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In this episode of On The Pen: The Weekly Dose, Dave Knapp breaks down why the idea of over-the-counter GLP-1 medications isn’t radical speculation, it’s a pattern already in motion. Drawing on FDA signals, past regulatory precedent with Orlistat, recent pricing negotiations, softened safety language, and public comments from pharmaceutical executives, Dave lays out the case that low-dose oral GLP-1s could be the first step toward OTC access. This episode connects the dots between regulation, access, pricing, and normalization of obesity treatment, and explains why the people laughing today may be asking how they missed it tomorrow.

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Shantanu Gaur, CEO of Allurion, returns to the podcast to break down their swallowable inflatable weight loss balloon, how it works, who it is for, how much it is expected to cost, and when patients can realistically expect access.

We talk real world weight loss results, safety, availability in the US, and how Allurion fits into the broader obesity treatment conversation alongside GLP-1 medications and bariatric options.

This is a clear, no hype discussion for patients who want more tools and better choices in obesity care.

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Thank you for tuning in! If you found this content valuable, make sure to like, share, and subscribe to my youtube channel for more updates on GLP-1, obesity, type 2 diabetes, and the latest news on Mounjaro, Zepbound, Wegovy, and Ozempic. Stay informed and entertained with my unique blend of breaking news, humor, and my personal journey. For in-depth articles and resources, visit onthepen.com.

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This week on On The Pen, we break down a rare FDA walk-back on GLP-1 safety labeling, major pharma signals coming out of JPM 2026, and the growing tension between patient access and legislative efforts that could restrict compounding. We discuss what these developments actually mean for patients, why access—not innovation alone—will determine the future of obesity medicine, and how the OTP community continues to play a critical role in shaping this landscape.

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Thank you for tuning in! If you found this content valuable, make sure to like, share, and subscribe to my youtube channel for more updates on GLP-1, obesity, type 2 diabetes, and the latest news on Mounjaro, Zepbound, Wegovy, and Ozempic. Stay informed and entertained with my unique blend of breaking news, humor, and my personal journey. For in-depth articles and resources, visit onthepen.com.

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This episode opens the year with one of the most consequential—and complicated—weeks in GLP-1 obesity medicine.

We break down three stories that, taken together, reveal why patients are increasingly reading past headlines and demanding accountability from the industry.

First, we examine early-phase trial data from Arrowhead Pharmaceuticals, after headlines claimed its experimental INHBE-targeting therapy “nearly doubled” the weight loss of Zepbound. We walk through what the data actually showed, why the comparison was misleading, how trial design and dosing matter, and why Phase 1 results should never be treated as superiority claims.

Next, we turn to a major access milestone: the official launch of oral Wegovy, the first FDA-approved GLP-1 pill for obesity from Novo Nordisk. We discuss how this pill differs from compounded oral semaglutide, why its pricing strategy is so disruptive, and what this launch means for people who have avoided injectable medications. We also explore how direct-to-consumer access, telehealth partnerships, and retail pharmacy distribution signal a broader shift in how obesity care is being delivered.

Finally, we address the most ironic—and uncomfortable—story of the week: manufacturing quality concerns involving branded Wegovy pens, reported to include biological particulate matter, at the same time Novo Nordisk continues a years-long public and legal campaign against compounded GLP-1 medications on safety grounds. We discuss FDA inspection history, the acquisition of Catalent, and why credibility depends on consistency—especially when millions of patients are paying close attention.

This episode isn’t anti-pharma or pharma-friendly. It’s patient-first.
And it asks a simple question: Who do we trust when science, marketing, access, and manufacturing all collide at once?

