1 in 4 Have a Tirzepatide Advantage! Downsized News

[00:00:00]This week, a study says one in four people on obesity medication may be sitting on a hidden biological advantage that doubles their weight loss. New data on what actually happens to your weight a full year after stopping tepatide.

[00:00:11]Welcome to the downsiz news for the week of July 19th, 2026. I'm Christopher Durham.

[00:00:16]>> And I'm Lorraine Durham. We've been on Tresepide since September of 2023.

[00:00:21]Together, we've lost more than 150 pounds.

[00:00:24]>> We're not doctors and nothing here is medical advice. We're patients who read the studies, sit through the earnings calls, and dig through the policy language so you don't have to start from zero every time something changes.

[00:00:35]>> If this is your first time with us, welcome. Hit that like button and subscribe to the downsized. And if you're already part of this community, welcome back and thank you for watching.

[00:00:43]Before we get to today's top story, I'd like to thank the sponsor of the downsized news, the Hume body pod. If you're on a GLP1, you already know the number on the scale doesn't tell the whole story. That's why Christopher and I use the Hume Body Pod instead of a traditional scale. It gives us a much more complete picture of our health by measuring things like body fat, muscle mass, hydration, and more with impressive accuracy. Unlike most smart scales that only analyze your lower body and rely heavily on estimates, the Hume Body Pod uses a retractable hand sensor with eight frequency technology to measure your entire body. That means more meaningful data, especially if you're working hard to preserve muscle while losing weight. One feature I especially appreciate is the hydration reminders. Since GLP-1 medications can reduce both your appetite and your thirst, it's easy to forget to drink enough water. The Hume app can send push notifications throughout the day to help you stay hydrated, which has been a lifesaver for me during these hot summer months. If you'd like to check it out, visit humebodypod.com and use our code to save. You'll also find the link and the discount code in the description below.

[00:01:56]>> So, onto our first story. Here's a story about what every person on a GLP1 wants to know. What happens when you stop?

[00:02:04]Fractal Health reported new one-year randomized data this week on Ravida, an experimental endoscopic procedure designed to help maintain weight loss after stopping GLP-1 treatment. The results come from the remain one midpoint cohort, a randomized doubleb blind controlled study of 45 adults with obesity who had already lost at least 15% of their body weight on tzepide.

[00:02:27]After stopping tepatide, participants were randomized 2 to one to either ravita or a sham procedure and followed for one year. Ravita is a procedure called duodinal mucosal resurfacing or DMR. It uses an endoscopic catheter to ablate part of the lining of the douodenum, the first section of the small intestine. Across the full study group, participants who received Ravita regained an average of 7.8% of their body weight compared with 13% in the sham group, about 40% less weight regain. Among participants who received a more complete ablation of more than 14 cmters, Ravita patients maintained about 81% of their weight they had lost on tepatide compared with 48% in the sham group. Their average weight regain was 4.8% compared with 13% with sham. In a smaller subgroup that had lost at least 17.5% of their body weight on trespatide and received the more complete procedure ravita patients maintained about 84% of their original weight loss compared with 46% for the sham. That subgroup included just 10 Ravita patients and eight sham patients. Fractal CEO and co-founder Dr. Harit Raja Kapalin said today's results are the first randomized shamont controlled evidence that a single ravita procedure can keep most of the weight off for a full year after GLP1 is stopped. The big limitation is that this was a small midpoint cohort of 45 people and was not powered for formal statistical significance. On safety, fractal reported no device or procedure related serious adverse events.

[00:04:04]Treatment emergent adverse events occurred in 24% of the Ravita group and 25% of the sham group. The larger remain one pivotal cohort is the more important test. Fractal says it expects topline six-month randomized results in early Q4 2026.

[00:04:21]This is a genuinely different approach instead of another maintenance drug.

