The Gillett Health Podcast Doctor ranks his favorite GLP-1's
Jan 16, 2026
Dr. Gillett and James O'Hara dive into the world of GLP-1 medications, ranking their favorites. They discuss the controversial retatratide, weighing its promise against safety risks. Ozempic's history unveils rare but serious side effects, while tirzepatide emerges as a clinical favorite. The duo also compares older GLP-1s like exenatide and liraglutide, revealing insights on tolerability and patient suitability. They explore the challenges of dulaglutide and oral semaglutide, plus the potential of non-peptide oral candidates. Engaging and informative!
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Retatratide's Promise And Uncertain Risks
- Retatratide is a triple agonist (GLP-1, GIP, glucagon) with strong efficacy but unknown long-term risks.
- Kyle Gillett, MD and James O'Hara expect a ~5% chance of unique serious side effects and keep it in F tier until FDA approval.
Prescribe Based On Current Approval
- Evaluate GLP-1s based on current FDA approval and clinical practicality before prescribing.
- Use approved agents for today's patients rather than experimental ones despite promising data.
Semaglutide: Efficacy With Rare Serious Risks
- Semaglutide (Ozempic/Wegovy) is effective but has rare serious side effects like retinal artery occlusion and gastroparesis.
- James O'Hara notes semaglutide may raise IGF-1 more than other agents, which could be harmful long-term.