Sceptical rather than excited about the triple agonist, and I would like somebody to talk me out of the scepticism with data rather than enthusiasm.
For anyone tracking the class: GLP-1 alone gets you appetite, GLP-1 plus GIP adds tolerability and lipid handling, and adding glucagon adds expenditure and liver-fat reduction. Each addition also adds a receptor system that can generate side effects.
The question I want answered is why adding glucagon agonism to an anti-obesity drug is not self-defeating, given that glucagon raises blood glucose.
I would rather have one careful answer than five confident ones.
Answering the narrow version, because the broad one does not have a single answer. Order of operations matters more than any single choice here: establish a baseline, change one thing, wait long enough for it to express itself, then measure again under the same conditions.
Happy to go further on any of that.
DanielChem_CHI said:Order of operations matters more than any single choice here: establish a baseline, change one thing, wait long enough for it to express itself, then…
That is correct as far as it goes, and here is where it stops going. The glucagon component looks paradoxical and is not. Glucagon receptor agonism raises energy expenditure and drives hepatic fatty-acid oxidation, and its hyperglycaemic tendency is offset by the GLP-1 arm's insulin secretagogue effect. Net result: intake down from GLP-1/GIP, expenditure up from glucagon, glycaemia neutral or improved. It is a balancing act, and it is why the liver-fat results are the most interesting part of the dataset.
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Browse GL Biochemandrew_nyc said:Sceptical rather than excited about the triple agonist, and I would like somebody to talk me out of the scepticism with data rather than enthusiasm.
Same pattern here, and in the same order. I had assumed I was the exception until I read this.
Adding the clinical framing, because it changes how the question reads. The mechanism and the magnitude are separate questions. Agreeing that something happens says nothing about whether it happens enough to act on.