Episode Timestamps

00:00 — Why this first episode of 2026 matters
02:10 — Hair found in Wegovy pens and why patients notice hypocrisy
06:15 — Arrowhead trial headlines vs. what the data actually shows
11:40 — Why tirzepatide dosing and trial design matter
17:30 — What INHBE targeting may actually be good for (and what it’s not)
21:45 — Sponsor: SHED and access pathways for obesity care
25:10 — Oral Wegovy officially launches: what’s different this time
30:20 — How the Wegovy pill works and why bioavailability matters
35:40 — Pricing, telehealth, Costco, and direct-to-consumer access
41:50 — Why pills lower barriers for millions of patients
46:10 —

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Thank you for tuning in! If you found this content valuable, make sure to like, share, and subscribe to my youtube channel for more updates on GLP-1, obesity, type 2 diabetes, and the latest news on Mounjaro, Zepbound, Wegovy, and Ozempic. Stay informed and entertained with my unique blend of breaking news, humor, and my personal journey. For in-depth articles and resources, visit onthepen.com.

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Decoding GLP-1 Book
Decoding GLP-1: A Guide for Friends and Family of Those On The Pen
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MY WORK RELIES ON YOUR GENEROSITY, WAYS TO SUPPORT:
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📺 We're Live M/W/F at 11 central: onthepen.tv

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Thank you for tuning in! If you found this content valuable, make sure to like, share, and subscribe to my youtube channel for more updates on GLP-1, obesity, type 2 diabetes, and the latest news on Mounjaro, Zepbound, Wegovy, and Ozempic. Stay informed and entertained with my unique blend of breaking news, humor, and my personal journey. For in-depth articles and resources, visit onthepen.com.

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Pharma Influence & Why Patient Voices Matter
Lobbying Power: Eli Lilly, Novo Nordisk, and Government Access
Why GLP-1 Medication Access Is at Risk
Introducing Sabina Hemi & the Mission of GLP Winner
Why Compounded GLP-1s Matter for Real Patients
The Federal “Safe Drugs” Bill: What It Claims vs What It Does
Why This Bill Raises Red Flags for Patients
What Real Compounding Safety Reform Would Look Like
How Compounding Pharmacies Are Actually Regulated Today
Prescription Reporting vs Patient Safety
Is This Bill About Safety or Litigation Data?
Dose Flexibility, Personalized Medicine, and Compounding
Florida SB 860: A Direct Threat to Compounded GLP-1s
Why Florida Compounding Impacts the Entire Country
Why Obesity Medications Are Being Singled Out
Active Pharmaceutical Ingredients (API): What Patients Should Know
FDA Oversight, the “Green List,” and State Overreach
Why Florida’s API & COA Requirements Don’t Add Up
FDA Inspection Backlogs & Impossible Compliance Standards
Branded Drug Safety Issues vs Compounding Scrutiny
Catalent, Novo Nordisk, and Manufacturing Concerns
Counterfeit Ozempic: The Overlooked Safety Crisis
Why Supply Chain Integrity Should Be the Priority
What Patients Can Do Right Now
Petitions, Advocacy, and Making Your Voice Heard
Florida Residents: Why Local Action Matters
Final Thoughts on Access, Power, and Patient Advocacy

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Decoding GLP-1: A Guide for Friends and Family of Those On The Pen
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Thank you for tuning in! If you found this content valuable, make sure to like, share, and subscribe to my youtube channel for more updates on GLP-1, obesity, type 2 diabetes, and the latest news on Mounjaro, Zepbound, Wegovy, and Ozempic. Stay informed and entertained with my unique blend of breaking news, humor, and my personal journey. For in-depth articles and resources, visit onthepen.com.

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Retatrutide is years away from FDA approval and yet the fight over access, price, control of this medication is already well underway. That's what this podcast is going to be about today. There's well over a hundred thousand people by my estimates who are already on some form of this medication today. And that should tell you enough about how disruptive this molecule is and will be. It is a game changer among game changer. We've been talking about it for three years here at On The Pen, well before any of your favorite gym bros were talking about Retatrutide. We were talking about Reta, who tried Retatrutide here at On The Pen. And that's because we identified this triple agonist as a game changer among game changers. So This is going to be a very Retatrutide heavy episode, and so I hope you'll join us and stick with us if this is a topic you enjoy, because I think this is really going to effectively lay the groundwork for what accessibility to this medication will look like. So let's get into it.