[00:04:25]Fractal is testing whether a one-time endoscopic procedure could help people keep more of the weight off after stopping trappepide. If you want to go deeper on this, we've actually interviewed Dr. Rajapollen before. If you'd like to hear more about what Fractal is doing, check the link in the description.

[00:04:40]>> So, that's interesting. Wouldn't you hate to be the patient who got the sham procedure and then had to wait a year to see uh >> Well, it's more complicated because they brought you in, put you under what whatever level it is. You have no idea.

[00:04:54]Yeah, I have no idea. Uh 5% weight gain, 10% weight gain after a year.

[00:05:00]>> Well, for comparison, >> yeah, sounds like uh switching to foundo.

[00:05:04]>> Yeah, that was >> only I don't have to do anything.

[00:05:07]>> So, in the trials that Lily did, when you switch from tzepide to foundo, this is a very similar result amount of weight regain.

[00:05:16]>> Yes. But with the fractal procedure, it's permanent.

[00:05:19]>> It's a onetime procedure. I don't >> I don't think it's technically permanent as I recall. So I talked to Dr. Rut.

[00:05:24]>> You might have to maintain every couple of years or something, but I'm not taking a daily injection. I'm not taking a daily pill anymore.

[00:05:32]>> Well, maybe maybe. So part of the conversation is >> for people who have lost lesser weight, maybe they're able to do this and not have to be on the medication. For people who have lost more weight, >> maybe it's a combination.

[00:05:45]Maybe you combined this with >> foundo. Yeah. If you've lost 100 pounds, you know, you don't want to gain 30 lbs back, 20 pounds back.

[00:05:53]>> Basically, it's given your doctor more tools in the tool box that if you could combine and maintain weight loss, >> it's a good thing. And this should be I mean, this procedure is used for other things.

[00:06:04]>> Oh, like what?

[00:06:06]>> It's already approved in Europe. I think there's some intestinal issues that it's dealing with, but it's used for other things. So, you should be able to go into your same doctor where you got your colonoscopy.

[00:06:16]>> Mhm.

[00:06:16]>> And it take no longer than that.

[00:06:19]>> Just kind of in and out.

[00:06:21]>> Uh when I talked to Dr. Raj Kapalin, he seemed to believe it would be a relatively easy procedure to get insurance approval for because it was something they understood. It was a one-time thing. It wasn't >> maybe I don't have to pay for medication anymore and my insurance covers the procedure. That's interesting, >> right? So, no, he it hasn't been approved yet. So, we don't know. But yeah, I'm glad they're doing more studies.

[00:06:42]>> In story number two, a new Mayo Clinic study is getting at one of the biggest questions in obesity treatment. Why do some people have a much stronger response to medications like trespathide than others? The study published in gastroanurology is titled a subphenotype of obesity with reduced inroagon like peptide one synthesis and enhanced tepatide response. The research was led by Alexander Ticho and senior author Dr. Andre Aosta of Mayo Clinic's precision medicine for obesity program.

[00:07:17]Researchers studied 483 adults with obesity and identified three different biological types of the disease. Within that group, they found a subgroup about one in four participants who appeared to produce lower levels of naturally occurring appetite regulating gut hormones, had faster gastric emptying, and reported greater hunger after meals.

[00:07:43]This is a subtype of what Aosta's team calls hungry gut obesity. After six months on trappepide, that group lost an average of 21.5% of their body weight compared with 11.7% for everyone else in the study. That's nearly double. The researchers believe the lower hormone levels were related to reduced production in the intestine itself rather than differences in the gut microbiome. These lower hormone levels in some people and not others could be one of the reasons why obesity doesn't behave exactly the same way in everyone.

