Semaglutide for the People
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From Shanghai to New York. I love hotels that feel like a living, breathing part of a city and makes me feel like I'm experiencing that place in an authentic, holistic way.

Hi, everyone. This is Michael. Hey, it's Lauren. We are off this week because Lauren is off. You're snorkeling in the Alps. What are you doing? I was snorkeling in the Alps. Yes, that's what I'm doing, according to Generative AI postcard. Okay. I asked it to make. Well, we have no new show for you this week, but we have a rerun for you. And it's a very good one. It is me in conversation with journalists from Wired, Kate Nibbs,

and Emily Mullen about GLP-1 drugs. That's right. Otherwise known as Ozempic, Wegovy, Manjaro. Everyone's talking about them. It's a huge cultural and scientific moment that we're living through right now with regards to these drugs. I actually wasn't here for this episode, Mike, but I listened to it afterwards. You guys did a fantastic job. And I heard from friends and family and our listeners that they too really enjoyed this episode.

Well, that's great. I'm glad to hear that. I'm glad it resonated with people. And now they get to listen again. So enjoy this episode and we'll be back next week with a new one. Hi, everyone. Welcome to Gadget Lab. I am Michael Kalori, Wired's Director of Consumer Tech and Culture. Lauren Good is off this week. She's on vacation and we miss her dearly. But we have two excellent guests, Wired Senior Writer Kate Nibbs. Hi, Kate.

Hi, Mike. Thanks for having me. Of course. Welcome back to the show and joining us for the first time, Wired staff writer Emily Mullen. Hi, Emily. Hi, Mike. Welcome. Thank you for having me. I'm excited to be here. All this month, Wired is running a special series on our website about the booming business and latest science of anti-obesity drugs.

The series is called The Age of Ozempic, and both Emily and Kate have been reporting stories for this series, so I'm really glad the two of you are here today. Now, most all of you listening have heard the brand name Ozempic. It's the name of a drug and the most well-known name in the class of drugs called GLP-1 agonists. Ozempic, WeGavi, and all the drugs like them mimic the hormone in your body that helps regulate appetite, digestion, and blood sugar.

They're an effective treatment for diabetes and obesity, and people who take GLP-1s typically eat less and they lose a lot of weight. In the second half of the show, we'll talk about the new science behind GLP-1s and what we're still learning about how they work. But first, we have to talk about how people are getting their hands on the drugs, because there's currently an ozempic shortage, so it's expensive and very hard to buy, and

But Kate, you found that it was pretty easy to buy Ozempic clones on the internet. And a lot of people are probably seeing ads for these clones on social media. So why don't we start there?

Yes. So I think anyone who has an account on X or Instagram or TikTok has probably seen at least one of the ads for one of the many, many telehealth clinics that have started selling versions of GLP-1 meds. And there's so much that we don't know about

how many people are taking this kind of medication because I've been reporting this story for weeks on this now and like no one has the numbers. Since Ozempic and Manjaro and Zepbound and Magovi and all of the other name brand GLP-1 agonists are currently in official FDA shortage, it's legal to create what's called a compounded version of these meds.

And that is largely what these telehealth companies are selling online. Some of them do sell the official meds, but they're still priced, you know, $1,000 a month for people without insurance. So they're primarily selling the compounded offerings and

So these are compounded drugs, but they're not generic versions of the drugs, right? Yes. And this is something that I think isn't super common knowledge. I didn't know about it until I started reporting this story. A generic version of a drug is when a patent expires and it's legal to manufacture a non-brand name equivalent.

a compounded version, the patents to the brand names haven't expired. It's just because that they're in shortage, there's this provision in the law that allows you to basically custom mix copies. I think I say in my piece, like in essence, it means dupes are legalized. And compounding, like this isn't a new thing. Compounding has been around for a long time. It's

like it was started because sometimes people will be like allergic to an ingredient in a name brand medication. So they wanted to come up with a way that pharmacies could make a version of a brand name med that someone was able to take if they might not otherwise be able to take it. But what is happening in compounding

Right now with the GLP-1 market is like completely unprecedented. We haven't had compounding at this scale before. So it's pretty wild to witness. OK, so you went to these telehealth companies to try and buy some faux Zempik. And did you have to like talk to a doctor or send a note or anything like that?

