A (4:00)

So it's happening in your brain, not in your gut necessarily.

B (4:04)

Absolutely, yeah. I think that there are actions in the gut, but the key when researchers knock out the receptors of GLP1, so there's a brain GLP1 system that can receive this GLP1 signal. And when researchers knock out those receptors in the brains of rodents, basically the weight loss effects disappear. And so the idea is you have to tap into that brain system to get that change of appetite.

A (4:29)

With this new piece of information, what positive outcomes have providers seen their patients outside of weight loss?

B (4:37)

Well, this is fascinating. Basically there are lots of studies going on as well as a lot of I learned self experimentation happening in patients across the country and around the world. And people are using these drugs for just a very multitude of reasons. So irritable bowel syndrome, post concussion syndrome, type 1 diabetes, there were people who are using the drugs for long Covid to manage perimenopause symptoms. We found that then there are all the different types of addictions that people say these drugs have helped with. And I want to be clear, we do not have very high quality evidence on many of these endpoints. But it's kind of shocking the different people who are reporting relief, at least for the period that they've been taking the drugs. And there are of course questions of is this going to be. For example, I spoke to one woman who had A she was involved in a car accident. She was going to pick up her children from daycare on her bike and she got hit by a car and she hit her head. And she basically had what's called post concussion syndrome for almost a decade. And everything she tried and she tried basically everything and nothing helped. And then she read about this early research on GLP1 to help post concussion syndrome, and she ends up taking one of the drugs and immediately finding relief. And basically it's the first time she's been able to return to her previous functioning in 10 years. And now is that going to be like 1% of patients who use the drug? Is it going to be 50% of patients who have concussion and use the drug and see that benefit? No one knows at this point, but the evidence was, is just are these anecdotes are just extremely compelling and very interesting for sure.

C (6:29)

As more and more people begin to take GLP1s for weight loss, many are reporting unexpected positive side effects outside of weight loss. Julia Belous, contributing opinion writer for the New York Times, joins us to discuss her piece, the Great Ozempic Experiment. Listeners, we'd like to hear from you. If you've taken a GLP1 medication like Ozempic, Wegovy or Mounjaro, have you experienced any unexpected sights, side effects, positive or negative, have you noticed changes beyond what you or your doctor anticipated, like cravings or mood or other health conditions? And if you stop taking one of these medications, what led to that decision? Call or text us now. 212-433-969-2212,3333. WNYC. Julia, let's take a few calls. Let's talk to Peter in Huntington. Peter, thank you for making the time to call. All of it. You're on the air.

D (7:22)

Yes.

C (7:25)

Oh, no, he's pulled over. Try it again.

D (7:27)

Peter, I'm sorry. Can you hear me there?

C (7:30)

You sound great.

D (7:33)

Okay. What I was saying is great metabolic numbers, weight loss was fantastic. The one side effect, good or bad? Absolutely no desire any longer for alcohol.

C (7:44)

None whatsoever.

D (7:45)

It's none whatsoever. And I have bourbons in my home that I've been saving for years and you know, just a casual weekend drinker, but absolutely no desire, socially or otherwise, to have alcohol. I guess that's a good thing.

C (8:00)

Thank you for calling, Peter. Yeah, for some people, it helps curb addictions. Julia, what kind of addictions were you referring to in the piece?

B (8:08)

So I talked to people who had a range, so people who were had more of a problematic relationship to alcohol than it Sounds like the caller had people who were addicted to smoking. Some people wrote to us about sex addiction. There was a range of addictions that people seem to have found relief with these drugs on. There is a question among researchers. So basically, it's long been known that when you make animals hungry, they're more susceptible to addiction. And these drugs severely blunt hunger longer until. Until people's weight begins to plateau. And then some of the old signals start to come back when they're, when they stop losing the weight. And so there is this idea that maybe eventually some of this benefit might wear off. But there was recently a randomized controlled trial that was published around, I think it was. Was it around alcohol and people that this finding bore out in the trial? But it didn't last a very long time. So, so the, the question is, like, how durable? And even if, you know, the drugs seem to be working now and blunting these different appetites or addictions that people have, will that effect last? And that we still don't know.

