AMA #45: Pros and cons of GLP-1 weight loss drugs and metformin as a geroprotective agent

**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 AMA episode number 45 I'm once again joined by Nick Stenson. In today's episode, we focus on two topics, both of which are getting a lot of questions lately. The first is GLP-1 agonists, most notably semaglutide, also known as Ozempic and Wigovie, and terzepotide. These weight loss drugs are all the rage right now. And there is probably not a day that goes by where someone isn't asking me my thoughts on them. So in the first part of this episode, we dive very deep into these, what they are, their differences, how they're marketed, how they came to market, meaning what we learned about them when they were just being used as diabetes drugs, what we know about them clinically, because we've been using these drugs sparingly for about three years.
Most importantly, I think where my reservations are. And I do have many reservations that I discuss here.
If you're thinking about taking these drugs, if you're taking these drugs, if you're curious about them, this episode is for you.
The second part of this podcast, we go a little deeper into metformin. This is something I've talked about in the past, but a little more attention has come up lately. Just by way of background, metformin has gathered a lot of interest over the past few years, but a lot of it goes back to a study that came out in 2014 that suggested that diabetics taking metformin actually had better health outcomes, i.e. lower mortality, than non-diabetics not taking metformin. This is a very counterintuitive finding, and of course, it suggests that metformin is indeed zero protective. Well, in this episode, I dive much deeper into that assumption, both going back to the original 2014 study and looking at a more recent study that uses a very similar analysis, but on a different population. So if you have any interest in metformin, if you have any interest in GLP-1 agonists, this is the episode for you. Now, if you're a subscriber and want to watch the full video of this podcast, you can find it on the show notes page. If you're not a subscriber, you can watch a sneak peek of the video on our YouTube page. Without further delay, I hope you enjoy AMA number 45

**Nick Stenson** (2:49)
Peter, how you doing?

**Peter Attia** (2:51)
Doing very well.

**Nick Stenson** (2:52)
You ready for another AMA here?

**Peter Attia** (2:54)
I am.

**Nick Stenson** (2:55)
We got some fun topics, two main ones that I think people are gonna be interested in, but one thing I realized, although not at the time of this recording, but by the time this is released, we'll be about two weeks out from the book launch. Did you ever think we would be able to use those words two weeks out from the book launch?

**Peter Attia** (3:15)
No.
No. This book is like a cat that died eight times and somehow managed to eke out survival before the ninth and final death.

**Nick Stenson** (3:26)
Well, and there's no turning back now, right? Like if we're recording this and something went wrong where the book's coming out, like I just can't imagine what it would be. It's going to print, it's done.
Cover looks good. Cover looks great. We'll have a dedicated book podcast coming up for listeners where we kind of talk about it, like let people know what's going on. But yeah, it's kind of mind blowing if you think about by the time people are listening to this, it's about two weeks out until they get their hands on it.

**Peter Attia** (3:53)
Yeah, well, I hope it delivers.

**Nick Stenson** (3:57)
Peter, I think what we're going to talk about today is really two different subjects, both of which we've covered a little bit in the past, but there's been a lot of new insights that have come out, new studies, new information, and we receive a lot of questions on them. And the first is something you and Bob covered back in AMA 29, which was back, I think, end of 2021 And I remember at the time you guys were talking about, hey, we're going to do an AMA on GLP-1 agonists and these drugs. And it was kind of one of those things where I hadn't really heard much being talked about. It seemed so new. And I was kind of like, are we sure we want to do this? And you and Bob were both like, yeah, just wait. There's going to be a lot of talk about this.