[00:08:19]Dr. Aosta and his team have been studying different obesity phenotypes for years, including what they call hungry brain, hungry gut, emotional hunger, and slow burn. This new work goes a step deeper by identifying a biological subgroup with reduced natural GLP-1 production that may be particularly responsive to a medication like trespide which acts on both the GIP and GLP-1 receptors. The researchers are not saying we can use this information tomorrow to predict exactly who should get trapped. They specifically caution that prospective studies are still needed before this kind of testing can become part of routine clinical practice. But the direction is important. Right now, obesity medication is still largely prescribed through a process of trying a treatment, seeing how someone responds, and then adjusting from there. Research like this raises the possibility that eventually doctors may be able to look at an individual's biology and have a much better idea of which medication is most likely to work before treatment even begins. As Mayo Clinic put it in announcing the study, the findings move the field closer to precision medicine for obesity rather than a one-sizefits-all approach.

[00:09:36]>> So, I read this whole study because it's fascinating. You can Google it, you can find it. Essentially about one in four people have a GLP-1 deficiency. So your body is not producing enough naturally.

[00:09:48]>> I can believe that >> no matter what you did, it's not your fault. Right.

[00:09:52]>> Right. It's not your fault.

[00:09:54]>> Right.

[00:09:54]>> And by adding tepatide, it fixes that or not fixes.

[00:09:59]>> It fills in that problem.

[00:10:00]>> Fills in that problem.

[00:10:01]>> Yeah. Well, you know, you wonder why some people lose 20% on this medication, some people lose 10%, some people don't lose at all. This could be part of that reason why. And you know, as someone who is now in maintenance, still taking a weekly shot, >> you know, the future of obesity medicine of of course is interesting. And which medication would fit someone in the future? You know, that's definitely interesting, but you know, we as patients wonder why. And we talk to people who lose all different amounts of weights and we wonder why that is. And this could be one of the reasons. Well, and it opens up the possibility for more research. So, for all those people that want to ask, well, 50 years ago there wasn't this much obesity. This this this caused it and this caused it and this caused it.

[00:10:49]>> Yeah.

[00:10:50]>> There's no real way to identify that.

[00:10:52]There's so much stuff that has changed over the last 50 years from video games to >> Yeah.

[00:10:57]>> our jobs are different.

[00:10:59]>> Why do some people's body produce less of this particular thing? Is it genetics? Is it environment? Is it food related? Is it?

[00:11:08]>> But if you can identify this one in four and do clinical research against that subgroup, >> you may be able to do more trials and figure it out or begin to figure it out.

[00:11:21]It may be a lot of times research leads to research.

[00:11:24]>> You have more questions.

[00:11:26]>> You have more questions.

[00:11:27]>> So I think it's exciting.

[00:11:28]>> Story number three, Nova Nordis kind of meaningful Europe story this week.

[00:11:32]Actually two. First, on July 15th, Nova announced that the European Commission approved oral WGOVA once daily 25 milligram semiglutide pill for adults with obesity or adults who are overweight with at least one weight related coorbidity. According to Novo, that makes it the first oral GLP1 approved for weight management in the European Union. Second, Novo said the European Commission approved a single readytouse pen for the higher 7.2 milligram dose of WGOi. That dose was approved back in February 2026 in the US and Novo has reported it produced about 21% average weight loss in its clinical study. This week's approval adds the easier pen delivery for that same dose.

[00:12:14]Novo Nordisk president and CEO Mike Dustar said for many people a tablet may be a simpler and more acceptable way to start and continue treatment. This also lands at a critical point for Novo. The company dominated the early GLP1 market with WGOI, but Lily has pulled ahead with Zepbound, and Novo has been trying to regain ground ever since. One exception has been the US launch of the Waggoi pill. Oral WGOi has significantly outperformed Lily's competing Fondo pill since both entered the US market. Fondo accounted for only about 11% of new prescription volume between the two oral drugs, with Wiggoi taking the overwhelming majority. That doesn't erase Lily's strength in the broader obesity market, particularly with Zepbound, but it gives Novo something it badly needs, an edge in a brand new part of the market. So, these European approvals matter beyond Europe. Novo is trying to rebuild its position with more options around the Waggoi brand, a pill and a higher dose injectable while Lily keeps up the pressure. So, our European viewers have been asking like, "When's it coming? When's it coming?"

