The Real RCT

Eli Lilly just showed that you can lose tons of fat while barely losing any muscle using their activin type-II receptor inhibitor, bimagrumab. We are approaching a golden era of weight loss, where everyone can easily be muscular and skinny. Prepare for hordes of hot Americans.

The leading cause of death worldwide — atherosclerotic cardiovascular and cerebrovascular disease is completely preventable. We can crush ApoB — the root cause of plaques — and end this disease before it begins. 🧵👇

Every time I see a story like this I have renewed rage for Sylvain Lesné, a neuroscientist and associate professor at the University of Minnesota, who faked research into the cause of Alzheimer's and wasted 15+- years' effort to cure such diseases.

Ozempic. Wegovy. Mounjaro. The weight loss looks effortless. But the side effects? Most people only hear horror stories or marketing. Here’s what the data actually says about which fears are real vs completely overblown. 🧵👇

Ozempic. Wegovy. Mounjaro. The weight loss looks effortless. But the side effects? Most people only hear horror stories or marketing. Here’s what the data actually says about which fears are real vs completely overblown. 🧵👇

Diet matters. But you can’t eat your way to strength. If you want to live longer and move better, there's one intervention that outperforms all others: Build muscle. 🧵

Ozempic, Wegovy, Mounjaro. You’ve heard the names. But where did they come from? These drugs didn’t appear overnight. They were decades in the making—from gut hormones to $100B blockbusters. Here’s the wild history of GLP-1 meds 🧵

Most people who lose a lot of weight end up weaker, slower, and “skinny fat.” But a new wave of medicine is aiming for something different: Lose fat. Build muscle. Here’s why that matters—and how it could change your health forever 🧵👇

Most people think GLP-1 drugs are just for weight loss. But the truth is far bigger—and far more surprising. They may protect your brain, reduce cancer, and even change how we age. Here’s everything you didn’t know about GLP-1s 🧵

Most people think GLP-1 drugs are just for weight loss. But the truth is far bigger—and far more surprising. They may protect your brain, reduce cancer, and even change how we age. Here’s everything you didn’t know about GLP-1s 🧵

We are witnessing a revolution: GLP-1 drugs (like Ozempic, Wegovy, and related semaglutides) are storming the markets, generating over $40 billion in annual sales for Novo Nordisk alone in 2024, with the broader GLP-1 market projected to exceed $50 billion by 2025 as demand surges. This has moved food company stocks downward—think snack giants like Mondelez and Hershey seeing dips amid shifting consumer habits—creating an economic and cultural force. Another striking feature of these drugs is their ability to reduce risks and mortality from diseases not directly tied to diabetes or obesity (their primary indications). The effects are measurable but modest—around 20-30% risk reduction in cardiovascular events, for instance, which might translate to a few extra years under the Gompertz law of mortality. This isn't entirely surprising, as early diabetes can rob 6-8 years of life, so controlling it could extend lifespan. Remember the promise of the TAME trial? It's the ambitious idea of testing metformin against aging in a massive Phase III-like study, hinting at broader longevity potential. In a way, GLP-1 drugs have fulfilled the geroscience dream for the first time in a practical sense: creating a medication that hits levers behind multiple age-related diseases at once, from heart disease to potentially neurodegeneration. As the dust settles, interesting questions pop up. Developing GLP-1 drugs was hard but didn't require alien-level tech. The more people reflect, the more comments surface suggesting that one of the biggest barriers was cultural: to many, obesity was a choice rather than a disease. This perception, fueled by stigma and misconceptions, led to hurdles like delayed regulatory approvals (regulators were cautious, imposing stricter criteria and slower pathways, as seen with Ozempic's initial diabetes-only approval before weight loss extensions), limited insurance coverage (insurers often denied claims for weight loss use, viewing it as non-essential despite the medical necessity), and slowed research and development (pharma investments lagged due to the 'personal failing' narrative, reducing incentives for new treatments). That apparently slowed development—potentially by years or even decades, as obesity wasn't formally recognized as a disease by bodies like the American Medical Association until 2013, which finally spurred more focused R&D and approvals. Does this sound familiar? It may be: look at drug discovery against aging—same issues here. Aging isn't classified as a disease by regulators like the FDA, so longevity biotech companies often pivot to targeting specific age-related diseases (including metabolic health, of course!) to get funding and approvals (this is a thread, see below). 1/2

Diet matters. But you can’t eat your way to strength. If you want to live longer and move better, there's one intervention that outperforms all others: Build muscle. 🧵

Most people who lose a lot of weight end up weaker, slower, and “skinny fat.” But a new wave of medicine is aiming for something different: Lose fat. Build muscle. Here’s why that matters—and how it could change your health forever 🧵👇

Eli Lilly just showed that you can lose tons of fat while barely losing any muscle using their activin type-II receptor inhibitor, bimagrumab. We are approaching a golden era of weight loss, where everyone can easily be muscular and skinny. Prepare for hordes of hot Americans.