Published by Dave Knapp GLP-1 Industry Insider
On The Pen is the leading GLP-1 news podcast and platform covering obesity medicine, FDA actions, drug shortages, access policy, and the business of NuSH therapies. The podcast is in the top 1% of all podcasts globally, and On The Pen is a top Substack best-seller.
Listen on Apple Podcasts20 min
https://www.otplinks.comhttps://www.voafit.com/otpEpisode Referenced: https://www.youtube.com/watch?v=K8kaSoFCZ0c&t=41sThe retatrutide biologic fight is bigger than folks understand.This breakdown covers the current situation surrounding the retatrutide discussion. If you have been following the narrative, this episode provides context on why this biologic fight is garnering a lot of attention, and more importantly why it matters to every person watching this space. I first reported on these developments two years ago and offer insights gained from direct conversations with industry experts.We analyze the trajectory of this controversy to help you separate the signal from the noise. This episode serves as a vital update for anyone trying to track the retatrutide saga as it continues to evolve.Subscribe for weekly internet news breakdowns and let me know in the comments if you want more updates on this story as it develops.
27 min
Novo Nordisk just declared legal war on Eli Lilly as the battle over GLP-1 patients intensifies. But just because patients are being fought over does not mean they are being fought for. In this episode, we break down Novo Nordisk’s lawsuit accusing Eli Lilly of misleading patients through advertisements comparing Zepbound and Mounjaro with Wegovy and Ozempic. The fight is not simply about which medication produces more weight loss. It is about who controls the information patients receive, which evidence gets highlighted, and what gets left in the fine print. Then we examine STAT News’ investigation into LifeMD, a major telehealth company promoted by Novo as a legitimate pathway to GLP-1 treatment. Former employees alleged providers were pushed to process patients at breakneck speed, sometimes reviewing as many as 25 cases per hour, while refill queues, dose increases and patient messages piled up. LifeMD strongly disputes those allegations. But this cannot become another simplistic story about telehealth being bad. More than 100 million Americans are living with obesity, and only a small number of clinicians have dedicated obesity medicine expertise. The traditional healthcare system does not have enough specialists, appointment slots or geographic reach to provide every patient with an ideal, hour-long consultation. So how altruistic can we afford to be about access? Can we demand a perfect standard of care that most patients will never be able to reach? Or does scaling treatment too aggressively risk turning patients into transactions inside a prescription machine? Access cannot become a shield for negligence. But perfection cannot become another form of gatekeeping. The patient is being fought over. This episode asks what it would actually mean to fight for them. Learn more and follow On The Pen: https://www.otplinks.com This episode is sponsored by VoaFit, where I receive care for obesity and metabolic health. https://www.voafit.com/otp to learn more!
31 min
What happens when patients stop taking a GLP-1? New real-world data reveals that more than half eventually come back, and it may completely change the way we think about obesity treatment. In this week's On The Pen Podcast, we're breaking down one of the biggest shifts happening in obesity medicine. We dive into new research on GLP-1 persistence, the early challenges facing Medicare's obesity drug rollout, and why pharmaceutical companies are racing to solve the problems patients have been talking about for years. We also discuss the next generation of obesity therapies, including oral GLP-1s, implantable medications, muscle-preserving treatments, and why the future of obesity medicine may be less about losing more weight and more about helping patients stay healthy for the long term. In this episode: • Why patients who stop GLP-1 therapy often return • The first weeks of Medicare's obesity medication coverage • The future of oral GLP-1 medications • New implant technology from Novo Nordisk • Muscle-preserving obesity treatments • Why patient experience is becoming the next frontier in obesity medicine The goal of On The Pen has always been simple: translate complex obesity and diabetes news into information that helps you have better conversations with your doctor. 👇 What has been your biggest obstacle to staying on treatment? Insurance? Cost? Side effects? Tell us in the comments. 📰 Read more obesity medicine news: https://OnThePen.com 📩 Subscribe to my free newsletter: https://obesity.news 🔗 All my links: https://OTPLINKS.com 👍 If you found this helpful, please Like, Subscribe, and Share this episode with someone navigating obesity, diabetes, or GLP-1 treatment. #GLP1 #Obesity #WeightLoss #Zepbound #Mounjaro #Ozempic #Wegovy #ObesityMedicine #Type2Diabetes #OnThePen #Healthcare #Medicare #Podcast