[00:13:18]>> You know, you have viewers outside the US, right? Yeah. Uh, so this is for you people. people in other countries.

[00:13:24]>> Well, there's a lot of people looking for that higher dose injectable. So, that 7.2 milligrams, that's an exciting dose for them and the pills. We don't know what the pricing is on those yet in the various countries, but >> sure it'll be less in the US >> probably. Yeah.

[00:13:38]>> In story number four, a new review published July 17th in Frontiers in Nutrition takes a closer look at something GLP-1 users talk about all the time. Food just doesn't seem the same anymore. The paper is titled altered eating experience during GLP1 receptor agonist therapy a sensorylike wanting framework for food preference and nutritional behavior. It was written by J Du Zu Yang and Yang Chen of the second hospital of Gilin University in China.

[00:14:10]This is a review of the existing science, not a new clinical trial. The researchers argue that when someone says a food suddenly tastes different on a GLP1, we may actually be lumping several different experiences together. There's taste, what your tongue is actually detecting. There's liking, or how pleasurable or enjoyable you find the food. And there's wanting, or how motivated you are to seek it out or eat it in the first place. Authors say the current evidence does not consistently show that GLP-1 medications directly impair our basic ability to taste.

[00:14:45]Instead, they write that the changes appear more consistent with quote state dependent food re-evaluation and reduced rewarddriven motivation. End quote. In other words, the food itself may not literally taste different. Your brain's response to the food, how rewarding it feels, and how much you want it may have changed. That distinction could help explain some very familiar GLP-1 experiences. Foods you once loved suddenly seem now unappealing.

[00:15:15]Highly palatable foods lose their pull or taking a few bites of something and simply not caring about finishing it.

[00:15:22]The authors also emphasize that this isn't universal. Responses vary substantially. Some people experience major changes in food preference and appetite while others continue to experience hunger, food cravings, or only limited effects.

[00:15:39]>> Well, so this reaffirms what I've been saying now for a long time. It's not that the food tastes bad to me. It's that the fireworks don't go off.

[00:15:46]>> Your perception of how the food tastes has changed, right? It's uh >> the taste has stayed the same, but your brain's reaction to the taste. Your perception.

[00:15:56]>> So my brain didn't go M >> right. I say that with sweets. I still like sweet things. I just don't get a big dopamine hit from them. So, I don't want to continue eating them. But some people report food aversions like people who loved coffee now can't drink coffee and and similar things such as that. So, this may be part of that.

[00:16:15]>> And see, it's my premise that my reaction was always an overreaction.

[00:16:20]>> So, what I perceived to be normal was really too much. Well, >> and what these medications are doing is moderating that down to a more average response, >> right? When I want to eat all 12 donuts in the box, that should not be considered a normal response.

[00:16:37]>> One donut normal. Yeah.

[00:16:40]>> Story number five. Eli Liy is putting money into Aura, the company behind the Aura Ring, a wearable smart ring that tracks things like sleep, activity, heart rate, stress, and recovery. On July 15th, Aura announced that Lily has made an equity investment in the company, giving the wearable maker additional capital to develop more health tools focused on connected and personalized care. The companies did not disclose the size of the investment.

[00:17:04]This isn't their first move together. In June, Aura and Lily Direct announced a collaboration aimed specifically at people using GLP-1 medications. Lily Direct customers became eligible for a complimentary Aura ring sizing kit and the company said the collaboration was designed to connect prescribed treatment with behavioral support tools. Aura said the collaboration does not involve data sharing between the two companies. Aura says more than 100,000 members have already logged GLP-1 use in the Aura app. The company has also launched what it calls GLP1 insights, which connects logged medication use with biometric trends such as sleep, activity, stress, and recovery. In announcing the Lily investment, Aura said as more people turn to new therapies to manage chronic conditions, there's a growing opportunity to connect those treatments with real-time insights and everyday support. Ora also said the opportunity is especially clear in metabolic health.

