Episode Timeline & Main Topics

00:00 — Opening & Community Update
• First week doing the podcast fully live thanks to the On The Pen community
• Overview of why this week’s news is a major turning point in obesity medicine

02:30 — Introducing the “One-and-Done” Obesity Drug (Wave Life Sciences)
• WVE-007 early data drops
• Why this therapy is unlike GLP-1s or any nutrient-stimulated hormone
• Fat loss results and lean-mass increase

06:30 — How Wave-007 Works: INHBE Gene Silencing
• Mechanism behind visceral fat reduction
• Why this shifts the field toward “quality of weight loss”

09:15 — Why Lean-Mass Preservation Matters
• Current GLP-1 medications and muscle loss
• Why women dominate trial enrollment and the larger implications
• Medicare patients and the coming wave of GLP-1 coverage

13:45 — The Future of Maintenance Therapies
• Fractyl Health Revita results
• Lilly’s orforglipron maintenance design
• Why “holding the line” after GLP-1 therapy is the next major category

17:30 — Amylin Agonists: Cagrelintide vs. Eloralintide
• Novo’s delays and the strategy behind them
• Lilly’s surprising phase 2 results (up to 20% weight loss)
• Combination therapies with tirzepatide or retatrutide

22:30 — FDA Pipeline Acceleration
• Potential removal of traditional phase 3 trials
• How this speeds up the arrival of next-generation therapies

24:15 — Oral GLP-1 Small Molecules (Structure Therapeutics)
• Alaniglipron data and the stock surge
• Comparisons to orforglipron and past failures like denuglipron
• Why Dave remains skeptical

28:40 — Sponsor Break: Shed & Shapa
• Access, coaching, and patient support
• Using a numberless scale to build a healthier relationship with weight tracking

31:10 — Counterfeit Ozempic Warning
• New fake lot discovered in U.S. pharmacies
• How to identify counterfeit pens
• Why this should be a national headline
• The broader question of drug supply-chain vulnerability

36:00 — Closing Thoughts on the Future of Obesity Medicine
• Moving from “more weight loss” to “better weight loss”
• Why the field is closer than ever to reshaping obesity as a disease
• Gratitude for the community making full-time coverage possible

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