Because Good Medicine Deserves Better Explanations
At first, they were diabetes drugs.
GLP-1 receptor agonists—liraglutide, semaglutide, and later tirzepatide—were developed to help patients with type 2 diabetes regulate blood sugar. They mimicked a gut hormone, GLP-1, that modulates insulin, glucagon, and gastric emptying. They also acted on the brain.
Appetite went down.
Weight came off.
And people noticed.
We’ve become a society defined by distraction, acceleration, and mental erosion. The fog isn’t a glitch. It’s the weather report.
Not long ago, I saw a 58-year-old man who had done “everything right.” His LDL cholesterol (LDL-C) was well controlled on a statin, his blood pressure stable, and he exercised regularly. But he carried extra weight around his waist, his triglycerides were persistently high, and a CT scan revealed clear signs of atherosclerosis in his … Read more
He knew it was coming. The way a storm announces itself in the bones.The way a man knows the land he’ll die on. Lyndon Baines Johnson had already faced the thing most men spend their lives avoiding: death. It had gripped his chest, dropped him to the bedroom floor of his Texas ranch, and whispered … Read more
In cardiovascular medicine, some numbers are sacred. LDL-cholesterol (LDL-C) has long been the cornerstone of risk assessment and treatment targets. But what if we’ve been following the wrong number? This updated article revisits and expands on a piece I wrote in 2021 — enriched by new evidence, deeper clinical insights, and a clearer understanding of … Read more