[00:17:56]The bigger story here is what Lily appears to be building around its medications. Lily already has Zepbound and foundo and it has been investing heavily in Lily Direct as a way to connect patients with doctor's prescriptions and medication access. Now it's also investing in a company that makes a ring you wear on your finger that continuously tracks health and activity data. That doesn't mean an aura ring is suddenly part of a Zepbound or foundo prescription, but it does show where Lily sees part of the future of obesity treatment. not just selling a medication, but building a broader system around how people access treatment, track their health, and stay engaged over time. In story number six, let's start with something every GLP-1 patient should know. A new record study published in the Annals of Internal Medicine is adding to the ongoing conversation around GLP-1 medications and eye health. The study was led by Chintan Dave Farm D, PhD, an associate professor at the Ernest Mario School of Pharmacy and a core faculty member of the Ruter Centers for Epidemiology and Treatment Science. Co-authors included Coma Reynolds, Kimberly Ali, and Jason Roy. Researchers examined a large database of US adults ages 18 to 65 with type two diabetes who were starting medications to treat the condition including GLP-1 receptor agonists. They found an association between GLP-1 use and a higher risk of eskeemic optic neuropathy, a rare condition caused by reduced blood flow to the optic nerve that can lead to sudden vision loss. But the numbers are important here. Dave said the increase amounted to approximately three to four additional cases for every 10,000 patients treated with GLP-1 medications over 18 months.

[00:19:44]This is in type 2 diabetics. He said although eskeemic optic neuropathy was rare, it is clinically important because it can involve sudden vision loss and added the increase in risk was small.

[00:19:57]Approximately three to four additional cases per 10,000 patients treated with GLP-1s over 18 months. More than four out of five cases of eskeemic optic neuropathy are estimated to be the nonarteric anterior form known as Nion. This type of vision loss is usually permanent although roughly one-third of patients may experience some improvement generally within the first 6 months. The researchers were careful not to say GLP-1 medications cause the condition.

[00:20:28]They said the findings could reflect differences in patients underlying health and that research is needed to determine causation. This is a serious but rare potential risk and the study does not establish cause and effect.

[00:20:42]It's something to be aware of, not a reason to panic or suddenly stop treatment. But sudden blurring, dimming, or loss of part of your vision should be taken seriously and evaluated immediately.

[00:20:54]So for patients with type 2 diabetes, >> three to four out of 10,000 >> might develop >> might develop this >> problem, >> but they did not show that the medication caused it, >> right? It was just they happened to be taking it. They and they were type two and they noticed this result among that population.

[00:21:16]>> So, and we get this question all the time.

[00:21:19]>> Am I going to go blind on a GLP1? um you know, if you have type 2 diabetes, >> you're more likely to anyway, >> right? That's already putting you at risk of a whole host of of uh problems.

[00:21:31]So, you know, getting on a GLP1, uh you know, three or four people out of 10,000 develop this vision issue and they have not confirmed that one causes the other. But just something to be on the lookout for. Talk to your doctor about what you know. Just just be aware, but there's no reason to be scared.

[00:21:53]Story number seven, a new phase 2 study published July 15th in the Lancet gastroenterology and hepatlogy is getting attention because simaglutide showed a signal for improved liver fibrosis in people with advanced mash including some with compensated cerosis.

