The Gut Punch Weekly #7
Growing concerns over weight cycling, obesity meds linked to rare eye disease, Novo responds to Hims Super Bowl ad, and more!
Top Stories
1) Experts Warn About Weight-Loss Drug Long-Term Effects
Health experts are raising concerns about the widespread use of GLP-1 weight-loss drugs like Ozempic and Wegovy, highlighting major challenges such as high costs, potential side effects, and patient dropout rates.
The drugs show promising medical benefits, including reduced risk of heart attacks, stroke, and potentially some cancers, but come with substantial financial and health downsides.
Most patients discontinue these medications within two years, commonly citing prohibitive costs (up to $1,000 monthly), periodic drug shortages, and severe side effects like gastrointestinal distress and occasional pancreatitis.
Experts warn about potential long-term metabolic consequences, such as muscle mass loss, reduced metabolic rate, and weight cycling, which could ultimately make future weight loss more challenging for patients.
(Axios)
2) Rare Eye Complications Linked to Obesity Drugs
A retrospective case series of 9 patients revealed potential ophthalmic complications associated with semaglutide and tirzepatide, including 7 cases of nonarteritic ischemic anterior optic neuropathy, 1 case of bilateral papillitis, and 1 case of paracentral acute middle maculopathy.
The study emphasizes the importance of monitoring visual health in patients using these increasingly popular antidiabetic medications.
Researchers cautioned against drawing definitive conclusions, suggesting that the rapid normalization of blood glucose levels might be more likely responsible for the observed complications than a direct drug toxicity effect.
(JAMA)
3) Novo Nordisk Challenges Hims & Hers Super Bowl Ad
Hims & Hers aired a controversial Super Bowl commercial promoting compounded weight-loss drugs, which sparked significant backlash from medical organizations and pharmaceutical companies for potentially misleading consumers about drug safety.
Novo Nordisk responded with a direct print ad warning consumers about the risks of non-FDA-approved compounded semaglutide, emphasizing that these medications have not been verified for safety, quality, or effectiveness.
The controversy has escalated to a political level, with Senators Dick Durbin and Roger Marshall suggesting upcoming bipartisan legislation to address pharmaceutical advertising requirements and patient safety.
(Fortune)
4) Microdosing GLP-1s Gains Popularity Despite Risks
Patients and some physicians are exploring microdosing GLP-1 medications at lower than recommended therapeutic doses, seeking benefits like weight maintenance, reduced side effects, and lower treatment costs.
This approach is particularly appealing given that only 34% of employee health insurance plans cover these medications, and brand-name versions can cost $1,000-$1,300 monthly.
Social media platforms like Reddit and Facebook have become hubs for patients sharing microdosing experiences, with discussions exploring potential benefits beyond obesity and diabetes, such as reduced inflammation and improved concentration.
However, medical experts remain cautious, with many physicians warning about the lack of clinical research, potential contamination risks, and the dangers of patients self-determining dosages.
(Medscape)
5) Novo Nordisk Obesity Drug Sales Surge 56%
Novo Nordisk's obesity drug sales, including Wegovy and Ozempic, experienced a significant 56% increase, propelling the company's net sales to 290B DKK in 2024.
While shares have fallen approximately 40% from their June highs due to investor concerns about the obesity drug market, Novo Nordisk remains confident in its product pipeline and potential for continued growth.
The pharmaceutical giant expects sales growth of 16-24% in the coming year, driven by continued expansion of its obesity and diabetes drug portfolio and increased manufacturing capabilities.
The company is investing heavily in manufacturing, including a $4.1bn factory in North Carolina, to support its growing demand and global expansion strategy.
6) Avian Flu Drives Up Egg Prices for Ozempic Users
Egg prices have skyrocketed to $7.08 per dozen in the Midwest, up from $1.65 three years ago, primarily due to avian flu outbreak.
Avian flu has reduced the US egg-laying hen population by 8% over the past three years.
GLP-1 medication users, who typically buy more eggs and lean proteins, are particularly impacted.
Many are seeking alternative protein sources like tofu, chicken breasts, and plant-based egg substitutes like Just Egg.
Retailers and restaurants are responding to the shortage, with Waffle House adding a 50-cent egg surcharge and Aldi limiting customers to two dozen eggs per purchase.
GLP-1 Industry Intel
Eli Lilly Posts Massive Q4 Revenue Surge: Eli Lilly reported a robust 45% Q4 revenue increase, driven by strong sales of diabetes and obesity drugs Mounjaro and Zepbound, which together generated $5.4 billion during the quarter.
Lilly Plans to Test Obesity Drugs in Neurology: Pharmaceutical giant Eli Lilly will launch clinical trials to investigate the potential of its incretin drugs in areas like brain health, substance use disorder, pain, and neuropsychiatry.
