your life. Okay, let's get into now, how do we keep the muscle?”

“And you want to eat it consistently day in and day out. Now, one thing I want to add to this is this is hard to do when you're not in a GLP. This is hard to do when your appetite isn't restricted because of a GLP because protein is very satiety producing.”

“You throw a GLP on top of that and you're choking it down. So there are some strategies that you can do with this. And I'll give you two of them. One, start with a high-protein breakfast. Don't get behind the eight ball.”

“Number two, protein shakes can help a lot. And in many cases, when people are on a GLP, especially in the beginning stages where your appetite's really restricted, you're probably going to have to have two shakes a day to hit those targets. So those would be the two most important things.”

“it every single day versus the average. Because another mistake I see people make is, especially on GLP ones, is you'll notice if you're on one or if you've ever taken one or you decide to take one, the first three days, if it's a shot, it crushes the appetite.”

“me. And that's coming from somebody who was hitting their protein targets. So to me, with somebody that's on a GLP1 that's already in that range where they're struggling to get enough calories and/or protein kind of becomes kind of a no-brainer supplement to take next is use creatine.”

“It lowers. Okay. So you want to do the minimum amount to elicit the most change here. And in this case, for most people in a GLP, you know what this looks like? Two days a week of strength training. That's it. Two full body workouts, not more. More will probably not get you better results.”

“Lastly, don't let your fats get too low. So we talk about protein. Everybody knows about protein, but here's what happens sometimes with people on GLPs, right? They're really conscious about the protein intake. So they start taking all these shakes. And shakes are protein and nothing else.”

“The other one I would add to this that I also see that's really common is fiber. And since GLP1 slowed down motility as it is, and if you're also not getting a lot of fiber, you'll also hear a lot of people report: I haven't gone to the bathroom in four or five days. And so, if you're eating super low-calorie, low-fat, and/or also low fiber, this can make a big difference too.”

“everything else, other psychosocial interventions, other medications, some of those patients, when we put them on a GLP-1, they get into recovery when nothing else works. So that's very exciting because in general, what we find is that no matter what the tool is, it's only going to work for some of the people.”

“It's been my like new favorite move I'm doing on leg days. I gotta, I gotta, I'm gonna change direction. Scott, I gotta tell you guys about this, these studies that are coming out on people who use GLPs. The nutrient deficiencies they're finding in these people is wild. Oh, I can only answer. The vast majority of them.”

“So like if you're on a GLP, you need to supplement with a multivitamin for sure and try to eat whole natural foods, nutrient dense foods. That means your nutrient deficiency rate will go through the really good. I mean, I'm talking somebody studies 90%.”

“And this and that, what he's asking me dose of. I said, well, I said, me talking to you about my doses won't do you any good. But let me tell you the things I'd be worried about if my mom gets on a microdose of GLP-1 for psoriasis. And I listed off all these things. I listed that. Like, you got to make sure she's hitting her essential fats. You got to make sure she's hitting her protein intake.”

“But if she's getting nutrient deficiencies, you're just shooting her in the foot. Here's how bad it is. I just found the data. Trip off this. They're doing food records of these GLP users. 99% of them are below vitamin D. 99%. 99% of them below potassium. Now keep in mind, 60 to 70% of everybody is below vitamin D.”

“hit protein. There's a good chunk of people, half or a little more of people that are just taking the GLP and really not focusing on anything other than, oh, cool. I'm not hungry. I'm not going to eat.”

“and skinnier with other health issues. Listen, if you are going to take the plunge with a GLP one and you're willing to invest and spend the money on that, you've got to be willing to spend and invest the money on a coach to take you through that. Yes. Because if you really want to make such a big difference, huge difference to have somebody coaching you through that process”

“We're only hiring coaches that we really like and we don't want anybody representing us. But I'm going to, what's our link, Doug, if someone wants, because we have coaches that work with GLP. Yeah, mindpumppersonaltraining.com. Okay, so mindpump personal training. You want to work with a coach that's experienced with this, then unfortunately, it's probably going to be a wait list, but”

“So, you know, it's one of the best brig I've ever had. Head into that. So I've just come off GLP1 where I've lost 18 kilos. So it's about 40 pounds in your talk. I managed to maintain my muscle mass by lifting weights.”

