#16 GLP-1s to the Rescue?

Old questions about new drugs

GLP-1 receptor agonists like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) have moved from specialist diabetes drugs to cultural obsession in what feels like about five minutes.

For some people they seem like miracle cures in injectable form. For others they may be a pharmaceutical shortcut that undermines discipline and personal responsibility. And, along with the upside is a possibly serious downside and a lot of unknowns.

But, neither the miracle nor the disaster framing survives contact with physiology.

This week I want to do the boring, grown-up thing: explain what these drugs actually are, what the best trials show (with some numbers), where they sit relative to the remission biology we know from Roy Taylor’s work etc., what happens when you stop, and what the real trade-offs and unknowns look like so far.

Take note, however: I am not a doctor and this is not medical advice. For anything related to your medical care, talk to your healthcare team. Do not start, stop, or modify your medication based on anything I write here (or elsewhere). This is a scientist’s view of the emerging and established research.

Let’s get right to it.