Welcome back for another weekly update, where I share my personal progress and dish out news and opinions about GLP-1 drugs. This week, we’ll dive into an exciting new discovery from Eli Lilly that’s grabbing headlines and making investors dance in the streets. I’ll also recap my roller coaster week, including updates from the honey experiment I kicked off last week.

If you’re new here, I’m a 78-year-old guy who has been on Mounjaro (tirzepatide, a GLP-1 receptor agonist) for ten months. During that time, I’ve managed to lower my HbA1c to 5.4% (36 mmol/mol) and shed 65 pounds (29.5 kg). Now on a 7.5 mg dose, my focus has shifted to muscle preservation and maintenance rather than just weight loss. Remember, losing weight at the expense of muscle isn’t exactly a victory—it often means replacing valuable muscle with fatty infiltrates, turning your limbs into something resembling Wagyu beef. My secondary goal is to hop off the GLP-1 train by year’s end. We’ll see…

Unnecessary Disclaimers

Who would take advice from me, anyway? Well, if you do, it’s entirely at your own risk. I’m neither a doctor nor a physical therapist. While I’ll share what works for me therapeutically, it’s purely informational. As they say, one man’s meat is another man’s poison. Feel free to leave your comments—YouTube cliché alert!—below.

All Hail the New GLP-1 Pill!

Well, folks, there’s a hot new drug in town. Surprise, surprise, it’s another GLP-1 receptor agonist from our friends at Eli Lilly, but this time, it’s a pill! Because who doesn’t like the idea of a magical weight-loss pill taken daily, especially those who cringe at needles?

Here’s the Hard News

Eli Lilly’s latest innovation is orforglipron, a once-daily oral medication for managing Type 2 diabetes and promoting weight loss. This small-molecule, non-peptide GLP-1 receptor agonist offers an attractive needle-free alternative to injectables like Mounjaro (tirzepatide) and Ozempic (semaglutide).

In the Phase 3 ACHIEVE-1 trial, orforglipron showed impressive efficacy. Patients experienced HbA1c reductions between 1.3% and 1.6%, compared to a negligible 0.1% with a placebo. Those on the highest dose (36 mg) lost about 16 pounds (7.3 kg), equivalent to roughly 7.9% of their body weight over 40 weeks. Moreover, over 65% of these patients reached an HbA1c less than 6.5% (47.5 mmol/mol), aligning with American Diabetes Association standards.

Side effects? Nothing unexpected for GLP-1 therapies—mostly gastrointestinal issues like nausea, diarrhea, indigestion, and constipation. About 8% of participants at the highest dosage discontinued treatment due to these effects, compared to just 1% in the placebo group. Lilly plans to submit orforglipron to the FDA for weight management approval by late 2025 and for diabetes treatment by 2026.

And Now, My Comments

Sure, Lilly’s latest wonder pill has Wall Street jubilant, and diabetics—particularly needle-phobics—have good reason to cautiously celebrate. Fewer needles is always nice, right?

However, let’s be clear: Lilly’s marketing team is undoubtedly salivating at the thought of tapping into the lucrative weight-loss market. Officially aimed at Type 2 diabetes, it’s pretty obvious they’re eyeing the much larger group of folks eager for a miracle weight-loss solution.

Will orforglipron replace insulin completely? Don’t bet on it. Insulin’s role isn’t diminishing anytime soon, though fewer needles are always a welcome development.

At What Cost?

Now, the elephant in the pharmacy aisle: the price. Lilly hasn’t yet disclosed specifics, but we know the game—expect sticker shock, insurance squabbles, and outraged letters to Medicare. Innovation doesn’t come cheap—just ask pharma CEOs shopping for their next yacht.

What’s truly maddening is how quickly these diabetic drugs become trendy among folks whose biggest diabetic risk is their daily doughnut binge. Thanks to influencers and wellness gurus, this pill will likely become another fashionable health accessory, even for people whose greatest health challenge is squeezing into last year’s jeans.

A Transformative Drug?