C (9:28)

This text says, I have been on zepbound for two and a half years, and before I lost any weight, I felt so much better. It was like fog had lifted. I have autoimmune diseases, celiac, and it felt like it reduced inflammation in an extraordinary way. I stopped drinking almost altogether. I just didn't want it anymore. After two years, I've lost 70 pounds and my cholesterol dropped 100 points. That's from Alicia in Queens. I have a friend who decided to microdose GLPs, didn't need to lose any weight. And he said it, it really helped brain fog. It really helped him with his cognition. Did you hear that?

B (10:02)

Interesting. Yes. Yeah, I did hear that. I also heard anecdotes in the opposite direction, by the way. And, and, and, yeah, we, we should say on the flip side of this, as we discover more and more benefits as millions of people take it, I think we're also going to discover more and more higher harms and side effects just because of the way these drugs will interact uniquely with all of our different physiology and makeup. But the thing about this idea that, yeah, you can reduce inflammation, that is something that researchers are seeing. And they have this idea that with inflammation reducing medications in the past, you sort of shut off the immune system and you increase the person's risk for cancers or infections. So think about corticosteroids with these drugs. They seem to be almost fine tuners of the immune system, and they're turning down inflammation, but having this more subtle effect. So they're not increasing the risk, it seems, of cancer or infections. And this is absolutely frontier science. And that this is happening with these drugs, it's opening up new avenues of research, raising the question of what other hormones might we have in our bodies that could have this subtle but beneficial effect on immune system and on inflammation. This is really new stuff. But, but already, as you say, many patients are observing this effect. And there's also this question, your friend who is micro dosing right, there's a question of like, how much drug do you need to get that benefit? And we, we don't know that. So a lot of the trials are focused on diabetes control and weight loss. And for those endpoints you need larger doses. But it's possible that we'll see these other benefits at much smaller doses. Those trials, as far as I know, they're just not being Right now we're

A (11:54)

talking to Julia Belous, contributing opinion writer for the New York Times. She's joining to discuss her piece, the Great Ozempic Experiment. Julia, let's take some more calls. Let's talk to Julie who is calling from Detroit. Hi, Julie, thanks for calling, all of it. You're on the air.

E (12:10)

Hi. Thank you for taking my call. I have had irritable bowel syndrome for most of my life. And it's really, you know, life change. You cannot basically can't leave the house before noon because I've had just chronic problems with that. And I got diagnosed with celiac disease. I hope that upon getting that diagnosis, my new diet would control my irritable bowel, but that did not help. I went on WeGovy for weight loss and my condition is completely clear. I do not have any issues. I have, my mornings are now my own. I have like, I'm not tied to saying how many using the bathroom. It's just incredible freedom. I told everybody I get on the Internet looking for studies. I know there has been some study that showed some connection, but I've seen like Reddit users posting the same thing, seeing what I'm saying. So I'm really excited to have other people try it. For that reason, I would continue using it even without the need for weight loss, which I'm pretty much doing now.

A (13:20)

Thank you for calling in. Let's talk to Jane in North Brunswick who had a different experience. Hi, Jane, thank you so much for calling all of it. What went on with you?

F (13:30)

I guess a couple years ago I was on WeGovy for three to six months somewhere in there. And it, it killed my stomach. I already had GERD So managing constipation and nausea. Yeah, that's what happened with that. I went off of it. I guess I lost a little bit of weight. And then I went on Manjaro. And after like the second or third level of the dose, I was getting a well. And I'm not talking about a small well. And I. People were talking about on the Facebook groups like a giant well that would barely. It wouldn't even go away when I was ready to inject for the next week. So that wasn't good. I think I did lose more on Jara. Didn't bother my stomach, but I was getting it well.

A (14:19)

Yeah.

E (14:20)

So.

F (14:20)

But then I think it helped me, though, just kind of because I was 100 pounds overweight and I always had problems with overeating and food addiction. And then I went to intermittent fasting after that. So it kind of like, it was good to kind of get me see that I could actually lose weight because after a while you're trying and trying and, you know, it's just not happening. And it was good to. I can't think of a good way to explain it, but, like to start a weight loss journey.

C (14:51)

Thank you for calling in, Jane.

A (14:52)

Did you want to respond to either of our callers?

C (14:54)

Julia?

