cover of episode #320 – AMA 64: New insights on GLP-1 agonists (Ozempic, Wegovy, Mounjaro) - efficacy, benefits, risks, and considerations in the rapidly evolving weight-loss drug landscape

#320 – AMA 64: New insights on GLP-1 agonists (Ozempic, Wegovy, Mounjaro) - efficacy, benefits, risks, and considerations in the rapidly evolving weight-loss drug landscape

2024/10/7
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Peter Attia: 本期播客深入探讨GLP-1激动剂,涵盖长期疗效、副作用、停药后的影响、身体成分变化、抗阻训练的作用、不同GLP-1受体激动剂的比较、配药药房的作用、口服与注射剂型的比较、以及其他潜在的健康益处(如对睡眠呼吸暂停、痴呆症、癌症、肾脏疾病、心血管疾病、生育能力和药物滥用等的影响)。同时,也讨论了该药物可能存在的风险,例如增加抑郁症或自杀意念的风险。 Peter Attia还回顾了过去几年对GLP-1激动剂认识的变化,以及目前已知和未知的信息。他强调了上市后监测数据的重要性,以及对长期疗效和停药后体重变化的进一步研究。他还详细解释了GLP-1激动剂的作用机制,包括其对胰腺、小肠、肝脏和大脑的影响。 最后,Peter Attia总结了决定是否使用GLP-1激动剂减肥的关键考虑因素。 Nick Stenson: Nick Stenson主要与Peter Attia共同探讨了GLP-1激动剂的各个方面,并对Peter Attia的观点进行补充和提问,推动了讨论的深入。他帮助引导了话题,并对一些关键问题进行了总结。

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This chapter introduces GLP-1 agonists, initially developed for type 2 diabetes, and their surprising weight loss effects leading to their use in obesity treatment.
  • GLP-1 agonists mimic the hormone GLP-1, stimulating insulin release and reducing blood sugar.
  • Originally used for type 2 diabetes, they showed significant weight loss effects, expanding their use to obesity treatment.
  • Semaglutide, unlike earlier liraglutide, showed dramatic weight loss alongside improved blood sugar control.

Shownotes Transcript

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In this “Ask Me Anything” (AMA) episode, Peter dives back into the increasingly popular topic of GLP-1 agonists, such as Ozempic and Mounjaro, which have garnered widespread attention for their ability to promote weight loss. Peter covers the latest findings in this rapidly evolving landscape, including new insights into their long-term efficacy, side effects, and what happens when the drug is discontinued. Peter also explores their impact on body composition and how resistance training interacts with these treatments. Additionally, he compares different GLP-1 receptor agonists and discusses promising new drugs in the pipeline. Finally, Peter addresses questions about the role of compounding pharmacies in the GLP-1 agonist market, compares oral vs. injectable options, and provides key considerations for anyone deciding whether to use a GLP-1 agonist for weight loss.

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We discuss:

  • The rapidly evolving landscape of GLP-1 agonists [2:15];
  • The mechanism of GLP-1 agonists, their origin as diabetes treatments, and how they evolved into weight-loss drugs [6:45];
  • Overview of new data and open questions related to the benefits and risks of GLP-1 agonists [10:30];
  • New insights into the long-term safety of GLP-1 agonists, side effects, and more [16:45];
  • The long-term efficacy of GLP-1 agonists, financial barriers, and more [19:45];
  • The mechanisms behind GLP-1 agonists' ability to promote weight loss [22:00];
  • New data on body weight changes after discontinuing the drug [26:00];
  • Effects of GLP-1 agonists on lean mass and body composition, and the role of protein and resistance training in preserving muscle [31:30];
  • Semaglutide vs. tirzepatide: comparing benefits and side effects [36:30];
  • How compounding pharmacies affect availability of GLP-1 drugs and the types of formulations that are available [39:15];
  • How do oral formulations of GLP-1 drugs compare to injectable formulations? [44:15];
  • How do sublingual (under tongue) formulations of GLP-1 drugs compare to injectable formulations? [46:15];
  • Guidance for using compounding pharmacies to purchase GLP-1 agonists [47:15];
  • Data on retatrutide—a promising new triple receptor agonist in the pipeline [50:15];
  • Can GLP-1 agonists be beneficial for sleep apnea and immune function? [57:00];
  • Potential neuroprotective benefits of GLP-1 agonists: impact on dementia risk [1:00:45];
  • Exploring why GLP-1 agonists may reduce the risk of cancer, kidney disease, and cardiovascular disease [1:04:00];
  • How GLP-1 agonists might boost fertility in women [1:10:15];
  • Early indications that GLP-1 agonists may help treat substance abuse disorders [1:12:00];
  • Potential health risks of GLP-1 agonists: addressing thyroid cancer concerns and the unknowns due to lack of data [1:14:00];
  • Examining the potential link between GLP-1 agonists and increased depression or suicidal ideation [1:16:00];
  • Major remaining questions: the effects of cyclic use, rebound appetite, impact on adolescents' development, and more [1:19:30];
  • Key considerations when deciding whether to use a GLP-1 agonist for weight loss [1:23:45]; and
  • More.

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