When we decided to investigate how these telehealth companies are operating, I selected six different companies basically just off of who I was seeing pop up in my own social media feeds. And I filled out all of their questionnaires. And they all do things. There's little differences, but they basically all required a

questionnaire that you fill out online that was sort of like yes or no questions about your health history. You would click boxes if you'd had any specific conditions that they listed. Then you had to input some of your personal stats. After you did that, I think almost all of them required that I show my driver's license and a few made me take photos of myself. And then one of them had me do a video chat with the doctor.

And then altogether, four of them ended up sending me the meds. None of them asked me for lab work.

And I actually did lie on my app because my BMI isn't in the range that is considered appropriate for being treated with this med. What's the appropriate range? So they generally, I think the FDA's recommendations is if your BMI is 27 and you have a comorbidity that's weight related or 30, just

If it's 30, you can just get it. And so I added 25 pounds to my weight, which is a fairly significant amount. And so we were seeing if anyone would notice the discrepancy when I took photos of myself or if we FaceTimed. We were just curious to see if anyone would catch the exaggeration, especially because

Um, I think I'm kind of one of like the target demographics for this med in that I don't meet the requirements to get it through insurance or for any medical reason. Um, but I would like to lose weight and I, I am the type of person, like if I was in a different place in my life,

I could see myself lying about my weight and actually ordering these meds to take. And I suspect because I'm feeling that way that there's people out there that are doing it. And so that was one of the reasons I was motivated to report this story in this way, because I, I anecdotally can tell you that people who are around my size, I know personally have these compounded meds. And I think it's happening probably at a pretty high

Large scale. It's really hard because there's like literally no statistics on how many people are taking these drugs. But yeah, anecdotally, I'm aware that this is happening, at least on a small scale. I wanted to see, yeah, what whether they would catch me pretty much. So how does the FDA feel about this?

They are definitely concerned, I will say. So the FDA has sent out some letters to different professional groups in the healthcare world advising that compounded semaglutide medications might not be as effective as the name brand versions. And there's also been a lot of concerns about

uh quality control and compounding pharmacies like some of them are are great maybe most of them are great but there's just certain compounding pharmacies were using semaglutide salts instead of just regular semaglutide when they were mixing the medications and the FDA sent out a warning about doing that and there are some of the major compounding pharmacies have had issues in the past um

So the FDA stance is basically that potential patients should be aware that compounded versions of these medications are not subject to the same approval processes as name brands. The FDA is not evaluating them for safety, quality, or efficacy before they're being sold. So there's just some question marks that they think people should know about, especially considering how popular these drugs seem to be.

So I'm guessing you did not take the drugs that you got in the mail. No, it was purely a reporting effort. Um,

We are actually trying to test them. I don't know if this might be sort of spoiling a future story, but I think it's fine because it turns out it's like incredibly hard to test them. But I'm holding on to the samples in the hope that perhaps we can get them tested. If anyone works for a lab and is listening to this, please get in touch. But yeah, we just, it was really just an experiment. And I've also canceled all of my

Accounts because I used our editor in chief's credit card to buy all of them. So they're just hanging out in your fridge. Yes. Okay. I hope they stay there. Yeah. All right. Let's take a quick break and we'll come right back.

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From Shanghai to New York. I love hotels that feel like a living, breathing part of a city and makes me feel like I'm experiencing that place in an authentic, holistic way.

I'm CNN tech reporter Claire Duffy. Claire Duffy was right. I cover artificial intelligence and other new technologies for a living. And even I sometimes get overwhelmed trying to keep up with it all. So I'm starting a new show where, together, we can explore how to experiment with these new tools without getting played by them. It's called Terms of Service. This technology is so crazy powerful. Follow CNN's Terms of Service wherever you get your podcasts.

I want to shift gears a bit and talk about what we're learning from the trials and the research being done on GLP-1 drugs. Emily, for this Wired series, you reported on the so-called non-responders, the people who take anti-obesity drugs and then lose a little bit of weight, but not as much as they were expecting, and maybe not enough to get them down to a healthy weight. So to understand the response of the drug or the non-response of the drug, can you just tell us quickly how the drug works and then how people typically respond to it?

