On The Pen GLP-1 News

This week on On The Pen, the GLP-1 story is moving in two very different directions.

The Fifth Circuit handed FDA major wins in the fight over semaglutide and tirzepatide shortages, FDA updated its consumer guidance around compounded GLP-1 medications and multi-dose vials, and employers continue questioning whether they can afford obesity-drug coverage.

At the same time, the medical case for these medications keeps getting stronger.

We break down Mounjaro’s new cardiovascular indication and what preventing heart attacks and strokes could mean for the true long-term cost of GLP-1 treatment. We also look at 600,000 Medicare beneficiaries already enrolling in the $50 GLP-1 Bridge program, California’s effort to tackle affordability, the rapidly expanding oral GLP-1 market, and new real-world data on patients staying at lower doses of semaglutide and tirzepatide.

The science is expanding. Access is contracting.

And that may be the biggest challenge facing the next phase of the GLP-1 revolution.

In this episode:
• What the Fifth Circuit compounding decisions actually mean
• FDA’s updated language around compounded GLP-1 vials
• The 28-day multi-dose vial controversy
• Mounjaro’s new cardiovascular indication
• Why GLP-1s may reduce long-term healthcare costs
• Employers dropping obesity-drug coverage
• 600,000 people joining the Medicare GLP-1 Bridge
• California’s push for lower GLP-1 prices
• The oral GLP-1 race
• New data on lower-dose semaglutide and tirzepatide

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This content is for informational and educational purposes only and is not medical advice. Always discuss medication and treatment decisions with a qualified healthcare professional.

GLP-1 access is getting tighter just as obesity treatment is becoming more effective, more affordable, and more important to public health.

In this episode of the On The Pen Podcast, Dave Knapp breaks down two of the biggest GLP-1 stories of the week: why most states are opting out of the Trump administration’s new Medicaid obesity-drug coverage model, and why employers are preparing to cut GLP-1 coverage in 2027.

We also dig into the growing conversation around GLP-1 microdosing after Real Housewives of Orange County star Emily Simpson described using a lower-frequency maintenance strategy after losing around 50 pounds. Could lower-dose or intermittent GLP-1 therapy eventually become a legitimate maintenance tool? Could it help lower long-term healthcare costs? And could earlier, lower-intensity treatment eventually become a form of prophylaxis against obesity-related disease?

This episode covers Medicaid GLP-1 coverage, the BALANCE model, Zepbound coverage, Wegovy coverage, employer insurance changes, compounded GLP-1 access, GLP-1 microdosing, obesity maintenance, semaglutide, tirzepatide, metabolic disease prevention, obesity medicine, healthcare costs, and the future of GLP-1 treatment.

If you take Ozempic, Wegovy, Mounjaro, Zepbound, compounded semaglutide, compounded tirzepatide, or simply follow the rapidly changing world of obesity medicine, this is a conversation you need to hear.

Subscribe to On The Pen for breaking GLP-1 news, obesity medicine updates, access and insurance coverage news, new weight-loss drugs, clinical research, and patient advocacy.

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#GLP1 #Ozempic #Wegovy #Mounjaro #Zepbound #Semaglutide #Tirzepatide #Microdosing #ObesityMedicine #WeightLoss #Medicaid #HealthInsurance #CompoundedGLP1 #Obesity #GLP1News

Could GLP-1 medications eventually cost just $40 to $50 per month? Hims & Hers CEO Andrew Dudum thinks so, and if he’s right, it could completely change access to obesity treatment in America.

But getting there may depend on something most patients have never heard of: the global peptide manufacturing supply chain.

In this episode of The Weekly Dose from On The Pen, Dave Knapp, Man on the Mounjaro, breaks down one of the biggest weeks in GLP-1 and obesity medicine news, including the surprising role of Chinese pharmaceutical manufacturer WuXi AppTec, which Bloomberg described as having a “GLP-1 chokehold” while U.S. policymakers wrestle with reducing America’s dependence on Chinese biotechnology.

We also dig into one of the strangest GLP-1 stories of the year. Amylyx Pharmaceuticals just reported positive Phase 3 results for avexitide, a GLP-1 receptor antagonist, meaning it actually BLOCKS GLP-1. The drug reduced serious hypoglycemic events by 55% in patients with post-bariatric hypoglycemia, a debilitating condition that can occur after gastric bypass surgery.

Then we get personal.

Online personality Clavicular recently described becoming apathetic while taking a high dose of retatrutide, renewing the conversation around GLP-1 medications, anhedonia, emotional blunting, dopamine and reward signaling. Dave has firsthand experience with anhedonia during GLP-1 treatment and previously discussed that experience as part of coverage on the Today Show.

At what point does turning down food noise start turning down everything else?

We also examine Serena Williams’ return to professional tennis while openly using Zepbound (tirzepatide) and the growing debate over whether GLP-1 medications could ever be considered performance-enhancing drugs in professional sports.

Plus, new research suggests GLP-1 medications and significant weight loss may improve testosterone levels and fertility markers in men with obesity-related low testosterone, raising important questions about metabolic health, hypogonadism and when testosterone replacement therapy may or may not be appropriate.

In this episode:

💉 Could Ozempic, Wegovy, Mounjaro and Zepbound eventually cost $40 to $50 per month?

🇨🇳 Why WuXi AppTec and China matter to the global GLP-1 supply chain

💰 How manufacturing capacity could determine future GLP-1 prices

🧬 Amylyx avexitide Phase 3 results and the “anti-GLP-1”

🩸 Post-bariatric hypoglycemia after gastric bypass surgery

🧠 Retatrutide, anhedonia, apathy and emotional blunting

⚖️ Why anecdotes about GLP-1 side effects still need scientific context

🎾 Serena Williams, Zepbound and the performance-enhancing drug debate

💪 GLP-1 medications, weight loss and testosterone in men

🧬 Obesity, metabolic health, fertility and hypogonadism

The goal here isn’t to cheerlead GLP-1 medications or scare patients away from them. It’s to understand what the headlines actually mean so patients can have better conversations with their healthcare providers.

If GLP-1 medications were available for $40 to $50 cash per month without insurance, would that change your ability to stay on treatment? Let me know in the comments.

And if you’ve experienced anhedonia or emotional flattening while taking a GLP-1 medication, particularly after increasing your dose, I’d be interested in hearing about your experience as well.

The Weekly Dose is shot live in the Bask Health Studio. Learn more at bask.health

Thanks to VoaFit and the MyLevel app for sponsoring the podcast. Learn more at voafit.com/otp

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On The Pen covers breaking news and patient-focused reporting on obesity medicine, GLP-1 medications, Ozempic, Wegovy, Mounjaro, Zepbound, tirzepatide, semaglutide, retatrutide, compounded GLP-1 medications, obesity treatment, type 2 diabetes, metabolic health and the next generation of obesity medications.

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Based on the transcript flow, here’s a clean YouTube description with chapter timestamps. The transcript itself doesn’t include timecodes, so these are estimated from speaking pace and topic position. 

A GLP-1 Death_ Chrissy Metz & a Stunning Harvard Study.txt

More than 200 deaths in the UK have now been reported in association with GLP-1 medications, including the heartbreaking death of a 19-year-old woman taking tirzepatide.

But the headline does NOT tell the whole story.

Today, we unpack what those 216 reports actually mean, what investigators found in the death of Josephine Nassar, and why adverse-event reports are very different from proving a medication caused a death.

Plus, This Is Us star Chrissy Metz reveals she is using a GLP-1 to treat obesity, and I think what she did deserves a lot more respect than she’s getting.

