Good morning. It’s Friday, August 23rd.

In today’s email:

• Focus: Will GLP-1 Drugs Save Our Health?

• Listen: Rethinking Obesity

• Cook: Green Goddess Salad

• In the News: Cortisol Face

• Brain Games: 70/30

Stat of the Day

The market for weight-loss drugs in 2032 - 10x the current market ($47B) for these drugs. (source)

Focus

Will GLP-1 Drugs Save Our Health?

In January 2017, Novo Nordisk was a pretty big pharma company - worth about $90B. That’s when the FDA approved the drug Ozempic for treatment of type 2 diabetes.

Today the company is valued at $600B - it’s the 15th largest company in the world with about the same value as Walmart and JPMorgan.

The Obesity Epidemic

Public health campaigns can actually make a difference.

Back in 2000, 23.3% of adults in the U.S. smoked cigarettes. Today that number is down to 14% (which still seems crazy high knowing what we know).

At the same time, the number of obese adults in the U.S. grew from 30.5% in 2000 to 42% in 2024 - and three-quarters of all Americans are overweight.

So something’s not working.

First - it’s absolutely an uphill battle.

We’re programmed to eat when food - especially high-energy food like carbs - are in front of us.

Second - no matter how much money or education is spent on these public health campaigns, it’s nothing compared to the advertising budgets of big food companies.

And - even among so called “experts” - there’s no agreement as to what’s the “right diet.” Most people have simply tuned out because it’s confusing or just not worth the effort to fight through the online noise.

Pharma to the Rescue

So now there’s a “better” solution than willpower - GLP-1 drugs.

It should be noted that these drugs aren’t exactly new and there’s been weight loss drugs for almost 100 years. Amphetamines were prescribed to help lose weight back in the 1930’s and drugs like DNP and others have been proven to be effective at weight loss - but most of the time they killed you too.

Is GLP-1 different?

GLP-1 is glucagon-like peptide 1, a hormone released by the gut after eating. It triggers insulin and slows down digestion. The net effect is that it lowers your blood sugar (hence why it’s effective for diabetes) and inhibits hunger - basically you still feel full.

Is it effective? Absolutely.

Studies show people on these drugs can definitely lose weight - like a lot of weight. And it also lowers our HbA1C - the primary biomarker to measure our blood sugar and the metric to determine if someone has type 2 diabetes.

PRO TIP: All of us should have our HbA1C measured annually.

But as with any drug there are some significant risks.

First - Peter Attia has found that for every pound of fat lost from the drug, you lose just about an equal point of lean body mass.

One of the most important factors for longevity is strength and muscle mass - but these drugs make it really hard to maintain any muscle.

Second - all that weight that’s lost, well it’s probably coming right back as soon as anyone stops taking the drug. So you’re basically left injecting yourself forever. (NOTE: Yes, I realize there may be an oral version in the future, but you get the point).

The other side effects are no joke and extremely common: severe nausea (nearly half of people in clinical studies) and diarrhea (one-third of people) are the most common. This makes sense because you aren’t digesting food efficiently (by design of the drug) so your gut gets really messed up.

Other common symptoms include headaches and nasal issues.

Another effect noted by Dr. Attia is that every single one of his patients had their heart rate go up 10 points at night - for optimal health & longevity we definitely want a lower resting heart rate.

These are just the effects we know about today. What will we find out 10 years from now?

It also leads to long-term costs. These drugs can vary from $8-16K a year per person. Some will argue there are pharma company rebates and that insurance will cover it. 

But if Medicare or private insurance is covering it - we’re all paying for it. Maybe that’s why the $400B+ market (see Stat of the Day) is so scary.

So should we embrace them as a society and should you consider them?

Honestly - after a ton of research I don’t have a final answer to that question.

I would say that if someone is significantly overweight to the point it’s hindering their health now and they’ve tried all they can - this drug might be a useful tool to help them get their life back.

But remember - we aren’t overweight because we’re low in GLP-1. It’s not solving the problem that brought on the weight in the first place.

Messing with hormones can have all kinds of unintended consequences and these drugs might end up on the list of things we thought were safe, but weren’t.

For anyone considering these drugs for purely aesthetic reasons or just looking to lose those last 10 pounds - I can promise you that there’s a much healthier, much cheaper, much better way to do that than to start injecting yourself with GLP-1.

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Listen

Rethinking Obesity

Want to get further into the weeds on obesity drugs?

Dr. David Allison joins Peter Attia on the latest episode of The Drive, as he dissects the evolving landscape of obesity treatment and nutrition science. From GLP-1 agonists to the need for higher research standards, this episode challenges old paradigms and explores the future of public health. Dive into discussions on the ethical considerations of obesity drugs, the complex relationship between nutrition and body composition, and why we need a paradigm shift to effectively tackle obesity. Plus, uncover insights on protein intake, environmental triggers, and the impact of public health initiatives.

Cook

Green Goddess Salad

Try this vibrant, nutrient-packed salad bursting with fresh flavors and textures. Featuring creamy avocado, crisp sugar snap peas, broccoli, and lettuce, it’s balanced with a lightened-up dressing made from Greek yogurt and olive oil. Fresh herbs and green onions add a zesty finish, making this salad not only delicious but also rich in vitamins, healthy fats, and antioxidants - perfect for nourishing your body and boosting your health!

H&L in the News

Cortisol Face - Fact or Fiction?: Can stress really change your face shape? Experts debunk the "cortisol face" trend popularized by influencers, explaining how cortisol actually works. Learn the facts behind the hype. (NYTimes)

Decoding Health with AI: An AI-powered app uses your smartphone’s microphone to detect heart issues and more by analyzing subtle body signals, revolutionizing health monitoring. (WIRED)

Empowering Teen Mental Health: Google and Selena Gomez’s Rare Impact Fund are teaming up to bring mental health resources directly to classrooms, supporting one million students and empowering teachers with essential training and supplies. (Google)

Brain Games

70/30

In each episode of the 1% Club, host Patton Oswalt asks a series of increasingly difficult, logic-based questions. The show starts with the 90% question - one that 90 out of 100 people got right in a previous survey - and builds toward the 1% question, which only 1 out of 100 people answered correctly.

Let’s see how you can do with two questions of varying “difficulty.”

70% question (70/100 people got this right)

30% question

Credit: The 1% Club (FOX)

** For answer, scroll to the bottom of the email

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Brain Games Answer

70% Question: A - it’s 6:00.

30% Question: B - ALTERNATING.

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To health!