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The Lead: Muscle Growth Drug Could Reduce Lean Tissue Loss with Weight Loss InjectionsA drug that promotes muscle growth could significantly reduce the loss of lean body mass when using slimming jabs, research suggests. While GLP-1 based jabs such as Wegovy and Mounjaro have proved highly effective at helping people who are overweight or obese, experts have warned it is not only fat that is lost.Breakthrough in Combining Muscle Preservation with Weight LossStudies suggest 25-40% of total weight loss from GLP-1 drugs is due to a reduction in lean body mass – non-fat components of the body, including muscle. The authors of the study said this mattered because lean body mass was important for physical strength and overall health. It burns more calories than fat tissue and is linked to a lower risk of type 2 diabetes.Now a small trial has suggested the use of a monoclonal antibody called apitegromab can help retain lean body mass when losing weight with tirzepatide – the drug found in Mounjaro. Apitegromab works by blocking myostatin, a protein involved in inhibiting muscle growth.Clinical Trial Results Show Significant Muscle RetentionWriting in the journal Nature Medicine, researchers in the US reported how they randomly divided 102 participants into two groups, with 51 given apitegromab alongside tirzepatide, and the other 51 given a placebo with tirzepatide.The trial, which was funded by the apitegromab producer Scholar Rock, revealed after 24 weeks that total weight loss was similar for the two groups. However, participants given apitegromab alongside tirzepatide lost on average 1.6kg (3.5lb) of lean mass (corresponding to 14.6% of total weight loss) while those given apitegromab alongside a placebo lost on average 3.5kg of lean mass. In other words, the use of apitegromab was associated with a 55% greater retention of lean mass relative to placebo.The team added that the number of people experiencing side-effects were similar between the two groups, with most deemed to be mild. However, the study has limitations, including that most participants were women and the study was small and short in duration.Addressing a Critical Limitation of Current Weight Loss TreatmentsProf Alexander Miras, an obesity expert at Ulster University who was not involved in the work, described the findings as very important, noting that while GLP-1s had been associated with improved 'functionality' – meaning it was easier to carry out everyday activities – they had also been associated with a loss in muscle mass and strength.'This means that [people] may be less able to lift heavy weights, for example, or walk up a hill,' Miras said. 'This new medication may help reduce the effects of GLP-1-based drugs on muscle strength and therefore improve functionality even further compared to someone not on the new medication who is just taking tirzepatide.'Prof Naveed Sattar, a cardiometabolic medicine expert at the University of Glasgow, said far larger-scale and longer trials were now needed, not least to check safety.'This is an early-stage trial that suggests novel drugs can help mitigate muscle mass loss with prescribed tirzepatide. However, it's too early to say whether this actually benefits peoples health or ability to move or function better,' he said.Future Directions for Weight Loss Therapies'In the meantime, people prescribed these drugs should be supported to increase their physical activity, as this can help maintain muscle mass in a physiological way. Importantly, activity should also be framed as something enjoyable and sustainable, rather than purely as a medical add-on,' Sattar added.

A phase‑3 trial of retatrutide, a once‑weekly triple‑hormone injection, showed patients with type 2 diabetes cut HbA1c by up to 1.9 percentage points and shed up to 15 % of body weight after 40 weeks.Triple‑Hormone Mechanism Sets Retatrutide ApartThe drug combines analogues of GLP‑1, GIP and glucagon, targeting appetite, glucose regulation and energy expenditure simultaneously. Unlike Ozempic or Wegovy (GLP‑1 only) and Mounjaro (GLP‑1 + GIP), the added glucagon activity aims to boost metabolic rate.Trial Numbers Reveal Double‑Digit HbA1c Cuts and 15% Weight Loss930 adults with type 2 diabetes, BMI ≥ 23, not on other diabetes meds.Randomised to 4 mg, 9 mg or 12 mg retatrutide or placebo for 40 weeks.HbA1c reduction: 1.7‑1.9 pp vs 0.8 pp placebo.Weight loss: 11.5‑15.3 % vs 2.6 % placebo.Improvements in cholesterol and blood pressure observed.Serious adverse events in 14 participants (including 2 on placebo); most side effects were mild gastrointestinal issues.Potential Shift in Diabetes‑Obesity Treatment LandscapeExperts say the dual impact on glycaemic control and weight could reshape management pathways. Dr Kath McCullough (Royal College of Physicians) called the results “life‑changing,” while Dr Marie Spreckley (University of Cambridge) cautioned that head‑to‑head data against existing agents are still needed.For health systems such as the NHS, a drug delivering both outcomes may reduce long‑term cardiovascular complications and associated costs, but pricing and safety profiles will drive adoption.Next Steps: Head‑to‑Head Comparisons and Long‑Term SafetyFurther phase‑3 studies are planned to compare retatrutide directly with semaglutide and tirzepatide. Regulators will scrutinise the balance of metabolic benefits against gastrointestinal adverse events before approval.

