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The Weekly Dose

The Oral GLP-1 Era Begins — And Five Other Things You Need to Know

Issue #1 · April 27, 2026

6 articles·5–10 min read·Curated weekly

Editor's Note

This was the week the delivery method became the story.

For three years, the GLP-1 conversation has been about the molecules — semaglutide, tirzepatide, retatrutide. Which one works best. Which one hits the most receptors. This week, Eli Lilly changed the subject. The question isn't which GLP-1 anymore. It's whether you need a needle at all.

That's the headline. But underneath it, five other things happened that matter just as much for anyone paying attention to peptide science. The FDA is reconsidering its stance on 12 peptides. Someone finally counted all the BPC-157 studies. Semaglutide keeps accumulating indications that have nothing to do with weight loss. And the stacking conversation got a lot more rigorous.

Here's what you need to know.

The Big One: GLP-1 Goes Oral

On April 1, the FDA approved Eli Lilly's orforglipron under the brand name Foundayo — the first oral GLP-1 receptor agonist that you can take without fasting, without water restrictions, without restructuring your morning around a pill. Once daily. With or without food. That's it.

The clinical data is substantial: 12.4% average body weight loss in 72 weeks (ATTAIN-1 trial), and in a head-to-head against oral semaglutide, orforglipron delivered 73.6% more weight loss (ACHIEVE-3, published in The Lancet). The pricing is aggressive — $149/month self-pay, $25 with commercial insurance.

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The FDA's Peptide Reconsideration

While Lilly was grabbing headlines, a quieter but potentially more consequential development was unfolding at the FDA. The agency is provisionally reconsidering 12 peptides that were placed on the bulk drug substance list — effectively restricting compounding pharmacies from producing them — over the past two years.

This doesn't mean the restrictions are being lifted. It means the FDA is reviewing whether the original decisions were justified. For researchers and clinicians who've been unable to source certain peptides through compounding channels, this is the first sign of movement.

We broke down exactly which 12 peptides are involved and what the review process looks like. [@portabletext/react] Unknown block type "span", specify a component for it in the `components.types` prop

BPC-157: 150 Studies, One Honest Assessment

Someone finally did the meta-work on BPC-157. Not a new trial — a systematic review of the existing evidence base. Over 150 published studies, spanning wound healing, gut integrity, tendon repair, neuroprotection, and cardiovascular function. The preclinical data is remarkably consistent.

The less good news: almost all of that data is from animal models. Human clinical trials remain sparse. The compound sits in an uncomfortable gap — too much evidence to dismiss, too little human data to prescribe.

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Semaglutide's Expanding Resume

Everyone knows semaglutide for weight loss. But the drug keeps accumulating clinical trial data in areas that have nothing to do with the scale. Alzheimer's disease. MASH. Chronic kidney disease. Alcohol use disorder. Heart failure with preserved ejection fraction.

The mechanism is becoming clearer: GLP-1 receptors are expressed throughout the body. When you activate them systemically, you get anti-inflammatory effects, improved endothelial function, and neuroprotection that go well beyond appetite suppression.

We mapped six areas where semaglutide is being studied beyond weight loss. [@portabletext/react] Unknown block type "span", specify a component for it in the `components.types` prop

The Stacking Conversation Got Serious

Two articles this week tackled peptide stacking from different angles. The first is a practical framework: how to actually design a peptide stack based on mechanism of action, receptor overlap, and evidence quality.

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The second goes deeper on the science — why certain combinations produce effects that are greater than the sum of their parts. BPC-157 + TB-500 for tissue repair. Ipamorelin + CJC-1295 for growth hormone release.

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What to Watch Next Week

The oral GLP-1 approval will dominate the news cycle, but the more interesting story is what it triggers. Watch for Novo Nordisk's response on pricing. Watch for the FDA's peptide review timeline. And watch for the first real-world data on Foundayo.

We'll be covering all of it. See you next Sunday.

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