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Dr. Gupta
Hey there. Welcome to Paging Dr. Gupta. Thank you so much for joining us. My favorite time of the week. As you know, today we're going to talk about peptides. You've certainly heard about peptides. A lot of wellness influencers out there are making these claims about these injectable drugs, saying that they can help promote muscle growth, improve your cognitive function, even make you live longer. But at the same time, most of these peptides are coming from the gray market. They're not approved by the Food and Drug Administration. So last week there was some news. An advisory panel to the FDA met to decide whether or not these peptides should actually be more accessible to people and patients like you.
Podcast Host 1
You may be hearing a lot today about peptides.
John Bonifield
An FDA advisory committee has greenlit six
Derek Van Dam
peptides for pharmacy compounding.
John Bonifield
Two years ago, no one had even heard of peptides, and now they're everywhere.
Dr. Gupta
We'll get into it after the break.
Podcast Host 1
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Dr. Gupta
Welcome back to paging Dr. Gupta. So first of all, a little bit of history here. A few years ago, during the Biden administration, 17 peptides were put on a particular schedule. This was the FDA's restrictive Schedule 2 list of drugs and essentially that banned compounding pharmacies from making these peptides. Now, over the course of a two day meeting last week, the FDA's Pharmacy Compounding Advisory Committee discussed seven of those 17 restricted peptides and whether or not to recommend that pharmacies be able to dispense them. It was sort of a fascinating hearing and I followed the news really closely along with my colleague John Bonifield. He's a supervising producer for CNN's medical unit. And I decided to invite John onto the show today to talk about what we're learning from these hearings and, and what it might all mean. John, thanks so much.
Audie Cornish
For being here.
John Bonifield
Thank you so much for having me.
Audie Cornish
You are the peptide producer, and peptides have been sort of very much in the news lately. We're gonna talk a bit about this today. I hopefully give people information that can really help them. But first of all, just why did you get so interested in this?
John Bonifield
Gosh, so many of my friends are using these and talking to me about it. You know, John, do you. Do you take tessamorelin? John, you know, have you considered a peptide? And so it's existing my own world. And then you see it on social media. It's so prolific. Millions and millions of posts on TikTok, on Facebook, on Twitter, X. And so it's prolific. It's out there. You're seeing these studies. There's a market study that's projecting the growth in this market to more than double in the next 10 years, from 146 billion to nearly $335 billion. So it is a huge market. Right.
Audie Cornish
It's unbelievable. And the v majority of these are banned technically. So these are, you know, people are spending billions of dollars, hundreds of billions of dollars on something that they frankly shouldn't even be taking. Because they've been banned, right?
John Bonifield
They're banned. They used to be made by compounding pharmacies. You know, compounding pharmacies exist in the United States to make drugs that you wouldn't necessarily get from a typical drug maker. And so the compounders could make them. And it existed that way for a little while. And then recently you had 17 peptides, and you saw a navigation of people moving to social media and websites that would market them over an unregulated market.
Audie Cornish
Yeah, and I gotta tell you, like, I have the same friends that you have, apparently, because so many of my friends have been saying the same thing. And, you know, I asked them, where are you getting these peptides? Because they're not being prescribed. And as you point out, it's these gray markets out there. But we, you know, people have questions, and I think that's the purpose of this podcast. So let me. Let me start off with just some basics here. Our bodies are made up of 20 fundamental amino acids. Those are the building blocks, frankly, for just about everything. Muscles, tissue, enzymes, hormones. When those amino acids combine in short change, sometimes just three or four of these amino acids, they form peptides. One of the ones that came up in the news this past week is kpv, a type of peptide. People may have heard of that. That is lysine, proline, and valine. So that just gives you an example, these peptides are supposed to navigate different functions in the body. And the claims, John, are astounding. Everything from prolonging your life to giving you more muscle to improving your tissue, ulcerative colitis treatments, all that sort of stuff. There have been peptides that have been approved, right? To be clear.
Dr. Gupta
Right.
John Bonifield
Insulin is a peptide. You know, a lot of people who have diabetes have to take insulin. That is a peptide. The active ingredient in Ozempic is a peptide.
Audie Cornish
Yes. Glp, the P is peptide. Glucagon, like peptide.
John Bonifield
And so a lot of Americans might not even realize that they're taking a peptide because so many Americans are taking GLP1s and they don't necessarily know what that P stands for. But you're taking a peptide.
Audie Cornish
Does it surprise you, given all your digging into this topic, that there aren't more peptides approved?
John Bonifield
It's interesting.