Then we dig into a stunning new Harvard working paper examining what happened to women’s employment and relationship outcomes after starting GLP-1 treatment, and Starbucks becomes the latest major employer to pull GLP-1 coverage for obesity.

This is a BIG episode.

⏱️ CHAPTERS

00:00 The GLP-1 headlines you need to know
01:40 VoaFit / MyLevel
03:30 200+ GLP-1 deaths reported in the UK
04:25 The tragic death of 19-year-old Josephine Nassar
09:40 The hidden heart condition found after her death
12:30 Did tirzepatide contribute to her death?
15:35 What the UK’s 216 GLP-1 death reports actually mean
19:15 Pancreatitis and how regulators identify real safety signals
22:35 Chrissy Metz reveals she’s taking a GLP-1
24:35 Why Chrissy Metz’s decision to tell the truth was incredibly brave
27:05 Harvard’s stunning “Obesity Penalty” study
30:30 Starbucks drops GLP-1 coverage for obesity
33:10 What happens when employers stop paying for these drugs?
34:15 Final thoughts and your call to action

If you’ve lost significant weight, I want to hear from you: Did people start treating you differently?

And if your employer stopped covering your GLP-1, would you consider changing jobs to keep access to treatment?

👇 Drop your experience in the comments.

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On The Pen brings you the stories and information that empower you to have better conversations with your doctor.

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#GLP1 #Mounjaro #Zepbound #Ozempic #Wegovy #Tirzepatide #WeightLoss #Obesity #ChrissyMetz

If you give me the actual final runtime of the uploaded video, I can tighten those timestamps much closer to the real chapter breaks.

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Novo Nordisk has spent years warning patients, regulators, lawmakers, and courts about the risks of synthetic semaglutide. Now, as patents begin to expire and China’s pharmaceutical industry becomes increasingly important, Novo may be staring at a very uncomfortable question: what happens if synthetic semaglutide suddenly makes sense when Novo is the one making it?

In this week’s episode of The Weekly Dose, I dig into Novo’s long-running recombinant-versus-synthetic semaglutide argument, the lawsuits and FDA petitions built around it, and a clip from more than 16 months ago showing that we were covering this exact issue long before it became part of the mainstream conversation. Novo Warned Us About Synthetic Semaglutide_ Now This_.txt

We also break down Pfizer’s decision to kill two clinical-stage obesity drugs, including an oral GLP-1 acquired through its $10 billion Metsera deal, the strange science behind GIP receptor antagonism, and why Pfizer’s remaining obesity pipeline still deserves attention. Plus, Wall Street is looking at Eli Lilly’s obesity-fueled rally and asking just how big this market can get.

In this episode:

00:00 Novo’s synthetic semaglutide problem

02:00 VoaFit sponsor message

03:30 The 16-month-old On The Pen receipt

05:00 Recombinant vs. synthetic semaglutide

07:00 Novo’s FDA, legal, and political strategy

09:00 Pfizer kills two obesity drugs

11:00 What happened to Metsera’s oral pipeline?

13:00 The GIP agonist vs. antagonist paradox

15:00 Why China matters to Pfizer and Novo

17:00 Could Novo eventually make synthetic semaglutide?

18:30 What comes next for Lilly, Novo, and Pfizer

The big question: If Novo Nordisk eventually launches its own synthetically manufactured semaglutide, does that change how you view the arguments it has made against compounded semaglutide over the last several years?

Comment below. I want to know where you land.

More obesity medicine news and analysis: OnThePen.com

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This episode is sponsored by VoaFit. Learn more at voafit.com/otp.

#GLP1 #Semaglutide #Ozempic #Wegovy #NovoNordisk #CompoundedSemaglutide #ObesityMedicine #Pfizer #EliLilly #Mounjaro #Zepbound #Metsera

https://www.otplinks.comhttps://www.voafit.com/otpEpisode Referenced: https://www.youtube.com/watch?v=K8kaSoFCZ0c&t=41sThe retatrutide biologic fight is bigger than folks understand.This breakdown covers the current situation surrounding the retatrutide discussion. If you have been following the narrative, this episode provides context on why this biologic fight is garnering a lot of attention, and more importantly why it matters to every person watching this space. I first reported on these developments two years ago and offer insights gained from direct conversations with industry experts.We analyze the trajectory of this controversy to help you separate the signal from the noise. This episode serves as a vital update for anyone trying to track the retatrutide saga as it continues to evolve.Subscribe for weekly internet news breakdowns and let me know in the comments if you want more updates on this story as it develops.

Novo Nordisk just declared legal war on Eli Lilly as the battle over GLP-1 patients intensifies. But just because patients are being fought over does not mean they are being fought for.

In this episode, we break down Novo Nordisk’s lawsuit accusing Eli Lilly of misleading patients through advertisements comparing Zepbound and Mounjaro with Wegovy and Ozempic. The fight is not simply about which medication produces more weight loss. It is about who controls the information patients receive, which evidence gets highlighted, and what gets left in the fine print.

Then we examine STAT News’ investigation into LifeMD, a major telehealth company promoted by Novo as a legitimate pathway to GLP-1 treatment. Former employees alleged providers were pushed to process patients at breakneck speed, sometimes reviewing as many as 25 cases per hour, while refill queues, dose increases and patient messages piled up. LifeMD strongly disputes those allegations.

But this cannot become another simplistic story about telehealth being bad.

More than 100 million Americans are living with obesity, and only a small number of clinicians have dedicated obesity medicine expertise. The traditional healthcare system does not have enough specialists, appointment slots or geographic reach to provide every patient with an ideal, hour-long consultation.

So how altruistic can we afford to be about access?

Can we demand a perfect standard of care that most patients will never be able to reach? Or does scaling treatment too aggressively risk turning patients into transactions inside a prescription machine?

Access cannot become a shield for negligence. But perfection cannot become another form of gatekeeping.

The patient is being fought over. This episode asks what it would actually mean to fight for them.

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This episode is sponsored by VoaFit, where I receive care for obesity and metabolic health.

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What happens when patients stop taking a GLP-1? New real-world data reveals that more than half eventually come back, and it may completely change the way we think about obesity treatment.

In this week's On The Pen Podcast, we're breaking down one of the biggest shifts happening in obesity medicine. We dive into new research on GLP-1 persistence, the early challenges facing Medicare's obesity drug rollout, and why pharmaceutical companies are racing to solve the problems patients have been talking about for years.

We also discuss the next generation of obesity therapies, including oral GLP-1s, implantable medications, muscle-preserving treatments, and why the future of obesity medicine may be less about losing more weight and more about helping patients stay healthy for the long term.

In this episode:
• Why patients who stop GLP-1 therapy often return
• The first weeks of Medicare's obesity medication coverage
• The future of oral GLP-1 medications
• New implant technology from Novo Nordisk
• Muscle-preserving obesity treatments
• Why patient experience is becoming the next frontier in obesity medicine

The goal of On The Pen has always been simple: translate complex obesity and diabetes news into information that helps you have better conversations with your doctor.

👇 What has been your biggest obstacle to staying on treatment? Insurance? Cost? Side effects? Tell us in the comments.

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👍 If you found this helpful, please Like, Subscribe, and Share this episode with someone navigating obesity, diabetes, or GLP-1 treatment.

