In the beginning, weight loss was just a side effect. GLP-1 RAs were first developed to treat type 2 diabetes; their hormone-mimicking action provokes insulin production. In 2005, the US Food and Drug Administration approved the first drug of this kind, Exenatide, for diabetics. Throughout the 2000s, more and more GLP-1 RAs came onto the market. Right away, patients noticed that these drugs didn’t just treat their diabetes—they also helped them lose weight.
Ozempic and Wegovy, the brand names of a GLP-1 RA known as semaglutide, are both made by Novo Nordisk, a Danish pharmaceutical company. Though they both contain the same active ingredient, the drugs have different indications, dosages, prescribing information, titration schedules, and delivery devices. In 2017, Ozempic was first approved as a diabetes treatment, and doctors soon began to prescribe it off-label to overweight patients. Subsequently, Novo Nordisk developed Wegovy specifically for weight loss. In June 2021, it became the first new treatment for chronic obesity approved by the FDA since 2014.
Then, in May 2022, the FDA approved Mounjaro as a diabetes treatment; now the agency is officially “fast-tracking” the investigation of its active ingredient, tirzepatide, for obesity. A spokesperson for the drug’s manufacturer, Eli Lilly, said it is presently only approved for glycemic control in adults with type 2 diabetes and the company “does not promote or encourage use of Mounjaro outside of its FDA-approved indication.” Nonetheless, since the drug came to market, doctors have been prescribing it off-label for weight loss—there are almost 100,000 members in a Facebook group called “Mounjaro Weight Loss Success.”
Clinical trials have shown that tirzepatide patients lose at least 20% of their weight in 72 weeks, while overweight adults on Wegovy lose an average of 15% of their body weight in 68 weeks.
Edenfield is one such success story. Unable to work at the height of the pandemic, he had stayed at home “eating a lot and eating very unhealthy.” He compares his diet to a teenager’s: regular consumption of fast food sandwiches, cheese steaks, and burgers accompanied a “crippling addiction” to Coca-Cola. When his weight crept up to 357 pounds (he is 6 feet 3 inches tall), he sought gastric sleeve surgery because his employer would cover the cost. Yet the doctor he met with suggested Ozempic instead. He lost 15 pounds in his first month on the drug and switched to Wegovy in February 2022. He now weighs 228.
COURTESY OF MICHAEL EDENFIELD
“It’s changed every aspect of my life,” Edenfield says—he no longer feels “hijacked” by hunger and doesn’t get out of breath walking to work. “I feel like I’m in my 20s again,” he says.
The results may be enviable, but the day-to-day reality of weight-loss injections is not always pleasant. The most common side effects are gastrointestinal, including nausea, diarrhea, and constipation. Edenfield consulted Reddit for tips on alleviating “brutal” nausea. A number of subreddits dedicated to semaglutide have sprung up or grown in popularity over the last year—the one Edenfield posted on was created in 2021 and has almost 22,000 members today. Meanwhile, countless Facebook groups have also been created during the weight-loss injection boom. Here, people report experiencing vomiting, headaches, fatigue, “sulfur burps,” and hair loss—though the vast majority seem to feel it’s a small price to pay for losing weight.
During the 68-week Wegovy trial, 4.5% of participants discontinued treatment because of gastrointestinal events. Peter Kurtzhals, Novo Nordisk’s chief scientific advisor, says that such side effects normally decline gradually as patients build up a tolerance to the drug. A company spokesperson adds that patients experiencing nausea on Wegovy “should contact their health-care provider, who can offer guidance on ways to manage it.”
The Frost nails its uncanny, disconcerting vibe in its first few shots. Vast icy mountains, a makeshift camp of military-style tents, a group of people huddled around a fire, barking dogs. It’s familiar stuff, yet weird enough to plant a growing seed of dread. There’s something wrong here.
Welcome to the unsettling world of AI moviemaking. The Frost is a 12-minute movie from Detroit-based video creation company Waymark in which every shot is generated by an image-making AI. It’s one of the most impressive—and bizarre—examples yet of this strange new genre. Read the full story, and take an exclusive look at the movie.
—Will Douglas Heaven
Microplastics are everywhere. What does that mean for our immune systems?
