Is Medicine Captured? (And Some Big News)
A deep dive into how pharma funding shapes medical narratives, how the status quo perpetuates itself, and why science isn’t the meritocracy we imagine.
*Author’s Note: I composed this letter prior to an extreme set of recent events that coincidentally reinforce the thesis of what you’re about to read: Behind closed doors, the integrity of the scientific process, and by extension academic medicine, are failing. But we can identify these failures, call them out, and as a collective – fix them. But let’s start with the text as it was initially intended, and then we will tie it into recent and evolving events.
I recently caught a line in a paper that stopped me in my tracks.
The paper was published in a major journal, The Lancet Diabetes & Endocrinology, and had been used by legacy and social media to proclaim the benefits of a new generation weight-loss drug: Retatrutide.
Think Ozempic on steroids.
Retatrutide is a newer generation GLP-1 receptor agonist that targets two other pathways, which is why it’s sometimes called a “GLP-3.”
But that is not the point.
If you go to page 678 in the PDF, there’s a line:
“The study sponsor provided the study drugs and was involved in the study design, data collection, data analysis, data interpretation, and writing of the report.”
In this case, the study sponsor was Eli Lilly, the pharma company that stands to profit from the drug they’ve patented.
Now, it’s completely understandable in a capitalistic society that pharma companies are going to fund drug trials. That’s obvious, and it’s not something with which I take issue per se. That’s capitalism, and it drives innovation.
But those five words at the end — “and writing of the report” — stopped me.
They are explicit: that pharma company helped write the published paper that went through peer review, got the stamp of academia, and will ultimately push the needle on the standard of care.
The reason I take issue here — the reason this is so insidious — is because when this line is crossed, when the pharma company isn’t just funding and designing trials but also helping with data analysis and writing the report, the framing ends up being such that seeds of misinformation are planted.
Let’s take a look at the interpretation presented in the abstract, which is primarily what gets read.
Most people don’t read the foreword or dig into an aside on page 678.
The final line of the abstract reads:
The proportion of lean mass lost to weight loss was similar to other obesity treatments.
These findings could provide reassurance that a greater proportion of lean mass is not lost with retatrutide despite overall increases in weight loss.
That wording is technically correct, but deceptive.
Other obesity treatments — specifically other weight loss medications — cause a similar amount of lean mass loss, on the order of 25% - 39%, which has been a point of concern.
There’s more total weight loss in this trial with this new-generation GLP receptor agonist (retatrutide) and the lean mass loss is roughly proportional.
Ultimately, lean mass loss was just over 14 pounds in this trial — the mass of your average 4-month-old child.
To me, that’s disconcerting.
But the statement that these findings “could provide reassurance” is fluffy enough that, legally, everyone’s safe.
But what happens when this wording becomes the headline finding? People run with it, saying this new miracle weight loss drug not only causes gangbusters weight loss, but also preserves lean muscle.
This became the narrative on social media. The claim “Reta, unlike prior GLP-1 drugs, ‘preserves lean mass’ became gospel.”
Now, let me be clear: this is not a one-off.
Oh boy, it is not a one off!
Another Example: Statin Meta-Analysis of Randomized Controlled Trials
To cite another recent example, a major 2026 meta-analysis of randomized controlled trials on statin safety was proclaimed as a huge win for the safety of statins.
Subsequently headlines ran, “Millions more people should be taking statins.”
And major academic bodies piled on.
The Lancet Group even inappropriately claimed that the study proves statins are safe and don’t cause most side effects attributed to them.
This was, in effect, a statistical sleight of hand at the very best. I think it could accurately be called an outright lie by academics who should know better.
IMPORTANT: Not achieving “statistical significance” for an outcome is not the same as demonstrating absence of a biological effect.
And given the conflicts of interest with Merck, AstraZeneca, Eli Lilly, Novartis, Amgen, Pfizer, and other pharmaceutical companies, I find it hard to believe that’s a coincidence.
Now, I’m not saying statins are “bad.” I’m providing no value judgement on the medication or its clinical use here.
What I am saying is the conclusions drawn exceeded the data presented. I’d argue that, in many cases, they were outright falsehoods.
I am stating the obvious: there is a thumb on the scale in how narratives are written.
And that presents us with a conundrum.
The question is: is science, and by extension medicine, captured?
And the follow-up: what can we do about it? (Spoiler: You have more power than you realize)
Why am I (Nick) Talking about This?
As much as I hate to lean into academic authority, I do think it’s pertinent here to reveal that I have some degree of insight into how the sausage is made.
I graduated top of my class at an Ivy League college, did my PhD at a nearly 800-year-old institution in England — ironically the same one that put out the “statins are safe” meta-analysis — and then crossed back over the pond to attend medical school at Harvard.
I have been inside the ivory tower and know what discussions happen, at least to an extent.
I understand how the incentive structures are built. I’m not saying this is my area of particular expertise. I am young and early in my career. I am not “the expert” on these matters. I’m just saying that firsthand, and secondhand through friends, colleagues, and family, I have insight into these matters and understand some of their nuances.
Commentary: Recent Developments (KETO-CTA)
Now, as a brief aside, I want to take a moment to acknowledge recent events.
For those of you who have not only learned with me here at StayCurious Metabolism, but who have followed my broader public and research journey, yesterday we shared important news regarding a highly controversial study on which I served as co–first author.
I’ll reserve deeper discussion of that for the postscript of this letter, and you can also read my statement on X.
The short version is as follows:
While I’ve long been aware of the shortcomings of the scientific process and the meritocratic failures within academic medicine, my experience with this project was — without exaggeration — the most disillusioning of my career.
That’s not a statement I make lightly.
I trained and built my career within academia. It is an ecosystem I know intimately and one whose aspirational ideals I still value. What unfolded here, however, defied, disregarded and wholly disrespected those ideals in ways I find difficult to fully articulate.
I recognize that to many — particularly within academic circles — the facts I have recently and will continue to describe as the story unfolds further may strain credibility, or even sound conspiratorial. To be candid, if I were hearing them as an outside observer, I’m not sure I would accept them at face value either.
But for now, let’s set that aside and continue.
Caution: Please Don’t Blame Doctors & Healthcare Workers
Sorry for the long-preamble, but I need to highlight one final interpretative caution: nothing I’m going to say is an accusation toward healthcare workers.
To accuse a healthcare worker of being malicious or of misdeeds in treating their patients because of the incentive structures of the system is, honestly, blaming one of the victims.
One thing I’ve definitely learned is that doctors are trapped in this dysfunctional system as much as, if not more than, the rest of us.
But with that said, let’s return to our operative question:
Are science and medicine captured?
I think the unequivocal answer is: Yes, at least to some extent.
Now, the question you obviously want answered is: What do we do with this?
In the rest of this letter, for StayCurious Premium subscribers, I’ll break down actionable tips to help you become a more informed consumer of scientific literature:
How to look for funding sources and conflicts of interest
The difference between statistical significance and clinical significance
How to spot potentially important but “non-significant” trends.
We will also walk through specific examples of science gone wrong, like a major study that yielded claims that were the opposite of truth, but one that remains cemented in “the science” to this day.
And, yes, I’ll also discuss what happened to me that has inspired this deeper reflection.
But we’ll end on a note of hope — something that gives me a genuinely optimistic vision for the future of science.
And you — yes, you — get a shout out for something truly revolutionary.
If you’re a curious person who wants to join a very special community of passionately curious people, make the leap and find out why premium members attest StayCurious Metabolism is the best investment they’ve made in their health and learning journey.
