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. He Took Retatrutide 40mg and Proved a Point

    2D AGO

    He Took Retatrutide 40mg and Proved a Point

    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 — 0:00:02A 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) — 0:05:02Deep 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 — 0:07:20How 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 — 0:16:31The 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 — 0:19:06State 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 — 0:21:55Interview 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.

    37 min
  2. SURVODUTIDE Phase 3 Data: Why Weight Loss Isn't The Whole Story

    APR 28

    SURVODUTIDE Phase 3 Data: Why Weight Loss Isn't The Whole Story

    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.

    19 min
  3. Ozempic Personality With Dr Spencer Nadolsky

    APR 19

    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

Ratings & Reviews

5
out of 5
6 Ratings

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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