“But recently, the past sort of 12 months, I've really enjoyed resistance training, lifting weights. So while I was on the GLP1, I was eating around 2,000 calories, but now I've increased to about 3,000 calories a day, hitting a minimum of 200 grams of protein. Most days around sort of 220 to 230 grams of protein.”

“He's done a good job. Really good job. Yeah. Yeah. He's done a really good job. He's listened to us while on the GLP, which has helped him preserve muscle. He's way off, which is reverse dieting, which is great. So he sounds like he missed the common pitfalls that people run into while on GLPs.”

“fermented foods, fish, seafood, all of those things seem to nurture a really healthy microbiome. When it comes to rapid weight loss, as the case now with a lot of these GLP1s, I call them GLP1s because now we have like tiers of them, not just receptor agonists. We got like multiple versions of them now.”

“Yeah, I think GLP1s are really interesting because they're pointing to so many interesting things about obesity. So first, this is by far the most powerful anti-obesity drug ever invented and it was discovered by accident.”

“And they're, in fact, they're FDA approved as an adjunct to nutritional lifestyle. The actual FDA language says GLP-1s are approved for obesity treatment as an adjunct to nutritional lifestyle. So you're supposed to have foundational nutritional lifestyle and then add this drug to that.”

“quickly and you don't gain it back. You gain back fat. And so I think for the vast majority of people on GLP-1s, if they don't think about food and lifestyle, I think they're going to... It's an economic disaster for our country because of the cost.”

“But now it's because our bones have no reason to be strong. And it's quite common. And then on top of it, you know, this is why you're seeing young people on GLP medications, which GLPs severely limit your appetite, right? So they make you lose weight through that process. Super low calories. But they're not strength training.”

“So basically, I started GOP1 about three years ago. I was 364 pounds and I'm currently at 161 to 165. Back in March, I had a tummy tuck, lipo, brachioplasty.”

“And so sarcopenia and loss of strength is a big deal. I feel like it's going to become even a bigger deal with GLPs. It is. I was just going to say the same exact thing. Because if you think about it, if they had more muscle mass, then when they go on GLP1s and a third of that is muscle loss, it'd be no big deal because they already had more muscle.”

“the outline of the fat. And the problem is, is that, and we know this, if you don't plan on being on that GLP1 for the rest of your life, then it's going to be harder that next time around unless you're following the nutrition and you got into strain training.”

“But are you seeing anything else in their testing that is surprising? So all of this is new. And I always try to stand biased, meaning like if people are going to live that healthy 100 years on GLP1s, okay, I'm all for it. Like let's do whatever it is. But what I'm finding, what I can't yet parse from all the data right now is that all of these people using”

“Right. Right. Right. Right. If you're microdosing. So the jury's not out yet. And again, I'm waiting for it to see when we have enough data, because GLP-1s have been around forever. Like they've been around for a good 20 years and been used. And they've always shown to be worthwhile if you're obese. But now people are using them on a healthy weight.”

“Somewhere between 10 and 20 million Americans are using GLP-1s. They believe it's going to be 30 million in the next 18 months. So if you look at that, that's like 10% of the population. That's like 20% of the adult population. So a huge number of people. We don't know what that's going to look like over the next five or 10 years.”

“one that I'm seeing. I'm seeing exactly the same. I mean, that's what it seems to be is that in the beginning, it's all rainbows and unicorns and sunshine, right? Like it's amazing. And then you start to hit that tipping point somewhere around six months to eight months is what I see it in my practice. And your body is now starving. It can't compensate anymore. And so once you've”

“And good experimental people can do fussy experimental science. Sid, the GLP-1 agonists, while potentially in the very near term, will transiently raise insulin levels to aid with glucose disposal, ultimately tend to reduce hyperinsulinemia.”