Putting cynicism aside momentarily (which isn’t easy for me), oral GLP-1 therapies could genuinely revolutionize diabetes management, especially for those struggling with adherence and complications like obesity or fatty liver disease (NAFLD). Let’s hope Lilly keeps its eye on genuine patient needs and doesn’t just chase profits.

As this unfolds, remember the golden rule: no pill replaces the tried-and-true methods of diet, exercise, and consistent medical oversight. Sure, it’s dull advice, but boring often works—just ask anyone who has successfully managed diabetes over decades.

Stay tuned, fellow cynics and realists—this promises to be an entertaining ride, if nothing else.

My Week on Mounjaro

Easter week: let there be food! Despite staying mostly disciplined, I succumbed to a delightful pig-out session on Easter Sunday. The young folks created a kid-friendly buffet featuring traditional Easter hamburgers, hot dogs (with Wonder Bread buns), Doritos, and carrot cake. Jenny and I brought a healthier cucumber salad, which, unsurprisingly, remained largely untouched. My glucose graph, courtesy of my erratic Stelo biosensor, ended up resembling the Leap-The-Dips roller coaster at Lakemont Park in Altoona, PA (bonus trivia, folks!).

Outside Easter, Jenny and I enjoyed our usual Thursday lunch, opting for a neighborhood Greek restaurant. Thankfully, I stayed disciplined, choosing snapper filet on a bed of tasty spinach while politely declining the persistent waitress’s offers of rice and lima beans.

You might recall my honey experiment, where I’m testing a YouTube health guru’s claim about honey’s beneficial effects on blood lipids and insulin resistance. So far, my Stelo device consistently shows glucose spikes an hour after each daily tablespoon. I’ll have my blood tested at the month’s end to gauge the impact. For more details, check out last week’s column.

And Now, My Mounjaro Numbers

After my Easter indulgences and honey trials, my fasting glucose remained reasonably steady at 96 mg/dL (5.33 mmol/L), though I’m aiming for below 90 mg/dL (5 mmol/L). My average glucose this week was slightly higher at 106 mg/dL (5.89 mmol/L). My weight dropped a pound (0.5 kg), likely due to a brief encounter with Montezuma’s revenge toward week’s end.

And That’s It for This Week on Mounjaro

Thanks for joining me for another update. Together, we’ll continue monitoring Eli Lilly’s oral GLP-1 developments and their stock’s ups and downs. Feel free to comment with questions or topic suggestions for future columns.

Stay healthy!

For an annotated catalog of all my Mounjaro updates, please visit my Mounjaro Update Catalog page.

Honey, Politics, and Big Pharma, Oh My!

Welcome to another week of fun musings about the wonderful world of incretin drugs for Type 2 diabetics. Here, I chronicle my progress on Mounjaro, which through 45 weeks has been a helpful adjunct to diet and exercise in bringing my blood glucose and body weight under control. Currently at the 7.5 mg dose, my HbA1c has dropped from 7.6% (60 mmol/mol) to 5.4% (36 mmol/mol), and I have lost 65 (29.5 kg) pounds of Kosher pork.

In addition to my boring progress, we touch on various subjects related to GLP-1 receptor agonist drugs like Mounjaro, Ozempic, Wegovy, and Zepbound and the massive weight-loss market. I provide information about diet, exercise, drug research, helpful monitoring devices. You name it, we got it!

This week, I’ll be looking at some current research into honey, which has inspired me to experiment with the sweet stuff. I happily offer my body as a sacrifice to the gods of science. I’ll also drone on about the war between Big Pharma and the compounding pharmacies, with an additional tidbit about a governmental reversal on Medicare coverage for weight-loss drugs.

Always Consult Your Doctor

But first, I must spout the usual disclaimers. As a 78-year-old pretend amateur metabolic scientist and geriatric gym rat who is not a licensed physician, I can’t legally dispense medical advice and I am certainly not prescribing Mounjaro. Telling you what to do is my nature, but you have only yourself to blame for following any advice I offer. In other words, don’t sue me because something you read here doesn’t pan out for you. Instead, visit your local flesh-and-blood doctor, or even someone of indeterminate national origin in a white coat on a tele-health screen at a profiteering weight loss salon or compounding pharmacy. They have the necessary malpractice insurance to protect them when they screw up.