[00:22:09]The study was led by Dr. Roit Lumba of UC San Diego included about 700 participants with biopsy confirmed metabolic dysfunction associated stoeppatitis or MASH and fibrosis ranging from moderate to compensated cerosis. The trial was actually designed primarily to test zeramine an experimental metabolic drug from novo nordisk alone and in combination with semiglutide. While the combination therapy did not outperform placebo, semaglutide on its own showed a statistically significant improvement in liver scarring without worsening underlying liver inflammation, even among patients with the most advanced disease. Dr. Lumba said this is the first clinical trial to demonstrate that semiglutide may improve liver fibrosis in patients with advanced mash, including those with compensated cerosis. He added that the results with semaglutide alone were encouraging and could point towards another potential treatment option for a group that has historically had very few. This adds to a growing body of work on semaglutide's expanding role in MASH. Previous phase three data from the essence trial showed that semaglutide improved both mASH resolution and liver fibrosis in patients with moderate to advanced fibrosis. Although that study did not include people with cerosis in the same way. So this new study pushes the question one step further. Could semaglutide also have a meaningful role once liver diseases progressed into compensated cerosis? The answer isn't clear yet, but the results are strong enough that researchers say it's worth continuing to study.

[00:23:41]>> Okay.

[00:23:41]>> But they're testing people that are advanced and have scarring and it's helping a little bit.

[00:23:47]>> That's a good thing.

[00:23:48]>> Yeah.

[00:23:48]>> And story number eight, Boinger Ingleheim is adding another drug to the fast growing obesity pipeline. On July 16th, the company announced that BI3034701, an experimental triple receptor agonist targeting GLP1, GIP, and NPY2, has entered phase 2 development in people with obesity or overweight. The GLP1 and GIP part will sound familiar.

[00:24:18]Trespatide also targets those two pathways. What makes this drug different is the addition of MPY2 or neuropeptide Y2. According to Boringer, NPY2 is involved in central regulation of hunger, appetite, and food intake. While GLP-1 and GIP contribute to satiety, weight reduction, and metabolic regulation. The company is trying to attack obesity through three different biological pathways at once.

[00:24:48]Boowinger is calling BI303471 a potential first-in-class therapy, but that's still very early language. The drug is only entering phase 2, and we don't yet have the kind of large-scale weight loss data that would tell us how it compares with medications like Zepbound, WGOI or next generation drugs such as reatride. The company said phase one studies showed a generally favorable safety and tolerability profile, which was enough to move the drug forward. The new phase 2 trial will focus on dose finding while evaluating both efficacy and safety in a broader group of participants. Dr. Ana Yesterbuff of Yale quoted in Boinger's announcement said, quote, "The obesity treatment landscape is rapidly expanding with a need to target a broader variety of therapeutic mechanisms given that obesity is a heterogeneous disease." She added that this kind of approach could eventually help doctors move toward quote matching the right treatment to the right patient at the right time. We are moving well beyond the first generation of GLP-1 drugs. Companies are now combining GLP-1 with GIP, Glucagon, and other targets trying to improve weight loss, metabolic outcomes, or identify drugs that work better for different types of obesity.

[00:26:05]Bonger already has cervidide its GLP-1 glucagon dual agonist in latestage development. BI30471 gives the company another very different shot at the obesity market as competition for the next generation of drugs keeps accelerating.

[00:26:24]>> This is exciting stuff. I'm telling you, another pathway.

[00:26:27]>> I use the car analogy all the time because I think it works here. But I think what's going to happen is 20 years from now we're going to look back >> driving down motor.

[00:26:37]>> We're going to look you're going to be driving but I think we're going to look back and we're going to realize that semiglutide and tzepide were essentially the model T's >> and you'll be driving a Honda Accord or a Corvette or right all these other things and as much and people are like oh I love this one. I love this one. I only do it this way. I think there will be so many more options that help so much. When we were at obesity week, what was that last when did we go to that?

[00:27:05]Last year, >> Boowinger had a huge huge booth.

[00:27:08]>> A huge booth.

[00:27:10]>> No GOP ones to talk about, no medicine to talk about.

[00:27:14]>> Mentioned on the signs in >> You really had to read through their uh >> Serbot Tide was on the side >> stuff to figure out. I said, "When is this going to come out?" "Oh, you know, not for three or four years probably." I said, "But you're here." Yeah, we're we're in it. We're doing it. We're in it. So, >> the world is going to change. The more medicines, the better. And I do believe we're going to look back and go, man, those were great drugs.

