In just a few years, OIC has become a household name and a cultural phenomenon. GLP-1 drugs are everywhere, and already 1 in 8 US adults have tried them. The Danish company that makes OIC is worth more than the Coca-Cola company and McDonald's combined. Look online, and you'll see comments about OIC, face hair loss, severe stomach problems, and dangerous side effects. And then a moment later, you'll see a report that it could help with fertility or treating Alzheimer's or even shopping addiction. And it's not just weight loss drugs; we've been lied to about weight loss itself for years now. How much do we know about GLP-1 drugs, and are we being told the full truth about them? I've spent the last few months diving into the research and even tried to get some GLP-1 medication myself to see what's really going on here. At this point, I spent a lot of time on social media digesting what the discourse is out there about this medication. One of the pieces of

misinformation I'm seeing over and over again is this idea that these drugs are brand new, that they're not well-studied, and that they're not well-understood. It's not studied for this, you know, there's no studies on what it does to a body without diabetes. There is no research, no research on a person that is not diagnosed with type 2 diabetes. So, we know that this line that they are untested or not understood is just not true. They've been studied a lot for both safety and efficacy, for both diabetes and weight loss. Thousands of people have been studied in clinical trials specifically for obesity, but not for diabetes. The new phenomenon is that OIC is a household name, and it became a household name because of its weight loss effects. However, it's part of a class of drugs that have been used for decades to help people with type 2 diabetes regulate their blood sugar, and just in that regard, it's been a huge medical breakthrough. I think we could probably critique that on its own in

that our society is so weight-obsessed that none of these diabetes treatments were a household name, even though a million and a half people die of it each year. But as soon as it started making celebrities skinny, all of us were talking about it. That's probably worth unpacking, but that's more than we will have time to do here. So when Noo started testing these drugs as an obesity treatment, the outcome of those trials suggested that these are the most effective weight loss drugs ever. So the main ingredient in OIC is semaglutide. It's part of a class of drugs called GLP-1 receptor agonists, which basically just means they mimic a hormone that naturally occurs in your body called GLP-1. Semaglutide is in both OIC and Wovi, but Wovi is the one that's FDA-approved for weight loss. If these medications are paired with a healthy diet and exercise, people who are on semaglutide lost, on average, 15% of their body weight. The people who were just dieting and

exercising lost on average 2.4% of their body weight. A newer drug made by Eli Lilly called Tepati did even better in its clinical trials, with people losing an average of 20% of their body weight. And so, based on that data, we started to have all this very hyped news coverage about how these drugs were a game changer and a blockbuster, and how maybe obesity would be cured forever, which honestly is kind of a bizarre framing. Even from the very first studies, there were people who were not responding to these drugs. Yes, it's a really big deal that 86% of people in a trial lost a significant amount of weight; however, that means 14% of people didn't. Despite all this talk about miracle drugs, the figures are basically the same for both semaglutide and Tepati: roughly one in 10 people don't lose significant weight while on this medication and are what's called nonresponders. I really wanted to speak to someone who went through this, so I put a survey up on BI's social media.

channels and that's how I found Erica. It's working for other people, like why isn't it working for me and my body chemistry. But I'm mad it didn't work, but then it just I accept it and I just got to find another way to lose the weight. Erica says her doctor didn't warn her that these drugs don't work for everybody. Like many of us, most of her information came mainly from media coverage. When you set these drugs up as a miracle or a magic pill, you're also setting people up for massive disappointment if they had high hopes of weight loss and then these drugs don't work for them. There is one more thing that a lot of coverage has missed. Real life is not the same as a clinical trial. Since those first trials and all that news coverage, there's been more data about what real-world usage looks like. A 2023 study followed people on semaglutide for 52 weeks, and those people lost an average of 4.4% of their body weight. So we went

from 15% down to 4%, which is a dramatic difference. Most of the early coverage of these drugs used the numbers from the clinical trials, which makes sense because it was the first time these drugs were studied. The subsequent real-world usage impacts have not gotten as much press coverage, and that definitely feeds into an inflated sense of how revolutionary these drugs could be. Certainly, they are a really big deal; they're more effective than prior drugs, but there are limitations. The other thing that I think might be getting lost here is that weight loss from these drugs will have a plateau, which is similar to diet, to exercise, and even to bariatric surgery. At some point, every weight loss intervention plateaus. There's this popular conception that losing weight is the hard part and maintaining weight loss should be easy. What we know is that it's actually the opposite, right? The maintenance of weight loss is actually the hardest part. You wouldn't want a drug that allows you to lose unlimited amounts of weight; that would be dangerous for one and then