“I think it's a beautiful study. It would be a beautiful study. You would randomize to patients with on GLP-1 versus not GLP-1. You would study their insulinemic response versus their weight loss response.”

“And just ask the question: listen, if people who are on GLP-1 versus not GLP-1, you know, is there a lower risk of endometrial cancer? Now, see, I prefer the experimental approach here. Yeah, not just because of time.”

“And I think someone should fund this study. I mean, you know, if it's not the NIH, if it's not the Eli Lilly or Novo or whoever else is now making, you know, any of the GLP-1s, you know, any of the people, anyone in the audience who's, you know, interested in”

“Yeah, I mean, you know, as I said, we have, and we have some tools. We have the GLP ones, for instance, in obesity and potentially in inflammation. So that's a trial that I would like to watch very, very carefully. I hope someone listening to us today, by the way, has taken, has become motivated by that idea.”

“Today we discuss many topics, including GLP drugs, how they work, how they impact hunger, and how they impact things like longevity, cognition, and drives in general. As you'll soon see, Dr.”

“But we also have this obesity epidemic, which seems to be partially mitigated by the GLP drugs. But there's a lot to this whole thing that we call hunger and food and appetite and weight and all of that.”

“And today you'll educate us about all of it. But to start things off, because it's on everybody's mind, what are the GLPs? What is this glucagon-like peptide one in its natural form in the body? And then perhaps we can talk about the drugs that increase their levels, because either everyone's taking one of these now, coming”

“know is taking one. So GLPs are here. In its natural form, it's an incretant hormone. So it's secreted from the distal intestines around food ingestion.”

“their weight loss capacity in the present day. But they started off as diabetes treatment. My understanding is that the GLP-1 drugs, so Ozempic, Wegovy, and on and on, that they increase levels of GLP-1 a thousand-fold more than we ever experience now.”

“future. So we're kind of left with anecdotal reports in that zone. I also hear about some non-weight loss-related benefits of the GLPs. In fact, I know people who are of healthy body weight who are taking quote-unquote microdoses or even full doses in order to glean what they claim are some of the benefits on cognition, on energy.”

“This is somewhat of a controversial topic in our field of research. The first generation of GLP-1 drugs, so 2005 to 2012, we collected some preclinical evidence in rodents suggesting that a large part of the mechanism of action for food intake suppression was through brain action.”

“So the drugs would get into the brain, activate receptors. Whether these newer generation of GLP-1 drugs like Ozempic, Wegovy are getting into the brain, it's less clear. Really? Again, controversial. So some studies will, mostly preclinical, exclusively preclinical, will tag the peptides with a fluorescent molecule and try to look at where it accumulates in the brain.”

“And it looks like some of the early generation of GLP-1 drugs readily get into the brain and some of the newer ones less clear. Maybe it takes a little bit longer, but the jury's still out.”

“also seems to be a strong component. I know you've worked in these areas, but as a way of getting directly there, I'm very curious how the GLPs are actually suppressing hunger. Let's assume that it doesn't get into the brain, that these drugs aren't getting into the brain.”

“receptors that are expressed on the vagus nerve. So that's one mechanism through which GLP-1, both the GLP-1 drugs as well as our physiological GLP-1, may be producing this feeling of satiation.”

“There's a lot to uncover in that area still. What's the evidence that the vagus nerve is crucial for the action of GLPs in suppressing hunger? If you do a selective lesion to the sensory vagus nerve as it comes up from the GI tract to the brain and then inject GLP-1, it's not effective in reducing food intake.”

“Some are taking even more aggressive measures. And now there's the discussion about the GLPs. It's like maybe these will improve longevity of brain function or improve memory. So I don't think it's too much of a leap to just chop it up around this topic.”

