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this point, there's little doubt you've heard about

0:37

these new weight loss medications that are seemingly

0:39

taking the world by storm. Ozempic,

0:42

it is literally the hottest drug

0:44

in the country right now. Everyone's

0:46

like, a smaller portion. Like, shut the

0:48

fuck up. You're

0:50

on Ozempic. Everybody I know is on it.

0:53

A reality TV star told the Wall

0:55

Street Journal. But here's the thing. Ozempic

0:57

is not just for famous people. It's

1:00

injection day, week two of Zepbown 2.5.

1:02

I'm going to tell you guys the

1:05

weirdest thing about being on Wogowi. When

1:07

I look around this room, I can't help but wonder, is

1:10

Ozempic right for me? I've

1:14

been a medical reporter for more than 20 years. And

1:17

I got to tell you, I don't think

1:19

I've seen medications become household names as quickly

1:21

as this in quite some time. And

1:24

I'll be honest, whenever there's a new medication out

1:26

there that's suddenly getting a lot of hype, I

1:29

am typically a little skeptical. It's

1:32

not that I don't want these medications to work.

1:34

I really do. But

1:36

I also know that science, at least good

1:38

science, can take time. It takes

1:40

a lot of rigorous testing and trials and

1:42

data to truly know how effective and safe

1:45

these medications are really going to be. That's

1:48

why on today's show, I'm turning to an

1:50

expert in obesity medicine and weight loss to

1:52

try and get some answers. I

1:55

remember, I remember exactly I was in my office

1:57

reading the article about

1:59

Zemmiglou. Tairu Zembe, and my

2:01

first response was, it works.

2:03

It really works. Dr.

2:06

Jorge Moreno is an assistant professor of

2:08

medicine at Yale School of Medicine. He

2:11

treats patients looking to manage their weight.

2:14

And when we sat down to chat, he answered

2:16

a lot of the burning questions I had about

2:18

these medicines. So today,

2:20

we're going to go beyond the hype

2:22

and talk about what anyone should really

2:24

know about these medications, from the

2:27

benefits to the risks to

2:29

the unknowns. I'm

2:32

Dr. Sanjay Gupta, CNN's chief

2:34

medical correspondent, and this is

2:36

Chasing Life. You

2:41

know, if there's one thing I've learned this podcast season,

2:44

it's that talking about weight

2:46

is still really stigmatized. Even

2:49

those of us in the medical community struggle sometimes

2:51

to find the right words. That's

2:53

why before I even got into the nitty-gritty

2:55

of how Zempic and other drugs like it

2:58

work, I wanted to ask Dr.

3:00

Moreno a bit of a personal question. How

3:03

is your diet? Is

3:05

this something that you think about as somebody who's an

3:07

expert in this area? I

3:09

do get asked this sometimes. My diet is

3:12

just as mixed as anyone's. My wife is

3:14

Puerto Rican. I'm from Mexico, so whenever

3:16

we go to my mom's house, it's a Mexican

3:18

diet. When we're home, we cook a lot of

3:20

Puerto Rican dishes, but I'm not plant-based. I do

3:23

a little bit of everything. I'm looking

3:25

at you on the Zoom call, and you look like a

3:27

healthy young man, but have you gone through

3:30

periods of time when you've tried to lose weight, and if so,

3:32

how did you do it? That's a

3:34

great question. I haven't been asked that before, but

3:36

yes, in college, I was about 250 pounds. Right

3:39

now, I'm about 200 pounds. For

3:42

my obesity, the treatment that helped

3:44

me was lifestyle and exercise. I

3:47

think that once we get into more

3:49

of the conversation, we'll start to see

3:51

that obesity is one entity, but I

3:54

think down the line in 10, 15

3:56

years, we're going to be talking about different

3:58

types of obesity. like obesity type

4:01

A, obesity type B, obesity type

4:03

C. I say that because

4:05

there are people that succeed

4:07

with lifestyle changes. And many times

4:10

in the media, we see that

4:12

these people want to replicate that

4:14

same exact lifestyle in someone

4:16

else that their obesity

4:18

does not respond to the lifestyle change, but

4:21

they may respond to a medication. Or

4:24

there's another type of patient with

4:26

obesity that may respond to bariatric

4:29

surgery. And so I think that

4:31

that's really important to realize that

4:34

we call obesity a disease and it

4:36

is, but I think that there is

4:38

gonna be a gradation of that and

4:40

there's a spectrum of that. And we're

4:43

still, just in the beginning,

4:45

I think we're still working to figure all of

4:47

this out and really tailor the medications

4:50

and the treatments and the management for

4:52

the patient. And that's what I tell

4:54

patients. I don't know how they're gonna respond.

