American Diabetes Association Conference Preview 2026

Hinzugefügt: 2026-06-02

[00:00:01]This is one of the most important weekends of the year upcoming in obesity medicine. For the next four days, uh, starting on June 5th, virtually every obesity drug company on the planet will be presenting in New Orleans data at the American Diabetes Association scientific sessions. Now this is where obesity medicines are introduced new ones uh where expectations on pipeline drugs get reset because there's presentation of drill down data of the clinical trials and where billions of dollars in market value can be created or destroyed in a single presentation. ADA scientific sessions like I said runs June 5th through June 8th in New Orleans and is expected to feature thousands of research presentations.

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[00:00:57]Go to otpinks.com and you can find it there. Obesity.news because we're going to be covering this stuff all week. Over the next couple weeks, there's just going to be an absolute deluge of information. And today we're going to preview some of that and we're going to talk to Hamone about obesity and gut health. We're going to do all that together on today's episode of On the Pen Live. Welcome back. You're about to be injected with the highest dose of information, empowerment, and inspiration.

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[00:02:07]Welcome back to On the Pen Live for this Monday, June 1st, 2026. I'm your host Dave Napman of the Mjaro. That's why I'm here. You are on the pen. Wiggoi, Saxenda, Vtosa, Trulicity, Mangaro, Zepbound, Compound. That pen. It's what we talk about each and every week here at On the Pin Live. And we're live Mondays, Wednesdays, and Fridays at 11:00 a.m. Central time, 12:00 p.m.

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[00:03:25]Type that into your browser right now.

[00:03:27]And right at the top of OTPs, you're going to see a little banner. And on that banner, it is going to uh tell you that there are a couple of charts that I have put there for you. And hopefully this will be useful for you along the way because you'll be able to download this chart. You'll also be able to download the chart. It's that that first thing that's listed there. So you should be able to see that pretty easily. Um but if you go to otpinks.com you'll see that right at the top. The cheat sheet what we're talking about today will be there and you can download that. Now also what will be there will be the uh will be the zbound quick pen uh click chart estimation that we talked about on Friday. I ended ended up taking that video and private making it private. I just I didn't have it on Friday and so I just uh and and I also wasn't uh super confident about putting that information out there. But um you can download that for yourself and talk to your doctor about that at otpinks.com and check that out if you were interested in getting that. And also everything that we post it's like I got emails like saying, "Hey, where do I find the chart?" I can't say it enough.

[00:04:41]Go to o go to obesity.news.

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[00:05:09]So yeah that'll go in the lost episodes file for sure. So that is the uh the general housekeeping for this week. Of course later this week my wife and I are heading out on vacation. Uh so a lot of the updates that are going to come from ADAR initially are going to come via our Substack which is that obescd.news. So if you want to stay in touch, you got to you got to go to obesity.news and you're going to get it through the Substack.

[00:05:37]But I wanted to lay out early on in this episode some of the things that we are watching closely at ADA this coming week because ADA has fast become the place for uh huge information drops in obesity medicine and it didn't always used to be that way. It used to be a lot more the obesity society, obesity week, but ADA has become kind of the the place now.

[00:06:04]And as you can see, there are a ton of presentations and I just wanted to highlight a few. This isn't meant to be an exhaustive list, but just some of the few things that we're watching here specifically at on the pen as I think I think what I said early on in the in the episode was there are literally thousands of presentations and so these are the ones that we pulled out to be maybe most valuable to the community at least on the surface. So let's go through some of these together and we're going to start with retatride. Now retatride is a very popular topic of conversation not only here but really everywhere on the internet these days. It's such a big topic. It's it's just assumed to be the best right because it's the triple agonist. We we only up till now have the qu uh the sorry the the dual agonist and tzepide that's GLP1 and GIP and we add glucagon to that and we get reached. So the the common you know thought process among people uh that pay attention to the pipeline or that it's got to be the best and so I think it's a bit of a misnomer. I think that tzepide my opinion is tzepide will ultimately serve more patients uh because I think the pie of people that could benefit from tzepide is perhaps bigger than the pi that can benefit from retride and also we've had the benefit of seeing like the largest phase 4 sort of anecdotal clinical trial take place that we've never had before and that's because I what I believe is over a million people have likely been on a version of reddit true tide through the gray market now is this a scientific thing no not at all but what we hear over and over and over again about reatite is it really ramps up the heart rate in a lot of people and not everybody can tolerate it and perhaps for the people who cannot tolerate it tepatide may be enough uh and so I I just really do believe that what we'll see is is that ultimately tzepatide will serve more patients and I believe that Lily's also positioning it uh that way as well. I believe that the way that they're positioning reatrite is going to be their kind of behind lock and key. It's not going to be for everybody. It's going to be an escalation therapy for those that your zepatide doesn't quite do the trick for.

[00:08:20]But I I'm sort of digressing here. Reat tide. We've exhausted this topic. But what are we going to get at ADA? We're going to get the full data from Triumph 1. That's this that's the phase three trial in obesity. And we're going to get the transcend type 2 diabetes uh from uh transcend type two diabetes drill down data for that clinical trial as well.

