Episode 259: What Is a Peptide, Really? GLP-1s, Retatrutide, & the Truth Behind the Hype

[00:00:00] Welcome back to the Back on Track: Achieving Healthy Weight Loss, where I help you get on track and stay on track with your weight loss journey. I'm your host, Dr. Alicia Shelly. So let's get started.

[00:00:27] Welcome back to the Back on Track Achieving Healthy Weight Loss podcast. I'm your host, Dr. Alicia Shelly. Now today, we're going to talk about something that I think has become increasingly confusing in the world of weight management. What exactly is a peptide?

[00:00:45] You've probably heard that word before, whether peptide therapy, peptide injection, weight loss peptides, GLP-1 peptides, and you probably hear it all throughout social media or on somebody's med spa or weight loss clinic. Or maybe someone has even told you that they're taking a peptide because they wanted something more natural than a medication.

[00:01:09] But what does the word peptide actually mean? And is a peptide a vitamin? Is it a supplement? Is it a medication? Is it a GLP-1? Well, those are very different things. And recently, I heard a story that made me realize that we need to talk more about this and kind of demystify all these different names and nomenclatures so that people can understand exactly what they're taking.

[00:01:38] Now, a friend of mine shared a story about a conversation she had with somebody she knew. A year earlier, the person had been interested in losing weight and had considered seeing her to discuss GLP-1 therapy. But ultimately, he decided against it. Essentially, he thought, no, I don't want to take medications, which is fine. I mean, there's a lot of people who are like, I want to do this naturally. I want to just focus on my lifestyle interventions and maximizing that.

[00:02:06] And which is cool. That's fine. But fast forward about a year later, she sees him again and he has lost significant amount of weight. So naturally, they start talking about it and he tells her that he found something that works incredibly well. But according to him, he's not taking one of those medications. He was taking something more natural, a peptide, almost like a vitamin.

[00:02:32] And he could not understand why people would take medications when something like this existed. So she asked him, what are you taking? And he said, Reda. Now, if you are familiar with obesity medicine, you probably already know where this story is going. Reda is short for RETA-trutide. And RETA-trutide is definitely not a vitamin.

[00:02:56] It's not a dietary supplement. It is not simply some natural product that you can compare with taking a multivitamin. Redditrutide is an investigational medication that acts on three different hormone receptors. GIP, GLP-1, and glucagon. And in fact, it is one of the most powerful medications that has been studied to date. It has been shown to reduce weight by 28 percent.

[00:03:26] So definitely stronger than what's already on the market. And when I heard this story, I thought to myself, wow. Here is someone who specifically did not want to take a GOP-1 medication. They said it. They wanted to do it naturally. And now he's taking an investigational medication that actually targets GOP-1 plus two additional receptors. And he thinks it is a vitamin.

[00:03:55] And from our conversation, he was in disbelief when she told him that it is actually a GOP-1. Because he thought he was taking a vitamin. And that's when I realized that we really need to talk about this. Because he's probably not the only person who is confused, who thinks they're taking something more natural. But in actuality, they're taking something different.

[00:04:22] So the question is, what exactly is a peptide? So let's start with the basics. Now, I want you to go back to when you're in high school, when you're in chemistry, or if you took biology and chemistry in college. And I want us to remember the basics. A peptide is essentially a chain of amino acids.

[00:04:45] And remember from Biology Cast, amino acids are the building blocks that our body uses to make peptides and or proteins. When amino acids are linked together in relatively short chains, we call them peptides. And our bodies make peptides naturally. Some peptides function as hormones, as signaling molecules. And they help different parts of your body communicate with one another. And guess what?

[00:05:13] GLP-1 is a peptide hormone. The full name for GLP-1 is glucagon-like peptide 1. So when someone says, I'm taking a peptide, that really doesn't tell us very much. Because peptides are all over, right? They're just amino acid chains in the body. It's almost like you're telling me, I'm taking a chemical. But the question is, which chemical are you taking? Because the word peptide describes the structure of a molecule.

[00:05:41] But it does not tell you that the molecule is a vitamin. It does not tell you whether it's a supplement. It does not tell you whether it is a medication. And it certainly does not tell you whether something is safe. So I want you to remember this. Peptide is a description of chemistry. It's not a safety rating. So let's talk a little bit more about what a GLP-1 is.

[00:06:08] GLP-1 is a hormone that your body naturally produces, primarily in the GI tract, in that stomach, your small intestine, large intestine tract. After you eat, your body releases GLP-1 naturally. And GLP-1 does several things. It helps to stimulate insulin secretion when your blood sugar is elevated. And that insulin brings down your blood sugar. It helps to regulate glucagon. And it slows down gastric emptying.