4:57

I will work with them to

4:59

find the best treatment for them.

5:02

And it's very personalized one-on-one. We

5:04

try to really figure out what will

5:07

work for this in a particular patient.

5:10

So let's start with this. Dr.

5:12

Moreno believes that obesity is

5:14

a disease in and of

5:16

itself. And not only

5:18

that, but a serious, complicated disease

5:21

that deserves an equally aggressive approach.

5:24

But what you just heard is

5:27

still a relatively new concept in the field

5:29

of medicine. For a long

5:31

time, doctors thought obesity was mostly

5:33

due to a lack of willpower

5:35

based on someone's diet or exercise

5:37

routine. But as you've already heard this

5:39

season, that's not always the case. For

5:42

decades now, drug companies and researchers have

5:45

been trying to find safe and effective

5:47

medications to try and help.

5:49

Friends, here's an amazing free offer

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technique called mesotherapy. is now

6:01

being used in the United States. Redox

6:03

and fen-phen, two of the hottest names

6:05

in weight loss. The

6:08

problem is there haven't been that many

6:10

additional treatment options that really work that

6:12

can be used in a large number

6:14

of patients or don't come with some

6:16

serious side effects. OBCD

6:19

medications have been around for a long

6:21

time, right? In the 1950s we have

6:23

fentramine, we've had a medication called Olistat

6:25

in the 1990s. All

6:28

these medications had been around. The problem

6:30

with some of them were that they

6:33

had side effects. Some side effects

6:35

that did not allow them to be used for

6:37

long periods of time. Some people did, some people

6:39

don't. That said, the weight loss

6:42

maximum of these pills was about 10%,

6:44

some of them 5%, some of

6:47

them 10%. So we either had

6:49

medications for 10% or bariatric surgery for

6:51

25 to 30% of weight loss. Like

6:54

we had two spectrums. And then we had

6:56

this gap, right? That medications was not addressing.

6:59

Typically patients' options were to

7:01

choose between invasive surgery or

7:04

pills that had risks. Some

7:06

of those medications in fact would later be pulled

7:08

off the market. But then in the

7:11

early 2000s things started to

7:13

change. Doctors and researchers

7:15

found a new type of medication for

7:17

treating diabetes that also happened to

7:20

lead to weight loss. In

7:23

2017, the FDA approved one of

7:25

these new drugs, Ozempic, for treating

7:27

type 2 diabetes. Wigovi,

7:30

Zepphound, Monjaro, those

7:32

are other names of drugs that you may now be

7:35

familiar with. They followed soon after.

7:37

And that's how we ended up with this

7:39

boom of these new medications. Now

7:42

all of them contain a molecule

7:44

that mimics a hormone our body

7:46

produces naturally. That hormone is

7:49

called GLP1. It's

7:53

a peptide that is secreted by our

7:55

intestine. And it's normally very

7:57

short acting and it's degraded by other enzymes

7:59

in the body. body really quickly. And

8:01

so the GLP-1 activates when you have

8:03

a nutrient. So they're nutrient stimulated hormone.

8:06

So what that means is you have

8:08

an intake of any food and then

8:10

these medications are activated to basically tell

8:12

your body that you just had food.

8:15

And so they go into the area of

8:17

the brain that is the hypothalamus, the energy

8:19

central of the brain, and

8:22

they tell your brain you've

8:24

had food, stop eating, right? And so

8:27

it's like a stop signal. And so

8:29

the pharmaceutical companies basically develop these medications

8:31

that are longer acting.