The Buzz about Honey

This week, I’ve decided to dive head-first into yet another dietary rabbit hole—this time, it’s honey. Lately, YouTube health gurus, notably Thomas DeLauer, have been touting honey as not just another form of sugar, but as an outright health boon. The idea that honey might even benefit people with Type 2 diabetes seems about as likely as my HOA admitting that stupid STOP sign was a mistake! Nevertheless, the research intrigued me enough to give it a closer look.

At first glance, honey is just liquid sugar, right? Yes, it is mostly glucose and fructose—just like table sugar. However, it also contains trace minerals, antioxidants (like flavonoids), vitamins, and enzymes that are notably absent from your average Domino’s bag. More interestingly, honey boasts a lower glycemic index than regular sugar, meaning it should cause a slower, gentler rise in blood sugar levels. Plus, antioxidants in honey might reduce inflammation and oxidative stress, both of which are big troublemakers in the insulin resistance game.

Scientific Evidence Exists

Scientific studies back up some of these claims. For instance, a 2018 study published in Nutrition & Diabetes showed that moderate honey intake could improve cholesterol profiles and decrease inflammation compared to traditional sugars—even among diabetics. Another recent review suggests honey could improve glycemic control and insulin sensitivity, thanks to its complex interaction with gut bacteria and antioxidant content. Yes, indeed, we’re talking about the all-important gut microbiota!

But let’s not start guzzling jars of honey just yet—there are caveats. The studies showing beneficial results dealt with moderate amounts. As always, dose makes the poison. Moreover, raw, unprocessed honey contains a plethora of beneficial compounds, whereas processed honey amounts to colored Karo syrup.

Another Experiment for You

Given this backdrop, your favorite self-anointed geriatric diabetic Kosher Mounjaro guinea pig (yours truly) is running yet another self-experiment. (Recall that last week’s allulose vs. erythritol experiment didn’t work out so well for my digestive tract, but I digress). I’ll be consuming one tablespoon of raw, unprocessed honey daily for 30 days. I’ll be watching its effects on my blood sugar like a hawk using my trusty, schizoid Dexcom Stelo.

Just for shits and grins, I initiated this scientific investigation on Saturday by slurping up two tablespoons of honey during my afternoon workout. Interestingly, my glucose remained steady, with no significant spike detected—so far, so good. But on Sunday, taking my dose of bee sugar on an empty, morning stomach created a glucose spike to about 140 mg/dL (7.78 mmol/L). This could be an interesting and eventful investigative path toward the truth. So, fasten your seat belts for a bumpy ride.

The Quest for Proof

At the conclusion of my thirty-day honey-soaked adventure, I’ll top it off the pseudo-science with some lab measurements. I am thinking lipid profile, HbA1c, fasting glucose, and insulin levels will tell the tale whether more than just sweet hype is behind honey’s claims. Of course, I’ll note any obvious interim weirdness in my weekly updates here.

So, please stick around, mateys. Either I’ll emerge enlightened with yet another dietary trick up my sleeve, or I’ll provide a cautionary tale proving once again that YouTube health gurus are full of…honey. In any case, after a month of forced honey ingestion, I might never manage to stomach the sight of those damn ridiculous plastic bear-shaped honey jars again!

The Obesity Industrial Complex—A Tale of Two Grifts

Welcome to the latest installment of “As the Waistline Turns,” where we dissect the ever-expanding saga of the obesity industrial complex. This week, we’re spotlighting the dual-pronged assault on GLP-1 medications for obesity—a narrative so rich in irony, it could give a sugar-free candy a run for its money. (And the sorbitol they use to sweeten that crap sure does give you the runs!).

The Great Obesity Rebranding: Disease or Marketing Ploy?

Once upon a time, obesity was considered a condition—a complex interplay of lifestyle, environment, and yes, in rare cases, genetics. Enter the rebranding: obesity is now a “chronic, relapsing disease,” a term so catchy it could have its own jingle. This semantic shift isn’t just academic; it’s a strategic maneuver that opens the floodgates for pharmaceutical interventions, conveniently covered by insurance and, by extension, taxpayers.