Audie Cornish
I mean, in some ways it seems like it wouldn't be surprising because in order to get something approved, I mean, you want human data, Right. If you look at what an FDA approval process means, it typically means that there's been lots of human studies and things like that. But that doesn't seem to be the case for a lot of these peptides.
John Bonifield
Right. A lot of these peptides are not studied. You don't see drug developers doing those big, expensive, million dollar clinical trial, gold standard research studies along the lines of what you might want as a regulator to evaluate. And so there's been a tension point there about, you know, how do we handle this apparent desire of people wanting to access these peptides without having that kind of scientific research to back up the usage.
Audie Cornish
There's these hundred so page documents from the fda. You've gone through these documents? I've read them as well. I think one of the things that struck me like we're Talking about these 17 peptides that were banned. And if you had to characterize the level of evidence behind these peptides, you know, how well do they work, what are the safety concerns? Most of the data around these peptides are animal data, their anecdotal data and their laboratory data. There's very few human trials, right? I think you found one.
John Bonifield
Yeah. So the researchers were looking into one of the peptides. It's called BPC157. And they were looking for studies to understand how do peptides like BPC157 treat ulcerative colitis. And they found one abstract reporting on the results of one randomized, double blind, placebo controlled study, what researchers would consider a high Quality study. It was a 53 people over two weeks who took a peptide or the placebo. So the people who took the peptide, they appeared to improve more than the people who took the placebo. But there were problems in the data. And the researchers ultimately said that because of those issues, there was a lack of evidence to make a conclusion on the effectiveness of BPC157 for treating ulcerative colitis. Yeah, ulcerative colitis, yeah.
Audie Cornish
There's the. When you think about new compounds, you always think about do they work and are they safe. So when it comes to these peptides, and again, very popular out there, a lot of people who are listening may have taken peptides or are thinking about it. Here's the fact, there just isn't very good human data. And that's not an indictment, that's not designed to be overly critical. It's just a fact. Sometimes there's not human data because that human data is not required. Like if you look at the supplement industry, for example, you don't have to have these large scale clinical trials because there's not an fda, FDA approval process for supplements. Here with peptides, we're talking about something that people are injecting into their bodies. And so this is sort of raised another level of concern. It would have to be compounded by a compounding pharmacy and then prescribed by a doctor. If these new sort of proposals go through in any way. What happened this past week, we know in the past that the FDA advisory committee said, look, we're not doing this. Basically, we're not going to allow these compounding pharmacies to make peptides. And then this past week we had a change. First of all, what led up to this? Did the committee itself change?
John Bonifield
Right. So the committee did change. There was a committee advisory meeting that happened in 2024 during the Biden administration. And the panel was composed of people who were working in that era. On that panel, we had a presidential election, a shift in who was leading the country, and we have a new
Audie Cornish
health secretary who's a big fan of peptides.
John Bonifield
Big fan of peptides.
Audie Cornish
He says this all the.
John Bonifield
He says he's used a couple of them himself on some injuries. And, you know, he's also said that he wants to end the war on peptides. And so under. Under this new administration, we've seen a change, a shift in what that panel is composed of. And so a number of people on the panel now, in fact, the majority, you know, are folks who are attached to the peptide world.
Audie Cornish
Yeah. You know, I will Say this and again, I, this isn't a political podcast, but just it strikes me that the, what we refer to in science as the evidentiary threshold, how much evidence do you need to make a decision about taking something you're going to inject into your body? As we've established, there's hardly any evidence when it comes to peptides. And yet you have the Secretary of Health, Robert F. Kennedy Jr. Promoting them, saying he's taking them. Whereas with vaccines, another big topic for this administration, there's plenty of evidence about efficacy, all that sort of stuff. And there, if anything, there's been a war on vaccines and this sort of embracing of peptides. It's just weird. I don't know how else to sort of describe it. I've been a medical reporter for 25 years. That's just strange. However you want to think about that. But going back to the hearings, so what has happened then? So there was these seven peptides, right, that are being evaluated. So you have a hearing where people get up and they make their case in terms of why it should or should not be allowed to be compounded by a compounding pharmacy. What has happened this past week?
John Bonifield
Right. So they have looked. We're talking on a Friday morning. The hearing lasted for two days. It started on Thursday and Friday, on Thursday, they, they essentially voted to let compounding pharmacies. They voted to let them compound four of the seven peptides that they're considering. All of these were part of the 17 that were banned. And so four of them so far that were banned. They voted to let compounders make. And there are still some votes to come as of Friday morning.
