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Can Ozempic end addiction? | Dhruv Khullar | Your Body on Tech
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The Downsides: Cost, Dropout, Muscle Loss, and Unknown Long-Term Effects
At 36:38 · chapter starts 34:55
When Manoush asks for the downsides, Khullar gives a thorough and balanced accounting. The adherence problem is fundamental — drugs only work if you take them, and more than half of patients stop within a year. Cost is a real barrier at up to $1,300 a month without insurance coverage. GI side effects may affect more people in the real world than clinical trials suggest. Muscle loss is clinically significant: rapid weight reduction strips away lean mass, increasing frailty risk, which is why Khullar recommends GLP-1 use be paired with high-protein diet and strength training [1] — Dhruv Khullar "More than half of patients stop GLP-1 medications within a year, whether from side effects, cost, or access. The sticker price can hit $1,3…" 31:50 . On long-term effects, he draws reassurance from the fact that exenatide, the first GLP-1 drug, launched around 2005–2006, giving the class a roughly 20-year track record — but acknowledges newer formulations may carry risks yet to surface.
The first GLP-1 medication (exenatide) was approved around 2005–2006, meaning these drugs have a roughly 20-year safety track record, providing some reassurance about long-term effects.
When a drug is powerful enough, it becomes tempting to stop addressing the social root causes — poverty, loneliness, trauma, the food environment — that produce the problem in the first place. Khullar worries that widespread GLP-1 use could reduce pressure to fix broken food systems and built environments. But he also acknowledges we've been failing at that work for decades, and people need help today.
