Mechanism
How GLP-1 drugs actually work
Slower gastric emptying, hypothalamic satiety signalling, and why "it just makes you eat less" is both true and incomplete.
Keine Vorher-Nachher-Bilder, keine Influencer. Nur die randomisierten Studien, die Effektgrößen und die Teile, die das Marketing weglässt – jede Behauptung verlinkt mit ihrem PubMed-Eintrag.
Each page answers one question and shows its working. If you only read one, read the page on stopping — it is the finding that changes how you should think about the whole class.
Mechanism
Slower gastric emptying, hypothalamic satiety signalling, and why "it just makes you eat less" is both true and incomplete.
Drug
STEP 1 through STEP 5, SELECT, and the head-to-head against tirzepatide.
Drug
SURMOUNT-1 and -2, sleep apnoea, heart failure, and the largest weight losses recorded for a drug.
Body composition
Roughly a quarter to a third of the weight lost is lean mass. Whether that matters is a harder question.
Safety
Nausea is near-universal and usually transient. The rare events are rarer than the coverage suggests.
Durability
Most of the weight comes back within a year. This is the single most important finding in the field.
Outcomes
SELECT found a 20% reduction in major cardiovascular events — in a population that was not diabetic.
Other uses
Where the evidence is strong, where it is emerging, and where it is currently just hope.
Pipeline
Oral semaglutide and orforglipron: same class, no needle, slightly smaller effect.
Intermittent fasting, time-restricted eating and meal timing, judged on the trial data.
Energy expenditure, insulin resistance and metabolic adaptation, without the folklore.
Diets, drugs, behaviour and maintenance — ranked by the strength of the evidence behind them.
Sleep, circadian rhythm and the wearables that claim to measure both.
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