Weight loss wonder drugs: the Good, the Bad, and that controversial Super Bowl Ad

Here's a through line of recent chatter.

Addendum 2/21/2025: Looks like the compounding side hustle for these medications is up. You’ll see why that’s probably a good thing, though many will be upset at higher prices for the FDA-approved versions.

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One of the more memorable, manipulative, and indeed mercenary ads during the Super Bowl was for “Hims and Hers,” a company selling compounded versions of the very popular GLP-1 weight loss medications like Wegovy and Zepbound. As a Philly resident, the rest of the Super Bowl was big easy and big fun. But this ad felt jarring. And so I’m going to dive into some of the current controversies and science that has been coming out lately with respect to GLP-1 meds (primarily semaglutide/Wegovy/Ozempic and tirzepatide/Zepbound/Mounjaro).

In this post we will review that Super Bowl ad. Then we will see conflicts of interest developing in the new FDA leadership. I’ll help spot you beyond the paywall on that recent landmark study in Nature Medicine to summarize the findings of a massive effort looking at real world risks and benefits emerging from these GLP-1 medications. We will review the offramps from treatment, as well as evidence and an important opinion about starting and stopping these meds. And finally we will pay a visit to Gwyneth Paltrow’s website Goop, and consider whether the trend of microdosing of these medications really works?

As a primary care doctor I discuss and manage these medications with many of my patients. They have lots of upsides and enough downsides that our conversations are complex and nuanced. But I will admit that helping many chronically frustrated people to finally lose weight is big easy and big fun. It can truly be life changing to lose 100 pounds.