you'd have to go off of it when you reached your goal weight, and then you would just start to climb back up again, and it would be this constant yo-yo. However, that doesn't stop people from talking about this plateau like it's some sort of betrayal of the drug or some sort of failure of this medication. All evidence points to needing to keep taking these drugs to keep benefiting from them, which is interesting because we have study data showing that most people don't keep taking them. One study looked at thousands of people with GLP-1 prescriptions and found that about half of them stopped taking it after a year, and 70% of them stopped taking it at the 2-year mark. And another study found that after stopping the medication, people regained on average 2/3 of the weight that they'd lost. This is perhaps another big reason to dial down the hype machine on these medications. Yes, they are a big breakthrough medically, but if people don't want to be on them, then the impact of the drugs will be much lower than

were predicted in the flurry of news coverage. We had to begin with a lot of people hear that this is a long-term, potentially lifelong medication, and they see big Pharma dollar signs. The cynic in all of us sort of wakes up and says, What a win for big Pharma. It's true that it is a win for big Pharma. They're probably going to make a ton of money on this, and there is absolutely no denying that. I understand why people are mistrusting pharmaceutical companies and the media coverage around them at this point. We've seen some very irresponsible reporting. I think it's really important to be clear-eyed about the role of big pharmaceutical companies in our society. With just a quick Google, you could see that Nova Nordisk has paid fines after being accused of shady sales tactics. They've faced criticism for spending loads of money whining and dining doctors and that they've gotten in trouble with regulators in multiple countries. More famously, Nova Nordisk, along with other drug makers, faced massive criticism for high insulin

prices nowadays. Insulin is less profitable than it once was, but the potential profits of weight loss drugs remain astronomical. And make no mistake, Nova Nordisk will be cashing in on these drugs and already is. At one point, the company's valuation was bigger than the entire GDP of Denmark. Understandably, some people who don't trust big Pharma or simply don't have access to these drugs are turning to natural alternatives. Let's talk a little bit more about Nature's OIC. Nature's OIC. Nature's OIC. Nature's OIC. Nature's OIC. You'll find people presenting berberine, peppermint tea, green tea, vitamin B12, high fiber diets, high protein diets, all of these things as being natural alternatives to taking OIC. There are certain foods that can increase the amount of gp1 hormone that your body makes. The part where they get it wrong is that that doesn't necessarily equate to weight loss, which appears to be the goal of many people consuming this content. The level of gp1 production that

diets can provide is nowhere near what you can achieve with prescription medications. These interventions are leading to superprof physiological level of GLP-1, as opposed to kind of modest changes in your diet or some supplement that you could take. These are just orders of magnitude different, and you're not going to see anywhere near the same effects. But between influencer nutritionists and supplement grifters, we're seeing tremendous amounts of misinformation online about how effective a GLP-1 boosting diet can be. These foods and vitamins are generally less risky than a serious prescription drug, but they're almost definitely less effective as well. This is another subject of intensive news coverage where I think we just need to turn the hype dial down a little bit and look at what the research actually tells us. I also think people pay a lot of attention to side effects of these drugs because we've had plenty of examples of prescription drugs coming onto the market, and a side effect no one knew about ends up being very serious, particularly for weight loss drugs. The

most common side effects of these medications are gastrointestinal things like nausea, vomiting, and diarrhea. These can seem a little bit trivial, just like tummy trouble or whatever, but they can be quite serious. Extended periods of vomiting or diarrhea can leave you dangerously dehydrated. It's even been reported that one woman died while taking these drugs after months of gastrointestinal issues, including severe vomiting and abdominal pain. Besides the GI issues, the FDA label for these drugs includes a number of other warnings, some of which are for very serious conditions. So, if we just pull up the label now, there's what's called a black box warning about the risk of thyroid C-cell tumors. The warning label mentions findings in rodents, but a GLP-1 researcher I spoke to said that the thyroid in rodents and humans is quite different, so those findings probably aren't relevant. Sometimes, by putting a warning label on because of initial good intentions, you can cause more harm by scaring away people who otherwise might be willing to take this medicine and benefit from the