Audie Cornish
And these votes have been pretty much all eight to six, eight voting in favor of compounding, six against, and I think generally one abstention. So they're not slam dunk votes. They're very close, but they are tilting in favor of allowing this to happen. And we should point out, as I think people note, this is an advisory committee. This doesn't mean that this is what's going to happen. There's a rulemaking process that takes place and then the FDA ultimately will vote. Most times they take the advice.
John Bonifield
I was going to say, typically that is what happens.
Dr. Gupta
We're going to take a quick break, but when we come back, we'll talk about the pros and cons of more regulated access to peptides.
Audie Cornish
Stay tuned.
Derek Van Dam
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Audie Cornish
I'm Audie Cornish.
Ari Shapiro
I'm Ari Shapiro. And it's engagement party and we get to talk about what we're obsessed with, what we're engaged with, what we need to process with a friend. There is a specific nostalgia for the 90s, like the denim, the music, the TV shows, and I also think there a slightly separate nostalgia for an analog life.
Podcast Host 1
The analog life. I think it's a social media thing because this is a generation that's like, remember when my every move. The choice was mine.
Ari Shapiro
Yeah, but that's not specific to the 90s per se. So, like Instagram didn't debut until well into the 2000s, almost a decade into the 2000s.
Podcast Host 1
Yes, I was there.
Ari Shapiro
People are buying vinyl, they're buying records. What's interesting to me is that a lot of the nostalgia is aimed towards and being talked about by Gen Z who were not alive.
John Bonifield
Yeah.
Ari Shapiro
Follow engagement party, wherever you get your podcasts.
Audie Cornish
I'd like you to list the seven peptides that we're talking about. And as you're finding those, let me just say, you know, I think this is an interesting cultural moment as well as a scientific moment in our society, because here's the story. You have these substances that were in effect banned by the FDA a couple of years ago. They were banned because they said, hey, there's not enough evidence that they work and there's concerns about safety. What happened after that? Well, it didn't make a dent in usage. People still were using these peptides. They found all sorts of ways to find these peptides. They go to wellness clinics, they'd find vials that were for research use only. And if anything, the numbers have continued to grow despite the ban. And I think for, you know, the United States and frankly, any system, you have to ask yourself at that point, what is my obligation to society? I know people are taking this substance. Do I continue to say, hey man, you really shouldn't take this, I said it before, I'm gonna say it again. Or do you acknowledge the fact that they're taking it and try and create as safe a system as possible for them to do so? And I think that that's the tension, John. I think supporters of allowing Compounding pharmacies to do this would say at least they're probably getting a safer product now. They're made by a regulated compounding pharmacy in the United States. They're using active pharmaceutical ingredients that have been inspected. We're not saying that they work, but at least we're saying we're reducing harm. Critics will say, hey, that's not the way the FDA works. You know, if you're letting people just start to dictate what they should and should not put into their bodies and not allowing scientists and people who study this to have a voice in this, that becomes a problem in the long run. And frankly, I don't know where this, where this goes. I don't know what this means in the long term. But to me, it seems like that's the fundamental tension. This is much a cultural story as it is a scientific story.
John Bonifield
Yeah. One former FDA regulator who I was speaking to said, you're essentially letting people experiment on themselves. And that is just not really the way that this system has been set up or has worked before in the past.
Audie Cornish
Yeah. And I wonder what, what that might mean for the future. But tell us a little bit about these peptides. Maybe a sentence on what they are, what they're supposed to do.
John Bonifield
Sure. So the they first, they have a lot of different uses. When you go on social media, you'll see them, you know, for all kinds of things marketed for different uses. The fda, though, was sort of trying to hone in on some certain uses to sort of evaluate those. And so they looked at BBC157 for treating ulcerative colitis, a peptide called KPV, that, that three amino acid chain peptide that you were talking about for wound healing and for inflammatory conditions, A peptide called TB500, also for wound healing, sometimes gets paired with BBC157. It gets called the Wolverine stack, you know, like the comic book hero.
Audie Cornish
That's pretty compelling marketing.
John Bonifield
Yeah.
Audie Cornish
Who doesn't want to be the Wolverine?
Ari Shapiro
Right.
John Bonifield
There's one called Mott C for obesity and osteoporosis, there's a peptide called Amal. I'm going to pronounce this one wrong, but it's Imadeltide, I think for opioid withdrawal and chronic insomnia and even narcolepsy, a peptide called CMAX for certain neurological disorders, and then a peptide called Epitalon for insomnia. So Those were the seven peptides that the committee was looking at this week. Seven of again, the 17 that were banned three years ago.
