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Speaker 1: Welcome to Fearing Greed Q and A where we ask

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Speaker 1: and answer questions about business, investing, economics, politics, and more.

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Speaker 1: I'm Sean Almer. This might be a business podcast, but

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Speaker 1: scenes every week we're talking about a new health study

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Speaker 1: or medical breakthrough and the impact it can have on

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Speaker 1: individual society and of course the economy more broadly. Today,

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Speaker 1: I wanted to take a look at a couple of

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Speaker 1: the big breakthroughs and trends going on right now. Doctor

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Speaker 1: Zach Turner is a medical doctor, media personality and biomedical scientists.

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Speaker 1: Doctor Zach, Welcome to Fearing Greed Q and a.

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Speaker 2: Thank you for having me on. It's exciting.

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Speaker 1: GLP one drugs. We've been talking about them for a

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Speaker 1: few years now. Everyone knows someone that wants one of

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Speaker 1: those weight loss drugs, and we're talking about zen Pep.

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Speaker 1: I suppose it is one of the better known WIGOVI

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Speaker 1: tell us about them? Do they work? Are they safe?

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Speaker 1: What are the unknowns?

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Speaker 2: What are the unknowns? Good question? I guess these are

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Speaker 2: perfect is as well to have on a business podcast,

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Speaker 2: because essentially these are very fast becomings were the biggest

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Speaker 2: companies in the world, and even if you're not interested

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Speaker 2: in the health side, certainly the shares and the share

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Speaker 2: portfolio is really fascinating, and looking at the size of

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Speaker 2: the clinical trials that are being done on these medications

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Speaker 2: and how it impacts the investment potential for it is huge.

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Speaker 2: So what are GLP ones? Well, GLP one is a

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Speaker 2: type of receptor that we have across our bodies, and

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Speaker 2: essentially these medications came out ten plus years ago to

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Speaker 2: look at how we can help type two diabetics to

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Speaker 2: better control their sugar levels. What they found is that

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Speaker 2: the more control they were with these GLP ones agonists,

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Speaker 2: they are and these were some of the early ones

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Speaker 2: that were called saxender and seven glue tied and some

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Speaker 2: of the other ones. As NPIC is one of the

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Speaker 2: more recent ones that a lot of people talk about

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Speaker 2: with regards to a GOOV and so quickly it became

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Speaker 2: something more than just for type two diabetics. It became

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Speaker 2: an option that helped lots of people to lose weight,

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Speaker 2: and then that went on for a few years now.

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Speaker 2: Initially there was some really cool big studies that look

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Speaker 2: at this. The problem when you look at lots of

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Speaker 2: different studies is that you need some different types of

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Speaker 2: endpoints and we talk about the levels of clinical trial

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Speaker 2: and the amount of people in the trials, and whenever

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Speaker 2: I'm talking about clinical trials in general, I always go

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Speaker 2: who's funding them? Number one? That's what I think about first,

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Speaker 2: who makes money from them? Second, because then you can

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Speaker 2: kind of work out who and what is to gain

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Speaker 2: from it. And fortunately are unfortunately a lot of the

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Speaker 2: clinical trials initially were done by their companies because they're

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Speaker 2: the ones that are going to be making the money.

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Speaker 2: And so what they did show is that people lost weight.

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Speaker 2: And so we really focused, at least initially on these

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Speaker 2: people dropping huge amounts of weight because they'd go on

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Speaker 2: these medications and completely suppress their appetite. The issue being

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Speaker 2: from my point of view is I don't think that

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Speaker 2: evolution would have done away with our appetite had it

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Speaker 2: not been necessary and certainly not necessary for us to

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Speaker 2: eat a certain amount of protein and things throughout as well.

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Speaker 2: And so at least initially, lots of people did lose weight,

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Speaker 2: but they lost weight and they lost a lot of muscle,

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Speaker 2: a lot of bone, and yeah, they lost some fat

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Speaker 2: as well. And so the problem for me is a

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Speaker 2: practition that works in this space that really tries to

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Speaker 2: help people to move from a position of kind of

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Speaker 2: poor health into something that is potentially a less fat

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Speaker 2: version of you whilst trying to keep the muscle and

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Speaker 2: everything else going a version of health in the future.

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Speaker 2: I never want you to put you on a medication

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Speaker 2: and take you from one end point to another and

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Speaker 2: you might drop a third of your weight but still

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Speaker 2: being just as worse, just as bad health potential. And

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Speaker 2: so the real interest around these medications that for the

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Speaker 2: last while has really been around do they have other

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Speaker 2: hard end when it's other than just weight loss? Is

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Speaker 2: there different effects around brain health and liver and other organs.