8:33

And so they keep this mechanism

8:36

working consistently, right? They

8:38

basically decrease your appetite by signaling

8:40

in the hypothalamus that you're full.

8:43

And so that's really what these GLP-1s

8:45

are doing. So basically

8:48

sending a signal to your brain and

8:50

someone's tricking your brain that you've just taken

8:53

in a meal, even if you haven't necessarily

8:55

done that, it has slows

8:57

down your emptying in your intestines

9:00

and stimulates your pancreas to make more

9:02

insulin. Yeah, that's correct. As

9:05

someone who studies the brain, this

9:07

is really fascinating to me that

9:10

these medications basically trick your body

9:12

into thinking that it is full.

9:15

Some people even report that they

9:17

experience less food noise or food

9:19

chatter when they're taking these medications.

9:22

Here's how Dr. Moreno explains it. The

9:25

way that many patients describe this to

9:27

me is basically they have always had

9:29

this background thought process that they're thinking

9:32

about their next meal, right? They're thinking

9:34

about when they just ate lunch,

9:36

what am I going to have for dinner? Am I

9:38

going to snack between dinner? And am

9:40

I going to have popcorn later? Am I going to have

9:42

ice cream? And so it's a constant

9:44

noise and feedback basically that your brain is telling

9:46

you, keep your body

9:55

feeding me, right? And so these

9:57

medications are quieting that noise from

9:59

the perspective of patients that have

10:01

told me this and many patients have told me

10:03

this so that it's a very interesting change that

10:05

can happen with these medications sometimes. So I've heard

10:08

these patient reports. So

10:10

there's Ozempic, there's Monjaro, there's

10:12

Wigovi. How do you, everyone

10:14

talks about Ozempic, that's sort of become the

10:16

catch-all term I think for all these similar

10:18

medications. Yeah. Ozempic itself is

10:20

not approved for weight loss is my

10:22

understanding. So I'm just wondering

10:25

can you talk us through then what

10:27

are the available medications as someone sort

10:29

of navigate that? Absolutely. So I think

10:32

that the listeners should really focus on

10:34

two of the ingredients right. So the

10:36

main ingredient in Ozempic and Wigovi is

10:39

semaglutide. Semaglutide is the active

10:41

ingredient. This is the one that

10:43

we just talked about that causes

10:45

all these effects in the body

10:47

and those are branded differently. For

10:49

diabetes it's branded Ozempic and it's

10:51

the brand is Wigovi for obesity.

10:53

So it's really important to realize

10:55

that it's really a

10:57

branding situation that is the difference. It's

11:00

the same medication otherwise? It's the same

11:02

medication otherwise. There is no same dose.

11:05

What's different about it? Yeah so it's the

11:07

same medication. There's different pens for Wigovi and

11:09

Ozempic and I think in one of your

11:11

CNN specials you were able to bring out

11:13

some of the pens there and I think

11:15

that that was really helpful because people need

11:17

to know exactly what they look like. The

11:20

pen for Ozempic has some options for multi

11:22

doses and what I mean by that is

11:24

you can have two different doses in one

11:27

pen. The pen for Wigovi

11:29

actually is a one dose and

11:31

done kind of deal. The same

11:33

thing for Monjaro and Sepbown. So

11:35

Monjaro and Sepbown the active ingredient

11:37

is tersepetide and tersepetide is a

11:39

combination of two peptides that's a

11:42

dual agonist. So it combines GLP1

11:44

and GIP. GIP is another

11:47

gut hormone that also helps synergistically

11:49

with GLP1 to help reduce weight

11:51

and also affect all the different

11:54

things that we just talked about

11:56

similarly. And so these are the

11:58

two different medications and Really, in

12:00

terms of effectiveness, they're both very effective. You

12:02

lose about 15% of the weight on average.