[00:27:37]>> Remember when Ozepic was the big thing?

[00:27:39]>> Yeah. Remember that was all we had.

[00:27:41]>> Remember when we lost weight on Trazepide, honey?

[00:27:44]>> And there's going to be something that >> something that's even better.

[00:27:47]>> That's even better. And even cheaper.

[00:27:49]>> Cheaper. That's what we want for sure.

[00:27:52]>> Story number nine. And with so much of the obesity drug pipeline focused on GLP-1, GIP, and glucagon, one startup is taking a very different approach. Stat and the Boston Globe both reported this week on WGOL Therapeutics, a biotech company developing obesity treatments that do not target the GLP-1 receptor.

[00:28:09]According to CEO Luba Greenwood, I was not interested in another meto GLP-1 or GLP-1 plus something. The company has raised $60 million from investors including Tory Pines's Investment and Orbamemed according to the Boston Globe and is building a pipeline around several different nonGLP1 targets. One of its programs called MW-401, is an oral drug targeting GPR75, a receptor that has attracted interest because human genetic research has linked reduced GPR75 activity with lower body weight and lower obesity risk. In June, the company reported that in mice, its oral GPR75 compounds produced up to 25% body weight reduction compared with vehicle while preserving lean mass along with improvements in blood glucose.

[00:28:59]HBA1C, inflammatory markers, liver enzymes, and cholesterol. Now, of course, that's mouse data, not human results. And MW401 still has to prove both safety and efficacy in people. A second program targeting PTP1B, which is involved in leptin and insulin signaling, is actually the one closer to human testing, according to the Boston Globe, with clinical trials expected later this year. The company is also developing a program targeting NLRP3, an inflammatory pathway linked to cardioabolic disease. Greenwood said these data suggests that GPR75 inverse agonism may offer a differentiated obesity profile focused on quality weight loss rather than weight reduction alone. So the real story isn't that Mingal has found the next WGO or Zepbound. that one of the more closely watched obesity startups is deliberately looking outside the Inkrretton system. As more companies pile into dual and triple aagonist, Mingal is betting that the next meaningful advance in obesity treatment may come from a completely different biological pathway. I love this. This is them going the heck with cars. We're going to invent a plane.

[00:30:11]>> Yeah, cars can get you there fast.

[00:30:14]Planes can get you there faster. Uh, you know, it's it's it's a race to develop these medications for sure. I love that so many companies are throwing their hat into the ring. Last story of the week, and it's a bit of an odd one. You can now bet on whether a drug succeeds in a clinical trial. Prediction market platform Kulshi has launched markets that allow users to trade on latestage clinical trial results. FDA approvals and FDA advisory committee votes. The program is being developed with Applied Excel, a company that tracks and analyzes clinical trial data. The idea is simple. A contract might ask whether a drug will meet its primary endpoint in a phase three trial. Traders buy positions on yes or no, and the market price becomes a real-time estimate of how likely people think that outcome is.

[00:31:03]Cali says the markets will initially focus on latestage trials and only be listed after patient enrollment is complete with predetermined rules for how each result is settled. At launch, Kshi reportedly had more than a dozen drug development markets. This could get particularly interesting in the GLP1 and obesity space because right now there may be no bigger drugs in development than those aimed at treating the disease of obesity. Eli Liy, Novo, Nordisk, and dozens of smaller biotech companies are developing oral GLP-1s, higher dose drugs, dual agonist, triple agonists, and completely new obesity treatments.

[00:31:41]As we've mentioned here in this program, a single successful phase three obesity trial can add billions of dollars in potential value to a pharmaceutical company. A failure can do the opposite.

[00:31:54]Wall Street has always made bets on those outcomes indirectly by buying and selling pharmaceutical stocks. Khi is letting traders make a much more specific bet. Will this particular drug succeed or fail? That also raises an obvious concern. insider information.

[00:32:11]People working inside a pharmaceutical company, clinical trial site, or regulatory process could theoretically know something before the public does.