Yeah, so GLP-1 drugs mimic the effects of a naturally occurring hormone that is produced in all of us called GLP-1, and the body makes this and releases it after we eat.

And GLP-1 works in a couple of different ways, and thus GLP-1 drugs work in a couple of different ways. So they work on the gut by slowing stomach emptying and digestion. They also interact with receptors in the brain to increase the feeling of being sated. So they help people feel full faster.

And thus people tend to eat less when they're on these drugs, as you mentioned before. And so they really act as an appetite suppressor is sort of the main way right now that scientists think they are working to help people lose weight.

But as you mentioned, there are some people who take these drugs and they lose a little bit of weight or they might not lose any weight at all. I actually got an email from a reader a couple of days ago and he said he gained five pounds while he was on Ozembic for two months. So clearly these drugs don't work for everyone.

They work miraculously well for a lot of people, but there are about 10 to 15% of people who are non-responders in this group.

is what researchers are seeing in clinical trials. And it's also what doctors and obesity experts are seeing in their clinics right now, that there are a group of people who just don't respond as well. They may lose less than 10% or even less than 5% of their body weight. And as you said, never really get to that healthy weight that they want to get to, that their doctors want them to get to.

Is there a difference between how much weight men lose on these drugs and women lose on them? Yeah. So I'm glad you pointed that out because that does seem to be one of the indicators that people respond differently to these drugs. And

what some of the clinical trials are showing is that women, for whatever reason, seem to lose more weight than men on these drugs. So one possible reason is that women just have a different fat composition than men. Uh,

Another reason is that women on average are smaller than men. And so when you're taking the same amount of a drug and it has less places to go in the body, it's maybe more effective than somebody who is bigger and has more weight on them. I see. So you you can't just like.

take the drug and lose a bunch of weight without also making some other lifestyle changes, right? Yeah, exactly. So in clinical trials of semaglutide and terzapatide and

Just so that listeners are aware, semaglutide, we're talking about Ozempic and Wegovi and trozepatide, we're talking about Munjaro and Zepbound, those brand names. So in clinical trials, of course, these are very carefully designed and people are taking these drugs alongside a very prescribed diet and diet

exercise plan. So these are sort of the ideal conditions of taking this drug. And of course, in real life, people might not be following that quite as well. And another thing is one of the experts I talked to, an endocrinologist, she very astutely pointed out that there are a lot of different reasons why we eat. We don't just eat because we're hungry. We eat because it's a very social thing. And so I

If you are kind of one of those people who are in a lot of situations where there are social temptations to go out and, you know, eat socially or, you know, we eat just because like the food tastes good. Right. I think we all relate to like eating ice cream out of a tub or like finishing off a bag of chips, not because we are actually hungry, but because it just tastes good. Right. I eat because I'm sad or angry. Yeah.

Maybe that's a discussion for another podcast episode. I have a question, Emily, for you. Have you talked to any researchers who have been studying the differences in results between people who are taking brand name Ozempic or Zepbound, et cetera, and people who are taking compounded meds? Because that's something that I've been trying to find out and I haven't found anyone who's studying that yet. Yeah, I haven't run across that.

Is anybody doing any research at all about any of the compound drugs, like their safety or the composition of them? I've been trying to find, yeah, like I've been trying to find studies that are specifically looking at the compounded versions and it's really hard. Like a lot of the more well-established telehealth clinics will have their own, you know, lab work done and some of them will share it, but

independent researchers, I don't know if any of them are listening. I highly encourage them to do it because, you know, I, and again, this is totally anecdotally, but of all of the people that I know on GLP-1 meds, the majority are on compounded medications. Um, yeah, that are willing to talk to me about it. Um, so again, this is totally anecdotal, but we don't have, uh,

there's not really any good stats we can be pointing to, but it seems to me like it's a pretty large percentage of the American public who are taking these drugs or taking the compounded versions. And if there's all these studies that are being done on just the brand names, I'm like, okay, well, did those apply to the compounded versions? I hope so, because those are a lot more accessible to people, but it's just a little freaky what a black box it is right now.