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Speaker 2: Pancreatic effects, are their reductions in heart attacks and strokes,

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Speaker 2: and reductions in dementia and kidney failure, all these other

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Speaker 2: phase three trials that take a lot longer than just

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Speaker 2: going oh, in the first year, you dropped twenty something

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Speaker 2: percent of your body mass, but does it actually help

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Speaker 2: you live longer? And I think that that's where we're

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Speaker 2: getting to at the moment with these medications. And I

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Speaker 2: would suggest that if you're looking at these, if you're

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Speaker 2: having trouble losing weight, have a chat to a doctor.

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Speaker 2: But also I think there's some really interesting data on

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Speaker 2: a lot of practitioners prescribing these in an off label way,

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Speaker 2: so they're prescribing microdoses because they're finding that patients are

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Speaker 2: getting benefits without just the weight loss, so they're getting

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Speaker 2: benefits with inflammation and a range of other things.

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Speaker 1: Are they drugs that you're spaced to go on for

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Speaker 1: six months and then go off or are they drugs

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Speaker 1: that you're supposed to sit on for a long long time?

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Speaker 2: Great question. We initially thought that they would be probably

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Speaker 2: medications that you would go on for a brief period

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Speaker 2: of time and come off again. I think the problem

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Speaker 2: is is that when I talk to patients, I talk

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Speaker 2: about set points. If your set point has been that

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Speaker 2: you've been thirty or forty kilos more for the last

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Speaker 2: ten or fifteen years, then even if I rapidly drop

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Speaker 2: your weight down twenty or thirty kilos, your set point

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Speaker 2: if you come off this medication is still going to

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Speaker 2: be such that your body is used to being at

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Speaker 2: that bigger weight. And so a lot of people started

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Speaker 2: to put weight back on again when they came off it.

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Speaker 2: And I think this is because we really did it

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Speaker 2: too rapidly. We certainly didn't give patients enough information around

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Speaker 2: maintaining muscle mass and protein. Like I tell my patients,

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Speaker 2: if you're losing more than five hundred grams a week

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Speaker 2: after the first four to six weeks, if you're losing

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Speaker 2: more than five hundred grams a week, you are losing muscle.

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Speaker 2: You're not losing just fat. Generally speaking, you need to

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Speaker 2: have And this is a little bit controversial, but I

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Speaker 2: can't see anything wrong with going between one and a

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Speaker 2: half and two grams of protein per kilogram per day

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Speaker 2: for almost everybody. I think that the general amounts that

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Speaker 2: we say in our guidelines around dietary guidelines are far

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Speaker 2: too low, especially for people who are getting above fifty

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Speaker 2: and sixty. And so my suggestion with people is to go, well,

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Speaker 2: if this has been an issue for a while, we

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Speaker 2: want to try and fix it. A nice talk about this,

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Speaker 2: whether it's for weight loss, anxiety, sleep, skin, hair, whatever

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Speaker 2: it is. Wherever your baseline that I meet you at,

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Speaker 2: and then as we slowly move you back into a

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Speaker 2: healthier target range, that period will hopefully be reasonably fast,

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Speaker 2: but we need to keep you at that healthy range

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Speaker 2: for a while to start to move your set point

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Speaker 2: back to that range. And I think a lot of

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Speaker 2: people forget that. They think, oh great, I'm just going

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Speaker 2: to lose twenty or thirty kilos bam, and then they're

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Speaker 2: going to be really happy and healthy. But reality is

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Speaker 2: they lose a lot of their muscle mass, their bones, strength,

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Speaker 2: and often they're in osteoporosis and have a lot of

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Speaker 2: other issues.

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Speaker 1: Okay, I was reading about JLP one drugs in kind

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Speaker 1: of the next generation coming online, and if we'll bring

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Speaker 1: it back to something vaguely related to business, I mean,

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Speaker 1: no and a disc Its share price went through the

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Speaker 1: roof and then dropped. Eli A Lellies sort of has

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Speaker 1: maintained its share price. But the reason nomen nor disc

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Speaker 1: came is the fear of competitors, particularly the next generation

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Speaker 1: competitors actually being better than its GLP one drugs that

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Speaker 1: next generation are they addressing some of these sorts of

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Speaker 1: things that you're talking about or why? I mean, is

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Speaker 1: it the side effects that GLP the next generation don't

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Speaker 1: have so you're not feeling so unwell? What is it

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Speaker 1: about those drugs?

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Speaker 2: One, they're targeting more receptors, so we're finding that there's

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Speaker 2: actually multiple types of GLP on GLP one RECEPTORSJLP and

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Speaker 2: GLP one receptors across the body, and they're found in

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Speaker 2: all different parts from muscle cells and they can help

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Speaker 2: to depending if you can stimulate it, to help to

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Speaker 2: improve your insulin sensitivity, grab more glucose from the bloodstream.