YouTubers: The Unwitting Pharma Influencers

In the age of digital enlightenment, where every influencer with a ring light is a self-proclaimed health guru, the narrative of obesity as a disease has found fertile ground. These content creators, perhaps unknowingly, have become the de facto marketing arm of Big Pharma, peddling the gospel of GLP-1 medications like Wegovy and Zepbound as the panacea for our collective waistline woes.

Compounding Pharmacies: The Short-Lived Robin Hoods

Amidst the GLP-1 gold rush, compounding pharmacies emerged as the Robin Hoods of the healthcare world, offering more affordable, albeit unapproved, versions of these medications. But alas, their reign was short-lived. The FDA, in a plot twist worthy of a daytime soap, declared the shortage of tirzepatide over, effectively pulling the rug out from under these compounders. Enforcement discretion ended for 503A pharmacies on February 18, 2025, and for 503B outsourcing facilities on March 19, 2025 .

One Compounder’s Fall From Grace

Mochi Health, once a prominent telehealth platform offering compounded GLP-1 medications like tirzepatide and semaglutide, has faced significant challenges due to recent regulatory changes. The FDA has determined that the shortages of these medications have been resolved, leading to the end of enforcement discretion for compounding pharmacies. As a result, compounding pharmacies are now restricted from producing these medications unless specific criteria are met.

In response, Mochi Health has been working to adapt by partnering with pharmacies like Empower and Red Rock to fulfill prescriptions. However, patients have reported delays and uncertainties about the availability of their medications. The company has also faced scrutiny over its practices, including the provision of compounded medications to minors without thorough verification processes.

These developments highlight the complexities and challenges faced by telehealth providers and patients in navigating the evolving landscape of weight loss treatments and regulatory compliance.

Big Pharma Strikes Back

Not content with regulatory victories, pharmaceutical behemoths like Eli Lilly have taken to the courts, suing compounding pharmacies for producing unapproved versions of their blockbuster drugs. In a move that screams “protect the profits,” Lilly filed lawsuits against two compounders, accusing them of selling unapproved products containing tirzepatide. Expect more litigation as time goes by.

Medicare Coverage: A Political Football

Meanwhile, in the hallowed halls of government, the Trump administration has decided that Medicare will not cover anti-obesity drugs like Wegovy and Zepbound. This decision overturns a Biden-era proposal and maintains the longstanding policy that Medicare does not fund weight-loss drugs . While some may see this as fiscal responsibility, others view it as a denial of access to potentially life-changing treatments. Medicare will continue to cover some GLP-1 RA drugs for Type 2 diabetes, and as I told you last week, CMS will be negotiating prices with Danish Ozempic producer Novo Nordisk.

The Bottom Line: A Tale of Two Grifts

In this grand narrative, we’re caught between two grifts: one that medicalizes a condition to sell expensive treatments, and another that exploits regulatory loopholes to offer unapproved alternatives. As taxpayers, patients, and consumers, we’re left to navigate this complex landscape, questioning who truly benefits from these so-called solutions.

So, as we sip our unsweetened almond milk lattes and ponder our next steps, let’s remember that in the world of obesity treatment, the scale isn’t the only thing being manipulated.

My Week on Mounjaro

I resumed my workout schedule as my back and neck pain abated. I’ll further address the literal pain in the neck in my physiatrist appointment toward the end of the month. Meanwhile, my new Garmin Venu 3 fitness tracking smart watch provided an added high-tech inducement to play in the gym, both at my senior citizen rehab/gym and my semi-repurposed family room. At the former, I discovered the wonders of the “Gravitron 2000” assisted pull-up and dip machine, which convinced me that even an old fart can do copious pull-ups if he negates enough of his still excessive body weight. Yet another incentive to play gym rat and show off for the old ladies! (Just kidding, Jenny!).

My new paradigm prioritizes building muscle over continued weight loss while still on Mounjaro. So, over the past few weeks I have adjusted my caloric intake upward with an emphasis on protein while maintaining the low-carbohydrate approach. Instead of operating at a caloric deficit, I now have a surplus. Given my workout schedule, the high protein, and the confirmation that my ‘nads are still making testosterone (see Week 39 Update), my theory is that the surplus will be aimed at muscle growth instead of inflating my spare tire.

No hikes this week, alas. We’ll see if we can rectumfy that deficit this week. And now, the numbers.

The Mounjaro Numbers, Already!

I’ll reiterate that I am at the 7.5 mg dose of Mounjaro, hoping to go no higher and planning to dump the drug completely by the end of the calendar year. My progress has flattened out, but I won’t be chasing ever-increasing doses of Mounjaro to sink Big Pharma’s hook even further into my flesh. They want addiction for life; I want freedom and nirvana.

That having been said (as trite segues go), my average fasting glucose for the week was 94 mg/dL (5.22 mmol/L), down from 102 mg/dL (5.67 mmol/L) last week. My paranoid schizophrenic Stelo CGM device shows my seven-day overall average as 96 mg/dL (5.33 mmol/L). I’d say this is decent glucose control. Body weight for the week was flat at 182.4 lbs (82.9 kg).

Moving Right Along…

And so, we conclude another week in the annals of this Mounjaro-for-old-farts saga. This week, we gave you a taste of honey, the sweet elixir we’ll be savoring more over the next few weeks. We also looked at the attempt by Big Pharma to corner the market on GLP-1 RA drugs, squeezing out the parasitic compounding pharmacy industry. And finally, we opined on the Trump Administration’s reversal of the attempted taxpayer-funded incretin give-away by the cretins in the Biden Adminstration’s waning days.

Until next week, Happy Easter, Happy Passover, and stay healthy!

For an annotated catalog of all my Mounjaro updates, please visit my Mounjaro Update Catalog page.

Bureaucrats, Blood Sugar, and the Battle for Medicare’s Wallet

I’m back for Week 44 of my Mounjaro experiment—a strange week in which I unexpectedly shed some weight. While I’ve come a long way in taming my blood glucose and dealing with surplus flab, I’ve lately pivoted toward a new goal: clawing back some muscle mass lost during the early days of calorie-cutting. Yes, I’d still like to jettison the spare tire—but starving myself into a frail, wrinkled raisin of an old man doesn’t strike me as a smart trade.

As always, my goal here is to share the full range of what it’s like to use Mounjaro as a treatment for Type 2 diabetes. I throw in news, rants, and opinions to break up the play-by-play of what I ate, lifted, or avoided. I also encourage you, dear reader, to chime in with your own experiences—especially if you’ve got strong feelings or colorful language.

This week, we’re taking a detour into the foggy swampland of government price negotiations—specifically, Medicare’s recent decision to target some GLP-1 drugs for price negotiation while leaving others (notably Mounjaro) untouched. Yes, it’s time to point a crooked finger at Big Government. And as the old saying goes: “If you really want to screw something up, get the government involved.”

Administrivia

Before we get into the meat of the matter, here’s the usual legalistic eyewash: I’m not a doctor. I’m a 78-year-old Type 2 diabetic curmudgeon with strong opinions and a keyboard. That makes me dangerous, not qualified. So consult your own doctor before trying anything I mention here—especially if it sounds dumb or suspicious. If you disagree with my opinions, good. That just means you’re paying attention. Now on with the show.

Something Rotten in the State of Denmark?

Medicare recently published its inaugural list of drugs up for price negotiation, and wouldn’t you know it—Ozempic and Wegovy made the list. Missing in action? Eli Lilly’s Mounjaro and Zepbound. A bureaucratic oversight? Hardly. This looks a lot like a not-so-subtle tip of the cap to Lilly, the American pharmaceutical darling, while Denmark’s Novo Nordisk gets the shakedown.

Of course, the official explanation is that the IRA (Inflation Reduction Act—pause for laughter) only allows price negotiation for drugs that have been on the market for a set number of years: nine for pills, thirteen for biologics. Mounjaro and Zepbound are just too green. But hiding behind a rulebook is standard practice for bureaucrats doing something politically convenient. The result? Foreign-developed drugs get squeezed, while newer U.S.-made blockbusters skate.

Maybe They’ll Give Us a Better Deal on Greenland?