#GLP1 #Obesity #WeightLoss #Zepbound #Mounjaro #Ozempic #Wegovy #ObesityMedicine #Type2Diabetes #OnThePen #Healthcare #Medicare #Podcast

What If We've Been Asking the Wrong Question?Patients say compounded GLP-1s are more effective than branded medications. Dave explains why the answer may have nothing to do with the drug itself, and everything to do with the patient experience.

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Millions of Medicare beneficiaries are about to gain access to GLP-1 weight loss medications for as little as $50 per month through the new Medicare Bridge Program, launching July 1. In this episode of On The Pen, Dave Knapp sits down with obesity medicine expert Angela Fitch to break down exactly who qualifies, how to apply, which medications are covered, and what this historic expansion of obesity treatment access means for patients across America.

We discuss:
✅ Medicare Bridge Program eligibility requirements
✅ Zepbound, Wegovy, Foundayo (orforglipron), and GLP-1 coverage updates
✅ BMI and comorbidity qualifications
✅ Prediabetes, sleep apnea, cardiovascular disease, and obesity treatment access
✅ How Medicare patients can obtain GLP-1 medications
✅ Why obesity is finally being treated as a chronic disease
✅ The future of obesity medicine and Medicare coverage
✅ Concerns about access to care vs access to medication
✅ Muscle loss, nutrition, strength training, and healthy weight loss
✅ The Treat and Reduce Obesity Act (TROA)

This may be one of the most important developments in obesity treatment history, potentially opening the door for millions of Americans living with obesity, prediabetes, cardiovascular disease, and other weight-related conditions to receive evidence-based care.

📖 Read more obesity medicine news at Obesity.News
🔗 All links: linktr.ee/manonthemounjaro

#GLP1 #Medicare #Zepbound #Wegovy #Obesity #WeightLoss #ObesityMedicine #MedicareBridgeProgram #Tirzepatide #Semaglutide #Foundayo #Orforglipron #Prediabetes #Type2Diabetes #WeightManagement #AngelaFitch #OnThePen #MedicareCoverage #GLP1News #ObesityTreatment #HealthcarePolicy #WeightLossMedication #ChronicDisease #Mounjaro #Retatrutide #Lilly #NovoNordisk #ObesityAdvocacy #GLP1Community #MedicarePatients

ADA 2026 delivered a massive wave of obesity and diabetes data, and in this episode of On The Pen, Dave Knapp (@manonthemounjaro) sits down with Jen (@JcanNuSH) ​⁠ to break down the molecules, clinical trials, weight loss results, and safety signals that could define the next generation of obesity and diabetes medicine.

We dive deep into Survodutide, Mazdutide, UBT251, Berobenatide (MET-097), CagriSema, Zenagamtide (formerly Amycretin), Petrelintide, and so much more!

From GLP-1/glucagon dual agonists to triple agonists targeting GLP-1, GIP, and glucagon, the obesity treatment landscape is becoming more competitive than ever. Which therapies showed the strongest weight loss? Which struggled with tolerability? And what do these results mean for patients living with obesity, type 2 diabetes, MASLD, sleep apnea, and other metabolic diseases?

In this episode:

✅ Survodutide obesity and liver fat reduction data

✅ Mazdutide Phase 3 obesity and diabetes results

✅ UBT251 triple agonist weight loss data

✅ Berobenatide (MET-097) long-acting GLP-1 updates

✅ CagriSema diabetes and obesity trial results

✅ Zenagamtide (Amycretin) injectable and oral development

✅ Petrelintide amylin agonist info

✅ Future GLP-1, GIP, glucagon, and amylin therapies

The future of obesity medicine is no longer just about who produces the most weight loss. It’s about matching the right therapy to the right patient, improving tolerability, and addressing metabolic disease beyond the number on the scale.

Read more obesity medicine news at obesity.news

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#ADA2026 #Retatrutide #CagriSema #Survodutide #Mazdutide #UBT251 #Berobenatide #MET097 #Zenagamtide #Amycretin #Petrelintide #Inisepatide #Elcaglipron #GLP1 #ObesityMedicine #WeightLoss #Type2Diabetes #Zepbound #Mounjaro #Wegovy #GLP1News #ObesityResearch #DiabetesResearch #OnThePen

Dave sits down with nurse practitioner and former Retatrutide clinical trial participant David White to break down the biggest obesity headlines from the 2026 American Diabetes Association Conference. Together, they explore the latest data on Retatrutide's potential to deliver bariatric surgery-level weight loss, improve cardiometabolic health, and reshape the future of obesity and type 2 diabetes treatment.

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Dave breaks down an unreported Expanded Access Pathway that Eli Lilly has quietly established for Retatrutide.

Does Eli Lilly already have the solve for obesity? In this episode of On the Pen — the Weekly Dose Podcast, host Dave Knapp breaks down a stunning comment from Lilly's Chief Scientific Officer Daniel Skowronski, who suggested that obesity could become a solved disease within just a few generations of innovation.

What does that mean for the millions of patients still fighting for access to GLP-1 medications like Zepbound, Mounjaro, and tirzepatide? And what is Lilly seeing in its pipeline that the rest of us can't?

We dig into:

If you're on Zepbound, Wegovy, Ozempic, or any GLP-1 medication — or you're waiting for the next generation of obesity drugs — this episode is for you.

🔔 Subscribe for weekly updates on obesity medicine, GLP-1 news, and what it all means for patients.

💊 Sponsored by Shed — visit TryShed.com and use code OTP25 to save 25% on obesity care.

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This episode examines a serious case involving retatrutide, where an individual experienced an overdose due to improper medication administration. We discuss the critical importance of medication safety and patient safety, especially concerning prescription drugs.The discussion also touches upon a recent report of liver failure following the Foundayo launch, emphasizing the need for vigilant drug safety and thorough error analysis to prevent future incidents.

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1. 🚨 The 40mg Retatrutide Overdose Case — 0:00:02A 32-year-old self-administered gray market Retatrutide, forgot he'd dosed, injected again — hitting 40mg. The setup for the whole episode.

2. 🏥 What Actually Happened to Him (ER Visit & Why It Matters) — 0:05:02Deep dive into the published medical case: severe diarrhea, dehydration, kidney danger, and the frightening ease with which it happened.

3. ⚠️ Gray Market GLP-1s: The Real Risk Nobody's Talking About — 0:07:20How buying unregulated research peptides means guessing on purity, dose, and contents — and why that's terrifying at scale.

4. 💊 Orforglipron (Fondayo) & the Liver Failure Report — 0:13:00 (approx.)One month after Fonda's launch, a liver failure report emerges. The FDA's concerns, elevated liver enzymes in trials, and why Lilly scaled back from 45mg to 36mg in Phase 3.

5. 🔗 How These Two Stories Connect: Clinical Trials vs. the Real World — 0:16:31The through-line of the episode: drugs behave differently outside controlled settings. Peptide influencers hawking research-grade OrforglprIon pills mid-fast is the canary in the coal mine.

6. 🚪 Compounding Access Is Being Squeezed — State Boards, Lawsuits & the Gray Market Funnel — 0:19:06State medical boards in CA, RI, and KY pressuring doctors. As regulated access tightens, patients don't stop — they just shift to riskier sources.

7. 📱 Introducing the Pivot App: A GLP-1 Tracking Tool for Patients — 0:21:55Interview with Shed's Chief Product Officer Kyler Ockey about the Pivot app — dose logging, daily habit tracking, weekly check-ins, and why patient self-tracking is critical to safe GLP-1 use.