15 min
What If We've Been Asking the Wrong Question? Patients say compounded GLP-1s are more effective than branded medications. Dave explains why the answer may have nothing to do with the drug itself, and everything to do with the patient experience. ALL OUR LINKS: http://www.otplinks.com HEADLINE SPONSOR LINK: https://www.voafit.com/otp ACCOMODATIONS BY: https://thepixellab.co
44 min
Millions of Medicare beneficiaries are about to gain access to GLP-1 weight loss medications for as little as $50 per month through the new Medicare Bridge Program, launching July 1. In this episode of On The Pen, Dave Knapp sits down with obesity medicine expert Angela Fitch to break down exactly who qualifies, how to apply, which medications are covered, and what this historic expansion of obesity treatment access means for patients across America. We discuss: ✅ Medicare Bridge Program eligibility requirements ✅ Zepbound, Wegovy, Foundayo (orforglipron), and GLP-1 coverage updates ✅ BMI and comorbidity qualifications ✅ Prediabetes, sleep apnea, cardiovascular disease, and obesity treatment access ✅ How Medicare patients can obtain GLP-1 medications ✅ Why obesity is finally being treated as a chronic disease ✅ The future of obesity medicine and Medicare coverage ✅ Concerns about access to care vs access to medication ✅ Muscle loss, nutrition, strength training, and healthy weight loss ✅ The Treat and Reduce Obesity Act (TROA) This may be one of the most important developments in obesity treatment history, potentially opening the door for millions of Americans living with obesity, prediabetes, cardiovascular disease, and other weight-related conditions to receive evidence-based care. 📖 Read more obesity medicine news at Obesity.News 🔗 All links: linktr.ee/manonthemounjaro #GLP1 #Medicare #Zepbound #Wegovy #Obesity #WeightLoss #ObesityMedicine #MedicareBridgeProgram #Tirzepatide #Semaglutide #Foundayo #Orforglipron #Prediabetes #Type2Diabetes #WeightManagement #AngelaFitch #OnThePen #MedicareCoverage #GLP1News #ObesityTreatment #HealthcarePolicy #WeightLossMedication #ChronicDisease #Mounjaro #Retatrutide #Lilly #NovoNordisk #ObesityAdvocacy #GLP1Community #MedicarePatients
1 hr 15 min
ADA 2026 delivered a massive wave of obesity and diabetes data, and in this episode of On The Pen, Dave Knapp (@manonthemounjaro) sits down with Jen (@JcanNuSH) to break down the molecules, clinical trials, weight loss results, and safety signals that could define the next generation of obesity and diabetes medicine. We dive deep into Survodutide, Mazdutide, UBT251, Berobenatide (MET-097), CagriSema, Zenagamtide (formerly Amycretin), Petrelintide, and so much more! From GLP-1/glucagon dual agonists to triple agonists targeting GLP-1, GIP, and glucagon, the obesity treatment landscape is becoming more competitive than ever. Which therapies showed the strongest weight loss? Which struggled with tolerability? And what do these results mean for patients living with obesity, type 2 diabetes, MASLD, sleep apnea, and other metabolic diseases? In this episode: ✅ Survodutide obesity and liver fat reduction data ✅ Mazdutide Phase 3 obesity and diabetes results ✅ UBT251 triple agonist weight loss data ✅ Berobenatide (MET-097) long-acting GLP-1 updates ✅ CagriSema diabetes and obesity trial results ✅ Zenagamtide (Amycretin) injectable and oral development ✅ Petrelintide amylin agonist info ✅ Future GLP-1, GIP, glucagon, and amylin therapies The future of obesity medicine is no longer just about who produces the most weight loss. It’s about matching the right therapy to the right patient, improving tolerability, and addressing metabolic disease beyond the number on the scale. Read more obesity medicine news at obesity.news 🔗 Linktree: linktr.ee/manonthemounjaro #ADA2026 #Retatrutide #CagriSema #Survodutide #Mazdutide #UBT251 #Berobenatide #MET097 #Zenagamtide #Amycretin #Petrelintide #Inisepatide #Elcaglipron #GLP1 #ObesityMedicine #WeightLoss #Type2Diabetes #Zepbound #Mounjaro #Wegovy #GLP1News #ObesityResearch #DiabetesResearch #OnThePen
