Challenges and advancements in weight management and diabetes drugs

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The chapter explores the difficulties in developing diets for weight loss and the struggles individuals face in maintaining weight loss, discussing the counter-regulatory response to weight loss. It highlights the discovery of peptides that suppress appetite in Gila monsters and humans, particularly focusing on GLP-1 as a medication for diabetes. Additionally, it delves into the development of GLP1 drugs like exenatide, liraglutide, and semaglutide, detailing their increasing half-lives and improved weight loss effects, while also addressing the management of side effects like nausea through dose escalation.

In this episode, my guest is Dr. Zachary Knight, Ph.D., a professor of physiology at the University of California, San Francisco (UCSF), and Howard Hughes Medical Institute (HHMI) investigator. We discuss how the brain controls our sense of hunger, satiety, and thirst. He explains how dopamine levels impact our cravings and eating behavior (amount, food choices, etc) and how we develop and can change our food preferences and adjust how much we need to eat to feel satisfied.

We discuss factors that have led to the recent rise in obesity, such as interactions between our genes and the environment and the role of processed foods and food combinations. We also discuss the new class of medications developed for the treatment of obesity and diabetes, including the GLP-1 agonists semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro). We discuss how these medications work to promote weight loss, the source of their side effects, and the newer compounds soon to overcome some of those side effects, such as muscle loss.

Dr. Knight provides an exceptionally clear explanation for our sense of hunger, thirst, and food cravings that translates to practical knowledge to help listeners better understand their relationship to food, food choices, and meal size to improve their diet and overall health.

For show notes, including referenced articles and additional resources, please visit hubermanlab.com.