Published intermittently. Always cultural, never prescriptive. Subscribe to the monthly letter to get the next one in your inbox.
The cultural shorthand started in late 2024. Patients report blunted cravings — for food, alcohol, shopping, gambling, even Instagram. The mechanism is real: GLP-1 receptors are densely expressed in reward circuits. Here is the honest cultural read on what is signal and what is anecdote.
Read the essay →Not a ban — the expiration of a temporary legal exception written into a 1997 statute. Who actually lost: not the drugmakers, but the telehealth layer and the patients paying $199 instead of $1,999.
Analysis · Regulatory + policyThe 2026 FDA action closed a grey market that was never technically open. Understanding what changed — and what was always illegal — matters for understanding where this goes next.
Analysis · Clinical dataSELECT showed a 20% relative risk reduction in serious cardiac events. But the trial only enrolled patients with established CVD and no diabetes. Here is what the numbers actually say — and for whom.
Analysis · Clinical dataThe pivotal trials ran 68 weeks. Real-world persistence data shows 23.7% of patients still filling prescriptions at 12 months. The gap between those two numbers is the whole story.
Analysis · Clinical data analysisBulls say it proves the drug keeps working; skeptics say you gain it all back. Both misread the same withdrawal design — and the truth in between is the whole point.
Analysis · Clinical data analysisEveryone quotes 20.9%. The body-composition substudy underneath it quietly settles the "muscle loss" panic — and I think almost everyone reads it backwards.
Analysis · Clinical data analysisEveryone repeats 24%. I think it is the least interesting figure in the Phase 2 data — and the five that matter are what the TRIUMPH readouts will decide.
Essay · NewFor a century the equation had two terms: diet and exercise. Then a generation woke up and the sentence had a third. An essay on what that third sentence does to a culture.
Cultural · EssayThe cultural phenomenon, the honest read on the neuroscience, and what it means for how we talk about pleasure and motivation in the medicated era.
ReportageWhat it means culturally that the next generation of weight-loss medication is a tablet. How the conversation shifts when the friction of injection disappears.
ReportageEvery wave of medication brings its own cultural ripples. A reportage on what is coming, what it means for the conversation, and the questions the data cannot answer.