[00:08:44]And so we're we're highlighting this one because I believe that Retatride will will make some of the biggest headlines here because it's it's just again it's the it's the next one coming that has the most efficacy. Now of course that's not to be outdone by Kagrama which will come to the market at a similar time to to reach Tide maybe perhaps a little bit earlier. Now it has really failed from an efficacy standpoint to really differentiate itself from tzepide. In fact similar weight loss results but perhaps with higher side effect profile.

[00:09:22]Of course kagrama is a combination of semaglutide which is a GLP-1 receptor agonist and kagrillinide which is a dual amalin calcetonin receptor agonist. Even though they're calling it a dual agonist with with uh GLP-1 and and amalin, it also hits a third target and that's the calcetonin receptors which we've we've talked about here on the channel as to as to what that means. But with the kagracema data, uh we are looking at information from reimagine one which is their monotherapy for drug naive type two diabetes patients. We're looking for full reimagine 2 data. That's kagracema versus semiglutide in type two diabetes who are also on metformin and sgt2s two inhibitors and then reimagine 3 which is an add-on for basil insulin treated type 2 diabetes and metformin.

[00:10:14]So we're looking at a lot of data about kagrama and we have eagerly been waiting more drill down data on kagrama that it's been a real slow release and I think generally because Novo expected better performance against your zepatide and they just did not get that. Uh question does not tolerate reamine due to heart racing or losing too much weight. I I think all of the above. I I just think reatride is generally a different experience than tzepide because it ramps up the metabolism. It it works uh not only centrally on on reducing caloric intake, but it works peripherally. So, it amps up your your your metabolism and and as part of that, it's a cardiac stimulant. So, ramping up the heart rate and so it's going to there's going to be a certain subset of patients that simply don't tolerate reatrite. Um and honestly for those who who have not performed uh or or reached their goals maybe on the molecule tzepide I'm actually a little bit more bullish on on combining that down the road with a drug called a laurelide which is a amalin agonist. Now we talked about how kagracema is kagrillide and semiglutide and kagrillide is a dual amalin calcetonin receptors. Kind of the boiled down scientific information is that when you create a peptide that mimics am naturally occurring amalin in the body uh that peptide tends to want to also bind to calcetonin receptors. uh calcetonin being a different target altogether, right? But similar if you think about these peptides and the receptors like a lock and key the the lock the receptor the calcetonin receptor is very kind of similar to the amaline receptor. So it catches some strays along the way. Now with with what we've seen with the Laurel lintide is it's a selective amaline receptor agonist meaning that Novo or Eli Lily has modified that peptide so that it does not bind to the calcetonin receptors and what they've told us is that they believe that the calcetonin can be sort of a a drawback and that agonizing that that specific receptor can be sort of a drawback in terms of both weight loss and uh potentially in side effects. effect. So, we'll see more along the way in that. But the the phase there's a phase three allural lintide trial which shows all lintide as sort of an add-on to to your GLP-1 therapy and I think that's pretty exciting uh long term because that will be a great option to add on for the people who are doing well on tepatide but maybe retatride is not for them. So, we'll have to see. But retadratide, not to not to take away from the fact that it it is the most powerful metabolic modulating drug in human history. I think it will be a blockbuster in its own right. But if you're asking me, I think that in the long run, Drespatide will actually serve more patients than retreatide will.

[00:13:13]Yeah, be interested to hear what you have to uh think about that. But uh moving on, we've got or forg uh another uh topic that will be looked at very closely at ADA. Now or forg molecule GLP-1. It's known as foundo.

[00:13:33]It's on the market now for obesity.

[00:13:35]It'll be on the market perhaps with a different name in the coming months for type two diabetes as well. But foundo uh or or forgrron rather will be uh presented multiple times by Lily at ADA including the achieve two trials which is uh comparing or forgrron with depagloin in type two diabetics. So trying to show superiority to to superiority to depagloin.

[00:14:08]This is all fun to pronounce. the achieve three trial which is a head-to-head versus oral semiglutide and type two diabetes that will be a very interesting one because of course that's going to go up against um you know ri well what we knew as ribbelis right so it's not going to go up to the 25 milligram dose of wiggoi which technically would be available for patients it's a little bit of a misleading kind of study but in a sense they're just following what's available for diabetics and that's going to be uh a pretty low dose of oral simaglletide compared to what you can get it for obesity. But that will be interesting to get all of that data and then the drill down data from achieve five which is the add-on uh to titrated insulin glorine.

[00:14:50]So a lot in in diabetes of course this is the American diabetes association. So the achieve five is uh something that we'll be watching soon and and as you have seen the launch of or for has really underwhelmed the the investors of Eli Liy. It's really under underwhelmed Eli Liy as well I'm sure even though they won't say that publicly. Uh but it just sounds me that that the Wiggoi pill continues to severely outperform uh or for Lipron. So of course Lily will be looking to deliver some good news on or for glipron. Give doctors another reason to talk to their patients about that one and so three big readouts in or forgrron coming at ADA next week or this weekend rather as well. Now let's talk a little bit about amalain because amalain is another one that that you know we've touched on today already but but will I'm sure uh cause uh for a lot of a lot of investors to be perking their ears up. Right. So prolintide which is an amalin analog a long acting analog there we're going to get the first phase 2 data from uh ro it's a partnership between zealand pharmaceutical and ro on uh an obesity trial phase 2 obesity trial and petroyide very interesting to to see this um this one kind of emerge again as an amalin analog it is a non-incrin hormone amalin is co- secreted in the pancreas with insulin uh but it is not an incrretin like GLP-1 or GIP and perhaps looking at at another option down the road that patients may be able to combine with the current therapy to elevate the efficacy and and to do it without you know using another incretin. So that would be it's a nutrient stimulated hormone but not an incretinen hormone. Uh then we've got servotide. Now servotide the synchronized one study which is a a study in obesity uh without diabetes.