We know, though, that with any drug, there are differences in response rates. But I think there's been such a spotlight on these anti-obesity drugs because their results have been really hyped. And, you know, you can turn on the TV or read anything.

any publication like Wired, like any newspaper and see these amazing weight loss stories. And I think a lot of people go on these drugs expecting to lose a lot of weight. But of course, there are also things like differences in metabolism, how people break down food and convert it into energy. And then researchers are also looking into genetic factors that might be at play. One possibility is that

People might have genetic mutations in their GLP-1 receptors that just make them less responsive to these drugs. Maybe we can talk about some good news, because I know from reading your stories that researchers are coming up with all kinds of data that's showing more positive effects.

effects of these drugs than just weight loss. Can you can you talk about some of those? Yeah. So in March, the FDA actually approved a new indication for a Wigo V or semaglutide to reduce the risk of cardiovascular death, heart attack and stroke.

in adults with cardiovascular disease who are either obese or overweight. This was a pretty big deal because no medication has really ever reached the status of both a weight loss drug and also a cardiovascular drug. So there are lots of cardiovascular benefits that are being shown with these drugs. Yeah, but as you mentioned, Mike, there are lots of knock-on benefits that we're

we're seeing as well. So in addition to the cardiovascular benefits, there was just a study out that showed a reduction in risk of different types of cancers and also kidney disease from people taking

these GLP-1 drugs. So what scientists don't really know yet is whether all these benefits are really just due to the weight loss and people shedding pounds and thus being a healthier weight, or whether there's some other biological mechanism at play. Okay, so I think the thing that a lot of people want to know, and maybe we can solve this for them, is when is the shortage going to end? I would also love to know that. Um...

No one knows. I mean, some people at Eli Lilly and Novo Nordisk probably have the best idea since those are the two manufacturers or like those are the two pharmaceutical companies that own the brand names. It

It could be over in a few months. It could be over in a year. Most drug shortages last a year and a half, and this has been over two years. I think almost three years for semaglutide. A lot of people that I talked to while I was reporting seemed to think that because there are so many exciting new use cases that are happening,

being discovered. There's a world where this drug will go on and off the shortage list repeatedly, like indefinitely. So yeah, there's

The path forward is kind of uncertain. It's also very uncertain what is going to happen to all of these telehealth companies when the drug does come off shortage. Like technically, some of their manufacturers are supposed to cease production immediately. Some of their manufacturers will have like 90 days. But then some people have told me they think that they'll be able to sort of finesse way forward in the regulatory landscape, whether it's by

It's like adding vitamins to the compounded versions and saying it's like a new thing or I don't know. There's there's so many unknowns. That's one of the things that's really fascinating to me about this reporting is like we have this booming industry where all of these telehealth companies are selling compounded GLP one meds.

And they might have to stop like next week. And then what are all the people who are taking the meds going to do? Because the brand names are literally 10 times the amount of money sometimes. It's just it's an unprecedented and wild time in the pharmaceutical world.

I think one of the big issues here is that the pens themselves, the injector pens that are used to administer this drug are difficult to manufacture and produce. And so once we get to a point where there are oral versions of this drug, which Nova Nordisk and Eli Lilly are both working on right now,

If there's a pill version, if there's an alternate version, I think that's going to free up the injectable version more. And then I also think once there are more competitors in the market, stay tuned for my next story about this. There's a whole pipeline of more GLP-1 drugs coming and

anti-obesity drugs that target other things completely. So there are more of these on the horizon. And right now we're relying on these two companies to produce the world's entire supply of these drugs. So, yeah, there are going to be shortages for the foreseeable future until I think there's more competition. Great. See, more good news. It's a good place to end. Let's take a quick break and we'll come right back with recommendations.

This week on The Assignment with me, Adi Cornish. How the UFC has become a key part of a broader Trump campaign strategy to turn out disaffected young men looking for a political home. The kind of voters who have been peeling off from the Democratic Party the last few years. We talk about why that is. What, if anything, Democrats can do about it. Listen to The Assignment with me, Adi Cornish, streaming now on your favorite podcast app.

