Independent GLP-1 journalism
Nobody is short of opinions about these drugs. What people are short of is a clear account of the first two months — what the body does, when, and which parts of it are worth a phone call.
Read the pieceFresh off the desk
Most people on these drugs are monitored on a bathroom scale and nothing else. A short, cheap panel twice a year would catch nearly everything that quietly goes wrong.
Nobody is going to tell you to give up coffee, and nobody should. But it interacts with three things this drug class has already made more fragile, and the interactions are all avoidable.
Nausea gets the attention because it arrives first and loudly. Constipation arrives in week three, never fully resolves for some people, and is the thing they eventually stop over.
Acute kidney injury on this drug class is almost never a direct drug effect. It is three days of vomiting in someone who did not think to replace the fluid, and it is entirely avoidable.
Repeated vomiting erodes enamel permanently, reflux does it more quietly, and any dental procedure involving sedation now needs the same conversation as surgery. None of this is on the leaflet.
A drug famous for slowing the gut down produces loose stools in a substantial minority, which sounds contradictory until you know what else is usually in the picture.
No blood service in the United States defers you for taking one of these. What will defer you is the iron, the weight and the hydration — three things this drug class makes considerably more likely.
The standing pledge
Almost every large GLP-1 site in America is funded by the industry it covers. This one isn't, and the arithmetic of that is printed on every page.
Read the full policy01
Not a dollar from Novo Nordisk, Eli Lilly, a telehealth platform, a compounder, or a supplement brand. Not now, not later.
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We never earn a commission when you click through to a pharmacy, a program, or a product. Every recommendation is unpaid.
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Nothing on this site was written, reviewed, suggested, or approved by a company with something to sell you.
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One four-dollar book. That's the entire business model. It is meant to cover hosting, not to build an empire.
Deep Dive
Long-form investigations. One question, taken seriously, with the primary literature read in full.
SELECT enrolled seventeen thousand people with heart disease and no diabetes, and found a twenty percent reduction in cardiovascular events. The label change that followed did more for access than any argument about obesity ever has.
Surgery still produces more weight loss than any injection, and it is now being declined by people who would have accepted it three years ago. Both of those facts deserve more scrutiny than they usually get.
When Zepbound was approved for obstructive sleep apnea, it stopped being a weight-loss drug in the eyes of a large part of the American payment system. That distinction is worth thousands of dollars a year to some people.
An effective GLP-1 in tablet form is not mainly a convenience story. It is a manufacturing story — and manufacturing is what has rationed these drugs since the day they arrived.
On The Jab
The
GLP‑1
Handbook
Dr. Nick Robertson
MD
The book · 14 chapters
Everything I tell my own patients before their first injection. 214 pages of what actually matters in the first year — dosing, side effects, food, muscle, cost, and the part nobody prepares you for: maintenance.
Priced at four dollars because it should be affordable to everyone taking these drugs — not because it's worth four dollars. No upsell, no course, no supplement line.
Start here
Evergreen, practical, reviewed twice a year. The pages we send people to when they ask us where to start.
Most people on these drugs are monitored on a bathroom scale and nothing else. A short, cheap panel twice a year would catch nearly everything that quietly goes wrong.
Nobody is going to tell you to give up coffee, and nobody should. But it interacts with three things this drug class has already made more fragile, and the interactions are all avoidable.
Nausea gets the attention because it arrives first and loudly. Constipation arrives in week three, never fully resolves for some people, and is the thing they eventually stop over.
Browse
Fourteen hubs, each collecting everything we've published on the question.
Medications
Semaglutide for type 2 diabetes — and everything that followed.
Medications
Semaglutide at weight-management doses.
Medications
Tirzepatide, the dual GIP/GLP-1 agonist.
Medications
Tirzepatide for obesity and sleep apnea.
Medications
Orforglipron, retatrutide, CagriSema and the oral wave.
Your Body
Nausea, reflux, gallbladder, pancreatitis — risk in proportion.
The wire
Who writes this
Physician, writer, and founder of On The Jab. He has spent the last decade in internal medicine and metabolic health, and now writes full-time about the science, economics and lived experience of GLP-1 therapy.
Every clinical claim on this site carries a review date and a link to the primary source. Where the evidence is thin, we say so in the sentence rather than in a footnote.
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