News Feeds

Two or more satellites could communicate and manoeuvre around one another using magnetic fields, although getting the technique to work at scale in space might be tricky

The US’s federally funded space program has been struggling of late. With the recent cancellation of the Mars Sample Return mission, and mass layoffs / resignations taking place at NASA, the general sense of a lack of morale at the agency is palpable, even from a distance. Jared Isaacman, the billionaire software entrepreneur and rocket enthusiast who was recently confirmed as NASA administrator during his second confirmation hearing, hopes to change that, and one of his priorities is pushing the Artemis missions for a permanent human presence on the Moon. However, at least one big technical hurdle remains before being able to do so - how to power a base during the two week long lunar night. A recent press release describes how NASA, and another branch of the federal government (the Department of Energy - DoE) hope to solve that problem - with a lunar-ready nuclear fission reactor

Well, the cease-fire agreements in Gaza are proceeding, as Trump has appointed some committees (all approved by the UN) to run the territory. But again we have a dog’s breakfast, as there are multiple committees with two big problems: there are at least five committees with somewhat overlapping functions and members, and, second, there is no roadmap for the major task of getting rid of Hamas.

Here’s the composition as given by the NYT (bolding below is mine):

Mr. Trump’s “Board of Peace,” which he named himself the chairman of, is backed by a legal United Nations mandate and had previously been expected to be composed of world leaders who would supervise the Trump administration’s plan for an “International Stabilization Force” to occupy, demilitarize and govern Gaza during a yearslong reconstruction effort.

But the list of officials on the executive board announced on Monday included three members of the Trump administration — Secretary of State Marco Rubio, Steve Witkoff and Robert Gabriel — as well as Jared Kushner, Mr. Trump’s son-in-law; Ajay Banga, the head of the World Bank; the billionaire Trump ally Marc Rowan; and former Prime Minister Tony Blair of Britain. Of the seven, only Mr. Blair is not American, and he was previously the Middle East envoy for the Quartet, a diplomatic group made up of the United States, Russia, the United Nations and the European Union, and considered a candidate to lead a transitional government in Gaza.

A second executive board, similarly named the “Gaza executive board,” includes a wider roster of foreign officials from Europe and the Middle East, and is implied to be in a supporting role. Some American officials sit on both executive boards, as well as Mr. Blair.

Maj. Gen. Jasper Jeffers, the commander of U.S. Special Operations Command Central, which operates in the Middle East, was also tapped to lead the “International Stabilization Force,” the peacekeeping force authorized by the United Nations to be deployed to Gaza as part of the peace plan. General Jeffers previously helped oversee a brokered cease-fire between Israel and Lebanon last year.

Note that what seems to be the most important committee is almost all American, and the peacekeeping force, which presumably will be tasked with disarming Hamas, is also headed by an American general.  So who is going to disarm Hamas? Israel can’t, as that would violate the ceasefire agreement, and the U.S. certainly won’t send troops to Gaza. So how will Hamas disarm and disband: the first item on Trump’s agenda?

Trump apparently will solve it by threats:

It is not clear how the international force would ensure that Gaza is demilitarized. Hamas, which specializes in insurgent tactics and has not disbanded its battalions of armed fighters, has long regarded giving up all its weapons as tantamount to surrender, with armed struggle against Israel a crucial part of its ideology. On Thursday, Mr. Trump threatened Hamas with a renewed conflict if they did not disarm, writing on social media: “they can do this the easy way, or the hard way.”

The Times of Israel, as usual, has more information about the committees, and notes that the Board of Peace isn’t really the most important board, with the Gaza Executive Board really tasked with doing the heavy lifting. Bold headings are mine. And the ToI article implies that the NYT missed two committees:

The Board of Peace:

The Board of Peace is the umbrella body that was mandated by the UN Security Council to oversee the postwar management of Gaza until the end of 2027.