B (14:55)

I actually, I found both stories fascinating. On the IBS story, I heard actually from a bunch of patients who had that same experience. So there seems to be something going on there. But again, is it going to be 10% of patients, 60%? We don't know who benefit? We don't know that yet. And on the second caller. So I think we're really at this just frontier time where there's so much experimentation happening and researchers are trying to explain effects like the ones you're having. And as I said, I equally heard from people who are not, maybe not equally, but I heard from many people who had similar side effects that were just described. So, yeah, I think that this is why we're really in this experiment moment. And it seems like there's some effect, there's some genetic component here to why some people respond and others don't, because not everyone loses weight, for example, on these drugs. And it seems that there might be some genetic factor and you have some people who are very sensitive to the drugs and they get a lot of side effects and they get a lot of weight loss and other people who are insensitive to the drugs. And, you know, there's implications for how you approach and start to dose these medications in these different profiles of patients. But we don't have the tools yet to apply these in clinical practice.

A (16:24)

We're talking about the piece the Great Ozempic Experiment. It's written by my guest, Julia Belous, contributing opinion writer for the New York Times. Listeners, we want to hear your stories as well. If you've taken it GLP1 medication, have you experienced any unexpected side effects, positive or negative? Our phone number is 2124-3396-9221-2433. WNYC. We'll have more after a quick break. You're listening to all of it on wnyc.

C (17:04)

I'm Alison Stewart.

A (17:05)

As more people begin to take glps

C (17:07)

loss, many reporting unexpected positive side effects outside of weight loss. Julia Belous, contributing opinion writer for the New York Times, joins us to discuss her piece the Great Ozempic Experiment. As we get more calls lined up. Julia, I want to ask you spoke to more than 2,000 GLP1 users about how the drug affected them beyond weight loss. What kind of questions did you ask them?

B (17:33)

So just to be clear, we did a survey, a poll of the American public. So I didn't speak to all, I didn't speak to all 2,000 thousand of the people who responded. But yeah, we asked a range of questions. So we asked if the drug stopped working for the indication that it was prescribed, would you want to continue on it? And the majority said yes, they would. So that means if it was prescribed, for example, weight loss, but they had that benefit for their IPS or brain IBS or brain fog or whatever it is, they'd want to continue. And I think it was like over 60% said yes. We asked whether people would want to continue generally on the drug, and the answer was yes. We asked questions related to well being and those were also quite overwhelmingly positive. So people were reporting this improved sense of well being. Basically the biggest surprise to me was that I went into this story thinking this is going to be a negative story. We're going to tell the story of insurance gaps, of people disappointed, the weight plateauing, not where they want to be. That's really the story that I thought we were going to tell. And I was very surprised by the positive tenor of our survey respondents. And we followed that or I should say the poll. We followed that poll up with a call out and we asked people to tell us their stories about where they were finding benefits that were beyond just the weight loss and diabetes. And that's where we got thousands of people writing in with this range of surprising effects and benefits. And it all surprised me. I have to say, yeah, it's not, not at all the story I thought we were going to tell.

C (19:13)

Well, how often do insurance Companies actually cover GLPs for some of the conditions that people have been taking them for, such as migraines?

B (19:21)

So I think if you have diabetes, for example, you're going to have a pretty easy time getting the drug covered. But even for something like weight loss and obesity, it's still hard to get coverage. So there's lots of, like, patchwork and gaps in the insurance cover, in the insurance people have. And then for some of these other outcomes, I think it's. Unless you have another indication that's covered, you're. You're not. You're going to be paying out of pocket.

C (19:51)

We got a text that says, another complication. My dad started with Govi and it totally stopped his sense of thirst. He wasn't drinking water, and he was hospitalized for a week with dehydration and kidney failure and developed further complications in the hospital due to illness spreading easily in hospitals. He recovered, but did not even fully remember the experience. We have another issue about people becoming dehydrated, not remembering to drink. Let's take another call. Mike is calling in from Queens. Hi, Mike, thanks for calling, all of it. You're on the air. Oh, mic drop. Let's go to Mary. Hey, Mary.