12:04

And what that means is an average. There's

12:07

people that lose more than 15% and there's

12:09

people that lose less than 15%. So

12:12

that's the average. And over what period of time

12:14

is that? So the studies were

12:16

done over 68 weeks, so

12:18

a little over a year. Wow. Now,

12:22

this is pretty promising data. But

12:25

as you've probably heard by now, less

12:27

food chatter isn't the only side effect

12:29

some people report on these medications. So

12:32

coming up in a moment, we're going

12:35

to unpack the risks of taking this

12:37

type of drug. Plus, Dr. Moreno shares

12:39

why he thinks there's been some backlash

12:41

as well. I think that

12:43

there's still a stigma as to calling this

12:45

medication the easy way out because many patients are

12:47

like, why would I do that? I just

12:49

need to be better, right? More

12:52

chasing life in just a moment.

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for details. Let me ask you

14:15

a couple of just rapid questions. Is

14:17

there anyone who shouldn't take these medications? Oh

14:20

yeah. First and foremost, the

14:23

patient needs to follow the indications. In my opinion,

14:25

if you are not indicated for these medications based

14:27

on the current criteria, you should not be on

14:29

these medications. So what do I mean by that?

14:32

A BMI greater than 30, a

14:35

baddie mess index greater than 30, you should be

14:37

on these medications. You could be on these

14:39

medications. Let's put it that way. And

14:41

a BMI greater than 27 with

14:43

a coexisting condition like diabetes, sleep

14:46

apnea, hyperlipidemia, heart disease.

14:48

Yes, you are eligible for these medications. Now

14:50

people that should not be on these medications

14:53

despite those indications are people with gastrointestinal problems.

14:55

And what do I mean by that? People

14:58

with a known history of gastroparesis, which

15:01

is a slowing down of the GI

15:03

tract. People with

15:05

a history of pancreatitis should not be

15:07

on these medications. People

15:09

with a strong history of acid

15:11

reflux or GERD should not be

15:14

on these medications because these medications

15:16

can worsen that. And

15:18

anyone who has a significant gallbladder disease,

15:20

they should not be on this. And

15:22

then of course pregnancy. People that are

15:24

pregnant should not be on a medication

15:27

that can cause weight loss. Is

15:29

the expectation that if you start these medications, you're going to

15:31

be on them for the rest of your life? We

15:34

know from the studies that when the medications

15:37

are stopped, there is weight regain. And

15:39

so I think of these medications as

15:41

long term. Now how that

15:44

long term looks can

15:46

be different by the individual. And what

15:48

do I mean by that? So for

15:50

example, if someone has reached their goal

15:52

weight and we know that if

15:55

we take them off there's a potential for losing

15:57

more weight. But what we don't know is

15:59

what if we... we leave them on a

16:01

lower dose? Or what if we

16:03

extend the frequency of the medication, right? Instead

16:05

of every seven days, we go to every

16:07

10 days. These questions we don't know the

16:09

answer to. And so I've had a lot

16:11

of patients that have lost and have met

16:14

their goal and we

16:16

have conversations about what

16:18

do we do now? Do we have side effects? Do

16:20

we not? And so I

16:22

think, again, it's individual, but I

16:24

think of obesity as a chronic

16:26

condition. And the way that

16:28

I think about it is I equate

16:30

it to diabetes, right? These medications were

16:32

originally made for patients with diabetes, right?

16:35

Like that's the initial indication for all

16:37

of these GLP-1 medications. And so if

16:39

you have someone with a hemoglobin A1c of

16:41

10%, which is a high

16:44

glucose number, a very uncontrolled diabetes

16:46

number, and we put them on

16:48

insulin or we put them on

16:50

medications, we never talk about taking

16:52

them off of these medications. We

16:54

never say, okay, their diabetes is

16:56

gone. Let's just stop their insulin.

16:59

So why do we treat obesity

17:01

like a different entity? It's

17:03

a chronic disease. Why

17:06

do we set this bar that once

17:08

we get to the right weight, we're

17:10

done? There are appetite sensors in the

17:12

brain that are not working correctly. And

17:15

so there's a biology that we're treating with these medications. So

17:17

why would we stop them? It's interesting.

17:20

There's obviously a lot

17:22

of stigma associated with people who have

17:24

obesity. Is there

17:27

also a stigma that you have seen

17:29

associated with taking these medications? And

17:32

I'm not even sure I'm asking the question in the right way, but...

