The Tyranny of the Average: Why Medicine Struggles With the Individual

He sits across from me, his file glowing on the computer screen. Numbers everywhere: cholesterol edging upward, blood pressure leaning north, a family tree littered with cardiac potholes.
He leans forward, eyes narrowing.
“So, doctor—what are my chances?”
I recite the liturgy: statins cut relative risk by about 25%, blood pressure control lowers stroke risk by 30–40%. Add them up, and the curves bend favorably.
He doesn’t look reassured.
“Yes, but will it happen to me—or not?”

Medicating Appetite: The GLP-1 Dilemma

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.