I’m trying to get up to speed on the Glp-1 phenomenon. As always, I’m slow to recommend or adopt new medications, with a 7 year rule. Semaglutide was approved for Type 2 diabetes in 2017, so 9 years ago. For weight loss approved 2021, so 5 years. If you’re adopting purely for weight loss and you have a few pounds to lose, I would wait. Some side effects were not great, such as hair loss, bowel obstruction, pancreatitis, and decreased dopamine leading to a lowering of mood, or blunting of happiness. Please link to the full article below or read my summary.
For those who have read my book, the concept of a system being triggered (metabolism+inflammation+brain) may sound familiar. That is the elegance of using the body’s own systems. Whether Glp-1 s are an elegant nudge or a sledge hammer may determine how appealing and useful they end up being.
The GLP-1 Explosion: A Drug Class Rewriting Medicine
- A woman with severe post-concussion syndrome experienced a near “miraculous” recovery after taking a GLP-1 drug off-label—highlighting a growing wave of unexpected benefits beyond weight loss.
- GLP-1 drugs (like Ozempic, Wegovy, Zepbound) are now among the most widely used medications in the U.S., with roughly 1 in 8 Americans having tried them.
- Originally developed for Type 2 diabetes, and later popularized for weight loss, these drugs are now being used—often experimentally—for a wide range of conditions:
- Long Covid
- Irritable bowel syndrome
- Addiction (alcohol, nicotine, drugs)
- Anxiety and brain fog
- Arthritis and inflammation
- Hormonal and even fertility-related issues
Why They Work (and Why It’s So Surprising)
- The early theory—that GLP-1 drugs simply increase satiety—turns out to be incomplete.
- These drugs act primarily in the brain, influencing:
- Appetite and reward pathways
- Behavior and impulse control
- Possibly addiction circuits
- GLP-1 receptors are found throughout the body, meaning effects extend beyond metabolism.
- One of the most important mechanisms:
→ They “fine-tune” inflammation rather than suppress it outright, unlike steroids. - This has led researchers to a provocative idea:
→ Many diseases may share common root pathways (metabolic + inflammatory) rather than being separate conditions.
The “Great GLP-1 Experiment”
- Much of the current use is happening outside traditional medical research:
- Off-label prescribing
- Online telehealth platforms
- Social media-driven experimentation
- Survey data shows strong enthusiasm:
- 65% want to keep taking the drugs
- 63% would continue even if their original condition didn’t improve
- People report improvements in:
- Productivity
- Relationships
- Memory
- Social life
The Reality Check
- These drugs are not a universal miracle:
- Side effects: nausea, GI distress, fatigue
- High cost and limited insurance coverage
- Some patients stop quickly due to intolerance
- Clinical trials have already shown failures:
- No benefit in Alzheimer’s disease
- Mixed results in addiction and neurological conditions
- Long-term risks—especially with newer, more potent versions—remain unclear.
The Big Picture
- GLP-1 drugs may represent a paradigm shift:
- From treating isolated diseases
- → To targeting shared biological systems (brain + metabolism + inflammation)
- But here’s the tension:
- Mass adoption is outpacing science
- Medicine is playing catch-up
- Experts are clear:
→ We are at the beginning, not the end, of understanding these drugs.