[00:16:46]Now, servodutide is a GLP-1 plus glucagon dual agonist. So, it's you remember that from retrotride you got glp-1 and glucagon. So, it does not have the gip component. But as I was talking about on last week's live stream, when you talk about servadide, servadide could potentially be an interesting option uh depending on how they price it in the market. So if you are are priced out of retatride for some reason but Bay Ringer Engleheim decides to bring servadide to market potentially that could be an option for folks who cannot afford retatriide. Uh it it severely has underperformed retatride in in the data that we've seen so far. But the 76 week data showed about 17% weight loss. Uh which again is well under what we saw with retatride. But an interesting option potentially if you're looking for that glucagon agonism and then of course fizer who acquired a company called meta earlier this week year uh meta has the vesper program one two and three that's the ultra longacting GLP-1 receptor agonist uh that's the one where you can do monthly dosing across um both obesity and type two diabetes patients so met 079 or 097 is going to be something that we'll be watching closely as well as fizer and meta uh talk about that data as well. So these are some of the big ones that I think will make maybe some of the biggest headlines, but I also want to talk about some of the emerging pipeline things because UBT 251, which is the triple agonist from Novo Nordisk has garnered a lot of attention. So it also is a GLP1 GIP glucagon shown in phase 2 China Chinese trials uh to be pretty potent so far looking to maybe even eclipse the potency of retatriide but perhaps at a minimum compete with it. Of course Novon Nortis goal would be to improve upon tolerability and efficacy both with this. We'll have to see once they hit the global phase three trials. We talked a little bit about this on multiple live streams previously, but UPT21 uh there will be some information about UBT 251. So, we're looking forward to getting some phase 2 data there.

[00:18:57]Astroenica uh is another company who has is a a you know potential third company that could get into the race here. We're looking at AZD 50004 and the Vista trial. That's an obesity with overweight and a coorbidity a phase 2b trial as well as a50004 the solstice trial uh at looking at type 2 diabetes patients as well. So Astroenica will be delivering some data and then RO you know RO purchased a company called Karm therapeutics. Karma Therapeutics is a is a company that has multiple candidates a GLP1 and a GIP called CT868.

[00:19:34]I believe they also have a a oral small molecule version of of a peptide coming as well. We're going to get data on that CT868 was a G which is a GLPGIP receptor agonist in type 1 diabetes. So this is pretty exciting because a lot of type 1 diabetic patients in the onepen community have said you know I'm takingide or I'm taking some magletide and it's helped me tremendously. Uh there is some early indication that potentially the beta cells which are the cells in your pancreas responsible for producing insulin uh may be preserved with early interventions in type 1 diabetes uh with the help of uh some sort of incretin therapy. And so this will be an exciting one for type 1 diabetics because this is a GLPGIP. You may remember that from such drugs aspatide. Uh, and so we're looking for phase one and two trial results as well from RO, which is exciting. And then the one that I'm perhaps most excited about, which was one uh, story that we broke early on when the when the ADA uh, presentations were announced, this one's from Valari Therapeutics. Now, Valari Therapeutics is a company that kind of spills out of an Indiana biosciences uh, lab connected to, I believe, Indiana University.

[00:20:51]There's a lot of of uh researchers on this project that have ties to Eli Liy, but this is actually connected to Valari therapeutics and they're the ones that are looking at the quintuple agonist.

[00:21:03]And so this is early preclinical data that we'll get a presentation on. But I'm pretty excited about this because this is GLP-1, GIP, glucagon, amalain, and calcetonin. Or if you are one of the gym bros, you're going dude that's just ra and kag together. which kind of that's all I'll say. But pretty exciting because you're hitting those five different targets. And again, you could argue whether the the calcetonin is is sort of just catching strays or if it's a deliberate target there. But we will get rodent data on the quintuple agonist. That's the GLP1, GIP, glucagon, amalin, and calcetonin data. And so we're looking at Valari therapeutics for that potential for monthly dosing. Uh it's a five receptor approach uh showing superior weight loss so far in rodents to tra to bred a true tide and it's also designed for improved tolerability and targeting targeting severe obesity with high unmet need and so this will fill a a niche. So, a lot of people will hear about these different drugs and they'll go, "Is this better than that?" And that tends to be kind of where people go with these conversations is, "Will it be better than X?" And that's not really the way we look at at at the board here.

[00:22:19]The way that we look at this board is we say, "Who with obesity might this be right for?" And that's why getting treatment with a licensed physician who understands all the nuances of the disease of obesity, who understands metabolic dysfunction, perhaps getting connected with an endocrinologist and an an obesity specialist is going to be so important as these drugs continue to evolve, continue to get better because patients deserve individualized care because the disease of obesity is quite nuanced. It's not experienced the same way by every person. And there's a lot of different underlying metabolic factors that play into why a certain drug on this board may be perfect for someone and maybe worthless to someone else. And so we are at the advent. This is what I've been saying for three or four years to folks is like folks who think that we're well into this obesity race like we're still at the advent.

