Readers' stories on their experience with GLP-1 weight-loss drugs

Today I'd like to continue my series on the GLP-1 weight-loss drugs, most notably Novo Nordisk's (NVO) semaglutide (Wegovy/Ozempic) and Eli Lilly's (LLY) tirzepatide (Mounjaro/Zepbound).

I first wrote about these drugs – and labeled them "miraculous" – three and a half years ago. And I've written about them dozens of times since, including Monday and yesterday.

Readers may wonder why I'm writing so extensively about them in an investment e-mail...

I'll acknowledge up front that, to some extent, it's personal. I like helping people. I've lost count of how many of my family, friends, and readers have thanked me for providing advice that transformed – or even saved – their lives.

Heck, even a slim, fit guy like me might benefit from a tiny dosage of this type of drug for general health improvement...

But I would also argue that personal anecdotes are the root of moneymaking investments. This type of deep dive into a subject area via "scuttlebutt" research is what often yields novel, out-of-consensus insights and ideas.

Think about it: If all you know about a company or industry is what you've read in the newspaper, online, or in analyst reports – the same information everyone else has (i.e., the average) – then how are you supposed to earn better-than-average returns?

You won't.

Longtime readers will recall that I've bought stocks near multiyear lows thanks to insights I gained from boots-on-the-ground research and talking to the right people – including McDonald's (MCD) in 2003 and Netflix (NFLX) in 2012.

With that as background, I'd like to share several stories readers sent in about their experience with these weight-loss drugs. I received so much incredible feedback that I can't possibly share it all in this e-mail. So I've compiled them for you to read here.

Below, I'll be sharing a few more standouts in addition to the one from Jeff H. in yesterday's e-mail, along with some expert advice. So let's dive in...

Ken M. asked an excellent question:

I too resist taking "another" medicine with potential life-limiting side effects. I'm 76, still physically active, and have lowered my cholesterol and triglycerides. But I am fighting weight gain from using prescription meds.

I'm 5'8" (and shrinking) and trying to drop 15 pounds from a current range of 183 to 187 pounds. I have been trying to lose my belly by exercising and limiting my food intake, and eating a healthy diet. My target is 175 to 170 pounds, where I was just three years ago.

My question is: Should I use a GLP-1 med to help me drop weight, given I'm currently taking small doses of prednisone, a statin, plus a heart-regulating drug, plus a hypertension med? My blood work is all within normal ranges.

Thanks for sharing your story, Ken!

I forwarded Ken's e-mail to three top experts I know so I could get their takes: Dr. Kevin Maki, an esteemed researcher in this field... Dr. Jason Fung, author of The Obesity Code: Unlocking the Secrets of Weight Loss and other related books... and Rich Weil, an exercise physiologist and founder of Transformation Weight Control.

Dr. Maki wrote:

I am not a clinician, so I do not provide medical advice. I will provide some thoughts about issues to consider discussing with your physician or other clinician.

I usually start with an overview of risk factors for cardiovascular-kidney-metabolic diseases. Your current body mass index ("BMI") is about 28 kilograms per square meter, which is in the overweight but not obese category. I encourage measuring your waist at the navel. If it is more than 40 inches, that is a concern.

Your recent weight gain may be secondary to your use of a steroid (prednisone), which I assume is medically necessary. Statins lower risk for cardiovascular events, but they also produce some degree of insulin resistance, which slightly raises the risk for diabetes.

It sounds like you currently do not have diabetes, so you would not have an indication for Ozempic or Mounjaro. Therefore, the medications that may be considered by you and your clinician would be Wegovy (oral or injectable semaglutide) or Zepbound (injectable tirzepatide).

Other factors to consider include cardiometabolic risk factors such as blood pressure, inflammation (C-reactive protein), lipids (LDL cholesterol, triglycerides), and kidney function (estimated glomerular filtration rate).

What potential benefits would taking a GLP-1 receptor agonist drug provide? These agents have been shown to lower risks for diabetes, cardiovascular disease events (heart attacks and strokes), and kidney failure. If you have evidence of coronary artery calcium on a scan, kidney dysfunction, or prediabetes, one or more of those would make it more likely that your clinician would consider prescribing a GLP-1 drug.

Also, if you have chronic inflammation due to an inflammatory condition such as psoriasis or rheumatoid arthritis, that would also be a factor favoring consideration of a weight-loss drug.

There are some potential risks as well, which include gastrointestinal side effects (mostly transient), pancreatitis (a very low risk), and gallbladder disease (a low risk). So, decisions about the use of a medication like a GLP-1 agonist should involve a dialogue between you and your physician or other clinician about potential benefits, costs, and risks.

Dr. Fung wrote:

I agree with Kevin. The decision to prescribe a medication depends upon the expected risk versus benefits, and the baseline risk of end organ damage. Given the normal bloodwork, the baseline risk is relatively low and the magnitude of the weight loss is not very high.

Therefore, the expected health benefit is relatively small, but not zero. The risks of the medication are also relatively small but not zero. There are also persistent concerns about dysthymia and muscle loss out of proportion to weight loss.

The number of patients needed to treat to prevent one cardiovascular ("CV") event is 44 to 66, over four years in a high-risk population (SELECT trial, New England Journal of Medicine), which you are not. So, let's say, optimistically that you need to treat 100 patients to prevent one CV event. That means, roughly, that over eight years, you need to treat 50 patients to prevent one CV event, or 2%.

If you take Wegovy, you have a 2% chance of preventing a cardiovascular event and a 98% chance that it didn't make a difference over your remaining expected life expectancy. Balance that against the known side effects (about 87% of patients have gastrointestinal side effects, higher with higher doses).