A new large‑scale randomized trial presented at the European Congress on Obesity in Istanbul indicates that the oral GLP‑1 antagonist orforglipron can help patients retain the majority of weight lost with injectable therapies such as tirzepatide (Mounjaro) and semaglutide (Wegovy).Trial Shows Oral Orforglipron Preserves Most Weight After Switching from InjectablesThe study, funded by Eli Lilly, followed 376 US patients who had been on tirzepatide or semaglutide injections for 72 weeks and then randomized them to a daily orforglipron tablet or placebo for an additional year.Participants were previously on weekly GLP‑1 jabs that typically produce 15‑20% body‑weight loss.After the injection phase, subjects were switched to oral therapy or placebo for 12 months.Primary endpoint: proportion of weight loss retained at 12 months.Quantitative Outcomes: 75% vs 49% Retention for Tirzepatide Users, 80% vs 38% for Semaglutide UsersWeight‑loss maintenance differed markedly between the pill and placebo groups:Tirzepatide cohort: 75% of lost weight retained with orforglipron vs 49% with placebo.Semaglutide cohort: 80% retained with the pill vs 38% with placebo.Secondary benefits—blood pressure, cholesterol, and glycaemic control—were also sustained in the pill arm.Implications for Obesity Management and Healthcare CostsExperts highlighted the broader significance:Dr Louis Aronne (Weill Cornell Medicine) emphasized that treating obesity directly can simultaneously improve glucose, lipid, and blood‑pressure metrics.Dr Marie Spreckley (University of Cambridge) noted patient preference for oral therapy due to convenience, storage, and lower cost.Dr Simon Cork (Anglia Ruskin University) warned that injectable GLP‑1 drugs, while highly effective, are expensive and limit long‑term accessibility for both private payers and the NHS.The findings suggest a potential shift toward oral agents that maintain efficacy while reducing financial and logistical burdens.Future Outlook: Oral GLP‑1 Therapies Could Redefine Chronic Obesity CareIf further trials confirm these results, orforglipron could become a cornerstone of chronic obesity management, enabling earlier intervention (BMI 25‑27) and possibly preventing progression to severe obesity.Regulators and payers will likely scrutinize cost‑effectiveness models, but the prospect of a cheap, daily tablet that sustains weight loss may reshape treatment algorithms worldwide.

Peptides are short chains of amino acids that naturally occur in the body, acting as hormones such as insulin, oxytocin and vasopressin, or as fragments released during protein digestion.In recent years, a wave of interest has turned these molecules into purported therapeutic agents for everything from weight loss to anti‑ageing and tissue repair. Prescription drugs like semaglutide (Wegovy) and tirzepatide (Mounjaro) are synthetic peptides that have undergone rigorous clinical testing and are approved for specific medical uses.However, a large portion of the market consists of unregulated, experimental peptides sold for self‑administration. These products often bypass the strict approval processes required for medicines, raising serious safety concerns.Who is using these products? Initially confined to a niche of powerlifters and bodybuilders in the 2010s, the audience has expanded dramatically. Influential figures such as podcaster Joe Rogan have promoted combinations like the “Wolverine stack” (BPC‑157 and TB‑500) for injury recovery, while other compounds—CJC‑1295, MK‑677, ipamorelin, and GHK‑Cu—are marketed for muscle growth and anti‑ageing. Social media platforms are now flooded with instructions on purchasing and injecting these substances.Scientific backing is scant. Reviews of the literature reveal that most experimental peptides have only been tested in animal or cell models. For example, BPC‑157 shows promise for tendon and muscle repair in pre‑clinical studies, but no randomized human trials have validated these effects. Similarly, TB‑4 and its synthetic analogue TB‑500 have demonstrated limited blood‑vessel formation in laboratory settings, yet human data are absent and both are listed as prohibited substances by the World Anti‑Doping Agency.Researchers also highlight a critical knowledge gap: dosage, frequency and treatment duration remain undefined, making self‑administration a gamble.Legal landscape in the UK is clear that peptides not classified as medicines fall outside the Medicines and Healthcare products Regulatory Agency’s (MHRA) remit. If a seller makes medicinal claims, the product must hold a marketing