Should Everyone Take GLP-1s? (What Changed My Mind)

The definitive one-stop shop for understanding GLP-1s: risks, benefits, muscle, brain health, practical tips, and next-generation therapies. Insights you won’t find elsewhere.

I need to admit something:

When GLP-1s for weight loss started becoming big and everyone was talking about how they would change obesity medicine, I was a strong skeptic.

This has happened before: medicine and big pharma tell a compelling story about a miracle drug — then years later we find out we didn’t have the whole story, and people ended up harmed, sometimes critically.

However, the more I read about GLP-1s and their newer evolutions, the more my opinion shifted.

In fact, my perspective has even leapfrogged from “these are being overhyped” to “maybe they’re not being hyped enough.”

Or more precisely, maybe the benefits people are hyping are only the tip of the iceberg.

Because the deeper I dug into the literature, the more I realized these drugs are acting on systems far beyond weight: the brain, addiction circuitry, cartilage, inflammation.

There are now data suggesting GLP-1 signaling might directly reduce both amyloid and tau pathology, the hallmarks of Alzheimer’s disease.

Then, I thought:

Maybe we’re not looking at just obesity drugs. Maybe everyone should be taking a GLP-1, if only at a low dose?

Or maybe I’m just drinking too much of the Kool-Aid and missing potential harms: muscle loss, bone health, blindness, things we haven’t discovered yet?

Today I’m going to demystify all of it for you, with rigor, and give you practical insights I guarantee you won’t find elsewhere: how different generations affect lipids and cholesterol differently, tools to potentially build muscle while on GLP-1s.

All of it.

My goal here is to make the definitive guide to GLP-1s: one that synthesizes insights gained from hundreds of research papers and years of study into one place.

*Note: I have no conflicts of interest with the pharmaceutical industry whatsoever.

This letter is a StayCurious Metabolism Premium special.

In it, I consolidate insights from dozens of prior letters, hundreds of studies, and years of research into one place.

Fair warning: this one’s a lot… >6,000 words… and likely to grow over time with your input. But I genuinely want this to become your one-stop shop for understanding GLP-1s, so pleasespend some time with it.

We cover:

• Muscle preservation, and even building muscle on GLP-1s

• Bone health, eye health, and other potential risks

• Different generations of GLP-1s and poly-agonists

• The new oral GLP-1, orforglipron

• Weight-independent benefits on the brain and joints

• Combination therapies designed to build muscle during fat loss (I have one in my fridge right now)

• Addiction and alcohol use disorder

• Preventing weight rebound after GLP-1 discontinuation

• What to do About “GLP-1 Resistance”

• And more

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