Novo Nordisk Seeks Next Wave of Weight Loss Drugs: Despite strong recent performance with Ozempic and Wegovy, Novo Nordisk is planning for a post-Ozempic future by strategically developing next-generation weight loss drugs targeting specific obesity patient subgroups.
Novo Revamps CagriSema Obesity Drug Trial: Following underwhelming results in its first Phase 3 trial, Novo Nordisk is launching a new study to optimize dosing and evaluate longer-term effectiveness of its obesity drug CagriSema.
2025 Trials Reveal Promising Obesity Medications: A new wave of weight-loss drugs including tirzepatide, retatrutide, orforglipron, MariTide, and CagriSema are being developed to improve upon Ozempic by offering better weight loss, oral administration, and potentially longer-lasting results.
Food & Wellness Industry Intel
Ultra-Processed Foods Become Major Political Target: The Trump administration and congressional leaders are exploring unprecedented strategies to combat ultra-processed foods, including potential warning labels, legislative restrictions, and legal actions against food companies.
GLP-1 Drugs Could Disrupt $12 Billion Snack Market: A new EY-Parthenon study reveals that the growing use of GLP-1 weight loss drugs could potentially reduce snack food market growth by up to $12 billion over the next decade as users dramatically shift consumption away from junk foods.
Hain Celestial Targets GLP-1 Friendly Product Line: Hain Celestial is developing product lines tailored to GLP-1 medication users, focusing on better-for-you foods that maintain taste, convenience, and affordability while supporting healthier eating habits.
Danone Tracks GLP-1 Nutrition Conversations Post-Super-Bowl: Following a significant increase in social media conversations about weight loss medications during the Super Bowl, Danone North America hosted a nutrition advice session with dietitians to support individuals on GLP-1 medication journeys.
Frontline Focus
Weight-Loss Drugs Raise Concerns for Childhood Obesity: As childhood obesity rates rise globally, medical experts are grappling with whether weight-loss drugs are an appropriate intervention for teenagers, weighing potential metabolic health improvements against unknown developmental risks.
Weight-Loss Drugs Surge Among Young Women: Weight loss drugs like Ozempic and Zepbound have seen a dramatic 650% increase in prescriptions among young women, driven by societal pressures, health considerations, and the drugs' effectiveness in managing weight and related conditions.
Ozempic Weight Loss Leads to Costly Body Lifts: Weight-loss drugs like Ozempic are driving a surge in expensive body-lift cosmetic surgeries, as patients seek to address sagging skin after significant weight reduction.
Helix Builds Massive GLP-1 Treatment Patient Database: Helix has launched the world's largest clinico-genomic dataset of 15,000 GLP-1 agonist-treated patients, enabling researchers to gain unprecedented insights into treatment effectiveness and patient responses.
Physicians Find Personal Success with Obesity Drugs: A growing number of cardiologists and other physicians are increasingly turning to new obesity drugs like Ozempic and Wegovy to help themselves lose weight, with many medical professionals experiencing significant health improvements.
GLP-1 Clinical Insights
Semaglutide May Reduce Need for Blood Pressure Medications: Researchers found that semaglutide 2.4 mg treatment may facilitate medication dosage reduction or discontinuation for hypertension and lipid management in individuals with obesity.
GLP-1 Agonists Promising for Post-Bariatric Weight Loss: Researchers discovered that GLP-1 receptor agonists can help patients overcome insufficient weight loss or weight regain following metabolic/bariatric surgery, showing promise as a potential post-surgical intervention.
Meta-Analysis Reveals GLP-1 Medication Digestive Risks: A meta-analysis of 10 studies reveals that GLP-1 receptor agonists are associated with higher gastrointestinal adverse events in metabolic dysfunction-associated steatotic liver disease treatment, particularly during short-term use.
GLP-1 Drugs Raise Shoulder Surgery Risk: A national cohort analysis revealed that Type 2 diabetes patients on GLP-1 agonists face increased risks of adhesive capsulitis compared to patients not using these medications.
Amylin and GLP-1 Activate Sex-Specific Neural Networks: Researchers discovered that GLP-1 and amylin modulate brain functional connectivity differently in males and females, suggesting complex, sex-divergent neural mechanisms underlying appetite regulation.
Weight Loss Drug Helps Knee Osteoarthritis: Weekly semaglutide treatment, combined with lifestyle interventions, showed promising results in reducing both body weight and knee pain for adults with obesity and knee osteoarthritis.
The Bleeding Edge
Pharma Company Tackles Weight Rebound After GLP-1: Response Pharmaceuticals completed early enrollment in a Phase 2 trial for RDX-002, an investigational drug aimed at preventing weight rebound in patients discontinuing GLP-1 weight loss medications.
Oral Semaglutide Delivery Shows Promising Preclinical Results: Rani Therapeutics demonstrated in a preclinical study that its RaniPill® platform can successfully deliver semaglutide orally with comparable bioavailability and weight loss effects to subcutaneous injection.