F (20:24)

Hi. My question is this. I have a couple of friends on GLP drugs, and I've listened to a lot of shows, yours and others, I mean, WNYC and others, about the effects of these drugs. And I haven't heard anybody talk about the constant communication that goes on between the vagal nerve, I mean, from the vagal nerve, between the gut and the brain. And one major intervening variable, if you look at the overall picture, is the reduction of food load to the gut when these people start eating less. And that immediately changes the gut flora, which will immediately have an effect on the brain. And I'm wondering if there's any research going on looking at the amount of food eaten or the kinds of food eaten under this drug that takes into account something like that.

C (21:10)

Have you heard of this, Julia?

B (21:12)

I. I haven't, but that's a very good question and a good point, and I'm sure it's something that will. That. That the. They just either investigated now and I don't know, or will be investigated.

C (21:24)

Let's talk to Jerome on Shelter Island. I believe Jerome is a doctor. Hi, Jerome. Thank you, sir, for calling.

D (21:33)

Sure. So I'm a practicing cardiologist and I do prescribe these drugs. For a lot of my patients, aside from the weight loss effects, there have been demonstrated positive effects in terms of the cardiovascular system, hypertension, and also lowering the risk of heart things like heart attacks and things like that. So a lot of us are not sure whether whether these positive side effects that you're describing are separate from the effects of changes in diet, specifically lowering the intake of fats in your diet and weight loss, on the fact that those by themselves will lower inflammation. In other words, obesity is correlated with inflammation, and eating a very high fat diet is also correlated with inflammation. So how much of these effects are due to just the change in fat content in your diet and the weight loss itself, as opposed to other separate effects?

B (22:37)

Well, what you said is absolutely right, that obesity is associated with inflammation. And everyone had the assumption that if you give people a drug that causes them to lose weight, we'll see these reductions in inflammation. And that happened. But what's been surprising is that there are all these other benefits that seem to be weight independent. And in the case of like cardiovascular disease, liver and kidney disease, these benefits are happening regardless of whether people lose weight. But how that is tied into the changes in their diet, that I do not know. And it's a very good point because as you say, it's almost like bariatric surgery. When people start these drugs, they have very negative effects if they eat very fatty foods or. Yeah. High fat diet. And is that change that they're making driving some of this benefit, even independent of the weight loss? That I don't know. And it's a very good question.

C (23:30)

And I did want to ask you about a piece that published this morning. It really caught my attention. You wrote about children and GLP1s. You wrote that several of these drugs are now approved by the Food and Drug Administration for children ages 10 and older with obesity or type 2 diabetes. And the results so far are encouraging. Then you went on in the article to say that some doctors are considering using it on children as young as six. And you write, right, people are missing the point here.

B (23:59)

Could you tell us what the point

C (24:01)

is before people so they can read the whole article? But like, what your point is?

B (24:04)

Absolutely, yeah. So, so the, the, the article we've been talking about previously, this was about the great OIC experiment in adults. And through that piece, I learned about the experiment that's happening in kids. So there is this parallel experiment with GLP1s going on in kids, and it's very well underway. So there are dozens of trials that are already published or ongoing across the country are using these drugs. And as you say, children as young as six are engaged in research to see whether GLP1s might help their diabetes and obesity. And so I think the point is no longer should they be taking these drugs. We already have, like, you know, childhood obesity is at an all time high in America. They are taking these drugs and it seems like these diet caused diseases, they're so severe when they have this early onset that we do need a tool to, to help these children. And this does so far seem like a safe and effective tool. At the same time, there are astounding gaps in the research. There are so many things we don't know about what it means to use these drugs during, for example, puberty and this critical time of growth in kids. There are so many questions and so many things that haven't been studied yet. And so it is an experiment. Right. And the point I was trying to make was that, that we shouldn't even be here. We shouldn't have to be in a situation where there are millions of children who are suffering with obesity, diabetes and other diet caused diseases who can benefit from these drugs. We need to get a lot better at prevention. So that's the point that I was trying to make in the article. Do a bit of an assessment about where we're at with these drugs in kids and try to shift that conversation toward prevention.

A (25:54)

It's an excellent article, as is the great Ozempic experiment. We've been speaking with Julia Bellouge, contributing opinion writer for the New York Times. Thanks for sharing your writing and your reporting.

B (26:05)

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