[00:23:17]Look at this board. There are one, two, three, four, five, five different companies, six different companies on this board that are not Lily or Novo who are working on meeting the need of treating the metabolic disease of obesity. And I can't wait to continue to bring you this news as things come along the way. Now, again, this isn't an exhaustive list. There's there's a lot more that will be presented here. there there will be more that we'll probably even cover uh that isn't on this board but I would say the most five anticipated data drops are from retatride the triumph one and the transcend study then or forg data the achieve three petrolindide is something that folks are watching very closely with the supreme one study and then the met the vesper 3 data those are the five things that I think folks are really watching closely and five things that will make sure that we bring you information on as this evolves. So, make sure that you're liked, subscribed, that you've hit all the buttons down below to stay on top of this. It's going to be a great week. Now, how I'm going to balance covering any of this, we've got some we've got some partners that are helping me cover ADA. Uh we're going to bring you a bunch of content after ADA is over with some of the folks that really love to tear into this data. So, I'm can't I can't wait to bring that for uh forth as it comes out in the next couple weeks. But I'm going on vacation later this week. I don't know about you, but I'm looking forward to the beach. Uh so the end of this week represents my wife and I's anniversary.

[00:24:53]And so we'll have our wedding anniversary on the beach where we honeymooned. Uh my birthday is the next day. We're just looking forward to a nice time away. So, we're going to do a lot of work teeing this up and then on the back end of that vacation, we'll be doing a lot of coverage and then we'll be you we'll be leaning heavily on the community that loves to tear into this data, some of the some of the experts that are out there uh to help us bring awesome things. So, make sure you're tuned in to obesity.news news because that's where most of this stuff is going to drop at least initially and then of course we'll cover a bunch of stuff on the uh on the podcast forthcoming. So that's what we got for you today. Hopefully hopefully you found that helpful as we kind of look at what to anticipate over the next couple weeks with ADA and we will cover all of that. Listen uh I haven't had a chance to really catch up with the chat. How are you all doing today? Uh, I see wannabe farm girl sue the dude. Big rig Ohio. Jenna prefer Nebraska is in the house. Uh, Dawn is in the house. Good to see you, Don. Who am I missing here? Peachy Panda's in the house. Good to see you here. NY's in the house. Uh, Deb is in the house. Oh, man.

[00:26:04]We got a lot of folks watching. So, thank you all for being here. If you have a question, 18 years. Thank you.

[00:26:12]Want to thank you Hawkeye girl for uh doing the math for me there. I was like I thinking in my head I was like I think it's 18 years 2008 because you guys were married was it the year after was it the year after that you guys got married or was it two years after uh wasn't that long and I think you guys have a anniversary around this time of year as well. Uh but yes 2008 so however that math works out that sounds like 18 in the year 2026. So we're getting awfully close to 20 years. Oh, yeah. It is 18 because Jenny and I had this. You're You're niners. That's right. Okay. So, it's funny because I was talking to my wife and we were talking about the fact that this is our 18th wedding anniversary. Give uh Mrs. OTP some love in the chat, by the way.

[00:26:56]She's the one who is the wind beneath my wings uh and allows me to do all this stuff and pumps me up and she's my biggest fan in life. And so, um give her some love in the chat. But our our wed our marriage is now an adult. Uh so 18 years of marriage, that means your your marriage has finally hit adulthood. I don't know if anybody else ever thought about their 18th wedding anniversary that way, but I'm like, "Wow, our our our marriage can buy cigarettes now." Um and in two three more years, it'll be able to buy lottery tickets. Um so that's fun. Uh but yeah, I'm I'm so looking forward to um so looking forward to getting away with my wife and going back to the place that we that we love.

[00:27:42]Uh that's the place that we honeymooned.

[00:27:44]So that'll be so much fun. Uh let's see.

[00:27:47]George has a question. How about personal update? QQ.

[00:27:50]Um what what would you like to know?

[00:27:52]What would you like to know about my personal journey? So um this past let's see was it yesterday I weighed myself.

[00:28:02]So, my lowest weight that I had ever gotten to uh in like 10 years, I did a video update on this um last fall because I had gotten down to my lowest weight ever in like 10 years and I am back to within 11 pounds of that.

[00:28:23]So, um I've lost everything I gained back during the uh sbatical off of GLP-1 and I've done it with a combination of lowd dose tzepite lower dose I shouldn't say low dose it's not like a micro dose but I'm getting around four and a half milligrams per week of tzepide and I'm taking that every three days roughly and I'm maintaining a serum level of about four and a half milligrams down to about three and a half and I stay right inside that band which means I don't have a lot of peaks and I don't have a lot of crashes.

[00:29:00]Interesting. Tepatitide you know it peaks within your system in about 24 hours and that's why some of the new GLPGs are a little bit more intriguing like VK2735 from Viking therapeutics because it doesn't reach that peak so quickly and so the halflife is much longer. Turspite if terzepite has a problem it's that that the halflife unfortunately is five days it's not seven days and so I think that's why a lot of people struggle with you know the the supra dosing you know you get the big dose at the beginning of the week by the end of the week you have you know so much less medication in you than you did the first 24 to 48 hours.

