An interesting paper was just published looking at the way that drugs like Ozempic seem to reduce alcohol and drug use in the real world.
It’s a fascinating piece of data to add to what a lot of us are seeing in clinical practice: this class of drugs works in the brain to change behavior - the reason they cause weight loss is because of the way that they tell our brains that we’re full.
A paper like this is a reminder of something I’ve written about a few times before: Ozempic and the other incretin mimetics are changing the world in a lot of important ways that we’re still beginning to see and understand.
For today’s newsletter, I am re-releasing a podcast about the story behind the most important class of drugs that’s ever been developed.
This is part of a project that I’m working on called “Beyond Journal Club,” a podcast collaboration between Core IM Podcast and the NEJM Group.
We were just picked up for our second season of the podcast, which is a really exciting collaboration that I think has quite a bit of value in the medical education space.
The purpose of the podcast is to take a common medical learning tool, “Journal Club,” and elevate it, going beyond the usual deep dive of methods, figures, and tables.
We aim to tell the story behind a landmark clinical trial to help the results make sense in context.
The podcast really echoes two themes of the newsletter:
Context matters when you interpret any research. Without context, the information is just as likely to mislead as to be helpful
Not everything that’s published is important. By understanding results and the context in which they exist, you can understand
I hope you enjoy our second episode on the SURMOUNT-1 trial, which is the clinical trial that put tirzepatide (which you may know as Zepbound or Mounjaro) on the map as a weight loss drug.
This is the story behind the clinical trial.
In the podcast, you’ll learn about:
A framework for thinking about obesity as an environmental disease, and why this framework helps us understand the rising numbers on obesity and metabolic syndrome
The history of weight loss drugs before the current era - a story of unintended side effects, ineffectiveness, and not making a dent in the problem
How the Gila Monster - a venomous lizard native to the American Southwest and Mexico - inspired the development of Ozempic and Mounjaro
Why the scandal about the cardiovascular toxicity caused by the diabetes drug Avandia changed the nature of diabetes trials and opened the door for the weight loss drug revolution
The outcomes from the early studies on drugs like Ozempic and Mounjaro, including a head to head comparison
A deep dive into the SURMOUNT-1 trial, which showed a pretty astounding impact of tirzepatide on weight loss
I hope you enjoy!
Some of our graphics from the show notes below, and the show notes themselves can be found here.
The mechanisms that these drugs use is fascinating - they work all over our bodies, but the weight loss impact probably happens in the brain, where these medications reduce appetite:
The history of landmark trials of these medications on both diabetes and weight loss, as well as a peak into the future:
