On The Pen GLP-1 News

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.

  1. Ozempic Personality With Dr Spencer Nadolsky

    19 APR

    Ozempic Personality With Dr Spencer Nadolsky

    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.

    42 min
  2. Zepbound Dosing: What Your Doctor Didn't Explain

    2 APR ·  BONUS

    Zepbound Dosing: What Your Doctor Didn't Explain

    Are you on tirzepatide or semaglutide and struggled with inconsistent weight loss and side effects? On this episode of On The Pen, Dave Knapp and Dr. Ian Ellis dive into the surprising variability of GLP-1 dosing (retatrutide, tirzepatide), even when the weekly dose remains the same. We explore how these subtle dosage changes can lead to frustrating glp-1 side effects and why many individuals eventually give up on their weight loss medication. This new way of thinking about glp-1 dosing could change the obesity medicine game. Referenced Links: http://www.OTPLinks.com00:00 Why most GLP-1 users are never on the same dose twice01:55 Dr. Ian's background: trainer, nutritionist, ER physician04:00 His obsessive relationship with food and body composition07:45 The two impossible choices: obsession or obesity10:12 How medical school destroyed his health10:25 A colleague mentions Ozempic for the first time11:35 His first dose and what real satiety feels like13:00 Why the same dose felt worse every single week15:00 30 lbs lost but the body scan results were horrifying17:30 Why elderly patients are especially at risk on GLP-1s18:35 Patient case: Pat May, 310 lbs, lost over 100 lbs20:45 Semaglutide half-life and dose stacking explained24:50 The therapeutic window and finding your ideal level26:30 Why the dosing protocol was built for trials not people28:00 You are never on the same drug level twice29:00 Patient case: Mary Alice lost 30 lbs below the starting dose32:00 The math behind calculating your precise GLP-1 level35:00 The VoaFit app and making precision dosing scalable36:00 Their patients lost more weight using half the medicine39:30 Why 40 to 70 percent of people quit GLP-1s42:00 Compounding pharmacies and the case for flexible dosing46:00 Using GLP-1 as a thermostat dial for your appetite56:45 Where precision dosing is available now58:30 Beyond GLP-1s: applying this to testosterone and more1:05:30 Why hitting the dose ceiling kills long-term results1:07:00 Dr. Ian's outcome: off GLP-1s completely1:10:00 Fixing a broken one-size-fits-all dosing paradigm1:13:00 How to find Dr. Ian Ellis and VoaFit

    1hr 14min

About

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.

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