[00:29:38]Um so so the new molecules if you might be like why would anybody bother with a different GLP1 gip because they can mess with the peak and the trough and perhaps make it more effective. they can mess with the binding affinity. Um the the fatty acids that they wrap around the thing to make it last longer. Uh less frequent dosing, better binding, all of these things. But I think GLP-1 gip has been shown to be sort of the way moving forward. Um body composition has been tougher to track. So this has been frustrating. Um as you know, I've been working out for for many months. Um my body composition I I'll just show you. I'm going to pull up this um this is my my InBody scale, right? And so you can see my weight currently is at 276. Uh when I went off I got all the way back to 299. So that was after Lent.

[00:30:29]So around Easter I was at 299. Uh and so this I've been able to claw back to 276, you know, which is about where I lived for most of the last three years, uh with 15 milligram doses of of Zeppbound of Marjaro. Um, and so now, um, I've got a combination of of different peptides on board. I'm going to be introducing some more peptides. As I'm learning more about what each ones do, like and tessamellin have been part of my journey for the last couple of months. I'm I'm going to introduce a peptide called M C.

[00:31:02]We'll talk about that. And I'm finding that my vitality, I've got my my testosterone is back to normal levels.

[00:31:09]Um, and so I'm just feeling my vitality is so much better. But when you talk about body composition, I see you, Citizen Kane, about a Laura Lintai, too.

[00:31:17]I want to come back to that. Um, but when you look at body fat percentage, this is where I just go, I don't I don't trust this scale because I know what I look like in the mirror. I mean, fortunately, you guys don't, but I know what I look like in the mirror with my shirt off. And there's so much more muscle there. So, my my body fat percentage has been pretty flat uh over that time. my skeletal muscle mass uh started at that I I I didn't uh start this scale right away. This was back from 48. I happened to be at 48. I was at 294.

[00:31:52]Um let's see at what point I can't remember at what point I was back up to 299, but I can go back to my lose it app. But see, back then my skeletal muscle mass went up to about 114.9. And as I sit here today, it's at 106.3.

[00:32:09]So, I don't I just simply don't trust that. So, I'm looking for a better body composition scale. It's unfortunate because I spent several hundred on this one. But, um I've I've got another one coming this week and so I'm going to start to u start to use that. But, I feel so much stronger. I mean, if if you saw my my body, um my arms are much more strong and defined. my my muscles up here in my chest, my thighs, like I'm just carrying so much more muscle. And so the scale sort of be damned at this point. I am I am feeling good and I feel strong and I can feel the muscle and I can see the muscle. And so that's what I that's what I mostly care about. But we'll see if I can get a better scale to to track this a little bit more drill down. I've been frustrated with the InBody scale. So, that sucks because it was it was recommended to me, but you know, maybe I didn't get the right one.

[00:33:05]Uh, trust the mirror, uh, says George Wallace. So, so yeah, I'm I'm not only am I back down to where I was at at high doses of of tepatide, but I'm happy to report that my body composition is so much better at that weight. And so, I think we'll continue to low uh reduce the weight and we'll continue to add different peptides along the way that might help. Um, Matt C is one that can help with uh insulin resistance and that's my big problem. I just got my my blood work back the other day and I just have just about every marker for insulin resistance that is is there even though my A1C is now back in check again with a very low dose of tepatide. That's what like I still haven't met a diabetic who needed very high doses of tzepide to get their um to get their um A1C uh in check. And so for me that fi four and four foreign and change milligrams took my A1C it had crept back up to over six while I was off the medicine maybe 6.4 6.5 and now I'm I'm down to uh to like a 5.2 and so my A1C is in check but my insulin levels are still needing attention. So M C will introduce so I'm feeling great. That's the main thing. I don't care about anything else. I really I I want to track the body composition because I think the data would be good to have. I'm tracking my everything with my aura. You know, my aura ring is telling me quite a bit about my sleep.

[00:34:29]Um, and my sleep is generally pretty good. You know, it tracks my blood sugars. It tracks my sleep. This Aura Ring is cool. Uh, tells me if I'm stressed out, which I don't need an app to tell me that, but tells me where my my heart rate is. Right now, it's a little elevated. I've been running around all morning and now I'm live and it tends to run a little bit higher when I'm live, but it's getting down to about 65 at night. So, I'm happy with where all that is at and and feeling good. Um, ultimately ultimately I would love to have like an MRI done because I think that's the gold standard. Um, and but but u perhaps I'll go get a de DEXA scan. But feeling good.

[00:35:12]Feeling good. I'm going to take my shirt off in Florida if that tells you how good I'm feeling.

[00:35:18]So, um, I've been one of those fat guys who just generally wears a shirt all the time, but I've been taking my shirt off when I mow. I'm like, who cares? This is my body. This is my body. Deal with it.

[00:35:32]Um, so anyways, uh, any questions? Drop a Q in front of the in front of the, uh, question so that I know that it is indeed a question and I'll be happy to answer it. Um, feels like there was one thing that I wanted to Oh. Oh, do you guys know that I'm wearing a a sport coat today? Any idea why I might be wearing a sport coat today?

[00:35:55]Anybody have a guess? Anybody? Anybody?

[00:35:58]Um, check this out. This is a big announcement. Um, so today, this afternoon, I am doing an interview for CBS Sunday Morning with Jane Paulie. I don't think the interview is actually with Jane Paulolly, but it's Jane Pauliey's show. Um, so I am interviewing CBS Sunday Morning, and this is so cool.