[00:32:20]Khi says it will require employment verification and prohibit anyone with material non-public information from trading these contracts. We spent this whole episode on drugs, data, and devices. This latest one is a reminder that all of this, the trials, the approvals, the billions of dollars, is now something people can place a real bet on. Would you place a bet on new GLP?

[00:32:45]>> I might. I might.

[00:32:46]>> I mean, I think buying the stock might be a safer bet, but yeah, >> I'd like to see what the bets are. I mean, you're going to bet on the percentage. You're going to bet on whether they hit their end points. What are you betting on?

[00:32:56]>> I mean, you could there's so many little things to bet on there, right?

[00:33:00]>> The insider information. And for those of you who who follow politics, and this is really not a political conversation, but >> the teleprompter guy, >> the guy who runs the president's teleprompter, who obviously had predeter had access to the president's script, was betting on what the president was going to say and he knew >> and he knew cuz he's a tele and he's been the teleprompter teleprompter. He got fired and they're like investigating it.

[00:33:22]>> Well, good cuz that's illegal. So that would be like you at Eli Liy going, "Hey, >> or somebody at Eli, >> I'm going to place a bet on Nova Nordisk or whoever." But >> but I mean these clinical trials, I mean, like seems so few of them move forward, right? I mean, I don't know.

[00:33:41]>> Uh I I wouldn't waste >> They take the bet either way. Ah, throw five bucks at it. See what happens.

[00:33:46]Throw 20.

[00:33:47]>> I'm not I'm not a gambler. I don't buy lottery tickets. I'm Nope. Christopher, maybe different. I I I would buy a lottery ticket for sure.

[00:33:54]>> 10 stories this week, but they all point back to one important question. Does this make GLP1 treatment easier to access, safer to continue, and more affordable for the people who need it?

[00:34:04]That's the perspective we bring to every story we cover.

[00:34:07]>> If this made the last few days of GLP1 news make more sense or gave you something to feel more confident about in your own treatment, that's the job.

[00:34:14]Like this video, subscribe to the channel, and if someone in your life is on the fence about starting treatment, send them this video using the share arrow below. If you'd like to connect further, click the join button below and find out more about Club Downsized. Club Downsized is our paid membership community. This channel stays free for everyone always, but members get exclusive live shows, our private Facebook group, and the first pick of rooms on the next downsized cruise.

[00:34:42]>> Yep. For everything else, head to the downsize.org. That's where you'll find my GLP1 spreadsheet, our Amazon store, the email list, and a lot more. Come hang out with us right here live on YouTube Wednesday nights at 7 p.m.

[00:34:55]Eastern where we take your questions in real time.

[00:34:59]>> So, to update you on the schedule, because we'll be traveling this week, we'll actually be at the Obesity Action Coalition's Your Weight Matters conference and we'll be broadcasting from there. So, expect to see some live shows. Our normal Tuesday club live and our normal Wednesday live will change.

[00:35:14]I'm not sure what times they'll be.

[00:35:16]Probably during the daytime because the event will actually have a podcast studio there. So, we'll be broadcasting live. I would expect you might even see a special guest or two pop in.

[00:35:26]>> Yeah. So, hit that notifications bell so you'll get notified if we go live randomly at Thursday at 10 a.m. or something.

[00:35:34]>> Or whatever time. I don't know. I don't know at this point yet.

[00:35:37]>> Yeah. Um but we we will you'll see a lot of content coming out of that. There's a lot of good speakers. Dr. Ana Yastoff who has discussed in this episode is speaking. Uh >> Dr. Robin Pashby >> Dr. Robin Pashby >> Dr. Kushner.

[00:35:51]>> Dr. Kushner. Lots of cool stuff. So expect to see a lot of great content >> in the GLP1 space. Very exciting. Thanks for spending part of your week with us.

[00:35:59]I'm Lorraine Durham. And >> I'm Christopher Durham. And we are the downsized.