Independent GLP-1 journalism
Long-form
Long-form investigations. One question, taken seriously, with the primary literature read in full.
11 pieces
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.
Read the pieceSurgery 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.
Nobody measured it, no trial listed it as an endpoint, and it is the single most common thing patients volunteer unprompted. The most consequential effect of these drugs may be one we have no instrument for.
Roughly a quarter of the weight lost on a GLP-1 is not fat. Whether that matters, and what — if anything — you can do about it, is the most consequential unsettled argument in this field.
Taking a fraction of the standard dose is now common enough to have its own vocabulary and its own influencers. Some of the reasoning is sound. Almost none of it has been tested.
A single clause written in 2003, before anyone had a weight-loss drug worth arguing about, now shapes the entire American market. It is the most expensive sentence in obesity medicine.
A monthly fee, a fifteen-question form, and a prescription in under ten minutes. Some of these services provide genuinely good care. Distinguishing them from the ones selling access is harder than it should be.
Every article about these drugs ends at goal weight. That is roughly the midpoint. The second year is quieter, stranger, and the part where most of the decisions that matter actually get made.
Regain after stopping is not a failure of willpower or a scandal about the drugs. It is what happens when you withdraw treatment for a chronic condition — and it is entirely predictable, which is why it should be discussed in month one, not month twenty.
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.