medicine. While the link between GLP-1 medication and thyroid cancer has been hard to establish, the link between obesity and thyroid cancer is much clearer. One study found that for every five-point increase in BMI, the risk of thyroid cancer increases by 30%. There's also another category on this label called warnings and precautions, and it includes acute pancreatitis, acute gallbladder disease, hypoglycemia, acute kidney injury, hypersensitivity reactions, diabetic retinopathy, heart rate increase, and suicidal behavior and ideation. The label here just says monitor for depression or suicidal thoughts; discontinue Wovi if symptoms develop. That's not very reassuring to me. This is an ongoing and evolving thing, but the weight of evidence so far suggests that these drugs alone are not going to cause you to have suicidal thoughts. It is not uncommon for drugs to have very intimidating, if not downright scary-looking, FDA warning labels. It's important to remember that things listed on these labels are potential risks rather than guaranteed results, which

actually does seem to get lost in the shuffle a bit on social media. Most of the more serious side effects of GLP-1 drugs are on the rare side. Most people who take these medications will not get pancreatitis. Sometimes people wonder why a drug could be approved if it has so many alarming side effects, but it's really not uncommon. If you look at metformin, a very popular diabetes medication, it has a warning for potentially fatal lactic acidosis. If you look at the label for ibuprofen, it has a warning about potential increased risk of stroke. These things are calculated in the context of being sick. If you take these drugs and don't have a medical need for them, your risk calculation is different, and you are putting yourself at greater risk of harm. Your neighbor who is interested in taking this medicine to lose 10 pounds so they can get into a size eight dress for Uncle Harry's wedding, they weren't studied in a clinical trial. But besides what's on the label, which is scary enough on its own, there's all these

rumors on social media about a whole other category of effects that are mostly cosmetic things like OIC face or hair loss. And it's not just hair loss; there's been a ton of concern about how much muscle people lose while taking GLP-1 drugs. However, whenever you lose weight, even if it's just through diet and exercise, you do tend to lose some lean muscle. One thing that's often forgotten in this whole conversation is that weight loss itself can have some very serious side effects, particularly rapid or extreme weight loss. Even losing weight fast through diet has been linked to hair loss, muscle loss, depression, gallstones—all side effects that overlap with the side effects of OIC. So, it's really hard to tell where one ends and the other begins. Personally, I think this is just another example of how the conversation around OIC has just gotten really weird. People seem to want there to be a punishment for taking a vanity drug and almost gleefully report this idea that your face or your hair or whatever would fail you when

you've taken a step to make your body look nicer. At least that's the perception, and to be sure, some people have taken OIC as a vanity drug. These drugs became a household name because celebrities were touting them for weight loss, and in many cases, already thin celebrities were touting their weight loss benefits. So, we've talked about the bad, but there are also some really interesting positive effects that these drugs potentially have. Not only do they make you crave less food, they make you desire different, usually healthier food. There's a physiological response that causes some people to be more preoccupied with food than others. People I talk to who have been suffering from food noise say the drug feels like a switch is being flipped in their brains. People have now reported other cravings going away too, like the urge to online shop. These drugs could help with all kinds of conditions: Alzheimer's, Parkinson's, alcohol addiction, and other types of addiction, depression. There's even anecdotal reports of OIC babies, which are people whose fertility

improved while they were on these drugs. All these things aren't so much side effects as they are potentially brand new indications for the drugs, brand new conditions that they could treat. GLP-1 drugs have a really unusually high number of potential new indications. About one in eight Americans have already tried GLP-1 medications, and this explosion of interest has led to something we've never quite seen before. One of the strangest elements of this rush for everyone to try semaglutide is that it put the drug in shortage. And when drugs are on the official FDA shortage list, compounding pharmacies can make their own versions. Compounded versions of these drugs are not FDA-approved or reviewed, and because these pharmacies are regulated at the state level, there's no data available for how many people are taking compounded GLP-1s. In an environment this confusing, it becomes easier to take advantage of people. I spoke to a researcher who purposefully ordered compounded semaglutide from shady online sellers just to see what he would get. We looked

at um the online pharmacies that were no prescription and were highest ranked in search results. So, these were some of the websites that, you know, consumers will see first. Of the six drugs that he ordered, three never came at all. They were total scams. So, they took the three prescriptions that they actually received and put the drugs to the test. And what they found was evidence of contamination and improper amounts of the active ingredients. Semaglutide. The FDA has also issued a warning about some compounders using semaglutide salt, which is generally used only for research and is not approved for use in humans. So, for consumers, the most important thing is to understand that when you source it from a no-prescription online pharmacy, there's a lot of risks: either fraud, incorrect product, or again, you're not getting a product that is medically necessary for you or appropriate for you. Offering no-prescription versions of prescription drugs is illegal, but there's also what feels like a tidal wave of buzzy online health startups who