17:36

Okay, you bring up diabetes. I think if

17:38

someone says, look, I have diabetes and I

17:40

take insulin for my diabetes, everyone sort of

17:42

fundamentally gets that. If you

17:44

say I have obesity and I'm taking, you

17:46

know, Wigovia or whatever for obesity, are

17:49

we at the same point, do you think,

17:51

from a stigma standpoint, where it's thought of

17:53

as a disease, here's the medication for the

17:55

disease, that makes perfect sense? I

17:58

think that there's still a stigma... to calling this

18:00

medication the easy way out, right? Because many

18:03

patients are like, why would I do that?

18:05

I just need to be better, right? Like

18:07

the holidays just happened. I need to be

18:09

good. It's in the new year, new year

18:11

resolutions, everything like that. And so I've had

18:13

many patients, I talk to them and tell

18:15

them about the biology, tell them it's not

18:17

their fault, take that guilt away from them

18:20

that this is about their willpower and their

18:22

ability to exercise and their ability to eat

18:24

less. And I tell them,

18:26

there are hormones in your body that

18:28

are preventing you from decreasing your weight.

18:31

And these medications are there to help you

18:33

so that you can become more active, so

18:35

that you can work on different diet plan

18:37

that you wanted to do. And

18:39

so I've had many patients

18:42

that tear up in the room when

18:44

I take that guilt away because they've

18:46

been living with it. Every doctor they've

18:49

seen before or other healthcare provider has

18:51

told them, let's move more, right? That's

18:53

the old motto. And it's

18:55

more complicated than that. And taking

18:57

really that guilt away helps

19:00

them assess the options. You

19:03

sort of alluded to this earlier, Dr. Moreno, but

19:07

a lot of people are taking

19:09

these who wouldn't meet the strict

19:11

criteria for taking these medications. Is

19:14

that dangerous? The studies did not show

19:16

how the safety profile would be in

19:18

individuals without being migrated in 27 with

19:21

these conditions. So there is, in my

19:23

opinion, there's a greater chance for side

19:26

effects. There's a greater chance

19:28

for complications if they are not indicated

19:30

for these medications because we just don't

19:32

know what the safety profile

19:34

would look in someone that was not part

19:36

of these studies. And so

19:39

I think it's something to be very

19:41

cautious about. And I would

19:43

not encourage that practice because it could

19:45

be unsafe for these individuals to do

19:47

so. You know, when

19:49

it comes to the, again, the side

19:51

effects, and I think if I'm hearing

19:53

you correctly, Dr. Moreno, you're thoughtful about

19:55

this, but the side effect profile you

19:57

think is pretty good for these medications.

20:00

if given to people who really

20:02

qualify for them. And that

20:04

means a body mass index over 30 or

20:06

a body mass index over 27 if you have some

20:09

other condition alongside

20:11

that, diabetes or something. You

20:14

do hear a lot of these reports of

20:16

adverse events, you know, everything from loss of

20:19

hair to suicidal

20:21

ideations, thinking about suicide.

20:24

There's been these reports about intestinal obstructions

20:26

and things like that. How much do

20:29

you worry about that? Again, I

20:31

know these are anecdotal reports, but how do

20:33

you sort of approach that as a physician

20:35

in this space? Absolutely. So we

20:37

get questions about this all the time. As soon as

20:39

there's an article about this, there's questions about it. Like

20:42

I get messages all the time about this. And

20:44

so, yeah, so what I would say about

20:47

that is this, obesity

20:49

management is not a one and done

20:51

deal. It is a close follow up.

20:54

It is careful conversations with your patient

20:56

about the potential side effects, being

20:59

available to them and telling them what

21:01

to expect and what not to expect, right? Nausea

21:05

is different than abdominal pain

21:07

and vomiting, you know, multiple

21:09

times a day. And so what I mean

21:11

by that is we really have to consider

21:13

this a long-term management strategy and

21:15

we have to have close follow up.

21:18

And we cannot prescribe these medications and

21:20

then have the patient come back in

21:22

a year. That's not how

21:24

this works. We have to really know how

21:26

the patient is doing. And so

21:28

I think that I am cautious about them.

