When Ozempic and the related GLP-1 drugs came out—having seen the data on muscle wasting, gastrointestinal problems, and the radical bounce back in weight gain when the drugs were stopped—I was very much the skeptic. For diabetics and those who are severely overweight, these trade-offs seemed worth it, as the drugs were life-changing and life-saving. But these drugs were looking like the Fen-Phen of our time, a huge class-action lawsuit waiting to happen. My view has since shifted. As Malcolm Gladwell has said, one of the advantages of having a brain is we can change our minds. Over the last several months, I have had discussions with several medical professionals who have been sending me data on the positive, unanticipated effects of GLP-1s beginning to show up in studies: Alzheimer’s, Parkinson’s, osteoarthritis, addiction, and certain cancers seem to be reduced with GLP-1 drugs. There’s something about the anti-inflammatory effects of these drugs that seems to be very helpful. They theorize that the effects could happen at lower doses, and microdosing is being discussed. No one is quite sure about the dosing, what happens when one stops, and other crucial information yet; more studies are needed. I am not a doctor, and I am not in any way suggesting you try these; what I am saying is that when new information arises, it is a good idea to check it out, even if it flies in the face of what our current beliefs are. Pharma has a deservedly dodgy reputation, and off-target effects are almost always to the downside, but good surprises can also happen.
For those interested, here are a few studies to look into (here, here, and here). What everyone has cautioned me on, though, is that at any dose, strength training is an absolute requirement, as is paying attention to one’s protein intake. It is unclear if when taken as microdoses, the small appetite suppression also impacts muscle loss, but there is a good chance that it does. This is one of my original problems with these drugs—a large percentage of the weight loss was from muscle, and, if one is older, building muscle can be a challenge. If one did not strength train, and lost a good amount of muscle, and then came off the drugs, the weight gain would be almost entirely fat—and then the person would be muscle-wasted and overweight. As a reminder, muscle here is not about looking sharp at the beach. It is critical to living a long and healthy life.
The entire longevity industry is ripe with intersecting belief systems. Some feel we have no right to live longer than intended. I wonder how these people feel about antibiotics. Then there are those in the transhumanism immortality camp who feel it is possible and dutiful to escape death. I have yet to see the first immortal. Neither seems to be dealing with a full deck. There is a very good chance we will all be living longer and healthier than we imagined. It was not so long ago that 65 was considered ancient. At 66, I in no way feel ancient. I also don’t feel immortal. There will be an end. With the advances in AI-assisted targeted drug research, among many other positive advances, there is a good chance I am only halfway through my life. My current thinking is to do the best I can to keep my organ systems in the best shape possible so that I will be able to access whatever innovations come along. At the same time, there is always a new shiny drug, therapy, or treatment that may seem immensely promising. If there is no apparent downside, maybe check it out after you speak to a medical professional. But from everything I have studied, it’s really the basics that move the needle: sleep, fitness, nutrition, stress management, and purpose. It is an exciting time to be alive, so let’s be here for as much of it as we can be.
Onward and upward,
David
