We have three stories for you this week. First, the FDA has approved an oral version of Wegovy, to expand their weight loss hobbyist market to the needle-squeamish crowd. Then, sticking with the oral cavity, we examine claims of people losing teeth due to a syndrome dubbed “Ozempic Mouth.” For our self-centered sub-feature, I’ll give you results of my hernia surgery follow-up, and maybe even show you an internal photo taken by the da Vinci robot. Finally, Bullshit Corner wraps up the week with a sidelong glance at what fat-loss hobbyists are calling GLP-3s.
1) Wegovy Goes Oral: Novo Nordisk Tries to Take the Needle Out of the Conversation
Novo Nordisk has scored a legitimate milestone with FDA approval of oral Wegovy, the first GLP-1 pill formally indicated for weight loss. This is not influencer vaporware or compounding-pharmacy alchemy. This is real FDA approval, backed by trial data.
The once-daily 25 mg semaglutide pill delivers average weight loss in the low-to-mid teens, just shy of injectable Wegovy. Among adherent patients, results push higher, with roughly a third hitting the psychologically important 20% threshold. That is respectable, even impressive, for a pill.
Of course, this is not a “take it whenever” tablet. It must be swallowed on an empty stomach, with minimal water, followed by a mandatory waiting period before food, drink, or other medications. In other words, it retains the same finicky morning ritual that made Rybelsus so beloved by people who enjoy setting timers before coffee.
Still, this matters. Pills scale differently than injectables. They are easier to prescribe, easier to ship, and psychologically easier for patients who still recoil at needles. Novo’s introductory pricing, at least on paper, undercuts the injectable GLP-1s, though nobody should confuse launch discounts with durable affordability.
This is a format win, not a knockout. Eli Lilly still owns the efficacy crown with tirzepatide. But Novo just expanded the battlefield, and that alone will reshape prescribing patterns.
2) “Ozempic Teeth”: Dry Mouth Discovers Social Media
This week’s contribution to the GLP-1 Body Parts Cinematic Universe comes courtesy of the Internet’s newest diagnosis: “Ozempic teeth.”
The claim, amplified by viral anecdotes, is that GLP-1 drugs are causing gum disease, tooth decay, and bad breath. MedPage Today did the unglamorous but necessary work of calling an actual physician, who responded with a profoundly boring explanation: dry mouth and dehydration.
GLP-1 receptor agonists can reduce appetite and thirst. Less eating often means less drinking. Reduced saliva follows. Dry mouth is a well-known risk factor for gum irritation, dental caries, and halitosis. None of this is novel, exotic, or specific to semaglutide. It also happens with antidepressants, antihistamines, blood pressure meds, CPAP use, aging, and breathing through your mouth like a golden retriever.
The more severe cases highlighted online appear to cluster among people who are unsupervised, underhydrated, vomiting, or generally inattentive to basic self-care. That is not a pharmacologic mystery. That is neglect.
The fix, such as it is, will not trend on TikTok: drink water, eat adequately, maintain oral hygiene, and tell your dentist what medications you take. If GLP-1s truly caused spontaneous dental collapse, orthodontists would be retiring early.
“Ozempic teeth” is not a syndrome. It is a hashtag in search of a mechanism.
3) Meanwhile, Back at the Abdomen: Hernia Follow-Up and the Tyranny of Light Weights
For the self-absorbed portion of the column, a brief surgical update. Above is an internal picture of the polypropylene hernia repair mesh as it was deployed on December 9, when I had the da Vinci Xi robotic laparoscopic surgery.
So, I’m going on three weeks out from the robotic mesh repair of a right inguinal hernia. Last Tuesday, I had my postoperative follow-up with Dr. O, the surgeon who performed the master work. The verdict: boringly positive.
No recurrence of the groin lump, no infection, no drainage, no drama. Mild residual soreness at the incision sites, particularly the largest one, which is apparently normal and not a harbinger of mesh catastrophe. Bowel function returned on day three with pharmaceutical encouragement, after which my colon resumed its usual authoritarian efficiency.
Activity-wise, I’ve been walking a couple of miles daily, using the treadmill at the YMCA, and performing seated exercises with my humiliating purple, five-pound dumbbells. Now, the surgeon has cleared me for cardio, swimming, cycling, elliptical work, stair machines, and even squats—provided I behave myself and keep the load reasonable.
The bad news is that deadlifts remain verboten until late January or early February. The almost good news is that I am allowed to lift up to 20 pounds total, no more than 10 pounds per hand, but only if I refrain from engaging my core like an idiot. In other words, I am temporarily training like someone who writes op-eds instead of lifting heavy things.
The official plan is simple: continue progressive activity, avoid stupidity, and call the doc if anything new, painful, or anatomically surprising occurs. I’ve been discharged from surgical care, which is medical shorthand for “don’t do anything dumb and make us meet again.”
Bullshit Corner: GLP-3, the Drug That Exists Only If You Believe Hard Enough
Welcome back to the corner of the Internet where marketing cosplay gets mistaken for endocrinology.
Somewhere between TikTok pharmacology, Telegram peptide bazaars, and a Shenzhen catalog with questionable quality control, we have now arrived at the next great breakthrough in metabolic medicine: GLP-3.
Small problem: GLP-3 does not exist. There is no GLP-3 hormone, no GLP-3 receptor, and no physiology textbook chapter titled “GLP-3, obviously.” What people are usually gesturing at is retatrutide, an investigational triple agonist (GLP-1, GIP, and glucagon receptor activity) being developed by Eli Lilly. “Triple agonist” was apparently too many syllables, so the Internet rebranded it into something that sounds like a sequel with better special effects.
Step 1: Invent the Name
“GLP-3” is not nomenclature. It is a vibe. It implies inevitability, like the iPhone 17, except the iPhone actually exists and usually arrives without a warning about thyroid C-cell tumors.
Step 2: Cherry-Pick the Trial Slides
Retatrutide’s early trial results have been legitimately impressive in published data: large average weight loss, broad metabolic effects, and plenty of excitement in the “next-generation incretin” crowd. But the fine print matters:
- It is investigational (not approved, not marketed, not something you are supposed to be “running”).
- It includes glucagon receptor activity, which is not a decorative add-on.
- Side effects and long-term safety are still being characterized, because that’s what trials are for.
Step 3: Add the Gray Market
Because retatrutide is not commercially available, the hobbyists do what hobbyists do: they shop. Enter the miracle phrase “for research use only”, a legal incantation that somehow convinces adults that the vial is pharmaceutical-grade if it arrived in a padded envelope.
What buyers think they’re getting: pharmaceutical retatrutide, just early.
What they may actually be getting: unknown purity, unknown identity, unknown stability, unknown contaminants,
and absolute certainty that no regulator vetted it.
Step 4: Magical Thinking Sets In
Once the name becomes cool enough, the mythology writes itself:
- “It only burns fat.”
- “No muscle loss.”
- “Cleaner energy.”
- “Doctors are scared of it.”
These claims are unsupported, but they spread nicely because they flatter the buyer: early adopter, elite, smarter than the system. The system, meanwhile, is busy doing boring things like safety monitoring.
Step 5: Confuse Optimization with Intelligence
GLP-1s moved weight loss from discipline to medicine. “GLP-3” moves it from medicine to biohacking fantasy. People stop asking “is this safe?” and start asking “what dose are you running?” which is how you know the conversation has left the clinic and entered the gym locker room.
Peptide Purgatory Verdict
Peptide Purgatory chronicles one man’s ongoing experiment with GLP-1s, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia while reading policy papers. So, ask your doctor whether Peptide Purgatory is right for you!
For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.
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