21:30

Like I think about these complications,

21:32

but I'm also very in tune with

21:34

who's on what those, what medications are

21:36

there on and when do I have

21:38

their next follow up. And if the

21:40

follow up is not with me, it's

21:42

with one of my obesity colleagues in

21:45

the practice or it's with a

21:47

PRN in the practice so that they

21:49

have a time to discuss how they're

21:51

doing because that's important. I just got

21:53

a couple more questions. And I don't

21:55

mean to belabor this point about long-term

21:57

impact, but, you know, this is something

22:00

I guess I think about a lot. Again,

22:02

my world of medicine is different.

22:05

If I'm putting in a cervical plate

22:07

for a spine fusion, I'm curious how

22:09

long is that plate going

22:12

to last? How long is someone going to be

22:14

able to tolerate that plate before it starts causing

22:16

problems elsewhere in the spine, things like that? If

22:22

you're giving a drug that is

22:24

somehow mimicking or causing an increase

22:27

in these hormones, ILP1, which

22:29

is a post-eating sort of

22:32

hormone, five

22:34

years from now, ten years from now, if

22:36

you give this to someone who's in their

22:38

30s and you're saying, look, this is potentially

22:41

a lifelong or a long-term at least drug,

22:43

we could be talking about decades that they'd

22:45

be taking this medication. Yeah. And

22:48

I'm inherently conservative, so that's

22:50

why I'm talking to you. How

22:52

much should I worry or not worry about

22:56

starting someone on these medications or having

22:58

you start someone on these medications in

23:00

terms of the long-term proposition we are

23:02

now making? So, I think

23:04

that that goes back to some of

23:06

the stigma and bias we were talking

23:09

about before, right? So, for example, we

23:11

just talked about GLP1s that have been around for

23:14

close to 20 years, right? We

23:16

forget that these were introduced into the market basically

23:18

20 years ago. And we

23:20

think about obesity as this threshold

23:22

that these medications have to meet

23:25

for safety that is sometimes

23:27

unachievable, right? We have to make

23:29

them perfect. And these medications

23:32

were treating diabetes for 20 years,

23:34

so why would they be safe

23:36

long-term and in patients with diabetes

23:38

and be unsafe in patients with

23:40

obesity, right? And so, I

23:42

think, yes, we have to hold all

23:44

medications to a standard of quality, but

23:47

I don't think we have to set the

23:49

bar higher for obesity compared to something like

23:51

diabetes, right? To your question,

23:53

I think that we are going to continue

23:56

to see any possible effects and they're going

23:58

to be monitored. There was

24:00

a study that came out about suicidal

24:02

ideations, right? There was a huge concern

24:04

about that. And this study didn't show

24:07

an association with it. And

24:09

it was a pretty large study. And

24:11

so this is great news, but I

24:13

think that there's more studies that will

24:15

continue to come out and be helpful

24:17

to make these decisions. Now, I will

24:19

say we also don't know the positive

24:21

long-term outcomes of these medications long-term. And

24:23

what do I mean by that? There's

24:25

a lot of data coming out that

24:27

can help with addiction, that it could

24:30

help with depression, that they could help

24:32

with the reverse and fatty liver disease.

24:34

So it's great. This is fantastic news.

24:36

So yes, there's a lot to watch

24:38

out long-term, but I think that there's

24:40

also a lot of positives to watch

24:42

out for long-term. Just looking at your

24:44

story again, if we can, just because

24:46

you shared even in college

24:48

being 50 pounds heavier than you are

24:50

now, I don't know

24:52

what your BMI was at that point. But

24:55

let's say you did have a BMI that would

24:57

have qualified at that point. This is going back

24:59

to your college days. Knowing

25:01

what you know now, and if

25:03

you came into your office to see you in the

25:06

future, would you prescribe that

25:08

college student one of these medications? Yeah.