authorisation under the Human Medicines Regulations 2012. The MHRA warns that labeling items as “research use only” does not shield vendors from enforcement when evidence shows the products are intended for human consumption.Health risks are multi‑fold. Experts caution that benefits observed in animal studies do not guarantee safety in humans. Contamination with harmful impurities or bacterial endotoxins can trigger severe reactions, including septic shock. Injecting excess natural peptides may disrupt the body’s tightly regulated hormonal balance, potentially affecting multiple physiological pathways.There is also theoretical concern that augmenting peptide levels could accelerate tumour growth, as some cancers over‑express certain peptide pathways. While no direct cases have been documented, the possibility underscores the need for caution.Additional dangers include improper injection techniques (e.g., air embolism), unknown interactions with existing medications, and the lack of systematic monitoring of long‑term effects. As one researcher put it, “If something goes wrong, users may never notice until irreversible damage has occurred.”

The UK medicines regulator has opened an inquiry into a growing number of clinics that sell injectable peptides while promoting them as cures for everything from ageing to injury recovery. The investigation, disclosed by the Guardian, focuses on whether these businesses are breaching the Human Medicines Regulations 2012 by making unauthorised medicinal claims. Interest in peptide‑based treatments has surged in recent years, driven by social‑media influencers, some healthcare professionals, and direct‑to‑consumer marketers. Yet the scientific foundation for most of these claims is weak, with the bulk of research confined to animal models or cell‑culture studies. According to an MHRA spokesperson, any clinic that advertises a peptide as having therapeutic benefits must treat the product as a medicine, which triggers a comprehensive regulatory framework. "If clinics offering peptide injections make medicinal claims for those treatments, the products will be considered medicines and subject to regulation," the agency warned, adding that it will act against any identified breaches. Guardian reporters identified several high‑ranking Google search results that list peptides such as Cortexin (promoted for neuroprotection), BPC‑157 (claimed to aid tissue repair), and Thymosin Alpha (advertised to boost immunity). After being contacted, one clinic removed the statements from its website. Another clinic, while acknowledging the limited human evidence, continued to market seven specific peptides, providing price lists (£350 per month for a single peptide, £450 for two) and offering delivery via vials, syringes, or pre‑filled pens for an additional fee. During a free consultation, a clinician highlighted the experimental nature of the products, noting the absence of large‑scale, randomised clinical trials and recommending a break of four to eight weeks between treatment cycles to mitigate unknown risks. The clinician suggested BPC‑157 for post‑exercise recovery, describing it as a facilitator of cellular repair and blood flow, but warned against its use in smokers or individuals with a family history of cancer due to potential angiogenic effects. The second peptide discussed was MOTS‑C, portrayed as a mitochondrial enhancer that could improve stress resilience, lower insulin resistance, and reduce visceral fat by boosting cellular energy production (ATP). The MHRA confirmed it is reviewing whether the clinician’s statements constitute medicinal claims. The clinic defended its approach, emphasizing that it clearly informs clients that the peptides are not licensed medicines and that the evidence base is largely pre‑clinical. In a broader statement, Lynda Scammell, head of borderline products at the MHRA, explained that peptide products may be marketed as cosmetics, supplements, or medicines, and each case is assessed on its intended use, pharmacological effect, and supporting evidence. She added, "We disregard claims that products are for ‘research purposes’ if it is clear that such claims are being used as an attempt to avoid medicines regulations." Peptides are short chains of amino acids, some of which occur naturally (e.g., insulin). While synthetic peptide analogues like semaglutide and tirzepatide have secured approval for weight‑loss treatments, many of the compounds promoted by these clinics remain experimental and lack the rigorous safety and efficacy testing required for medicinal products.