“Yeah. And we, and most, many people try not to. There's also, I've been reading about this, that with the advent of the GLPs, we are entering perhaps the first time in nearly 75 years where we might start to see thiamine deficiencies and micronutrient deficiencies in a like fully modernized culture because people aren't eating enough.”

“So it could be that we end up with a large population of people who are kind of skinny fat because of the loss of muscle with the GLPs. They're not exercising plus micronutrient deficient. And in terms of hippocampal function, it seems like that would be maybe as bad as obesity.”

“That's not a concern that I have, but part of the reason for that is that people don't take, in general, they don't take these GLP-1 drugs for a long period of time. A majority will discontinue treatment within two years of starting because their side effects are caused by the side effects.”

“Another reason for discontinuation in elderly populations, there's lean mass loss, which is, I'm not saying that GLP-1 drugs preferentially reduce lean mass.”

“is that some people will do that. And many, many people are just, they're looking for a pill or a solution. And the GLP seem to have provided a solution at least to the weight piece. But I'm, it doesn't seem that they've provided a solution to the nutrient piece. And that has me concerned, frankly.”

“I mean, this is one of the most common sets of questions that I get around the issues we're talking about today, just incidentally, like, should I be taking GLPs? Like, what about, you know, what should I eat when I'm taking a GLP? You know, can I micro-dose it? Can I go off it?”

“You know, it's like, I think this is going to be a major theme for the next five to 10 years. And that's in adults, so to say nothing of the questions about kids and GLPs. I don't know that there are any data on GLPs, drugs, in younger populations. I'm sure there are, but I'm not aware of them.”

“GLP-1 drugs. It was a few other ones that have kind of fallen out of favor because the GLP-1 drugs are the most effective. But yeah, there was a period of time and probably largely due to the FenFen issue where pharmaceutical companies were not interested in developing obesity drugs thought at this point, 40 over 40% of U.S.”

“The reason I've heard about it is I follow these weird subreddits with biohacking. And this is how I learned about GLP1s. This is how I learned about a little bit about testosterone. And what I've noticed is oftentimes these people are wrong. They'll say things that are kind of ridiculous, but occasionally there comes conversations where you're like, okay, there's a signal here.”

“And you see this a lot of times, right? So you, as you know, we talked about GLP1s, as food calories become abundant, you know, you have DoorDash and you have fast food and you have all these, you know, the way that the food industry went. Well, then there became a higher, a greater need for the reaction.”

“but I get asked about peptides like every five minutes these days and not the peptides of the GLP sort. But what's happened in the health space is that the GLP drugs have destigmatized and taken away needle phobia by putting the, it's still a needle, but it's on a pen.”

“It wasn't really the thing about taking the peptide that may or may not have enough data. There are a lot of data on the GLPs, but it really was the delivery method. We saw this with computers, right? They were big clunky things. You had everyone had to use the same one. Then all of a sudden you turn it into a phone that's also a camera.”

“They don't want the situation to be a crutch. I think it needs a kind of a mark of character. Like, you don't want to be the kind of person who needs to take GLP1s or to like, you know, you want to be the sort of person who doesn't need that, right? So I think that to me is at least part of the answer. But you asked the question, like, what's not obvious?”

“A lot of it, I think, is because of the delivery mechanism. Like if anorectics and GLPs were first released as a shot. that you took a shot or it was just a tablet or something or maybe it was a patch or something else.”

“pounds before people start saying like, okay, this is probably just a good thing. Yeah. Have you tried any of the GLPs? Not yet. Okay. Would you maybe consider it if like, oh, I need a bit more help in my diet? Or it seems like you're pretty locked in as it is. Yeah, it's, I'm kind of right in the, I call it a sweet spot of diet.”