[00:06:36] And it communicates with areas of your brain to tell you that you're full. So in simple terms, it's one of the signals that your body uses to say, hey, I have eaten and now we're getting full. So let's slow down and stop. Scientists figured out that if we can develop medications that activate that GLP-1 receptor and remain active in the body longer than the naturally occurring GLP-1 does,

[00:07:04] we could use that biology therapeutically to help people with many different things. Not only with weight loss, diabetes, helps with protection for those people who've had a heart attack or stroke. It's helped treat sleep apnea. It's helped protect the kidneys. It has been shown to help with many different things. And it has led to the GLP-1 medications we use today. So yes, GLP-1s exist naturally in our body,

[00:07:31] but that does not mean that the medication in an injection pen is a vitamin or dietary supplement. That medication has been specifically engineered to produce a therapeutic effect. And not all GLP-1s are the same. And here is when things get even more interesting. We often use the term GLP-1 as a shorthand for the entire class of medications, but technically they are not all doing exactly the same thing.

[00:08:01] I think we think of them as one receptor, two receptors, and even three receptors. So when we think of the GLP-1s that target the one receptor, we are thinking about a medication like semaglutide, or we may recognize the brand names Wagovi, Ozimpe, Liraglutide, Ciccenda, Victoza. These are medications that target primarily the GLP-1 receptor or one receptor. So think of GLP-1 as one receptor.

[00:08:30] Now let's think about the medications that target two receptors. This is when you have terzepatide and its brand names are Zephavon and Monjaro. So terzepatide targets two receptors, GIP and GLP-1. And you may hear another term when we describe Zephavon and Monjaro. They're dual agonists, meaning that they target two hormones. And although we commonly put terzepatide in that GLP-1 conversation,

[00:08:58] technically it's a little bit stronger because it targets two hormones, GIP and GLP-1. Now let's look at the medications that targets three hormones. Now this is where we talk a little bit about that friend RETA or RETA-trutide. It targets three receptors, GIP, GLP-1, and glucagon. That is why you may hear RETA-trutide described as a triple agonist.

[00:09:24] So we have one receptor, two receptors, and three receptors. And of course that's why RETA-trutide is a little bit stronger because it is targeting three receptors. And this is why the story that I discussed is so fascinating. Because the person in the story did not want to take a GLP-1 medication. But what he eventually started taking was not somehow less pharmacologically active.

[00:09:49] He was targeting not only the GLP-1 receptor, but two additional receptors, GIP and glucagon. So is RETA-trutide a natural alternative to GLP-1s? No. And I want to be very clear about that. RETA-trutide is not the natural alternative to a GLP-1 therapy. RETA-trutide is a GLP-1-based pharmacotherapy that targets three receptors.

[00:10:18] And when this episode is recorded, RETA-trutide is also an investigational medication. Which means it's being studied in clinical trials, but it has not been FDA approved for general clinical use. That distinction is extremely important. Because if you are obtaining something that somebody tells you is RETA-trutide outside of a clinical trial, there are some very important questions you should be asking.

[00:10:46] Number one, where did this product come from? Who manufactured it? How do you know that what is inside that vial is actually RETA-trutide? And what dose are you receiving? Is it similar to what was studied in the clinical trials? Or is it just basically somebody making it up? How was it stored? Was it room temperature? Was it in the refrigerator? How was it manufactured? Who put this together?

[00:11:14] What was it under appropriate quality standards? And who was medically monitoring you while you're taking it? Those questions matter. Because what if you take this medication that you don't know the answer to any of these questions I just asked you? And you have an allergic reaction. You start having a rash going up your body. Or better yet, you have something, a condition that you can no longer take back. Like, it's important to make sure you're being monitored.

[00:11:43] And the question may say, is RETA-trutide or is these medications natural? And I want to spend a minute on the word natural. Because the word has become incredibly powerful in health and wellness marketing. Sometimes we automatically associate natural with being good. Synthetic with being bad. Supplements with being safe. Medications with being dangerous. But biology does not work that way.

[00:12:10] There are plenty of things found in nature that you absolutely do not want to put into your body. And there are medications developed in laboratories that have saved millions of lives. So the question should not simply be, is this natural? The better question is, what exactly is this? How does it work? What does it do? Has it even been studied yet? Do we know the appropriate dose? And do we know the potential risk?

[00:12:37] And most importantly, is this appropriate for me? And the one thing I would say is that in this world where we have ChatGPT, AI, Gemini Cloud, all these things that can answer questions, they are not your doctors. They don't have a medical degree. Yes, they can synthesize information. But how they apply it to you is the biggest concern.

[00:13:02] So you really need to talk to a clinician who knows you, who knows your history, who knows what medications you've been on in the past that worked or didn't work for you. I realize that people sometimes have a misconception about doctors and they don't feel safe talking to doctors. But you really need to before you take something that's investigational. Like you really need to know that this medication is not going to hurt you.