48 min
Dave sits down with nurse practitioner and former Retatrutide clinical trial participant David White to break down the biggest obesity headlines from the 2026 American Diabetes Association Conference. Together, they explore the latest data on Retatrutide's potential to deliver bariatric surgery-level weight loss, improve cardiometabolic health, and reshape the future of obesity and type 2 diabetes treatment. otplinks.com
20 min
Dave breaks down an unreported Expanded Access Pathway that Eli Lilly has quietly established for Retatrutide.
20 min
Does Eli Lilly already have the solve for obesity? In this episode of On the Pen — the Weekly Dose Podcast, host Dave Knapp breaks down a stunning comment from Lilly's Chief Scientific Officer Daniel Skowronski, who suggested that obesity could become a solved disease within just a few generations of innovation. What does that mean for the millions of patients still fighting for access to GLP-1 medications like Zepbound , Mounjaro , and tirzepatide ? And what is Lilly seeing in its pipeline that the rest of us can't? We dig into: Lilly's decision to stop disclosing its Phase 1 pipeline The Camurus fluid crystal technology deal and what it means for long-acting GLP-1s Eloralintide — Lilly's selective amylin agonist and potential dark horse in obesity medicine How eloralintide compares to Novo Nordisk's cagrilintide Why the future of obesity treatment is a toolbox, not a scoreboard The access crisis: prior authorizations, insurance exclusions, Medicare, and Medicaid coverage gaps Retatrutide , quintuple agonists, and what's coming out of ADA 2026 If you're on Zepbound , Wegovy , Ozempic , or any GLP-1 medication — or you're waiting for the next generation of obesity drugs — this episode is for you. 🔔 Subscribe for weekly updates on obesity medicine, GLP-1 news, and what it all means for patients. 💊 Sponsored by Shed — visit TryShed.com and use code OTP25 to save 25% on obesity care.
30 min
https://linktr.ee/manonthemounjaro
23 min
https://linktr.ee/manonthemounjaro
1 hr 7 min
http://www.otplinks.com
36 min
This episode examines a serious case involving retatrutide, where an individual experienced an overdose due to improper medication administration. We discuss the critical importance of medication safety and patient safety, especially concerning prescription drugs.The discussion also touches upon a recent report of liver failure following the Foundayo launch, emphasizing the need for vigilant drug safety and thorough error analysis to prevent future incidents. https://www.otplinks.com 1. 🚨 The 40mg Retatrutide Overdose Case — 0:00:02 A 32-year-old self-administered gray market Retatrutide, forgot he'd dosed, injected again — hitting 40mg. The setup for the whole episode. 2. 🏥 What Actually Happened to Him (ER Visit & Why It Matters) — 0:05:02 Deep dive into the published medical case: severe diarrhea, dehydration, kidney danger, and the frightening ease with which it happened. 3. ⚠️ Gray Market GLP-1s: The Real Risk Nobody's Talking About — 0:07:20 How buying unregulated research peptides means guessing on purity, dose, and contents — and why that's terrifying at scale. 4. 💊 Orforglipron (Fondayo) & the Liver Failure Report — 0:13:00 (approx.) One month after Fonda's launch, a liver failure report emerges. The FDA's concerns, elevated liver enzymes in trials, and why Lilly scaled back from 45mg to 36mg in Phase 3. 5. 🔗 How These Two Stories Connect: Clinical Trials vs. the Real World — 0:16:31 The through-line of the episode: drugs behave differently outside controlled settings. Peptide influencers hawking research-grade OrforglprIon pills mid-fast is the canary in the coal mine. 6. 🚪 Compounding Access Is Being Squeezed — State Boards, Lawsuits & the Gray Market Funnel — 0:19:06 State medical boards in CA, RI, and KY pressuring doctors. As regulated access tightens, patients don't stop — they just shift to riskier sources. 7. 📱 Introducing the Pivot App: A GLP-1 Tracking Tool for Patients — 0:21:55 Interview with Shed's Chief Product Officer Kyler Ockey about the Pivot app — dose logging, daily habit tracking, weekly check-ins, and why patient self-tracking is critical to safe GLP-1 use.