We just got done listening to the quarter one, 2026 Eli Lilly earnings call. There was a lot of information to get into, whether you're interested in retatrutide, eloralintide, or Foundayo, and all of the numbers that were so incredible to hear. This video analyzes Eli Lilly's Q1 2026 earnings call, discussing key products like eloralintide, brenipatide, and retatrutide, providing essential finance news and stock market news for those tracking pharmaceutical companies. The presenter highlights the strong start of Foundayo's U.S. launch and reviews the Lilly Select Pipeline, touching upon the U.S. Incretin Analogs Market and broader healthcare industry trends.

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A new GLP-1 and glucagon agonist dropped data that was supposed to rival retatrutide, just without the GIP, and on the surface the results look solid. But that is not the real story. Even when people successfully lose weight, a large percentage gain it back, and for years that has been framed as a failure of discipline or willpower.

This episode breaks down new research that helps explain why that happens. A study published in EMBO Reports shows that obesity can leave lasting changes at the cellular level through epigenetics, where gene activity is altered without changing the DNA itself. Researchers found that immune cells remained in a pro inflammatory, metabolically altered state even after weight loss, with some of these changes potentially lasting for years.

In practical terms, this means the body does not simply return to a neutral baseline after weight loss. It can continue to operate as if it is still in an obese state, which helps explain why so many people feel like their body is working against them. This shifts the conversation away from personal responsibility and toward biology, reinforcing the idea that obesity is a chronic, relapsing metabolic disease.

That distinction matters because it changes how treatment should be approached. If the underlying biology does not fully reset, then short term solutions are unlikely to be effective long term. These medications may not just be tools for losing weight, but part of ongoing management for a system that retains a memory of obesity and requires continued intervention.

Major disruption hits the GLP-1 landscape as another large 503B compounding pharmacy halts production of semaglutide and tirzepatide. In this episode, we unpack what’s driving the FDA’s increased enforcement and why these shutdowns could signal a broader shift in the compounded medication market.

Joined by Sabina Hemmi from glpwinner.com, we break down the key differences between 503A and 503B pharmacies, what these changes mean for supply and patient access, and why delays in prescriptions may be on the horizon. We also dive into the growing legal battles between pharma companies and telehealth providers and what that could mean for the future of affordable GLP-1 options.

If you’re using or considering compounded GLP-1s, this episode covers what you need to know right now and what could be coming next.

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What if the most powerful obesity drug ever created ends up being the one you can’t get?

That’s the real conversation around retatrutide right now.

In this video, I break down what Eli Lilly is doing behind the scenes, and why this isn’t just about whether retatrutide is better than tirzepatide. This is about strategy. This is about access. And this is about who gets left behind.

We’re talking about:
• The push to classify retatrutide as a biologic
• Why that could mean pricing in the $7,000/month range
• How LillyDirect is changing access to tirzepatide
• The “two lane” system that could define obesity treatment going forward
• And what this means for patients already struggling to stay on GLP-1 therapies

If you’ve ever fought insurance, dealt with compounding disappearing, or felt like the system decides what you’re allowed to have… this one is for you.

👇 Let’s talk about it
Have you ever felt stuck between “this is working” and “this isn’t enough”… with no clear path forward?

This conversation dives headfirst into one of the most controversial and least understood side effects of GLP-1 medications, what many are now calling the “Ozempic personality.” In this candid interview, Dr. Spencer Nadolsky joins On The Pen to unpack the growing reports of anhedonia, a flattening of motivation, desire, and emotional highs that some patients experience, especially at higher doses of tirzepatide and similar therapies.

What starts as a discussion about how these medications work in the brain quickly turns into something much deeper. We explore how GLP-1 and GIP receptor agonists don’t just reduce hunger, they fundamentally alter the brain’s reward system, dampening cravings, food noise, and in some cases, the very drive to seek pleasure at all. That is where the idea of the “Ozempic personality” begins to take shape, not as a diagnosis, but as a shared patient experience that is only now being taken seriously.

Dave opens up about his own journey, spending years at the highest dose and slowly realizing that while the medication gave him control over food and blood sugar, it also quietly muted parts of his identity. Hobbies faded. Motivation shifted. The highs and lows of life became more… flat. And it wasn’t until stepping away that he could see the contrast clearly.

Dr. Nadolsky brings clinical perspective to match the lived experience, explaining how this isn’t classic depression, but something more nuanced. Patients aren’t necessarily sad, they just stop wanting things. He shares how often this shows up in his practice, how he identifies it, and most importantly, how adjusting dose rather than stopping treatment altogether can restore balance.

The conversation also raises bigger questions about transparency in clinical trials, what drug companies knew about these “anti-hedonic” effects, and why something so impactful may not have been formally tracked. At the same time, both Dave and Dr. Nadolsky emphasize what matters most, these medications are still life changing, even life saving, but they are not one size fits all.

If you’ve ever felt like something changed beyond just your appetite while on a GLP-1, this is the conversation you’ve been waiting for. It puts language to an experience thousands are having but struggling to explain, and it gives you something even more important, a path forward.

Watch the full interview to understand the reality behind the “Ozempic personality,” how to recognize it, and how to work with your doctor to find your own sweet spot.

Orforglipron (also known as Foundayo) is one of the most promising drugs in the GLP-1 space, notably as only the second oral GLP-1 option for obesity. Unlike injectable treatments, it does not require refrigeration and is easier to scale for widespread use.

Dave highlights the ongoing questions that linger about the drugs approval as it relates to liver safety.

If you just look at the headlines, things look great for access to GLP-1 medications but for some of those already using these medications things are changing and getting tighter. Listen in as Dave breaks down the news of the week and puts it all in context.

Topics:

The GLP-1 paradox, Rise of telehealth powerhouses, FDA guidance on compounding, Enforcement risks and industry impact, Peptide imports and gray market concerns, New branded drug developments, Expansion of oral GLP-1 medications, New oral drug launches, Where the market is heading.

Are you on tirzepatide or semaglutide and struggled with inconsistent weight loss and side effects? On this episode of On The Pen, Dave Knapp and Dr. Ian Ellis dive into the surprising variability of GLP-1 dosing (retatrutide, tirzepatide), even when the weekly dose remains the same. We explore how these subtle dosage changes can lead to frustrating glp-1 side effects and why many individuals eventually give up on their weight loss medication. This new way of thinking about glp-1 dosing could change the obesity medicine game. Referenced Links: http://www.OTPLinks.com00:00 Why most GLP-1 users are never on the same dose twice01:55 Dr. Ian's background: trainer, nutritionist, ER physician04:00 His obsessive relationship with food and body composition07:45 The two impossible choices: obsession or obesity10:12 How medical school destroyed his health10:25 A colleague mentions Ozempic for the first time11:35 His first dose and what real satiety feels like13:00 Why the same dose felt worse every single week15:00 30 lbs lost but the body scan results were horrifying17:30 Why elderly patients are especially at risk on GLP-1s18:35 Patient case: Pat May, 310 lbs, lost over 100 lbs20:45 Semaglutide half-life and dose stacking explained24:50 The therapeutic window and finding your ideal level26:30 Why the dosing protocol was built for trials not people28:00 You are never on the same drug level twice29:00 Patient case: Mary Alice lost 30 lbs below the starting dose32:00 The math behind calculating your precise GLP-1 level35:00 The VoaFit app and making precision dosing scalable36:00 Their patients lost more weight using half the medicine39:30 Why 40 to 70 percent of people quit GLP-1s42:00 Compounding pharmacies and the case for flexible dosing46:00 Using GLP-1 as a thermostat dial for your appetite56:45 Where precision dosing is available now58:30 Beyond GLP-1s: applying this to testosterone and more1:05:30 Why hitting the dose ceiling kills long-term results1:07:00 Dr. Ian's outcome: off GLP-1s completely1:10:00 Fixing a broken one-size-fits-all dosing paradigm1:13:00 How to find Dr. Ian Ellis and VoaFit

A major shift in obesity treatment is underway following a surprising pricing move that could change how patients access care. This episode explores the growing divide between traditional healthcare and alternative pathways, the real tradeoffs behind cost and safety, and what the future may hold for medications, access, and long term health.

