GLP-1s: What's Real, What's Hype, and What's Next

This week's Livelong Women's Circle Studio Session welcomed Dr. Kathleen Jordan, Chief Medical Officer at Midi Health and a Menopause Society Certified Practitioner, for a conversation on what GLP-1 medications are actually doing in the body, and where the science is racing ahead of the headlines.

GLP-1s came to market as diabetes drugs more than 15 years ago, long before weight loss entered the conversation. Since then, the FDA has added indications for obesity, sleep apnea, and fatty liver disease, and Dr. Jordan says the next wave is already underway. She groups the most exciting emerging research into three categories: these drugs decrease inflammation, appear neuroprotective, and improve addiction and compulsive behaviors. Three areas, she noted, where medicine has historically had few good tools.

Weight loss lowers inflammation on its own, but that's not the whole story: “even before weight loss occurs, there appears to be a drug effect that... lowers inflammation”, she explained, meaning two separate mechanisms are working at once. That matters for women specifically, since estrogen is anti-inflammatory and inflammation tends to climb as estrogen falls in midlife.

When asked how GLP-1s interact with hormone therapy, Dr. Jordan was direct. For women considering both, she tends “to start hormone therapy first and then do the GLP-1 second because you're gonna get a better response.” She also pointed to trial data linking GLP-1 use to a 20 percent reduction in heart attacks, strokes, and all-cause mortality in patients with diabetes or obesity, while being careful to distinguish that established benefit from the still-unproven question of whether healthy people should take these drugs for longevity alone.

On safety, Dr. Jordan called GLP-1s very safe overall, with pancreatitis as the main tangible risk. (And even that is rare, showing up in fewer than a handful of cases across tens of thousands of prescriptions). On dosing, the goal isn't to stay at the highest FDA-approved dose forever: most patients do best titrating down to the lowest effective dose once they hit their health goal.

She also weighed in on the microdosing debate, whether GLP-1s could ever be called a longevity drug for healthy people, and early research into psoriasis and autoimmune disease, all covered in the full conversation.

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Dr. Jordan will be going further on this topic at the NYC Livelong Women’s Health Summit next month. Catch her session — All Things GLP-1s: The Landscape and What It Means for You — on Saturday morning.

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