25 min
We just got done listening to the quarter one, 2026 Eli Lilly earnings call. There was a lot of information to get into, whether you're interested in retatrutide, eloralintide, or Foundayo, and all of the numbers that were so incredible to hear. This video analyzes Eli Lilly's Q1 2026 earnings call, discussing key products like eloralintide, brenipatide, and retatrutide, providing essential finance news and stock market news for those tracking pharmaceutical companies. The presenter highlights the strong start of Foundayo's U.S. launch and reviews the Lilly Select Pipeline, touching upon the U.S. Incretin Analogs Market and broader healthcare industry trends. WAYS TO SUPPORT MY WORK ⬇️http://www.otplinks.com💊 OVER THE COUNTER ORAL PEPTIDE SUPPLIMENTS: BPC-157 // Can’t Weight // TB4-FRAG // KPVSign up here and use code “OTP10” to save 10%https://integrativepeptides.com/OTPWHY I TRUST INTEGRATIVE PEPTIDES:🇺🇸 Made in the USA📋 CGMP Compliant (FDA oversight of their products)🧑⚕️Trusted and Sold By Doctors and Clinics all over the USA📕 GET MY BOOK! Decoding GLP-1: A Guide for Friends and Family of Those On The Pen By Dave Knapphttps://amzn.to/4gAXrz4
18 min
https://www.otplinks.com A new GLP-1 and glucagon agonist dropped data that was supposed to rival retatrutide, just without the GIP, and on the surface the results look solid. But that is not the real story. Even when people successfully lose weight, a large percentage gain it back, and for years that has been framed as a failure of discipline or willpower. This episode breaks down new research that helps explain why that happens. A study published in EMBO Reports shows that obesity can leave lasting changes at the cellular level through epigenetics, where gene activity is altered without changing the DNA itself. Researchers found that immune cells remained in a pro inflammatory, metabolically altered state even after weight loss, with some of these changes potentially lasting for years. In practical terms, this means the body does not simply return to a neutral baseline after weight loss. It can continue to operate as if it is still in an obese state, which helps explain why so many people feel like their body is working against them. This shifts the conversation away from personal responsibility and toward biology, reinforcing the idea that obesity is a chronic, relapsing metabolic disease. That distinction matters because it changes how treatment should be approached. If the underlying biology does not fully reset, then short term solutions are unlikely to be effective long term. These medications may not just be tools for losing weight, but part of ongoing management for a system that retains a memory of obesity and requires continued intervention.
40 min
Major disruption hits the GLP-1 landscape as another large 503B compounding pharmacy halts production of semaglutide and tirzepatide. In this episode, we unpack what’s driving the FDA’s increased enforcement and why these shutdowns could signal a broader shift in the compounded medication market. Joined by Sabina Hemmi from glpwinner.com, we break down the key differences between 503A and 503B pharmacies, what these changes mean for supply and patient access, and why delays in prescriptions may be on the horizon. We also dive into the growing legal battles between pharma companies and telehealth providers and what that could mean for the future of affordable GLP-1 options. If you’re using or considering compounded GLP-1s, this episode covers what you need to know right now and what could be coming next.