TOPICS:

Wegovy Price Drop Changes EverythingWhat This Podcast CoversNew Savings Programs ExplainedWhy This Is Bigger Than PriceThe Broken Healthcare SystemRise of Telehealth & CompoundingThe New Parallel System of CareGray Market vs Medical AccessSafety vs Strength DebateRisks of Unregulated MedicationsWhy Long-Term Support MattersGray Market Supply ConcernsPharma Pressure & RegulationWhat Happens If Access ChangesTrust Issues with the System The Core Question: Safety or PowerAre OTC GLP-1s Coming?New Oral Drugs & NexboundWhy Pills Could Change EverythingAccess vs CareGLP-1s as Longevity DrugsEli Lilly’s Big Bet on the FutureThe Next 5–10 Years

Access to compounded and research-grade GLP-1s may be tightening, as comments from Robert F. Kennedy Jr. signal increased enforcement and a push back toward branded medications. At the same time, new data on retatrutide shows powerful results for people with type 2 diabetes, while drug companies are already developing next-generation therapies beyond GLP-1s.

Todat's topics:

The Throttling of Compounded GLP-1sFDA vs Telehealth, What’s Really HappeningThe Truth About “Research Peptides”The Rule That Created the Black Market If You Rely on This, Here’s What’s ComingWhy They Want You Back on Branded DrugsRetatrutide Might Be the Most Powerful YetThe Data That Changes Everything (Diabetes + Weight Loss)What Comes After GLP-1s, The Next Wave

On The Pen breaks down the latest GLP-1 news, compounded semaglutide updates, tirzepatide controversy, FDA and DDC list developments, Novo Nordisk findings, Eli Lilly B12 tirzepatide concerns, and new oral obesity drug data from Structure Therapeutics. If you follow obesity medicine, weight loss drugs, peptide news, semaglutide, Zepbound, Wegovy, Ozempic, Mounjaro, and patient advocacy, this episode is for you.

WAYS TO SUPPORT MY WORK ⬇️http://www.otplinks.com00:00 Massive compound shakeup00:00:43 Why compound users need this00:01:25 Sponsor, Shed obesity care00:02:11 Breaking news changed everything00:02:28 OTP semaglutide exclusive00:03:28 DDC list explained00:04:24 Novo’s lab findings00:09:57 302% dose shocker00:13:03 Catalent’s contamination mess00:16:33 Lilly’s B12 tirzepatide bombshell00:19:34 Is the molecule changing?00:21:46 New oral GLP-1 contender

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On this episode of the podcast, host Dave Knapp breaks down the latest updates on potential GLP-1 receptor agonists coverage for people on Medicare living with obesity. With new guidance released by the Centers for Medicare & Medicaid Services, the episode explains how two upcoming federal programs—the Bridge Program (2026) and the Balance Model (2027)—could expand access to medications like Zepbound and Wegovy.

Listeners will learn who may qualify, how the proposed $50 monthly cost could work during the temporary Bridge Program, and why coverage could change once insurance plans become involved in 2027. The episode also outlines the role of the proposed Treat and Reduce Obesity Act and why long-term Medicare coverage still depends on congressional action.

If you or a loved one are on Medicare and curious about access to GLP-1 medications for obesity treatment, this episode explains the key timelines, eligibility criteria, and practical steps patients should take with their doctors.

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Episode Summary (Short Version):

This week on On The Pen, Dave breaks down the rapid changes reshaping GLP-1 access — from new federal reforms targeting PBMs and possible FDA limits on compounded semaglutide, to Walgreens and Amazon launching cash-pay weight loss clinics.

As insurance denials continue and out-of-pocket costs rise, patients are stuck between a shifting policy landscape and a growing direct-to-consumer market. Plus, an AI-designed oral GLP-1 enters Phase 3 trials, signaling how fast obesity medicine is evolving.

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This episode unpacks Novo’s aggressive price cuts, Lilly’s head to head trial win, and the emerging triple agonist race, revealing how pricing strategy and next generation data are colliding in a full scale GLP-1 market war.

00:00 – Cold Open: Lilly vs Novo Shock Timing
Dave opens with the bombshell that Novo funded a tirzepatide trial while simultaneously announcing major price cuts to Wegovy and Ozempic, setting up a strategic chess match.

03:20 – Novo Nordisk Price Cuts Explained
Deep dive into Novo’s plan to cut list prices by up to 50% and what that actually means for formulary power, PBMs, and competitive positioning.

07:25 – Tirzepatide vs Semaglutide Head to Head Trial
Breakdown of the direct comparison study showing stronger weight loss with tirzepatide and what that means clinically and commercially.

11:55 – Market Reaction and Strategic Implications
Discussion of stock movement, competitive signaling, and how Novo’s pricing move may blunt Lilly’s trial victory.

14:25 – Novo Triple Agonist Data Drops
Shift into Novo’s early phase data on its triple agonist candidate and how it compares conceptually to existing dual agonists.

16:00 – Comparing Novo’s Triple to Retatrutide
Analysis of weight loss percentages versus Lilly’s retatrutide data and the caution required when comparing across trials.

18:15 – The Triple Agonist Era
Broader conversation about whether triple agonism consistently pushes weight loss higher and what durability may look like long term.

20:00 – Clinical Trial Results vs Real World Reality
Reminder that clinical trial outcomes do not automatically translate to everyday patient experience.

22:30 – Data Refresher on Allurion Ballon Approval
Quick recap of the headline numbers and strategic landscape as innovation and pricing

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Thank you for tuning in! If you found this content valuable, make sure to like, share, and subscribe to my youtube channel for more updates on GLP-1, obesity, type 2 diabetes, and the latest news on Mounjaro, Zepbound, Wegovy, and Ozempic. Stay informed and entertained with my unique blend of breaking news, humor, and my personal journey. For in-depth articles and resources, visit onthepen.com.

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Wegovy’s new 7.2 mg dose—three times higher than the current max—has just been approved in the EU, with U.S. approval expected soon. But now that Wegovy matches Zepbound on weight loss, the real question isn’t which drug helps you lose more weight—it’s which one treats your underlying metabolic disease more effectively.

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Thank you for tuning in! If you found this content valuable, make sure to like, share, and subscribe to my youtube channel for more updates on GLP-1, obesity, type 2 diabetes, and the latest news on Mounjaro, Zepbound, Wegovy, and Ozempic. Stay informed and entertained with my unique blend of breaking news, humor, and my personal journey. For in-depth articles and resources, visit onthepen.com.

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This week on The Weekly Dose, Dave Knapp breaks down the biggest questions shaking up the GLP-1 world. From whether patients should be stocking up on compounded injectables, to what Eli Lilly’s earnings call revealed about Zepbound QuickPens, refill rules, and the long-awaited retatrutide timeline, this episode covers it all. Dave also unpacks FDA enforcement signals, the escalating tension between Big Pharma and compounders, the Hims & Hers controversy, and what recent lawsuits and Super Bowl ads tell us about where obesity treatment is headed next. Clear context, real-world implications, and what patients should be discussing with their doctors right now.