Here’s the kicker: by strong-arming Novo into offering Ozempic and Wegovy at Medicare-friendly discounts, the government may actually help the Danish firm—at least in the short term. Lower prices could make semaglutide the drug of choice for Medicare Part D plans, especially if Lilly insists on clinging to premium pricing. If that happens, Lilly might just cede the GLP-1 Medicare market to Novo Nordisk without firing a shot.

Yes, Mounjaro and Zepbound have outperformed semaglutide in most efficacy trials. But efficacy doesn’t help if the insurance gatekeepers make access a bureaucratic nightmare. Right now, insurers seem happy to steer folks toward the older, cheaper drug.

So what we may be witnessing is a slow-motion market share transfer, cloaked in the garb of populist price reform. Lilly will get its turn in the negotiation dunk tank eventually—but for now, Novo enjoys a politically manufactured edge. The irony? The haircut is being given to the foreign company while the American firm gets a fresh coat of hairspray.

In the meantime, Medicare patients looking to jump on the Mounjaro train may find themselves priced out. That’s not just market dynamics at play—it’s policy with side effects. While I hope to be off this stuff by the time all these moves take effect, you’ll certainly be the first to know if these political gyrations impact me!

In the News This Week

Regulatory and Legal Updates

• FDA Cracks Down on Compounding: With brand-name GLP-1 shortages resolved, the FDA is now telling compounding pharmacies to back off. Most compounded versions of tirzepatide and semaglutide are being shown the door.
• Court Ruling Upholds FDA Authority: A federal judge denied a compounding industry request to block the FDA’s directive. Translation: the FDA’s in charge, and compounded Mounjaro is out—at least for now.

Industry Moves

• Lilly Goes Global: Mounjaro has launched in India, adding a few billion more potential users to the GLP-1 pool.
• Novo Eyes the Future: Novo Nordisk just licensed a triple-agonist compound (GLP-1/GIP/glucagon) from The United Laboratories. Early-stage, but potentially a big deal.

Clinical Tidbits

• GLP-1s Not Linked to Suicide Risk: A meta-analysis of 27 trials found no increase in suicide-related events from GLP-1s. Score one for safety.
• T1 Diabetics Taking GLP-1s: A growing number of Type 1 diabetics are trying these meds for weight loss, but risks of hypoglycemia mean it’s not one-size-fits-all.

My Week on Mounjaro

A quiet week. Jenny was in Chicago for her dad’s 87th, so no Thursday cheat lunch. Between back and neck pain, I barely got to the gym—just a light session Tuesday and leg day Thursday. I redeemed myself Friday with a 6.2-mile (10 km) hike in the 90-degree Florida swamp oven. Summer’s here, and it’s not playing nice.

I’ve ramped up calories lately to support muscle gain—yes, even at 78, I’m still trying to stave off sarcopenia. If I gain a pound or two, I’m hoping it’s biceps, not belly. My sketchy Chinese body comp scale may not be gospel, but I’m watching for trends. This week, though, if it isn’t lying, I paradoxically lost weight.

The Mounjaro Numbers, Man!

I’m still at 7.5 mg per week and hoping to avoid going higher. This week, I somehow dropped four pounds (1.8 kg)—go figure—weighing in at a pseudo-svelte 182 lbs (82.6 kg). My fasting glucose averaged 102 mg/dL (5.67 mmol/L)—up slightly, while my flaky Dexcom Stelo CGM claims my weekly average was 90 mg/dL, which I view as fiction. Still, it’s great for tracking food responses and trends.

I Experimented with Sweeteners So You Needn’t Do So

Bonus experiment this week: I tested allulose and monk fruit/erythritol on an empty stomach to see if either spiked my glucose. Nada. Flatline. However, they did move the needle in the digestive department—if you catch my drift. Better than Miralax. You’re welcome.

So, now, that paradoxical weight loss might have a viable explanation, as it were.

Until next week—stay strong, stay salty, and don’t let Big Pharma or Big Government pick your pocket.

Until next week, stay healthy!

For an annotated catalog of all my Mounjaro updates, please visit my Mounjaro Update Catalog page.