“Every day, ask me how many pull-ups I did because I'm training for the MRF. Remind me on Fridays when I take my GLP shot which side of my thing I'm on, left or right. Like I'm just doing each. It's like that's his only job is to only focus on that stuff. You're doing GLPs now?”

“probably testing this in parallel with the newer generation GLP-1 agonists. As best I can tell, that's what they're doing. And it's not now just Eli Lilly because many other companies who have seen the believe data, because we've been presenting it at national meetings and international meetings, for that matter.”

“GLP drugs that help people lose immense amounts of weight and stop feeling this food noise thing. And on and on. But can we start by just having a conversation about this tube that is the digestive”

“These are areas that, you know, square in your wheelhouse. Can't have this conversation without talking about the GLPs. Most everyone has heard of these things nowadays. Millions and millions of people, I've heard, I don't know if this is true, as many as 20% of people 18 and older have taken or are currently taking a GLP or either, you know, Zempic Mounjaro, soon Redatrutide will be out to”

“And we weren't doing much with it, unfortunately, until the GLP-1s came around. So GLP-1s are fantastic from that standpoint. They're not perfect, you know, there's limitations, but they're, it's much better to have them than not have GLP-1s for sure.”

“There's issues with, with certainly adherence, unfortunately, right? So there's a, there's a number over a million people a month are coming off GLP-1s, right? Right. For a variety of reasons, about 30% come off GLP-1s in the first month and then 50% or so by, by the end of the year, right?”

“That does weigh heavy on some people's minds. And that might be why they stop as well. So in my practice, where we do endoscopic therapies, over 85% of people have already been on a GLP-1 and either they're struggling on it or they've come off. 80%. 85%.”

“Like people love their drugs. Like I, you know, I've heard about the nausea. I don't, there are a number of people now who are quote unquote micro dosing the GLPs and finding that they're getting some benefits without taking the prescribed amount. I'm not recommending people do that.”

“you get to that dose, you're losing weight, you're losing weight. And then for maintenance, rather than just stopping it, because if you stop the GLP ones, there's problems, right? This is not meant to be stopped. These are kind of lifelong medicines instead of stopping it, just go to microdosing and you'll find a spot. Hopefully, you know, not everyone does,”

“okay? You're putting the fat back on. So now you've shifted your body composition to be less favorable than before you were on the GLP-1. And then you go on and again and you lose weight again and you lose a little more muscle. And then you go off and you put more fat on, not more muscle.”

“So there has to be a game plan. If you're coming off the GLP-1, you need either to micro-dose it or have a bridging plan to a procedure or something else, which will keep the weight off for you. Are there any good studies showing that resistance training can offset the muscle loss from a standard or micro-dose of one of these GLP drugs?”

“But you can actually see that that does play a major role in maintaining muscle. And that's with anything. It's not just GLP-1 medications. It's with the first generation medications. It's with any surgical procedure or endoscopic weight loss procedure. You know, if you're doing resistance training, you tend to maintain your muscle because the body realizes, oh, I need this muscle.”

“So you want to get screened for this structural thing in the eye. But it's not true that like GLPs are making people go blind all over the place. So what I'd like to ask is when patients come to you and they say, like, I didn't like the GLP or it wasn't working for me. Are they telling you why? Are they saying, like, it made me feel nauseous?”

“Make sure you have adequate muscle mass. And if you don't, you really have to think twice about if you want to do the GLP-1, right? Or if you want another avenue to try to lose the weight. And you definitely have to start hitting the gym. I think that's the most common thing is muscle loss in obvious places or sarcopenia.”

“big players. We're talking about the GLPs, which obviously play a role in satiety and other things, hence the side effects. So what are some of the big ones that we don't hear about so much anymore because of the GLPs?”

“People might be curious to know that this drug, retatrutide, that the more cavalier peptide curious folks are already getting off from compounding pharmacies and gray market, black market. Retatrutide, as I understand, promotes GLP, GIP and glucagon to I think the clinical trial Lilly ran showed a 30 percent reduction in body weight, which is really striking.”