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This week on On The Pen: The Weekly Dose, Dave breaks down one of the most consequential Eli Lilly earnings calls to date. We dive into major updates on retatrutide, new Phase 3 timelines, and why Lilly is positioning next-generation GLP-1 and GIP therapies far beyond obesity, including osteoarthritis, sleep apnea, addiction, and mental health. From manufacturing scale and Medicare access to brand-new molecules like bernipotide and amylin-based therapies, this episode explores what the future of incretin medicine could really look like for patients.

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This week on On The Pen: The Weekly Dose, we break down Pfizer’s $10 billion bet on obesity medicine and whether it’s shaping up to be a smart move or a costly miss. We dig into newly released Phase 2b data from Pfizer’s once-monthly GLP-1 candidate (formerly Metsera’s asset), what the results actually show, and how it stacks up in an increasingly crowded field that includes Novo Nordisk, Eli Lilly, and next-gen combination therapies. We also talk strategy, maintenance dosing, combination GLP-1 + amylin approaches, pricing pressures, cash-pay access, and what this all means for patients navigating a rapidly changing obesity treatment landscape. Plus, earnings week insights, where Pfizer may be headed next, and why pricing and access, not just weight-loss percentages, may end up being the real disruptors.

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Can Zepbound treat PCOS? That's the question this clinical trial will seek to answer, and we cover it exclusively on this week's On The Pen podcast.

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In this episode of On The Pen: The Weekly Dose, Dave Knapp breaks down why the idea of over-the-counter GLP-1 medications isn’t radical speculation, it’s a pattern already in motion. Drawing on FDA signals, past regulatory precedent with Orlistat, recent pricing negotiations, softened safety language, and public comments from pharmaceutical executives, Dave lays out the case that low-dose oral GLP-1s could be the first step toward OTC access. This episode connects the dots between regulation, access, pricing, and normalization of obesity treatment, and explains why the people laughing today may be asking how they missed it tomorrow.

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Shantanu Gaur, CEO of Allurion, returns to the podcast to break down their swallowable inflatable weight loss balloon, how it works, who it is for, how much it is expected to cost, and when patients can realistically expect access.

We talk real world weight loss results, safety, availability in the US, and how Allurion fits into the broader obesity treatment conversation alongside GLP-1 medications and bariatric options.

This is a clear, no hype discussion for patients who want more tools and better choices in obesity care.

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This week on On The Pen, we break down a rare FDA walk-back on GLP-1 safety labeling, major pharma signals coming out of JPM 2026, and the growing tension between patient access and legislative efforts that could restrict compounding. We discuss what these developments actually mean for patients, why access—not innovation alone—will determine the future of obesity medicine, and how the OTP community continues to play a critical role in shaping this landscape.

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In this week's episode we unpack some Orforglipron breaking news, plus a preview of this week's Eli Lilly VS Mochi lawsuit hearing.

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This episode opens the year with one of the most consequential—and complicated—weeks in GLP-1 obesity medicine.

We break down three stories that, taken together, reveal why patients are increasingly reading past headlines and demanding accountability from the industry.

First, we examine early-phase trial data from Arrowhead Pharmaceuticals, after headlines claimed its experimental INHBE-targeting therapy “nearly doubled” the weight loss of Zepbound. We walk through what the data actually showed, why the comparison was misleading, how trial design and dosing matter, and why Phase 1 results should never be treated as superiority claims.

Next, we turn to a major access milestone: the official launch of oral Wegovy, the first FDA-approved GLP-1 pill for obesity from Novo Nordisk. We discuss how this pill differs from compounded oral semaglutide, why its pricing strategy is so disruptive, and what this launch means for people who have avoided injectable medications. We also explore how direct-to-consumer access, telehealth partnerships, and retail pharmacy distribution signal a broader shift in how obesity care is being delivered.

Finally, we address the most ironic—and uncomfortable—story of the week: manufacturing quality concerns involving branded Wegovy pens, reported to include biological particulate matter, at the same time Novo Nordisk continues a years-long public and legal campaign against compounded GLP-1 medications on safety grounds. We discuss FDA inspection history, the acquisition of Catalent, and why credibility depends on consistency—especially when millions of patients are paying close attention.

This episode isn’t anti-pharma or pharma-friendly. It’s patient-first.
And it asks a simple question: Who do we trust when science, marketing, access, and manufacturing all collide at once?

Episode Timestamps

00:00 — Why this first episode of 2026 matters
02:10 — Hair found in Wegovy pens and why patients notice hypocrisy
06:15 — Arrowhead trial headlines vs. what the data actually shows
11:40 — Why tirzepatide dosing and trial design matter
17:30 — What INHBE targeting may actually be good for (and what it’s not)
21:45 — Sponsor: SHED and access pathways for obesity care
25:10 — Oral Wegovy officially launches: what’s different this time
30:20 — How the Wegovy pill works and why bioavailability matters
35:40 — Pricing, telehealth, Costco, and direct-to-consumer access
41:50 — Why pills lower barriers for millions of patients
46:10 — Manu

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Pharma Influence & Why Patient Voices Matter
Lobbying Power: Eli Lilly, Novo Nordisk, and Government Access
Why GLP-1 Medication Access Is at Risk
Introducing Sabina Hemi & the Mission of GLP Winner
Why Compounded GLP-1s Matter for Real Patients
The Federal “Safe Drugs” Bill: What It Claims vs What It Does
Why This Bill Raises Red Flags for Patients
What Real Compounding Safety Reform Would Look Like
How Compounding Pharmacies Are Actually Regulated Today
Prescription Reporting vs Patient Safety
Is This Bill About Safety or Litigation Data?
Dose Flexibility, Personalized Medicine, and Compounding
Florida SB 860: A Direct Threat to Compounded GLP-1s
Why Florida Compounding Impacts the Entire Country
Why Obesity Medications Are Being Singled Out
Active Pharmaceutical Ingredients (API): What Patients Should Know
FDA Oversight, the “Green List,” and State Overreach
Why Florida’s API & COA Requirements Don’t Add Up
FDA Inspection Backlogs & Impossible Compliance Standards
Branded Drug Safety Issues vs Compounding Scrutiny
Catalent, Novo Nordisk, and Manufacturing Concerns
Counterfeit Ozempic: The Overlooked Safety Crisis
Why Supply Chain Integrity Should Be the Priority
What Patients Can Do Right Now
Petitions, Advocacy, and Making Your Voice Heard
Florida Residents: Why Local Action Matters
Final Thoughts on Access, Power, and Patient Advocacy

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Retatrutide is years away from FDA approval and yet the fight over access, price, control of this medication is already well underway. That's what this podcast is going to be about today. There's well over a hundred thousand people by my estimates who are already on some form of this medication today. And that should tell you enough about how disruptive this molecule is and will be. It is a game changer among game changer. We've been talking about it for three years here at On The Pen, well before any of your favorite gym bros were talking about Retatrutide. We were talking about Reta, who tried Retatrutide here at On The Pen. And that's because we identified this triple agonist as a game changer among game changers. So This is going to be a very Retatrutide heavy episode, and so I hope you'll join us and stick with us if this is a topic you enjoy, because I think this is really going to effectively lay the groundwork for what accessibility to this medication will look like. So let's get into it.