can temporarily sell compounded semaglutide totally legally. I actually went through the process of being prescribed compounded semaglutide. I went through an online pharmacy where all I had to do was fill out a survey and then do a video telehealth visit with a doctor to be prescribed these drugs. I went through this process for reporting purposes to see how easy it would be to get these drugs, and it turns out it was pretty easy, which, depending on how much you value drug regulation, could be kind of concerning. There was sort of no question that I was going to get these drugs from the second the call started. It was a given. I don't know why, but I thought he might challenge me and say like, Ah, these are some pretty heavy-duty side effects. Are you sure you want to take these drugs to lose a small amount of weight? But he didn't, and the doctor that I spoke to in that process did not give any indication that I would need to stay on these drugs to maintain the weight loss. I'm not saying all this

to fearmonger about compounding pharmacies, but it is kind of wild how little we know about how many people are taking drugs from compounding pharmacies when we do know that they come with a higher degree of risk. However, there is one considerable upside, and that's that for some people, compounding pharmacies offer a cheap version of these drugs. In my case, a month supply of semaglutide cost $250. The list price for OIC in the United States is almost $1,000 for a month supply. For Wovi, it's $1,349. Those are shocking price tags. You can find economists estimating that GLP-1 medications will add $1 trillion in healthcare spending to the US. Then we have other economists estimating that it's actually somewhere between 20% and 50% of that. And it's not really possible to know who's right or wrong because the actual prices paid to drug makers are secret. And that's one of the many oddities of the American healthcare system is that no one knows exactly what

drug makers actually make from selling their drugs. It's considered proprietary information. At the end of the day, a lot of people seem to want it to be true that these drugs could actually save healthcare systems money, that we spend so much on treating obesity and related conditions, that these drugs could actually be a net money saver. And while that might eventually happen, especially if the cost of these drugs goes down, that is a very rare feat for a drug to pull off. The most important thing to remember is that if you see estimates of how much a certain drug is going to cost us healthcare systems or how much obesity costs America in general, remember that these are really rough estimates. And that's important because the stigma that people with obesity face is often couched in this idea that they're a tremendous financial burden to the healthcare system. I have seen countless comments saying, Why do you need OIC if you can just eat healthier? Why do you need to take these drugs? What you're looking for is willpower. It simply doesn't make

sense to talk about OIC as being the easy way out. The easy way out implies there's another way out, and for a lot of people, there just isn't. What these medicines have taught us is that a huge number of people living with obesity, they were restricting their calories, they were following diets, they were exercising, and it just didn't work for them, even though they really wanted it to work. And now we have something that helps them, and guess what? They're losing weight. We've been lied to about weight loss for a long time, and we're only just starting to figure it out. The reality is that we both, as a culture and the medical community, have been significantly underplaying how difficult it is to lose weight, and especially how difficult it is to maintain weight loss. We have a ton of data on this at this point, and we know that drastic weight loss is exceedingly rare and is usually temporary over time. We've also learned that exercise is not nearly as big of a factor in weight loss as people tend to

suggest it's has many benefits and is still important for overall health, but burning more calories is not a guaranteed path to weight loss. Many studies have shown at this point that even in the best of circumstances, where we're combining diet, exercise, and behavioral counseling, people tend to only lose 5 to 10% of their body weight. Then, after that, your body fights back. When you lose weight, your body starts to release hormones that increase appetite and reduce feelings of fullness. So, there's actually a biological mechanism encouraging people to eat more as weight is lost. Studies on people who've lost quite a lot of weight have found that they burn fewer calories than scientists expected, even when you account for the fact that their bodies are smaller and they're carrying less weight around. If you lose, um, you know, roughly 20 pounds or so, and you're maintaining that 20-pound weight loss, you're probably burning about 250 calories per day less than you were before you lost the weight. Uh, and we've known that for a very long.

time the advice doctors gave for years was that all it takes is small tweaks to your lifestyle. Swap your bag of chips for an apple or take the stairs. You can still find all kinds of advice like that online, and it's actually frankly bizarre that after decades of research supporting the idea that this is a very complex issue, so many people insist on acting like it's easy. It is understandable to have anxiety about medicating millions of people for what's seen as a wider societal issue, and some people say this is a Band-Aid on a bigger problem, um, those bigger problems being things like our food system or our sedentary lifestyles. And yes, there would likely be tremendous social benefit to addressing those very complex systemic problems, but for now, we have a relatively safe and effective drug that can give people another tool to manage their health in the meantime. So maybe it's a Band-Aid, but sometimes you just need a [Music] Band-Aid. If you want to see the sources

I used for this video. Check out the link in the video description, and for more truth complex, subscribe to Business Insider.

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