[00:36:23]This is like one of those one of those God winks, right?

[00:36:27]This episode of CBS Monday morning, which believe it or not, CBS Sunday Morning has a larger audience than the Today Show. Um, they want to talk about topics that I want to talk about. They want to talk about the future of obesity medicine. U, they want to talk about the podcast. That's huge because people might have been like, you're gonna get a huge bump from from the Today Show. And honestly, you I I've come to notice that whether it's Bloomberg or whether it's it's Fortune magazine, none of those things really give my podcast a bump. I didn't grow at all from the Today Show thing, but they don't really talk about what I do. So, they're not like promoting the podcast. So, I hope that what we'll get is a podcast plug on CBS Sunday Morning, which has a bigger audience than than the Today Show. And so I'm hoping for a bump there. Um, and so this afternoon I'll be recording that. It airs on my Bday on June 7th. So June se this coming Sunday is my 41st birthday and I will be on CBS Sunday Morning. So within a matter of a three week span, I will have been on the Today Show and CBS Sunday Morning. And I think that that's likely going to lead to more things. And so I'm hoping to just look back on this time and be like, "Hey, do you guys remember when you guys were hanging out with me like before this thing really took off like a rocket ship?" That is what this is feeling like right now. Um, stress that it is not a fat shot. They just recently changed the name of PCOS because it gave people the wrong impression. I wish they would change the disease of obesity to a diff.

[00:38:03]Yeah. Yeah, I wish they would, too. Um, but we'll get into all of that. We'll get into all of that. I'm I I guess we'll get into what they want to, but I'll try to make sure that I'm able to say the things that need to be said. So, try to represent the the community well and then um release what's in the pipeline and watch still Lily Stock Tank. Um and then we've got the uh if you've been following my Instagram uh we've been posting or my Substack even too. I think we've been posting um how the how the uh office the new office is coming which should be done by July and I saw somebody else in the comments mention earlier about a meetup we will be doing an is waiting in the wings and she doesn't know this yet but she will be helping me to plan a community meetup an open house of sorts at the new place I think that's probably a good time to bring Hamone into the live stream when I just uh give her a task to do but Hamone uh you are helping me to put together a uh a meetup for this fall.

[00:39:05]>> Okay. Well, I mean, we've talked about it casually that we should do one, so it's it's on my radar. It's not a complete >> Yes.

[00:39:13]>> But >> and I don't know like it's not the world's like biggest venue at at the at the office. So, I don't know. Like, I definitely think founding members should be invited. Founding members of the Substack. Um, we'll have to think this all through together. We'll have to think we'll think through it offline because I don't want people to be left out either, but I definitely want the people who help to build it, uh, to make sure that they get to be a special part of it in some way.

[00:39:41]>> Yeah.

[00:39:42]>> Um, >> well, and I'm guessing, you know, it's so hard for people to take time off and to travel. So, we might have a live stream and a lot of people might just be on the live stream. So, >> yeah, good point. Uh, good point. See, that's why you're in charge here. Um the the meetup will tentatively be at the new at the new podcast studio. So we're if you've missed that kind of part of the conversation, we are building our the first ever obesity medicine newsroom where we have a a special place for just folks with obesity to get news that empowers them to have better conversations with their doctor. Like it's the first place in the world uh that will exist exclusively for us. And you guys have helped to build it. You guys and gals. I always hate when people say guys and it's a room full of ladies.

[00:40:31]Um but you guys and gals have helped tremendously. Um and so want to have you help share in that excitement. Um so we'll put something together. Uh is there an app to maintain to is there an app you are using to check maintain that constant 3 to four milligram dosage? I'm definitely feeling the ups and downs of 15 milligram. Yeah. Uh for sure. Um, so I use the VOAFIT app, which um, if you missed the interview with Dr. Ian, oh gosh, what's Ian's last name? Why does it escape me all of a sudden?

[00:41:04]>> Oh, shoot.

[00:41:05]>> Ian justel.

[00:41:08]Um, Justl.

[00:41:12]See, my phone is Yeah. Ellis. Just Ellis. I'm not sure how you say Ellis. E L L I S. Dr. Ian. Um, it's going to be this episode. Maybe I can pull it up real quick videos.

[00:41:35]>> Sue the dude. Thanks for pretending I have a life anytime. Also, what's up, wannabe farm girl?

[00:41:43]And to all of my friends in the chat, I'm in Indiana today. I've mentioned it before, my husband and I, we go back and forth between Iowa and Indiana. So, we're seeing friends and family this week and it's just beautiful here.

[00:41:55]Although, my allergies I'm I'm I might be sniffling over the next 15 20 minutes. So, sorry about that.

[00:42:04]>> So, if you look up Zepbound dosing, Zepbound dosing, your doctor probably didn't tell you about this issue. It's that video. Um, got it pulled up here.

[00:42:20]present.

[00:42:22]Stop screen. Present. Did I just take away your your screen share? Hope not.

[00:42:28]>> Oh, no. No, you didn't. But no worries.

[00:42:32]>> So, this is the video that um that I'm talking about here. And it is this video has nearly 50,000 views on it. It is a wow >> banger. uh is is just such a good in interview and we're work we're cooking up the next the followup to this as well because it's such an important topic of conversation that the topic of building to your serum levels and not to a specific dose is the way that I think really a lot of people need to be looking at this this with their doctor because those those dosing um regimens are definitely not for everybody. I think it could help keep a lot of people on the medication. So, it's this interview here. You're looking for this guy, this guy's picture on the thumbnail and uh and definitely check it out.