“It does help. I think it helps with nausea. So it allows you to have higher doses potentially of GLP-1 with less nausea. So GCP, I think, plays that role. It has a role in insulin sensitivity as well. It does some of the same stuff GLP-1 does, and it's synergistic, I think.”

“And so the drugs just didn't pan out. I think that with the GLP-1s, it's another story, right? I think, you know, incretins in general, we've talked about incretins. We've been talking about these hormones that are produced in the gut. They go into the blood and they do something.”

“So you do surgeries of various kinds. The people are coming to you, have they all tried GLPs and they don't like them or they're not working for whatever reason? Or they'll microdose it, but it's not solving the problem. And what sorts of surgeries were you trained to do?”

“do a targeted approach. So you're not just doing that with drugs where GLP-1 is actually GLP-1 isn't really targeting a deficit necessarily. There's different ways you can treat things. You can either find a pathology and treat the pathology, right?”

“But your A1C corrects and it's a potential treatment for diabetes. They've also done some studies. I don't believe these are published yet, but I think that is showing that when someone comes off of GLP-1, if you use this treatment, it keeps them from regaining their weight. So you can take a GLP-1 and then have your duodenum kind of reset, if you will.”

“So, that's why it's so important. GLP-1s help fight part of that, right? You're replacing the GLP-1 that's you're not addressing the ghrelin or other things. So, time will tell if we can have long-term weight loss, but it does, it does. So, ghrelin isn't the whole story, right?”

“I'm kind of sensing a theme here, right? Like we have these drugs like Ozempic, Mounjaro, et cetera, that blasted GLPs through the roof, helped a lot of people that need help, but there were a lot of side effect issues.”

“But that doesn't mean it's irrelevant, right? So when you do a procedure, like say a gastric bypass surgery, right? Or you go on a GLP-1, you still got to fix the fundamentals that got you in the problem to begin with, right? You need to start getting more fiber. You need to, you know, have a better diet. You know, try to avoid the insulin spikes.”

“Well, I think one thing that's very exciting is gene therapy, right? So we talked about GLP-1s and how it's mega dosing, super physiologic. It's not nutrient responsive.”

“And I was involved in the very early work for this. And basically what they're doing is they've developed a viral vector that has the gene for GLP-1 in it. And they're using the promoter for a beta cell insulin gene, right?”

“So it's very exciting. So we'll see how that goes. But it looks like it'd be very promising, right? So one-time GLP-1 injection, that could be nice. Additionally, you could use it to augment other therapies. You can use it to augment the gastric procedure or the small bowel procedures. It might be another tool in your armamentarium.”

“these kids just can't stop eating because of the lack of hypothalamic signals. And I don't know, my read is that the traditional GLP drugs are not really working there. This would be amazing. And I mean, in road models, it's phenomenal because we did these trials where you randomize mice to get semaglutide, high-dose semaglutide, much higher than you get for a human, and then the transgene, right?”

“And along comes semaglutide and these GLP-1 agonists. And suddenly, you don't have to work to get something. You take an injection and then your cravings get reduced.”

“And then we're starting to see some really scary things around GLP-1s. So, they're amazing medicines because if you have, if you have like, if you're overweight and you have like cardiac risk factors, endocrinological risk factors like type 2 diabetes and stuff like that, these medications are amazing at all this kind of stuff.”

“Pornography gets worse. Yes. Video games? I haven't seen any data about that. Yeah. So, and there's a lot of really interesting signaling around GLP that we can get into, but this is exactly kind of what I mean is it's sort of a miracle drug. And our society has been filled with miracle innovations that actually cause silent damage around the edges.”

“isn't using control themselves, but is, is artificially supplementing their control by using GLPs? Your suggestion here is that people use CBT. There's an intervention that gives somebody an additional amount of control over their weight and how much they eat.”

