AMA #29: GLP-1 Agonists—The Future of Treating Obesity?

**Peter Attia** (0:11)
Hey, everyone, welcome to a sneak peek, Ask Me Anything or AMA episode of the Drive podcast. I'm your host, Peter Attia. At the end of this short episode, I'll explain how you can access the AMA episodes in full, along with a ton of other membership benefits we've created. Or you can learn more now by going to peterattiamd.com forward slash subscribe. So without further delay, here's today's sneak peek of the Ask Me Anything episode.
Welcome to Ask Me Anything episode number 29 I'm joined once again by Bob Kaplan. In today's episode, we discuss all things related to GLP-1 agonists.
And before you say why the hell would you dedicate an entire episode to an acronym I've never heard of, I would say fair question, but GLP-1 agonists are the class of drugs that are all the rage right now when it comes to understanding treatments for obesity. So you may not have heard the term GLP-1, but there's at least a decent chance you've heard of Ozempic or semaglutide. And even if you haven't heard of those, I suspect you'll find this episode very interesting. Earlier this year, a study was published in the New England Journal of Medicine that looked at the treatment of patients with overweight or obesity who were non-diabetic using a once weekly injection of a drug called semaglutide, also known as Ozempic. And the results were, quite frankly, out of this world.
So we're going to go through that paper. But of course, to get through that paper, you need to understand the physiology and the history of how these peptides were discovered and what it is they do in their natural state. So this episode's a little bit technical. I'm going to apologize for that in advance. I think as is the case with the majority of our AMAs, this one is going to be easier to follow. If you're able to watch it on video, because we do share a number of slides and figures, which I think makes it a little easier to understand this subject matter. If you can only listen to it, I think you'll still get the gist of it. But nevertheless, it is a bit technical. And I think that's just the price one has to pay to truly understand why this drug works and ultimately if this drug is for you. So if you're not a subscriber, of course, you can catch a sneak peek of this video on YouTube.
So without further delay, I hope you enjoy AMA number 29

**Bob Kaplan** (2:37)
Hello, Peter.

**Peter Attia** (2:38)
Hey, Bahab.

**Bob Kaplan** (2:41)
How's it going?

**Peter Attia** (2:41)
Good. What do we got going on today?

**Bob Kaplan** (2:44)
We got a lot of questions around one particular topic, actually one paper.
And the title of that paper is Once Weekly Semiglutide in Adults with Overweight or Obesity. And I don't think that a lot of people would be talking about this or asking this if the results of the paper weren't so freaking remarkable as far as the weight reduction with that study. So a lot of questions were around the study. Can you go over the findings of the study? What are the implications? Do we need a drug for obesity? What the heck is semiglutide?
How does it compare to other drugs in diets, et cetera, et cetera? I think people want to get more clarity around the study.

**Peter Attia** (3:25)
Yeah, this study, did it come out earlier this year? Was this early 21?

**Bob Kaplan** (3:30)
Yes.

**Peter Attia** (3:30)
Yeah. Obviously this is a study that those of us who spend time in this space knew a lot about and were kind of anticipating the results of this for a while. There are other drugs in this class, Lyraglutide that about six years ago showed also very promising results.
And basically once this study came out, I would say many of our patients were asking about it. And we actually did a journal club on this particular paper, the New England Journal of Medicine paper, I think back in the spring.
So it's great to see that a lot of people are basically kind of wanting to go deep on this. And I think as we'll get into today, you can't really go deep on this paper without doing a little bit of background on what GLP-1 is, because of course this drug is effectively just an analog of GLP-1. So yeah, I think we're about to go pretty deep on this topic. So let's start with GLP-1s, huh?

**Bob Kaplan** (4:28)
Yeah, let's do it.

**Peter Attia** (4:30)
I guess the easiest way to start this discussion is to really do it through the lens of what is an incretin or what is the incretin effect.