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Speaker 2: They can also help with potentially with neuronal firing and

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Speaker 2: settling down a lot of different nerve conduction issues and

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Speaker 2: also hopefully prevent and reduce some of the sugar spikes

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Speaker 2: and things that go on in our brains. And so

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Speaker 2: I think it's a really fascinating thing. I mean, other

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Speaker 2: than your podcast, I definitely probably only ever listened to

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Speaker 2: The Economist, and it is fascinating around the economy side

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Speaker 2: of these things, how much a new competitor coming into

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Speaker 2: the market has to play. And from medical point of view,

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Speaker 2: I'm a bit excited about them coming in, even though

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Speaker 2: these companies are literally spending billions of dollars trying to

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Speaker 2: block them in courts, because some of the parameters they've

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Speaker 2: found have been more effective. So one of them products

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Speaker 2: coming out soon, which is kind of a phase A

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Speaker 2: fourth generation for want of a better term. So the

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Speaker 2: first generation where the old yucky ones which we learned

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Speaker 2: from second generation. We've kind of learned from it. And

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Speaker 2: if you think, I don't know if you've ever watched

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Speaker 2: Alien versus Predator or anything like that, but certainly as

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Speaker 2: you put more research in and as you've got better

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Speaker 2: results and more money in there, you can kind of

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Speaker 2: come up with better versions. I think I'm probably talking

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Speaker 2: about Terminator maybe more than one of the other ones. Anyway,

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Speaker 2: the point being that the newer they come out, they

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Speaker 2: seeming to have less effect on some of the receptors,

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Speaker 2: especially in the stomach that are causing nauseaurine constipation, having

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Speaker 2: more systemic effects that are kind of causing better results

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Speaker 2: across all of the body. And certainly the majority of

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Speaker 2: my patients all want it. I mean, I always say

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Speaker 2: I don't do weight loss. It's not my thing. I

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Speaker 2: do fat loss. I do weight management, and a lot

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Speaker 2: of my patients are after weight management and fat loss.

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Speaker 2: And it's a really big thing that you have to

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Speaker 2: look at and go, well, if you want to do

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Speaker 2: this safely, we're going to do it. Are we going

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Speaker 2: to lose fat slowly? Okay? But at the same time,

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Speaker 2: when you're doing these medications, we're also going to be

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Speaker 2: targeting and hopefully helping brain health and liver function and

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Speaker 2: preventing heart attacks and things. And I think this is

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Speaker 2: where the question will be, do we stay on microdoses

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Speaker 2: of them long term? Because currently all of the prescribed doses,

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Speaker 2: all of the TGA approved doses are for diabetics and

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Speaker 2: are for weight loss. Well, if you're not after weight loss,

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Speaker 2: if you're after some of these other parameters, how do

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Speaker 2: you go about it? How do you find a practitioner

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Speaker 2: that's willing to prescribe off label for this type of medication?

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Speaker 1: I mean, just just wrapping this up, doctor Zach, it

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Speaker 1: sounds like we're kind of you know, it's it's not

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Speaker 1: quite a child, perhaps a teenager these types of drug,

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Speaker 1: and there's lots more maturation to go before we really

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Speaker 1: work out the pros, the full pros and cons and

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Speaker 1: how they should be used. They're not used, and particularly

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Speaker 1: for investors, not that we're an investment podcast, but in

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Speaker 1: terms of you know, the products coming out and somehow

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Speaker 1: trying to relate this back to fear and greed obviously,

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Speaker 1: but yeah, we've still got a ways to go. Is

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Speaker 1: the point with these strokes to work out the and.

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Speaker 2: Cons exactly right, there's a way to go, there's going

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Speaker 2: to be increasing improvements in them, and I guess if

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Speaker 2: you're wanting if you're someone that wants to invest in

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Speaker 2: your health, I always say, look, it's about being healthy

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Speaker 2: and wealthy, and it's difficult to separate each from the other.

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Speaker 2: But if you're looking at some long term health benefits,

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Speaker 2: I'm thinking that this is going to be something to

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Speaker 2: really watch, at least in an off label prescribing technique

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Speaker 2: where you are really cautious about that that the weight loss,

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Speaker 2: keeping just on the fat loss, but you're really using

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Speaker 2: it to help reduce inflammation and sugar spikes across your body,

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Speaker 2: which will then help with brain health, cutio vascular health,

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Speaker 2: and a range of other things.

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Speaker 1: Doctor Zach, thanks for talking to Fearing Greed.

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Speaker 2: Thank you so much.

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Speaker 1: There's doctor Zach Turner, medical commentator, doctor and biomedical fantist.

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Speaker 1: I'm sure a man.

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Speaker 2: This is Fearing Greed Q and a