[00:13:28] And sometimes as doctors, we look at medications who've saved lives. I think statins get a really bad rap because they could have been able to lower people's cholesterol. So it has been shown to improve your risk of developing another heart attack or stroke if you had a heart attack or stroke by 20 percent. So reduce you from dying from that. But people are like, oh, I don't want to take that because that's going to be dangerous. But you're taking an investigational medication you know nothing about.

[00:13:56] And so it concerns me because there are people who are trying to be their own doctors, but they may be setting themselves up for more problems down the line. And when we think about this word peptide, it can be extremely confusing. And this is where I think consumers can get easily lost. Someone may tell you, oh, this is just peptide therapy. And technically that description may be correct.

[00:14:23] But then your brain may need to make a few additional jumps. Peptides. My body naturally makes peptides. All of our bodies naturally make it. Therefore, this is natural. Therefore, it's basically a supplement. Or therefore, it may be safer than medication. But stop right there. Those conclusions do not automatically follow one another. Because remember what I said earlier in this podcast. Peptide describes a type of molecule.

[00:14:52] A chain of amino acids that have been put together and is in the body. It does not tell you whether a product is FDA approved. It does not tell you whether it has been adequately studied. And it does not tell you whether the vial that someone is selling you actually contains what the label says it contains. So let's look at this terminology. FDA approved, compounded, investigational, and research peptides.

[00:15:20] And let's clarify another area that causes a lot of confusion. Those terms are not interchangeable. When we think about FDA approved medications, FDA approved medications have undergone an FDA review for its safety, effectiveness, manufacturing quality, labeling, and approved indications. When a company is putting up a medication to go to the FDA, they spent years studying this.

[00:15:49] They had to have gone through three phases of scientific trials. Phase one, phase two, phase three. And they package all of those different trials and they submit it to the FDA. And usually it takes about six months to go through their review and for them to actually go through all the different studies, asking questions, coming back to the pharmacist to make sure this is safe for human consumption.

[00:16:14] Now, that does not mean that FDA approved medications do not have zero risk. In fact, no medications have zero risk. Even the supplement that you're taking has a risk because it's not pure. Like people have to put chemicals in order to make that capsule. So there's anything that's in that that could also cause you to have a side effect. However, with FDA approved medications,

[00:16:39] there are established standards and data that allow clinicians and patients to have an informed discussion about its potential benefits and risks. So let's talk about compounded medications. So compounded medications do have important roles in medicine. It has been used not just in the weight management treatment, but in other areas. However, compounded medications are not FDA approved medications. And you need to be very clear about that.

[00:17:08] The FDA does not review compounded medications for safety, effectiveness and quality before they reach patients in the same way it reviews an FDA approved drug. In fact, the FDA does not monitor any compounded medication. So they are created by a compounded pharmacist who is compounding the medications themselves. And each pharmacy, not necessarily their own different standard, but they have their own different way of putting it together.

[00:17:37] It's similar, but it's not the exact same as the FDA approved medication. And that distinction matters. And so let's talk about investigational medications. These are medications that are still being studied, which redditrutide, when I'm recording this, currently falls into that category. And being investigational does not mean a medication is necessarily bad or ineffective. Quite the opposite.

[00:18:03] Some investigational medications may eventually become incredibly important treatments. But until the clinical trials are completed and regulators have reviewed the totality of the evidence, there are still things we are learning. And then on top of that, you know, you want to make sure you wait until the FDA approves those medications before you attempt them. And so the last category I want to talk about is these research peptides that we see in all these different websites.

[00:18:30] And those products are being sold online as research peptides or for research purposes only or not for human consumption. And if you're purchasing something that literally says it's not for human consumption and then injecting into your body, Houston, we have a problem. A website may look professional. The packaging may look sophisticated. There may be testimonials. But people on social media may swear by it.

[00:18:58] You may have your biggest influencer who is swearing by this product. But none of those things establish what the product claims to be. None of those things tell you if it's safe. And just because an influencer says it's safe, you don't know if they actually took it. You don't know. Just because they took it doesn't mean that you're going to have some type of allergic reaction.

[00:19:24] Just because somebody else says it's great on social media where people lie all the time doesn't mean that it may be great for you. And so it is important that you talk to your doctors to make sure whatever you're putting in your body is safe for you. Specifically safe for you. But you may also be thinking to yourself, but doc, it worked, right?

[00:19:52] You may be thinking, hey, Dr. Shelley, the man in your story lost tons of weight. So it must have worked. Maybe it did. But that's actually a different question. Because something producing an effect does not establish that the product is safe. And the dramatic weight loss does not prove the identity or purity of whatever's in that vial. And I don't know the person, like I said, this is a friend telling me a story. But that guy, what if he had other issues? What if he lost muscle?