Microplastics are pretty much everywhere you look. These tiny pieces of plastic pollution, less than five millimeters across, have been found in human blood, breast milk, and placentas. They’re even in our drinking water and the air we breathe.
Given their ubiquity, it’s worth considering what we know about microplastics. What are they doing to us?
The short answer is: we don’t really know. But scientists have begun to build a picture of their potential effects from early studies in animals and clumps of cells, and new research suggests that they could affect not only the health of our body tissues, but our immune systems more generally. Read the full story.
Here, bits of plastic can end up collecting various types of bacteria, which cling to their surfaces. Seabirds that ingest them not only end up with a stomach full of plastic—which can end up starving them—but also get introduced to types of bacteria that they wouldn’t encounter otherwise. It seems to disturb their gut microbiomes.
There are similar concerns for humans. These tiny bits of plastic, floating and flying all over the world, could act as a “Trojan horse,” introducing harmful drug-resistant bacteria and their genes, as some researchers put it.
It’s a deeply unsettling thought. As research plows on, hopefully we’ll learn not only what microplastics are doing to us, but how we might tackle the problem.
Read more from Tech Review’s archive
It is too simplistic to say we should ban all plastic. But we could do with revolutionizing the way we recycle it, as my colleague Casey Crownhart pointed out in an article published last year.
We can use sewage to track the rise of antimicrobial-resistant bacteria, as I wrote in a previous edition of the Checkup. At this point, we need all the help we can get …
… which is partly why scientists are also exploring the possibility of using tiny viruses to treat drug-resistant bacterial infections. Phages were discovered around 100 years ago and are due a comeback!
Our immune systems are incredibly complicated. And sex matters: there are important differences between the immune systems of men and women, as Sandeep Ravindran wrote in this feature, which ran in our magazine issue on gender.
Artists are often the first to experiment with new technology. But the immediate future of generative video is being shaped by the advertising industry.Waymark made The Frost to explore how generative AI could be built into its products. The company makes video creation tools for businesses looking for a fast and cheap way to make commercials. Waymark is one of several startups, alongside firms such as Softcube and Vedia AI, that offer bespoke video ads for clients with just a few clicks.
Waymark’s current tech, launched at the start of the year, pulls together several different AI techniques, including large language models, image recognition, and speech synthesis, to generate a video ad on the fly. Waymark also drew on its large data set of non-AI-generated commercials created for previous customers. “We have hundreds of thousands of videos,” says CEO Alex Persky-Stern. “We’ve pulled the best of those and trained it on what a good video looks like.”
To use Waymark’s tool, which it offers as part of a tiered subscription service starting at $25 a month, users supply the web address or social media accounts for their business, and it goes off and gathers all the text and images it can find. It then uses that data to generate a commercial, using OpenAI’s GPT-3 to write a script that is read aloud by a synthesized voice over selected images that highlight the business. A slick minute-long commercial can be generated in seconds. Users can edit the result if they wish, tweaking the script, editing images, choosing a different voice, and so on. Waymark says that more than 100,000 people have used its tool so far.
The trouble is that not every business has a website or images to draw from, says Parker. “An accountant or a therapist might have no assets at all,” he says.
Waymark’s next idea is to use generative AI to create images and video for businesses that don’t yet have any—or don’t want to use the ones they have. “That’s the thrust behind making The Frost,” says Parker. “Create a world, a vibe.”
The Frost has a vibe, for sure. But it is also janky. “It’s not a perfect medium yet by any means,” says Rubin. “It was a bit of a struggle to get certain things from DALL-E, like emotional responses in faces. But at other times, it delighted us. We’d be like, ‘Oh my God, this is magic happening before our eyes.’”
This hit-and-miss process will improve as the technology gets better. DALL-E 2, which Waymark used to make The Frost, was released just a year ago. Video generation tools that generate short clips have only been around for a few months.
The most revolutionary aspect of the technology is being able to generate new shots whenever you want them, says Rubin: “With 15 minutes of trial and error, you get that shot you wanted that fits perfectly into a sequence.” He remembers cutting the film together and needing particular shots, like a close-up of a boot on a mountainside. With DALL-E, he could just call it up. “It’s mind-blowing,” he says. “That’s when it started to be a real eye-opening experience as a filmmaker.”