Audie Cornish
If the FDA follows the advisory committee's recommendations. What does that mean for the public?
John Bonifield
It will mean that the public can consider going to their doctor and getting a prescription for one of these. You know, for recently, doctors haven't been able to do that. You know, you might have a doctor who wants to give you a peptide, but they're banned and so the compounders can't give them. And a doctor wouldn't write that prescription for you right now. That could change. You know, a doctor could say, you know, John, I'd like you to take this. You know, consider taking this. They could write you a prescription. You could go to a compounder and you might have more confidence in what that substance is going to be. It might not give you the concerns that it would be adulterated in some way. In fact, listening to the panel yesterday, one of the panelists said the reason they voted yes is because she has patients who come into her office and she says they have to sort of fix things sometimes. Problems that come up. And one of the problems, she said, is they came in having purchased one of these unregulated peptides and it was laced with ecstasy, really. And she felt that her vote was in part to sort of prevent that from happening because she had said she'd taken a pledge to do no harm as a doctor. And this kept coming up yesterday. And this idea of what do no harm looks like because we had the inverse also happen, a doctor saying that she voted no for the same reason that not knowing if something could hurt you is a reason to say no and that she didn't want to do harm. And so you saw this tension, such
Audie Cornish
a fascinating time with regard to how we're looking at these substances. But I think the first example you gave, I think it's a very valid example. Look, if you have legitimate compounders making these substances going forward, the likelihood that they would be laced, for example, with MDMA or ecstasy, I think that goes down considerably. And, you know, I think people who are listening to the podcast that are going to have to sort of figure out how they think about this. But I think the headlines again are at this time there's really not very good, if any, human data that these peptides work. Mostly it's been animal studies, anecdotal reports, and some laboratory studies. There was one placebo controlled trial, as you mentioned, on BPC157, but that's it. Not very good data. Two, there have been some significant safety concerns, including potentially life threatening anaphylactic reactions. I mean, you know, really concerning stuff. Some of those Concerns about safety might actually go down if legitimate compounders are able to do this. And then, you know, the third thing is, and this is something I've thought for 20 years now, John, you know, I think about the supplement industry this way as well. If one of my patients comes to me and they say, hey, look, I'm taking this thing and it's helping me, it's making me better in some way, more muscle, more strict, more better sleep, whatever it might be, who am I to say, no, it's not, it's not helping you. That is your experience. So I would never be the guy to say it's not helping you. But I do agree that we do have the obligation of making sure it's not harming you. So whether it's helping you, that could be up for debate. But whether or not it's harming you, that is something that I think we need to be very serious about.
John Bonifield
And how does one evaluate harm? You know, what constitutes harm? How serious does it need to be? You know, what came up in the discussions yesterday at, at the panel meeting was sure there have been some incidents that have happened, but they noted that you have incidents happen even with FDA approved drugs. And so what does the standard look like for what that level of harm can be? And one of the panelists who voted yes to go ahead and recommend compounders make these peptides was that the risk was worth it, that he felt like the benefits outweighed the risks in his mind.
Audie Cornish
And potential benefits. Right. Because there's no actual evidence of that.
John Bonifield
It's interesting the way they evaluate evidence too. You have regulators looking for sort of high quality studies and then you have the compound industry saying, well, look, we've treated millions of people, we're tracking our patients, we're not observing through observational data the kind of harms that would give us pause or make us not feel like we should be doing this. And so you have a tension point there, a point of conflict that's happening between how to look at harm. Yeah.
Audie Cornish
And I think, you know, if you're ever, ever trying to sort this out, so sort of conception in your own mind. Think about your own body, think about the people you love. Would you recommend a peptide to them or not? Based on everything we've said, it's not an easy answer, but it is something that we are dealing with as a society right now. Real quick, before we end. So what happens next? These advisory committee meetings are happening now. This is, this is July. At what point might we hear some
John Bonifield
further information about this it depends on how fast the agency moves. You know, ultimately it will be up to the FDA to decide what to do. If they do vote to let compounders do this, we could start to see a market that looks a lot more like the supplement market that you were talking about, where you're not going to necessarily know how safe they are or how effective they are, but you'd have some confidence that you're getting a product that you can feel like at least it's safe to put in my body in terms of it's not laced with something.
Audie Cornish
Will you come back and talk to us when this, when we hear something from the fda?
John Bonifield
I would happily, happily come back.
Audie Cornish
So fun having you on the podcast.
Derek Van Dam
So great to be here.
Ari Shapiro
Appreciate it.