“kind of addiction to the control that they have. Are you suggesting that GLPs allow people to shortcut or people who wouldn't have typically that access to willpower, that these people would, uh, and they they're able to, um, the mechanism still holds, even though the way that they've arrived at the mechanism isn't, isn't the same mechanism is the same.”

“really high willpower. So the reason I think GLPs are causing lots of problems with body dysmorphia is because now I don't need a high willpower because I'm reducing my cravings. So, so they basically, allow people who have less control of themselves to achieve more dysmorphic goals.”

“So even people who are more overweight see greater reductions in alcohol use with GLP use compared to people who are normal weight. So if you have a normal weight and you start a GLP, your reduction in alcohol consumption is lower.”

“Well, that depends how messed up is your heart. And in the same way, the majority of GLP benefits are for people who are very unhealthy, right? And there's a lot of data that supports that. But then the second thing that I, this is like my personal thing.”

“are empty, you're not going to feel any of that. And so people aren't falling in love anymore because technology is draining our dopamine. Are you worried about GLPs impacting dopamine for people falling in love or cravings, I guess? Yeah. So they do blunt cravings. This is where things get like really neuroscientifically like.”

“GLPs do is they cap the amount of dopaminergic response that you can get. That's part of the reason that they're kind of like good. So if you look at studies of people who use alcohol on GLPs, their desire for the first drink is the same.”

“beer is blunted. And so that's really where GLPs work. Okay. So going back to someone doing all three of those things every day. So anhedonia is number one. So the inability to experience pleasure. If you talk to these people, life will feel boring, which is why they want to pass the time, right?”

“right so you're right it's it's all of the outcomes it is it is a deconditioning of people whole scale but glps i would guess for people starting under a bmi of 30 would probably”

“pieces of advice that i give to people this is family friends patients whatever when they start a glp i mean usually i don't prescribe glps so somebody else should be doing this but if i have a patient who's on it i try to tell them remember to eat so so they just don't feel like eating and”

“a lot of data that glps are like really good you know and i'm not saying that they're not good when you look at those indicators but there are these hidden costs like maybe we'll see micronutrient”

“that the same thing that happened with opioids is what's happening with GLPs so were they designed for morbid obesity or did the companies that develop them understand very clearly that this is a medicine that will make someone not want to eat?”

“but stays for a long time. So now we're moving away from those addictive ones. Here's a really fascinating thing. Everyone talks about GLPs like they're the same thing. They're not the same thing. Terazepatide, semaglutide, they're not the same. They all have different penetrations to the CNS, okay? So where all of these GLPs go is actually different.”

“they're not the same for all GLPs because they have different CNS penetration. So they enter your brain at different rates, okay? So I'm not sure, but the conspiracy theorist in me really wonders whether they know exactly what's happening, which is that they're going to release this medicine on the market.”

“but this is like a weight loss drug, right? That people, but it just had side effects that were completely unacceptable. Oh. And so GLPs, like there's a, there's a very real chance that someone somewhere, and I'm not, I don't think like pharma, like pharma is evil and bad and stuff like that. I think a lot of pharmacologic, I mean, no one's complaining about acetaminophen.”

“he can kind of see the picture now. Yes, insulin's a peptide, it came from the body, but all these peptides now pharma companies are like, what is the body making? Like in the case of GLPs, when you increase GLPs twofold, fourfold, you can see some relief from type 2 diabetes, some, but not much weight loss.”

“One of the things that the GLPs and peptides and physicians and the culture around medicine has really evolved to is that in recent years, people have realized, oh, you know, these GLP drugs are expensive. They have side effects. People are micro-dosing them. They're sharing them.”

“They have a reason to be pissed and scared. Like this is their big blockbuster drug, right as all the other GLPs come off protection from generics. They're all moving to generics. It's such an interesting time because there's really never been a time in my life where there's been more information more readily”