Is it worth it? That's for you to decide with your doctor. You might look better, have better self-esteem, etc. But from a cardiovascular standpoint, the overwhelming probability for you (98%) is that it won't make a difference.

Rich pushed back a little bit, writing:

Your e-mail reminds me of a time when I was still at a research center and hospital, and at that time all we had was one program: a 52-week program for patients who had BMIs over 30. But in reality, the BMIs were much higher – the average was 43.7.

Anyway, people kept bugging me to start a shorter 26-weeek program for patients who had much less than 50 pounds to lose, maybe just 10 to 20 pounds. And admittedly, I had a strong affinity for my patients whose BMIs were very high and I didn't think it was important enough to have a 26-week program for people who had less to lose, thinking the issues weren't that important.

But I started the 26-week program anyway, and almost instantly, I realized that the issues for people who had 20 pounds or less to lose weren't so dissimilar to those who had 80 pounds or more to lose. But even more important is that I discovered that it was just as important to lose weight for people who had 10 to 15 pounds to lose as it was for those who had more than 100. My whole viewpoint changed. It was quite a sea-change in my thinking. That was at least 25 years ago.

As I was reading your response, which was excellent from a health perspective, I thought that it didn't seem health was quite the main issue for this fellow Ken. He said he wanted to lose his belly and get back to the weight he was three years ago, which I figured was more comfortable for him. That's what resonated for me.

Thank you all for your insightful answers to Ken's question!

Back to reader stories, Lila S. highlights the problem of affordability:

My husband had access to a GLP-1 for a short span of time a few years ago. He lost about 30 pounds. Then every Hollywood star wanted it, and he was told insurance would no longer pay for it.

Like your friend, he has good bloodwork, but he has health issues, including sleep apnea, as well as bad knees from inflammation. He still asks his doctor periodically about a prescription, since he is prediabetic and overweight, but he's outside the bounds for insurance to cover it. I wish Congress would do something about this, but they are beholden to insurance companies.

We have a friend who was prescribed a GLP-1 for his diabetes. When he started on it, he was nauseous a lot, and it was hard to be on it. But he adjusted, lost weight, and feels better than he has in decades. I saw him recently wearing a ring that looked like a family piece. He said he'd had it for decades but it hadn't fit him. Now it fits again.

My friend Howard H., whom I saw at the ValueX conference in Klosters, Switzerland, notes the importance of maintaining muscle while losing fat on these drugs:

As I mentioned to you in Klosters, I'm currently on Mounjaro and had been on Ozempic previously.

The issue with both of these is that you do lose muscle mass in the process which, as a guy now over 70, is an issue. I now weight about 150 pounds, when I was a very comfortable 175 or so most of my adult life. Having recently been rediagnosed with latent auto immune diabetes in adults ("LATA," or diabetes 1.5), my endocrinologist lowered my dosage as I'm not having insulin-resistance issues, and the loss of muscle mass was a concern.

However, the many other benefits of GLP-1s (cardiovascular, etc.) outweigh that concern. What it does mean is that I need to make a concerted effort to keep building muscle so I'm in the gym and working with a trainer on that, doing dead lifts, bench presses, etc. In all honesty, I feel great!

From what I understand, the next generation of GLP-1 drugs being developed have a lower level of muscle-mass destruction, so that will be a big positive to aging people like me.

Bruno B. writes regarding dosages:

I've been taking Zepbound for two and a half months now. I was 216 pounds when I started. I'm now down 31 pounds, to 185.

I've been taking the lowest possible dose, 2.5 mg. It's actually what they call a "starting dose," just to get your body used to the drug. In my case, the effects of less hunger and food noise was so nice already with 2.5 mg that I asked my doctor to NOT increase the dose, which he agreed with. I'm like your friend and resisted taking it for a while, because I don't like taking ANY drugs at all – only if I REALLY need it.

Many people take GLP-1 drugs in medium or high doses. The more you take it, the more you'll feel the results (both good and bad). My take on it: Since taking the lowest dosage allowed me to NOT think about food during the day and reduced food noise and alcohol consumption by a LOT, I figured I would use this drug coupled with an "easier" diet. I feel great and I'm able to do the diet without suffering anything. I'm off sugar for 2.5 months (no cravings!) and occasionally drink alcohol (like once a week). I also started lifting heavy weights in the gym with a personal trainer, so I don't lose much lean mass. It's working great!

I have been taking monthly bloodwork exams to monitor the risk of pancreatitis, which is really small, and everything is fine. That might reassure your friend about taking the drug – you can monitor the risks. And if you drink a LOT of water, your pancreatitis risk decreases even further. And as you mentioned, my bloodwork has only been getting better, with most exams returning to normal ranges.

I hope this helps you "convert" your friend. If so, it'll be lifechanging for him.

Thank you all for sharing your stories (again, I've posted many more here). Hearing them reinforces my view that these drugs have enormous growth ahead of them – and, in turn, the companies that make them.

Novo Nordisk is a model portfolio holding for our flagship newsletter, Stansberry's Investment Advisory. Subscribers have access to our initial recommendation and specific buy advice for the stock. If you're not already a subscriber, you can become one by clicking here.

Novo's beaten-down stock is compelling at current levels, more than reflecting the fact that its drug isn't as good as Lilly's.

As for which stock I prefer right now, I'm leaning toward Lilly despite its nosebleed valuation. That's because of the impending launch of retatrutide, which I think will quickly become a bestselling drug.

Lastly, as for my stubborn friend who has resisted going on a GLP-1, I think we may have gotten him over the hump with these powerful testimonials. Stay tuned for an update!

Best regards,

Whitney

P.S. I welcome your feedback – send me an e-mail by clicking here.