# GLP-1s produce weight loss, but long-term effects remain unknown

Markdown copy of https://realalpha.app/s/glp-1s-produce-weight-loss-but-long-term-effects-remain/ on Real Alpha, the best minutes from long interviews with the people building AI. Cite and link the page, not this copy.

- Speaker: [Morgan McSweeney](https://realalpha.app/people/morgan-mcsweeney/) · Morgan McSweeney is a pharmaceutical scientist and medfluencer. · Translates medical evidence for the public and advises organizations, including the WHO and White House science office.
- Host: [Neil deGrasse Tyson](https://realalpha.app/people/neil-degrasse-tyson/)
- Host: [Chuck Nice](https://realalpha.app/people/chuck-nice/) · Comic
- Host: Gary O'Reilly · Comic
- Show: StarTalk
- Episode: [The Science of Looksmaxxing, with Doc Noc](https://realalpha.app/v/ESvls8ZUg58/), Oct 24, 2026
- Moment: 2:29 to 8:11 of the episode (6 min), playing on https://realalpha.app/s/glp-1s-produce-weight-loss-but-long-term-effects-remain/; the episode from there: https://realalpha.app/v/ESvls8ZUg58/?t=149

## Quote

> “what we do know is it **helps people lose weight** if it was medically indicated for them to lose weight.”
> — [Morgan McSweeney](https://realalpha.app/people/morgan-mcsweeney/) at [7:15](https://realalpha.app/v/ESvls8ZUg58/?t=435) · StarTalk

## Takeaways

1. Weight loss can range from 10% to 20%, depending on dose and starting point.
2. McSweeney predicts lower chronic-disease risk from weight loss.
3. He says 20–30-year effects remain unknown.

## About this segment

Morgan McSweeney says GLP-1 drugs can produce 10–20% weight loss and predicts lower disease risk from that. He says effects over 20–30 years remain unknown.

From “The Science of Looksmaxxing, with Doc Noc”, Oct 24, 2026. [Watch the full episode](https://realalpha.app/v/ESvls8ZUg58/)

## Transcript

Transcribed by machine (Whisper) from the episode’s audio, so a word may be off here and there.

[2:42](https://realalpha.app/v/ESvls8ZUg58/?t=162) Nobody wants to go to the gym for six months. They want a pill. They want an injection. And the closest thing we have lately, the GLP-1s. So let's start there. What has that done to the people who are not diabetic, where it was a medicinal treatment for their health condition? You have all kinds of other people injecting themselves. What is the consequence of that on our culture, on our civilization?

[3:10](https://realalpha.app/v/ESvls8ZUg58/?t=190) Yeah, I think there's two things, culturally and medically. Medically revolutionary category of drugs. They are peptide drugs. We can talk about other peptides. Okay, definitely want to go there. Yeah, so it's kind of the knight in shining armor story for peptides, along with insulin was one of them. But, I mean, I think they're a medical revolution. They're going to prevent a huge amount of chronic disease that otherwise never would have been prevented through lifestyle interventions alone.

[3:35](https://realalpha.app/v/ESvls8ZUg58/?t=215) No matter how much you talk about, you've got to get good sleep and physical activity and you've got to eat right. We've seen in practice for decades that even if you know that, it can be very hard to do in the context of real life. And for some people, even impossible, just given their own inability to focus. or, or, or, or, or challenges, everyone's got challenges. Sure, sure. Yeah. And so now to augment, you can, you still do those things, but in combination with these drugs, right, you're going to see huge reductions in chronic disease as a result. So I think that's a very good thing. Culturally, I think it has shifted what it means to lose weight. It's, I don't want to say it's easier now, but you know, with the medicines, it's more likely to happen for a lot of people. There's this familiarity with sometimes injecting yourself with medicines, which many

[4:22](https://realalpha.app/v/ESvls8ZUg58/?t=262) people who previously never took injectable medicines now maybe are with GLP-1s. And maybe some of that familiarity is leading into being comfortable with injecting other things like all the other types of peptides that aren't as well studied. All right. So what about, I mean, I don't want to distract ourselves on this, but I wanted to be there somewhere in the backdrop. Before the GLP-1s, there was a movement to be comfortable in your own body there'd be people overweight but not more positivity body positivity they were not morbidly overweight they're just a little chubby and now you can just get rid of that and are we resorting to the skinny person mindset and the body positivity is no longer a thing i think it's shifting self-perception for sure and so there's two separate things There is the health impact of particularly visceral fat, which is different from the health impact of subcutaneous fat, which is the part you can see in pinch and everything.

[5:20](https://realalpha.app/v/ESvls8ZUg58/?t=320) We need to talk about that because people need to know that the visceral fat is the really dangerous fat. It is. It's the fat that forms around your organs and, you know, which you can't necessarily see from the outside. I can't pinch that. You can't pinch that. Like subcutaneous fat is when you look in the mirror and go, I got a loose weight. Yeah. Yeah. Which is not as much of a health risk. So there's separately sort of the health side of reducing visceral fat is generally good for your health.

[5:47](https://realalpha.app/v/ESvls8ZUg58/?t=347) Totally different from, do I feel good when I look at myself in the mirror? I think what we know very clearly is even people who you would consider to be thin or athletic looking can look in the mirror and still not feel great about themselves. So I think it's a little bit deeper than necessarily just the number on the scale. I think a lot of people struggle with that, especially in the era of Snapchat filters and social media and unrealistic expectations.

[6:11](https://realalpha.app/v/ESvls8ZUg58/?t=371) I think we'll get into the psychology and the imposition of certain body shapes that people say you must adhere to this body shape rather than the one that you have. But take a step back with GLP-1s. How much clinical data is there that we have? Because we're seeing right there, we're there for, as you said, diabetes. We're now looking at it as a weight loss drug and it's sold mainly as a weight loss drug, regardless of your conditions, if you have or haven't any.

[6:38](https://realalpha.app/v/ESvls8ZUg58/?t=398) Do we think there are other downstream benefits Do we think, hang on a minute, this could cause problems, not just have a list of benefits? Yeah, so certainly it's always... When we turn 70, do we grow a second head or something, you know? I like one of those. I mean, if the drug has not been in civilization for more than a certain amount of time, you don't know what that will do as people age beyond that.

[7:02](https://realalpha.app/v/ESvls8ZUg58/?t=422) Right. So what do you know? You know taking these medicines can lead to weight loss on the order of 10%, 20%, depending on where you're starting, depending on your dose. what do we know about carrying, you know, in some cases, extra body weight? It increases your risk for a long list of diseases. We're talking even dementia. People are surprised about that one sometimes. Your cardiometabolic health, which is influenced by your visceral fat, influences your risk for brain disease, obviously for heart disease. And so what we do know is it helps people lose weight if it was medically indicated for them to lose weight. Therefore, we can predict it's probably going to help reduce risk for the long list of chronic diseases that we know are associated with carrying excess weight for a long period of time okay we don't know what will happen

[7:46](https://realalpha.app/v/ESvls8ZUg58/?t=466) in 20 or 30 years but is that enough rationale to wait 20 or 30 years to start taking them when we know there are some concrete benefits we could kind of act on now. I'm going to wait 30 years and then I'll start. So GLP-1 is semaglutide? Am I