Welcome to the On The Pen Podcast with your host, Dave Knapp. Welcome to the On The Pen, the weekly dose podcast. This is our weekly roundup in incretin memetic news. And frankly, there's no news that is bigger than Reta-Trutide news. Just find me any news that is bigger than the data that we got on Reta-Trutide. Now, we already did a video about the Triumph Phase II clinical trials that we got in osteoarthritis of the knee. You can go back and check out that video if you'd like more data. So we're not gonna super... rehash the data. We'll go over at a high level what the data showed us. We're not going to go over how the medicine works, because by now we all know that it's the triple agonist, right? If terzapatide was a dual agonist, GLP-GIP, Retatrutide is the triple agonist that adds to it a glucagon component, which is absolutely just shredding, shredding liver fat. It is absolutely revving up people's metabolism and showing a tremendous amount of weight loss.

So let's get into what the weight loss looked like in this first trial, because there are longer obesity trials where, where the primary outcome is the weight loss this was again a specific trial in measuring pain reduction in folks with osteoarthritis of the knee but check out these numbers these are placebo adjusted meaning it's taking the two percent out that people lost on placebo but looking at these numbers Folks on one milligram over forty eight weeks lost seventeen percent. They bumped up to four milligrams. Those folks lost twenty two percent. So right there a

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0:00 Welcome & today’s focus: Retatrutide and “chasing the biggest number”
1:11 On The Pen intro, live schedule (Mon/Wed/Fri) & housekeeping
2:10 How Dave first heard about retatrutide (work trip, early phase 1 data)
3:35 Flashback clip: early excitement about retatrutide phase 3 trials
4:40 Why this new retatrutide data feels different for obesity medicine
5:32 TRIUMPH-4 trial overview: obesity + knee osteoarthritis population
7:00 Headline results: 28.7% average weight loss, surgery-level efficacy
8:47 Breaking down weight loss by dose (9 mg vs 12 mg; 25–35% loss rates)
11:05 What “efficacy estimate” really means (race-track analogy)
13:28 Real-world view: treatment-regimen estimate (20–23.7%) vs trial ideal
15:40 Mechanism refresher: GIP, GLP-1, glucagon and why RETA differs from TIRZ
18:05 Side effects, dysesthesia/allodynia & who stopped treatment (BMI differences)
21:02 Why the lower doses matter & who actually needs 30% weight loss
24:15 From “just make the scale go down” to quality of weight loss & body composition
28:05 Future focus: health, longevity, and peptides beyond hitting goal weight
30:40 Viewer Q&A: combining RETA + TIRZ, amylin (eloralintide) combos & “talk to your doctor”
34:38 How retatrutide changes the next decade of obesity treatment conversations
37:22 News update: high-dose Wegovy 7.2 mg approval in the EU & US outlook
40:55 Orforglipron oral GLP-1: liver-signal concerns & fast-track FDA review
45:20 Why small-molecule oral GLP-1s aren’t the same as injectable peptides
48:40 New topic: Indiana “Safe Drug Act of 2025” and why Dave is concerned
51:02 Production caps, “essentially a copy” language & shifting power from prescribers to FDA
54:28 How the bill undermines personalization while ignoring real safety tools
57:05 Safety theater vs real safeguards: API sourcing, sterility & adverse-event reporting
59:45 Who actually gets hit: compliant 503A/503B compounders vs existing bad actors
1:02:05 Call to action: petition at otplinks.com & why patient voices matter
1:05:10 Change.org impact, media attention & centering the patient perspective
1:07:30 Final Q&A, subscribe, obesity.news email list & closing thanks

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Thank you for tuning in! If you found this content valuable, make sure to like, share, and subscribe to my youtube channel for more updates on GLP-1, obesity, type 2 diabetes, and the latest news on Mounjaro, Zepbound, Wegovy, and Ozempic. Stay informed and entertained with my unique blend of breaking news, humor, and my personal journey. For in-depth articles and resources, visit onthepen.com.