[00:43:18]>> Yeah, whether you're on a high dose or you're micro doing because it's like you're on a high dose, that's a lot of medication to dip from and then if you're on a small dose, you really don't want to go over a certain amount. So, it's just like it was it's definitely my favorite interview you've ever done.

[00:43:37]Well, maintaining the serum level allows you to feel the way that you want to feel for the longest period of time. And the the thing that I always talk about with folks is like I think the most eye openening thing about this interview and I I knew this cerebrally, right? But I didn't I didn't think about this at all.

[00:43:57]And the fact is when you when you do 2.5 milligrams and you do the titration process that Lily outlines in the surount trials, you go 2.5, next month you go five, next month you go 7.5 and and on up to 15. At no point during that entire titration process, which is going to be what, seven months?

[00:44:19]Um, at no point do you have the same amount of drug in your system. So if you feel really great today, there's no way following that titration process to maintain it because there's there's these serum levels and and the drug has a halflife of 5 days, but that doesn't mean that it's halfway out of your system at 5 days and then it's completely out of your system at 10 days. It has many half- livives. So half of it goes out of your system 5 days and then another half five days and another half of the medicine's gone and another five days and another half of the medicine's gone.

[00:44:50]And so each dose builds on the next. And so maintaining a serum level allows you to pinpoint those moments where I am feeling good today. And I want to feel good tomorrow, too. So I want to feel good next Tuesday, so how do I maintain where I'm at today? And then as you need more, you're able to bump that up with your doctor's, you know, approval. And so I really uh this is a great interview. Um that's that's what I've been using to help maintain my serum levels. So um that app will be available in the coming I think in a month or so.

[00:45:27]Um >> awesome.

[00:45:28]>> We'll we'll we'll bring you more information as that comes out.

[00:45:32]>> Um so so anyways, um really really hope that that you'll all continue to check those out as we make more um more content. This um this interview with Dr. Ian, I feel like was I I feel like what he's working on uh will change the trajectory of obesity medicine. I think it's that big um and has that much potential. And so we're just we're going to go all in with Dr. Ian. So anyway, um yeah. Anyway, that's what I got. Hambo, what you got?

[00:46:04]>> Yeah, I mean that was a whole lot. So maybe I'll just keep mine simple. Um >> yeah, some some of it you maybe can save for Are you coming on Wednesday? Yep, I am. I am.

[00:46:14]>> Wednesday is what day? The >> Wednesday the 3. Yes, because today is June 1st.

[00:46:20]>> Yeah, you could save save because what you have is really good. Um and I feel like we could we could maybe just come back to that all on Thursday because there's so much to talk about there.

[00:46:31]>> Totally. Let's do it.

[00:46:34]>> Um Jude wants to know why does the bridge program only use the quick pen?

[00:46:38]It's a solid question and it has to do with it's complicated, right? But when Lily launches Zepbound in the single-use pens, they make deals with the pharmacy benefit managers on this specific um they're all coded, right? So, this specific Zetbound pen has a specific code that is registered with the FDA and and the powers that be, right? And when those deals are made with PBMs, they're made for these specific presentations because each presentation, so whether you're talking about the singleuse pen or the singleuse vial, you are talking about different FDA approvals. So, this has its own FDA approval. Even though it's the same medicine inside of this vial as was once inside of this pen, they have different and separate FDA approvals because they're different presentations that come with different directions on how to use this versus how to use this. And so when they make deals with the pharmacy benefit managers, the deal is for this, which precludes them from offering it to somebody else at a better rate. or you know I mean I'm using an arbitrary a binding agreement but with baked suffices to say within these agreements with the PBMs there's contractually binding rules that would prohibit Lily from say turning around and offering this direct to a patient um that may have that same insurance for for much less. And so that's why when they released the cash pay version, it was in a totally different presentation because Lily's agreements with the PBMs are not for the vials. Now, I suspect that the that the quick pen being used for Medicare is a similar issue. They negotiated a special pricing with the federal government for Zepbound for $250, which probably preluded them from using this. May not necessarily have precluded this them from using this, but the quick pen allows patients an easy way to just dial up their exact dose uh with one pen. And I believe that that it has to do with both the ease of use of the pen and with um you know falling in line with other agreements that they have on on pricing and everything for the pens. And so I think uh I always want to call you by your first name, Hawkeye Girl. Let me know someday if I just can, but if it weirds you out. Hawkeye girl says, "Always PBMs." Um >> yeah, don't dox her.

[00:49:34]>> Yeah. Yeah. I promise not to give out your >> or him >> or your address.

[00:49:40]>> Just kidding.

[00:49:41]>> Um, but always PBMs. Yes, always PBM.

[00:49:44]So, the answer to the question of why is it just the the quick pen for the bridge program, always the PBMs is probably the easiest, cleanest answer. So, um, yeah.

[00:49:57]Anyway, um, yeah. So, what else do we have? I know.