Welcome to the On The Pen Podcast with your host, Dave Knapp. Welcome to the On The Pen, the weekly dose podcast. This is our weekly roundup in incretin memetic news. And frankly, there's no news that is bigger than Reta-Trutide news. Just find me any news that is bigger than the data that we got on Reta-Trutide. Now, we already did a video about the Triumph Phase II clinical trials that we got in osteoarthritis of the knee. You can go back and check out that video if you'd like more data. So we're not gonna super... rehash the data. We'll go over at a high level what the data showed us. We're not going to go over how the medicine works, because by now we all know that it's the triple agonist, right? If terzapatide was a dual agonist, GLP-GIP, Retatrutide is the triple agonist that adds to it a glucagon component, which is absolutely just shredding, shredding liver fat. It is absolutely revving up people's metabolism and showing a tremendous amount of weight loss.

So let's get into what the weight loss looked like in this first trial, because there are longer obesity trials where, where the primary outcome is the weight loss this was again a specific trial in measuring pain reduction in folks with osteoarthritis of the knee but check out these numbers these are placebo adjusted meaning it's taking the two percent out that people lost on placebo but looking at these numbers Folks on one milligram over forty eight weeks lost seventeen percent. They bumped up to four milligrams. Those folks lost twenty two percent. So right there at th

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0:00 Welcome & today’s focus: Retatrutide and “chasing the biggest number”
1:11 On The Pen intro, live schedule (Mon/Wed/Fri) & housekeeping
2:10 How Dave first heard about retatrutide (work trip, early phase 1 data)
3:35 Flashback clip: early excitement about retatrutide phase 3 trials
4:40 Why this new retatrutide data feels different for obesity medicine
5:32 TRIUMPH-4 trial overview: obesity + knee osteoarthritis population
7:00 Headline results: 28.7% average weight loss, surgery-level efficacy
8:47 Breaking down weight loss by dose (9 mg vs 12 mg; 25–35% loss rates)
11:05 What “efficacy estimate” really means (race-track analogy)
13:28 Real-world view: treatment-regimen estimate (20–23.7%) vs trial ideal
15:40 Mechanism refresher: GIP, GLP-1, glucagon and why RETA differs from TIRZ
18:05 Side effects, dysesthesia/allodynia & who stopped treatment (BMI differences)
21:02 Why the lower doses matter & who actually needs 30% weight loss
24:15 From “just make the scale go down” to quality of weight loss & body composition
28:05 Future focus: health, longevity, and peptides beyond hitting goal weight
30:40 Viewer Q&A: combining RETA + TIRZ, amylin (eloralintide) combos & “talk to your doctor”
34:38 How retatrutide changes the next decade of obesity treatment conversations
37:22 News update: high-dose Wegovy 7.2 mg approval in the EU & US outlook
40:55 Orforglipron oral GLP-1: liver-signal concerns & fast-track FDA review
45:20 Why small-molecule oral GLP-1s aren’t the same as injectable peptides
48:40 New topic: Indiana “Safe Drug Act of 2025” and why Dave is concerned
51:02 Production caps, “essentially a copy” language & shifting power from prescribers to FDA
54:28 How the bill undermines personalization while ignoring real safety tools
57:05 Safety theater vs real safeguards: API sourcing, sterility & adverse-event reporting
59:45 Who actually gets hit: compliant 503A/503B compounders vs existing bad actors
1:02:05 Call to action: petition at otplinks.com & why patient voices matter
1:05:10 Change.org impact, media attention & centering the patient perspective
1:07:30 Final Q&A, subscribe, obesity.news email list & closing thanks

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Episode Timeline & Main Topics

00:00 — Opening & Community Update
• First week doing the podcast fully live thanks to the On The Pen community
• Overview of why this week’s news is a major turning point in obesity medicine

02:30 — Introducing the “One-and-Done” Obesity Drug (Wave Life Sciences)
• WVE-007 early data drops
• Why this therapy is unlike GLP-1s or any nutrient-stimulated hormone
• Fat loss results and lean-mass increase

06:30 — How Wave-007 Works: INHBE Gene Silencing
• Mechanism behind visceral fat reduction
• Why this shifts the field toward “quality of weight loss”

09:15 — Why Lean-Mass Preservation Matters
• Current GLP-1 medications and muscle loss
• Why women dominate trial enrollment and the larger implications
• Medicare patients and the coming wave of GLP-1 coverage

13:45 — The Future of Maintenance Therapies
• Fractyl Health Revita results
• Lilly’s orforglipron maintenance design
• Why “holding the line” after GLP-1 therapy is the next major category

17:30 — Amylin Agonists: Cagrelintide vs. Eloralintide
• Novo’s delays and the strategy behind them
• Lilly’s surprising phase 2 results (up to 20% weight loss)
• Combination therapies with tirzepatide or retatrutide

22:30 — FDA Pipeline Acceleration
• Potential removal of traditional phase 3 trials
• How this speeds up the arrival of next-generation therapies

24:15 — Oral GLP-1 Small Molecules (Structure Therapeutics)
• Alaniglipron data and the stock surge
• Comparisons to orforglipron and past failures like denuglipron
• Why Dave remains skeptical

28:40 — Sponsor Break: Shed & Shapa
• Access, coaching, and patient support
• Using a numberless scale to build a healthier relationship with weight tracking

31:10 — Counterfeit Ozempic Warning
• New fake lot discovered in U.S. pharmacies
• How to identify counterfeit pens
• Why this should be a national headline
• The broader question of drug supply-chain vulnerability

36:00 — Closing Thoughts on the Future of Obesity Medicine
• Moving from “more weight loss” to “better weight loss”
• Why the field is closer than ever to reshaping obesity as a disease
• Gratitude for the community making full-time coverage possible

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Topics We Cover:

00:00 – New data from Harvard/Mass General may classify nearly 70% of adults as having obesity
03:00 – A new oral triple agonist shows record-setting absorption rates
07:00 – Fractal Health’s Revita procedure: weight maintenance after stopping GLP-1s
12:00 – Zepbound vial prices drop (full breakdown by dose)
16:00 – Dave’s personal experience switching off Mounjaro and intense hunger return
22:00 – Novo Nordisk’s EVOKE/EVOKE+ Alzheimer’s trial: what the data really means
29:00 – Why GLP-1 neurological research is just getting started
33:00 – Updates on access, partners, and major news coming soon for Medicare patients

If you’re on Wegovy, Mounjaro, Zepbound, Saxenda, Trulicity, or compounded versions, this episode gives you the insight and context you need to have more competent and confident conversations with your doctor.

Bullet Point Summary of the Podcast Episode

New Obesity Measurement Data (Harvard/Mass General Study)

Harvard and Mass General propose adding waist circumference to BMI to better diagnose obesity.

Traditional BMI misses key factors like muscle mass and body composition.

Using the updated measure, Americans classified as obese jumps from ~43% to almost 69%.

This means 7 out of 10 U.S. adults would now qualify as having the disease of obesity.

Dave notes this validates many people who “feel” metabolically unwell despite a “normal” BMI.

Reinforces his claim that “most people should be talking to their doctors about GLP-1s.”

New Oral Triple Agonist (Ascletis – ASC41/ASC? Molecule)

From Ascletis (A-S-C-L-E-T-I-S), developing an oral triple agonist targeting:

GLP-1

GIP

Glucagon

Similar in mechanism to retatrutide, expected around 2027.

Preclinical (animal) data show stunning results:

Oral bioavailability of 4.2%

9× higher than tirzepatide

30× higher than oral semaglutide

6× higher than oral retatrutide

57× greater drug exposure than oral retatrutide

Half-life ~56 hours

Stronger receptor activation than retatrutide in vitro

Suggests potential for the first powerful oral triple agonist—worth watching.