29 min
ON THE PEN RESOURCES AND LINKS: HTTPS://WWW.OTPLINKS.COM What if the most powerful obesity drug ever created ends up being the one you can’t get? That’s the real conversation around retatrutide right now. In this video, I break down what Eli Lilly is doing behind the scenes, and why this isn’t just about whether retatrutide is better than tirzepatide. This is about strategy. This is about access. And this is about who gets left behind. We’re talking about: • The push to classify retatrutide as a biologic • Why that could mean pricing in the $7,000/month range • How LillyDirect is changing access to tirzepatide • The “two lane” system that could define obesity treatment going forward • And what this means for patients already struggling to stay on GLP-1 therapies If you’ve ever fought insurance, dealt with compounding disappearing, or felt like the system decides what you’re allowed to have… this one is for you. 👇 Let’s talk about it Have you ever felt stuck between “this is working” and “this isn’t enough”… with no clear path forward?
42 min
This conversation dives headfirst into one of the most controversial and least understood side effects of GLP-1 medications, what many are now calling the “Ozempic personality.” In this candid interview, Dr. Spencer Nadolsky joins On The Pen to unpack the growing reports of anhedonia, a flattening of motivation, desire, and emotional highs that some patients experience, especially at higher doses of tirzepatide and similar therapies. What starts as a discussion about how these medications work in the brain quickly turns into something much deeper. We explore how GLP-1 and GIP receptor agonists don’t just reduce hunger, they fundamentally alter the brain’s reward system, dampening cravings, food noise, and in some cases, the very drive to seek pleasure at all. That is where the idea of the “Ozempic personality” begins to take shape, not as a diagnosis, but as a shared patient experience that is only now being taken seriously. Dave opens up about his own journey, spending years at the highest dose and slowly realizing that while the medication gave him control over food and blood sugar, it also quietly muted parts of his identity. Hobbies faded. Motivation shifted. The highs and lows of life became more… flat. And it wasn’t until stepping away that he could see the contrast clearly. Dr. Nadolsky brings clinical perspective to match the lived experience, explaining how this isn’t classic depression, but something more nuanced. Patients aren’t necessarily sad, they just stop wanting things. He shares how often this shows up in his practice, how he identifies it, and most importantly, how adjusting dose rather than stopping treatment altogether can restore balance. The conversation also raises bigger questions about transparency in clinical trials, what drug companies knew about these “anti-hedonic” effects, and why something so impactful may not have been formally tracked. At the same time, both Dave and Dr. Nadolsky emphasize what matters most, these medications are still life changing, even life saving, but they are not one size fits all. If you’ve ever felt like something changed beyond just your appetite while on a GLP-1, this is the conversation you’ve been waiting for. It puts language to an experience thousands are having but struggling to explain, and it gives you something even more important, a path forward. Watch the full interview to understand the reality behind the “Ozempic personality,” how to recognize it, and how to work with your doctor to find your own sweet spot.
20 min
Orforglipron (also known as Foundayo) is one of the most promising drugs in the GLP-1 space, notably as only the second oral GLP-1 option for obesity. Unlike injectable treatments, it does not require refrigeration and is easier to scale for widespread use. Dave highlights the ongoing questions that linger about the drugs approval as it relates to liver safety.
23 min
If you just look at the headlines, things look great for access to GLP-1 medications but for some of those already using these medications things are changing and getting tighter. Listen in as Dave breaks down the news of the week and puts it all in context. Topics: The GLP-1 paradox, Rise of telehealth powerhouses, FDA guidance on compounding, Enforcement risks and industry impact, Peptide imports and gray market concerns, New branded drug developments, Expansion of oral GLP-1 medications, New oral drug launches, Where the market is heading.