[00:20:20] What if he had a lot of vomiting and diarrhea and all that kind of stuff? Like there's things that can go wrong. And, you know, the question that we have to ask ourselves are two separate questions. Is does this molecule potentially work? And do I know what is actually in the product that I'm taking? Those are not the same questions. Because you go to the same company that somebody referred you to. You don't know if what's in that vial is what is in that vial. Is it watered down?

[00:20:48] You know, are they like, you know, having a little bit of a shortage? Or are they just putting some stuff in there and hoping you get the same effect? Like you just don't know. And so one thing I want to leave you with is something very practical. And I'm calling this know before you inject. Because honestly, this applies to whether you're injecting something, swallowing a pill, taking a supplement, or using any other weight management product. Before you take it, ask these questions.

[00:21:15] Number one, what is the exact generic name of what I'm taking? Not just RIDA, not just peptide, not just a GOP-1. What is the actual drug? I remember looking on Amazon. And Amazon is notorious for having companies from like China producing stuff. And the medication was just like GOP-1. That does not tell you the generic name. That doesn't tell you exactly what you're using. It's just a GOP-1.

[00:21:42] And so it's important that you know exactly what you're taking. Number two, is this a medication? Is this a dietary supplement, a compounded medication, or even an investigational product? Look it up of what you're taking. Number three, is this medication FDA approved? And if it's FDA approved, what is it approved to treat? And number four, how does this work? How is this going to affect my body?

[00:22:09] And does it target GOP-1 or GIP or glucagon or something even completely different? And number five, where did this product come from? Did it come from China? Is this a company that is actually in China and they're just producing and just sending products over because they're not really held to the FDA standard? So find out where this is coming from. Who manufactured it? Who dispensed this? Are they qualified to do this, right?

[00:22:37] We go to a pharmacy so we know that they are pharmacy trained. But if you're getting it from some website, who knows what you're getting? Number six, what evidence do we have that it works? Not just testimonials that people can fake. Not just TikTok. Where an influencer who has an affiliate link, who gets money, if you go to that link and buy this product or get something from it. You know, not somebody that's saying, my cousin lost 50 pounds.

[00:23:06] Because, you know, we know in this day and age that AI can say anything. They have taken the likeness of all these different celebrities and made them to say something completely different. How many times do I have a patient come in and saying, well, Oprah is using this or Kelly Clarkson is using that? And it's like, no, this is actually fake. I have to bring it up and show them that what you saw is fake. These people did not say that.

[00:23:35] It's AI changing their words around. Taking that video and changing it around to help them sell that product. And then most importantly, what does the scientific evidence show? Have they done studies looking at this? Number seven, what are the known risks and side effects? And number eight, who is medically monitoring me? Have I asked my doctor who knows me, who knows my history? Is this safe for me?

[00:24:03] And then number nine, if something goes wrong, who do I call? Because these companies that are in China, I don't think you can sue them. There's no jurisdiction here in the US. So who do you call when things go wrong? And last but not least, number 10, if someone is emphasizing that something is natural, do I actually know what I am taking? Because natural should never substitute the actual name of a drug.

[00:24:30] And I really want to take a moment to go back to the story that I started with today. The thing that concerned me most was not that the person was taking Reddit True Tide before his FDA approved, although that was concerning. But the other thing that concerned me was that he apparently did not understand what he was taking. He thought he had avoided medications. He thought he had found a natural alternative. He thought he was taking something that was almost like a vitamin. And those are very different things.

[00:24:59] You deserve to know what you're putting into your body. You do not have to become a pharmacologist to know that. You have people in your corner that can help you make these decisions and educate you on what you're putting in your body. And you do not have to understand every receptor or memorize every clinical trial. But you should understand the basics. You should ask the questions, what am I taking? Why am I taking? And how does it work? And what do we know about the benefits and the risks?

[00:25:28] And where did it come from? Being your own health advocate does not mean that you have to know everything. It means knowing enough to ask the right questions. So if you don't know, ask your doctor. I think I said that about five times this episode. Ask your doctor. Send them a message. Make an appointment. Ask them to explain it to you. And ask them, is this right for me? And remember, if someone tells you, oh, it's just a peptide,

[00:25:55] that should be the beginning of a conversation and not the end of it. Thank you again for listening to this episode of the Back on Track Achieving Healthy Weight Loss podcast. If you found today's episode helpful, share it with a friend who's been hearing all of these terms. GOP-1s, peptides, RETA, compound medications, and trying to figure out exactly what they mean. And don't forget to subscribe so you won't miss any of our upcoming episodes.

[00:26:22] And until next time, stay strong, stay committed, stay consistent. And remember, we are stronger together.