️ 3. Discussion of the Gray Market / TikTok Experience

Dave briefly recounts losing his TikTok account and landing in an algorithm filled with teenagers promoting gray-market “retatrutide.”

Expresses concern over unregulated peptide sales, especially to minors.

Fract

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💉 Story 1 — Fractyl Health’s One-and-Done Gene Therapy for Obesity
Fractyl Health just dropped preclinical results showing their GLP-1 + GIP gene therapy candidate RJVA-002 produced almost 30% weight loss in mice after a single dose. I sat down with Dr. Harith Rajagopalan, CEO of Fractyl Health, to talk about how this new Rejuva® platform works, what it means for people living with obesity and type 2 diabetes, and why gene therapy might be the future of metabolic care.

🏛️ Story 2 — Medicare Coverage for GLP-1s? Dr. Oz Drops a Hint
At the Aspen Institute, CMS Administrator Dr. Mehmet Oz said even a comment on GLP-1 coverage would be “market moving.” We break down what that means, why the Trump administration shelved a rule that would’ve added obesity meds to Medicare coverage, and how that decision might now be a bargaining chip to lower drug prices in exchange for tougher enforcement on compounding.

⚖️ Story 3 — The Retatrutide Ruling and the Future of Compounded Access
A federal judge ruled the FDA acted “arbitrarily and capriciously” when it rejected Lilly’s bid to classify retatrutide as a biologic. That may sound technical, but if the FDA changes its stance, it could have huge implications for tirzepatide (Zepbound, Mounjaro) and semaglutide (Wegovy, Ozempic)—especially when it comes to compounding and patient access.

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Dave discussed the latest update in the OFA vs FDA compound tirzepatide battle, as well as this weeks news in obesity medicine.

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CVS announces major partnership with Novo Nordisk as Lilly announces Q! 2025 earnings. Dave covers it all in today's breakdown.

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The Knapp family was featured in a health.com video!
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🧑‍⚕️Trusted and Sold By Doctors and Clinics all over the USA

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The Knapp family was featured in a health.com video!
Watch it Here: https://www.health.com/beyond-obesity-glp1-8685599

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Sign up here and use code “OTP10” to save 10%
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WHY I TRUST INTEGRATIVE PEPTIDES:
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🧑‍⚕️Trusted and Sold By Doctors and Clinics all over the USA

📕 GET MY BOOK!
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https://amzn.to/4gAXrz4

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Send a text

The Knapp family was featured in a health.com video!
Watch it Here: https://www.health.com/beyond-obesity-glp1-8685599

WAYS TO SUPPORT MY WORK ⬇️

💊 OVER THE COUNTER ORAL PEPTIDE SUPPLIMENTS:
BPC-157 // Can’t Weight // TB4-FRAG // KPV
Sign up here and use code “OTP10” to save 10%
https://integrativepeptides.com/OTP

WHY I TRUST INTEGRATIVE PEPTIDES:
🇺🇸 Made in the USA
📋 CGMP Compliant (FDA oversight of their products)
🧑‍⚕️Trusted and Sold By Doctors and Clinics all over the USA

📕 GET MY BOOK!
Decoding GLP-1: A Guide for Friends and Family of Those On The Pen By Dave Knapp
https://amzn.to/4gAXrz4

SOCIALS:
📸 : https://www.instagram.com/onthepen.official/profilecard/?igsh=dTRhY3JkYWo1bTIx
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Thank you for tuning in! If you found this content valuable, make sure to like, share, and subscribe to my youtube channel for more updates on GLP-1, obesity, type 2 diabetes, and the latest news on Mounjaro, Zepbound, Wegovy, and Ozempic. Stay informed and entertained with my unique blend of breaking news, humor, and my personal journey. For in-depth articles and resources, visit onthepen.com.

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📺: https://youtube.com/@ManOnTheMounjaro?feature=shared
❌: https://x.com/manonthepen?s=21
💻: https://www.onthepen.com

#ozempic #mounjaro #onthepen

🤝 Visit Our Sponsors!
OTPLinks.com

Decoding GLP-1 Book
Decoding GLP-1: A Guide for Friends and Family of Those On The Pen
Buy Here:https://amzn.to/3Dc66d4

MY WORK RELIES ON YOUR GENEROSITY, WAYS TO SUPPORT:
Venmo: OnThePen
Ca$h App: ManOnMounjaro

BECOME A MEMBER:
https://www.youtube.com/channel/UCDocQ-4IhVS3ihy_dW7nSKw/join

👉 My Amazon Affiliate Store:
https://www.amazon.com/shop/manonthemounjaroonthepen

WATCH MORE!
📺 We're Live M/W/F at 11 central: onthepen.tv

📲 Contact Me: dave@onthepen.com

Thank you for tuning in! If you found this content valuable, make sure to like, share, and subscribe to my youtube channel for more updates on GLP-1, obesity, type 2 diabetes, and the latest news on Mounjaro, Zepbound, Wegovy, and Ozempic. Stay informed and entertained with my unique blend of breaking news, humor, and my personal journey. For in-depth articles and resources, visit onthepen.com.

Send a text

WAYS TO SUPPORT MY WORK ⬇️

💊 OVER THE COUNTER ORAL PEPTIDE SUPPLIMENTS:
BPC-157 // Can’t Weight // TB4-FRAG // KPV
Sign up here and use code “OTP10” to save 10%
https://integrativepeptides.com/OTP

WHY I TRUST INTEGRATIVE PEPTIDES:
🇺🇸 Made in the USA
📋 CGMP Compliant (FDA oversight of their products)
🧑‍⚕️Trusted and Sold By Doctors and Clinics all over the USA

📕 GET MY BOOK!
Decoding GLP-1: A Guide for Friends and Family of Those On The Pen By Dave Knapp
https://amzn.to/4gAXrz4

SOCIALS:
📸 : https://www.instagram.com/onthepen.official/profilecard/?igsh=dTRhY3JkYWo1bTIx
🇨🇳: https://www.tiktok.com/@manonthemounjaro?_t=ZP-8sr5PrUuPQl&_r=1
👾: https://discord.gg/ZHeUh7WV
📺: https://youtube.com/@ManOnTheMounjaro?feature=shared
❌: https://x.com/manonthepen?s=21
💻: https://www.onthepen.com

🤝 Visit Our Sponsors!
OTPLinks.com

Decoding GLP-1 Book
Decoding GLP-1: A Guide for Friends and Family of Those On The Pen
Buy Here:https://amzn.to/3Dc66d4

MY WORK RELIES ON YOUR GENEROSITY, WAYS TO SUPPORT:
Venmo: OnThePen
Ca$h App: ManOnMounjaro

BECOME A MEMBER:
https://www.youtube.com/channel/UCDocQ-4IhVS3ihy_dW7nSKw/join

👉 My Amazon Affiliate Store:
https://www.amazon.com/shop/manonthemounjaroonthepen

WATCH MORE!
📺 We're Live M/W/F at 11 central: onthepen.tv

📲 Contact Me: dave@onthepen.com

Thank you for tuning in! If you found this content valuable, make sure to like, share, and subscribe to my youtube channel for more updates on GLP-1, obesity, type 2 diabetes, and the latest news on Mounjaro, Zepbound, Wegovy, and Ozempic. Stay informed and entertained with my unique blend of breaking news, humor, and my personal journey. For in-depth articles and resources, visit onthepen.com.