All right. Welcome back to the end of the show. This is where we go around the room and we ask everybody to offer a recommendation for a thing that our listeners might enjoy or a piece of advice. Emily, what is your recommendation for our audience? I'm just going to recommend staying cool right now because it's really, really hot and there's some dangerous temperatures. Right now it is...

in the 90s where I am and I don't have AC so I'm trying to keep cool by keeping my shades shut and with ice cubes and cold drinks and cold compresses and staying in the shadows like a hermit sounds like you need a heat pump yeah

Next on the podcast or you probably already covered. Oh, yes. We love heat pumps at Wired. Everybody go back like three or four weeks and listen to our heat pump episode. It helps you stay cool. It's not just about pumping heat. Well, that's that's too bad. I mean, it's right in the middle of the summer and I know a lot of people are suffering. Sorry, I need water. Electrolytes. Kate, what is your recommendation?

Okay, well, if you're keeping cool and you're staying inside with the shades drawn, I think you should watch what I'm currently watching, which is the 2008 HBO miniseries, John Adams, starring Paul Giamatti as the second president of the United States. I decided to rewatch this in like a weird patriotic fit over the 4th of July because my husband's Canadian and actually like still doesn't know that much about American history.

and was like who's John Adams and I went on this rant and so now we're on like episode six and honestly it's it's good it's entertaining it's like if Hamilton had no songs and was kind of boring um but not a story that's not a great pitch okay

It will lower. I feel like if you're hot and sweaty and just looking for something calm, like John Adams is going to keep you cool. You might take a nap. Who knows? That is my run. Is it some good Giamatti music?

Yeah, the acting is great. And actually, I've one of the fun parts of rewatching it has been, yeah, because I've already seen it. This is just a casual rewatch. There's like a lot of famous people today who pop up like Andrew Scott, who plays a hot priest in Fleabag is like a ne'er do well, sadist.

son-in-law of John Adams and then I'll watch it just for him. Yeah. Cousin from the bear. I've been, I forget what his last name is. He is John Quincy Adams, AKA the sixth president of the United States. It's great. You should check it out. Mike, what's your recommendation? My recommendation is shoot film. I, you know, I'm an old person and I, I learned how to shoot film in like 2010.

Grade school, junior high school, something like that. And then digital cameras happened and I forgot all about it and I haven't developed a roll of film in like well over a couple of decades. But recently I was just at a flea market and I found a very nice like 1979 Minolta camera.

automatic camera, a film camera, 35 millimeter film camera for a very low price. And I bought it and I shot a few rolls on it and I got the results back and I am just like blown away at how much fun this

It is to take pictures and not see what they look like until a couple of weeks later, and then be very pleasantly surprised by the quality of an inexpensive film camera. So it's like, you know, photography has always been a hobby of mine. Digital photography is a hobby of mine. If you follow me on Instagram, you know that I'm an excellent photographer. So, um,

Getting a film camera and shooting different kinds of things is good. It's good for your brain. It's good to put your phone away. It makes you think about things in a very different way. You get to learn a new skill. So, yeah, shoot film. That's my that's my rec. I had a Holga in college, which made me feel very artsy. Yeah, that's awesome. Did you ever have a Lomo, the other plastic camera? No, no.

Yeah, those things are great. And films, it's pretty expensive. I'll say it's like the getting one roll of film, like buying a roll of film and then getting that roll of film developed is more than I paid for the camera.

So you can get like if you know, if you want to if you want to get cheap film, it's around seven, eight, nine dollars a roll. If you want to get good film, it's closer like 15, 20 dollars a roll. And then developing it, you send it away and pay for shipping and then they send you scans via email. And it's like, you know, it's about 15 dollars a roll. So it is expensive, but I think it's worth it. Love that. You got to take you got to take our picks when we come to San Francisco later this year. I promise I will.

Okay. All right. Well, that is our show for this week. Watch out for the series of stories this month on Wired.com called The Age of Ozempic. Emily Mullen, Kate Nibbs, thank you for joining us. Thanks for having us. Emily, it's an audio medium. You can't just wave.

I gave a thumbs up. Excellent. Well, he spoke for both of us. Thanks for having us. No, yeah. Yeah. And thank you all for listening. If you have feedback, you can reblog all of this on Tumblr. Just check the show notes. Our producer is the superlative Boone Ashworth. Lauren and I will be back next week with a new show. Until then, goodbye.

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