Dr. Gupta
Now, since John and I talked, a majority of the members of the FDA advisory panel voted in favor of of expanding access to epethalon and cmax. The only peptide that did not get their support was Imideltide. Alright, that's all the time we have for today.
Audie Cornish
I hope that you got a better
Dr. Gupta
understanding of not just peptides, but how to think about them no matter what happens next. If you're thinking about taking them, obviously consult with your doctor first. And if you're listening right now and you're thinking, hey, I got a question about peptides, about anything else, send it in. We love hearing from you. We'll probably try and answer your question. Reach out to us. Record a voice memo, email it to paging Dr. Gupta.com or give us a call 470-396-0832 and leave a message.
Audie Cornish
Thank you so much for listening.
John Bonifield
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Derek Van Dam
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John Bonifield
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Derek Van Dam
Did the scratcher come to your house and hand you a check? No. How many scratchers did you hit to get that? I hit a button on Carvana.com once.
John Bonifield
Okay, that's fair.
Derek Van Dam
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John Bonifield
Not like the lottery at all, actually.
Derek Van Dam
Exactly. Inexplicably good offers worth bragging about. Sell your car today on Carvana. Pick up. Fees may apply.
Dr. Gupta
Go inside. The sports moments that brought us together and made history. From the underdogs to the rivalries and the miracles. The new CNN original series, Decades in Sports Watch back to Back premieres August 2nd on CNN. And next day on the CNN.
Chasing Life with Dr. Sanjay Gupta — July 28, 2026
This episode delves into the surge in popularity of peptides, injectable compounds touted by wellness influencers for benefits like muscle growth, cognitive enhancement, and even life extension. Host Dr. Sanjay Gupta, joined by CNN's John Bonifield and Audie Cornish, unpacks the science, regulatory controversies, and cultural factors fuelling America's fascination with peptides—especially in light of recent FDA advisory meetings considering reversing restrictions on several previously banned peptides.
Key Quote:
Key Quote:
Key Quote:
Update:
Key Quote:
“You're essentially letting people experiment on themselves. And that is just not really the way that this system has been set up.”
(Former FDA regulator, relayed by John Bonifield, 15:59)
“I think supporters... would say at least they're probably getting a safer product now ... We're not saying that they work, but at least we're saying we're reducing harm.”
(Audie Cornish, 14:50)
Key Quote:
Peptide Hype on Social Media
“Millions and millions of posts on TikTok, on Facebook, on Twitter, X. And so it's prolific. It's out there.” — John Bonifield (03:07)
FDA Process and Advised Peptides
“On Thursday, they essentially voted to let compounding pharmacies... compound four of the seven peptides that they're considering.” — John Bonifield (11:25)
Dilemmas of Harm, Autonomy, and Medical Ethics
“Critics will say, hey, that's not the way the FDA works... if you're letting people just start to dictate ... not allowing scientists... that becomes a problem in the long run.” — Audie Cornish (15:43)
Panel Split on Do No Harm
“The reason they voted yes is because she has patients who... came in having purchased one of these unregulated peptides and it was laced with ecstasy... And this idea of what do no harm looks like because we had the inverse also happen, a doctor saying that she voted no for the same reason.” — John Bonifield (18:08)
| Timestamp | Segment/Event | Participants | Summary | |-----------|-----------------------------------|--------------------------------|------------------------------------------------------| | 02:50 | Start of main discussion | Gupta, Bonifield, Cornish | Introduction of peptides and the regulatory debate | | 07:29 | Study on BPC157 | Bonifield | Explaining lack of evidence | | 09:34 | FDA panel change & political shift| Bonifield, Cornish | Current Health Secretary’s pro-peptide stance | | 11:25 | FDA votes + voting split | Bonifield, Cornish | Committee decision process | | 14:06 | Social/cultural dilemma | Cornish | Harm reduction vs. maintaining scientific standards | | 16:19 | Listing of seven peptides | Bonifield | Quick descriptions of each peptide | | 19:14 | Harm reduction & clinical dilemmas| Gupta, Bonifield, Cornish | Weighing personal benefits versus community safety | | 23:19 | Post-recording update on votes | Gupta | Epitalon and CMAX approved; Imideltide not |
“Whether it's helping you, that could be up for debate. But whether or not it's harming you, that is something that I think we need to be very serious about.”
— Dr. Sanjay Gupta (19:14)
For those seeking to understand peptides and the swirling mix of enthusiasm, skepticism, and uncertainty around them, this episode provides a balanced, nuanced, and engaging primer.