[00:50:02]I I think we should just save save your topic um for another day. If you have a question for Hamone or myself, drop it with a Q in front of it. Otherwise, we made a we made almost an hour out of this ADA thing. And I think it's it's worth the conversation because the ADA is just going to be huge. if if it didn't come across through all my bumbling and stammering through this um this chart which again is available at our otpinks.com and you can kind of peruse that at your leisure. Ah yes, there we go. Okay, thank you Amanda.

[00:50:40]So Amanda, meet Amanda. Amanda is Hawkeye girl 2003.

[00:50:45]So you will henceforth in hitherto be referred to as Amanda. But OTP links you can go download this uh there and you can also get the quickbend chart that we put up the other day that everybody was asking about. So OTPLinks.com.

[00:50:59]There's other stuff there too if you've never been there to peruse. And then while you're there, just take a moment and follow us somewhere else too. I you just never know what's going to happen with these these platforms. YouTube is not immune to it either. Um, and so just make sure you follow us somewhere else.

[00:51:17]The best place to follow us is at obesity.news where our newsletter lives.

[00:51:21]>> Uh, because there's no algorithm between you and the newsletter. It's like you get the newsletter and it'll be delivered to you. Unlike maybe we do a video here and it never makes it to your algo algorithm. Uh, the newsletter works differently because the newsletter is just going to show up in your inbox and then you decide is that for me, is it not? If it isn't, you just click past it. If it is for you, you drill in and you get the full information. and I think you'll be enriched by it. So, obesity.news for the newsletter, OTP links. If you forget anything that we mentioned here, just go to OTPs.com. It's probably linked there, including, like I said earlier, the um this chart at the top.

[00:51:58]So, check it out.

[00:52:00]>> Ambone, you got anything else for today?

[00:52:04]>> No, it's just uh I'm excited. On Wednesday, I'll I'll talk about those things that I'm I've been reading.

[00:52:10]>> Give us a little teaser about what you're talking about. The newsletter is completely free, by the way. Somebody said, "Is the newsletter free?" There is a paid version. Uh, but 95% of or I say maybe 90% of what we put out is is not put out behind a payw wall. It does ultimately go, I think, behind a payw wall after a certain amount of time, but if it's going to your inbox, you can always just read it from your inbox. So, so 90% of what we do is not behind a payw wall. Some of it is to help to pay for things like the fact that we are uh building a entire podcast studio. Like this all takes money. Like even the place that we're in right now, we're renting. This costs us money. And so um if you have the the means and you want to become a paid subscriber, you definitely can. know that when you become a paid subscriber, this is the kind of stuff that you are you are helping to do is you're helping to build uh the first ever obesity medicine news platform uh that ever existed. So yeah, and and if you join as a founding member, if you select that option, you'll be put on the founders wall, which will be a special place that we'll have in here. What what you're looking at right here, just uh shout out Hamone for the awesome camera work, by the way.

[00:53:22]Um what you're looking at here will be the kitchen. And so we're gonna have a full kitchen in there. We're going to be doing some cooking content. I'm just really excited. Um Shelley must be late to the party. Did you have a sport coat on today?

[00:53:34]Interview something someone happening again. Yeah, today uh I have an interview with CBS Sunday Morning. So next Sunday morning, you can expect to see this ugly mug on CBS Sunday Morning in front of five million people. So >> you're too self-deprecating.

[00:53:51]>> I'm I'm constantly self-deprecating.

[00:53:54]It's a it's a side effect of being fat for most of my life. So, we learned to self-deprecate, but also, let's just face it, it's kind of funny. Um, I'm laughing. You can laugh, too. Um, Linda's going to be 42 years in August.

[00:54:11]Congratulations. Happy almost birthday.

[00:54:14]Just a couple months away. So, awesome.

[00:54:16]Well, that's what we got for today.

[00:54:18]Thank you for hanging out with us.

[00:54:19]Hamone, you were going to tease um tease before I >> Yeah, last time I was on I was I brought up a couple of studies and they had a couple of things um in the details that were new to me and then I found some other studies that were kind of explaining some of those. One of them is metabolic flexibility and just how that is an important nuance between just having a metabolism that's always firing. It's actually more nuanced. It's it's different than that, which I think is a relief because it's it's it's a it's a different approach to healing and improving your your metabolism. Um and then um fasting affects longevity and fat metabolism. So, we're going to look at the nuance of fasting and and uh one of the teasers of that is you don't have to fast for long periods of time and constantly. It's it's more about like we have harped on in the past, consistency, low and slow. Um, but yeah, more to come on all that.

[00:55:26]>> Awesome. I'm looking forward to it. I think that's all going to be good stuff.

[00:55:28]So, thank you for hanging out with me, Hamone. Thank you all for being here with us today and we will get into that topic on Wednesday. Of course, podcast drops tomorrow afternoon. So, make sure that wherever you listen to podcasts, Apple Spotify, uh Amazon, wherever you listen, and actually you can just ask your uh spy device in your house if you have an Echo, you can just ask your spy device like listen to On the Pen podcast.

[00:55:53]>> Whatever AI is listening to you, >> yeah, whatever AI is listening, you can tell it to uh tune in to the On the Pen podcast. Um so, ask your spy device. If you forget how to find it, just ask your spy device. They should lead you right there. Thank you for being here and thank you for being the best part of what we do at On the Pen. Couldn't, wouldn't, shouldn't do it without you.

[00:56:11]Until Tuesday's podcast, we will catch you all on the next one. Thank you, my friends.