12 posts on this topic, sorted most recent first.
BPC-157 is the most-asked-about peptide on the internet right now. Real animal data, almost no human data, a market full of vendors making big claims. Here's the honest version.
The scale tells you weight. DEXA tells you what you're actually losing. The patterns at 3, 6, and 12 months on tirzepatide are more nuanced than the trial averages suggest.
The most-quoted patient experience on tirzepatide is that the food noise stops. Here's what people mean by it, what's actually happening neurologically, and why it doesn't return for everyone after stopping.
Rapid weight loss can shift kidney function metrics in ways that look concerning but usually aren't. Here's what to track, what's normal, and when the labs mean something.
GLP-1s slow gastric emptying, which slows gallbladder contraction, which can produce stasis and stones. The counterintuitive prevention involves more fat, not less.
Rapid weight loss can trigger gout flares in patients prone to them. The mechanism is well-understood, the pattern is predictable, and the prevention is mostly straightforward.
Most prescribers don't order routine labs on tirzepatide unless something goes wrong. Here's the panel worth requesting at baseline, six months, and twelve months even when nothing has gone wrong.
The pancreatitis warning on GLP-1s has been around since the early days of the class. The accumulated evidence after 8 years of widespread use is more reassuring than the warning suggests, but the patient-level decision still has nuance.
The trial averages on regain mask substantial variance. The patterns that predict who keeps the loss and who doesn't are partly biological and partly behavioral.
Resmetirom is the only approved MASH drug today. Survodutide just read out phase 3 obesity at 16.6%; LIVERAGE + LIVERAGE-Cirrhosis pending. Pemvidutide IMPACT-MASH starting phase 3 H2 2026. Why we hold on MASH-specific routing recommendations and what we'd need to see to start.
Eli Lilly's triple agonist (GLP-1 + GIP + glucagon) has TRIUMPH-1, TRIUMPH-2, and TRIUMPH-4 readouts in the public record. Weight reduction at 12mg lands above tirzepatide. Cardiovascular signal is being watched. FDA filing window now points at late 2026. What this changes in routing decisions today.
Retatrutide, orforglipron, CagriSema, survodutide, MariTide, pemvidutide. Where each one sits in phase 3, the readout window, the mechanism, and what each approval would shift for routing decisions today. Bleeding edge of the science, conservative on the rating.