25:11

I mean, if we have a conversation, and

25:13

this is an option that we're both in

25:15

agreement with, absolutely. Their medication

25:17

is safe. The medication is

25:19

efficacious. And if it would

25:22

help me get to my goals, why

25:24

not? What do you think about

25:26

the cost of these medications? Why are they so

25:28

expensive? It is frustrating

25:30

to providers that we have such

25:33

challenges to be able to have

25:35

these medications be covered. And

25:38

again, not to harp on this, but it's

25:40

the stigma and bias of obesity. I

25:42

think a lot of insurance companies don't

25:45

consider this a condition that they want

25:47

to treat. They don't

25:49

consider it a disease. Even in Medicare

25:51

policy, as you might know, there is

25:53

a clause that says we cannot prescribe

25:55

patients Medicare this medication. So they're like

25:57

65 plus. They

26:00

have obesity and they're eligible

26:02

for these medications. We cannot do that. There's

26:04

some legislation right now to try to change

26:06

that. But I think the cost

26:08

is high and I think

26:11

that we should really try to

26:13

make these medications affordable and to

26:15

reach individuals that really need them.

26:18

So this is something also that I think

26:20

about a lot. You

26:22

mentioned that these GOP-1

26:24

drugs, they've actually been around a

26:26

lot longer than people realize. Right.

26:29

It's important to know because it

26:31

also means that there is

26:33

20-year or so data on

26:36

the long-term effects or question

26:38

of side effects in these drugs as well. Good

26:41

note to sort of have. Are

26:43

there things that you see

26:45

on the horizon? Some have said that look,

26:47

Ozimpic and Wigovi may already be old news

26:49

in this regard. What

26:52

is on the horizon? Yeah. So like

26:54

I was saying before, atersepitide is a

26:56

dual agonist. In the future,

26:58

there's something that will be a

27:00

triple agonist, adding glucagon, GIP, and

27:02

GLP. And some early

27:04

data, close to 100% of

27:07

individuals on these medications have lost 5%

27:10

of their weight. And

27:12

that's just 5%. There's more to come in terms of

27:14

how much these other medications can do. So I

27:16

think that there's going to be a lot more

27:19

combination medications that are coming down the pipeline. You're

27:21

right. I think this is just the beginning. And

27:24

I think with more medications, there's going to be

27:26

more options for patients and the ones we start

27:28

to really tailor the treatment to these individuals instead

27:30

of using one medication for everybody.

27:33

So I think there's going to be

27:35

more options so that we really hone

27:37

in on who these medications will be

27:39

most efficacious for and safest for. These

27:42

new medications Dr. Moreno is referencing

27:44

have the potential to maybe

27:47

be even more effective. And

27:49

they might have the potential to be taken

27:51

as a pill, which is understandably more appealing

27:53

to some people than a weekly injection. But

27:55

I have to say this, if

27:58

these medications remain unaffordable... out

28:01

of reach for many patients who really need them,

28:03

then what good are these scientific

28:05

achievements really? Not to mention,

28:08

as things stand now, there

28:10

continues to be a regular shortage of

28:12

these drugs. And I think that's really

28:14

worth its own conversation. Which

28:17

is why, on next week's

28:19

episode, I'm sitting down with my

28:21

colleague and CNN medical correspondent, Meg

28:23

Terrell. She's been following the

28:25

business side of this news very closely.

28:28

This is expected to be the

28:30

largest class of medicines, I think,

28:32

of all time. The projections that

28:34

I've seen are something like $100

28:37

billion in annual revenue by 2030.

28:39

That's coming up next Tuesday.

28:58

Kena's our medical writer and Tommy

29:00

Bazzarian is our engineer. Dan

29:02

D'Zula is our technical director and

29:04

the executive producer of CNN Audio

29:06

is Steve Licktai. With

29:09

support from Jamis Andrest, John

29:11

Deonora, Haley Thomas, Alex

29:14

Manisari, Robert Mathers, Lainey

29:17

Steinhardt, Nicole Pessaroo,

29:20

and Lisa Namaro. Special

29:22

thanks to Ben Tinker, Amanda Sealy,

29:24

and Nadia Kanang of CNN Health,

29:27

and Katie Hinman. Thanks

29:51

for watching. the

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