The Board of Peace is chaired by Trump, and will largely be made up of heads of state from around the world.

Formal invitations to become members of the Board of Peace were sent out on Friday, and by Saturday the leaders of Turkey, Egypt, Canada and Argentina confirmed having received the offer — an indication that they will likely accept

While this is the most prominent of all the panels established, the Board of Peace will play a generally symbolic role and be more relevant during the fundraising stage, a senior Arab diplomat told The Times of Israel.

The Gaza Executive Board:

The Gaza Executive Board is the operational arm of the Board of Peace and the body that will actually oversee the postwar management of Gaza.

Sitting on the Executive Board are Turkish Foreign Minister Hakan Fidan, senior Qatari diplomat Ali Thawadi, Egyptian intelligence chief Hassan Rashad, UAE Minister of International Cooperation Reem Al-Hashimy, former UK prime minister Tony Blair, US special envoy Steve Witkoff, top Trump aide Jared Kushner, Apollo Global Management CEO Marc Rowan, Israeli-Cypriot businessman Yakir Gabay, former UN humanitarian coordinator Sigrid Kaag, and former UN envoy to the Mideast Nickolay Mladenov.

Israel has expressed opposition to the makeup of the Executive Board, apparently taking issue with the inclusion of representatives from Turkey and Qatar, who were heavily critical of its prosecution of the war in Gaza.

However, the inclusion of both countries demonstrates their perceived utility to Trump, who has touted his personal relationships with the leaders of Turkey and Qatar as well as their success in pressuring Hamas to accept a ceasefire deal in October.

The Founding Executive Board:

In addition to inexplicably sharing nearly the same name as the Gaza Executive Board, the Founding Executive Board also consists of many of the same members.

Joining Witkoff, Kushner, Blair and Rowan on this additional board are US Secretary of State Marco Rubio, World Bank president Ajay Banga and Trump’s former deputy national security adviser Robert Gabriel.

The White House said that each member of the Founding Executive Board “will oversee a defined portfolio critical to Gaza’s stabilization and long-term success, including, but not limited to, governance capacity-building, regional relations, reconstruction, investment attraction, large-scale funding, and capital mobilization.”

The National Committee for the Administration of Gaza:

. . . .The National Committee for the Administration of Gaza is the committee of Palestinian technocrats that will be tasked with running daily affairs on the ground and providing services for Gazans in place of Hamas.

While Egypt, in announcing the new panel, claimed it consists of 15 members, the actual figure is 12, and they are headed by former Palestinian Authority deputy planning minister Ali Shaath.

. . . . Each of the other panel members was given a portfolio covering the fields in which they are experts.

Abdul Karim Ashour, who heads an agricultural non-profit, will serve as agriculture commissioner.

Aed Yaghi, who currently heads the Palestinian Medical Relief Society, will serve as health commissioner.

Osama Sa’adawi, who previously headed the Palestinian Housing Council nonprofit, will serve as housing commissioner.

Adnan Abu Warda, a former PA Supreme Constitutional Court judge, will serve as justice commissioner.

Maj. Gen. Sami Nassman, who has served in the PA’s General Intelligence Service and is seen as a strong opponent of Hamas, will serve as internal security and police commissioner

And so on, including commissioners for water and municipal affairs, social affairs, communications, economy, and trade. You can see that their duties will overlap. Who resolves conflicts? A member of the Palestinian Authority, which of course is anti-Israel, and is an organization hated by Hamas.  Finally, there is the crucial

International Stabilization Force:

The International Stabilization Force is tasked with providing security for the Strip, while gradually phasing out the IDF, which currently remains in control of 53% of the enclave.

While the US has said the ISF will support efforts to disarm Hamas, officials familiar with the matter said the multinational force won’t be expected to engage in kinetic activity to seize weapons from the terror group, which has pledged not to give them up.

Instead, they will support the disarmament process once an agreement is reached, with mediators optimistic that Hamas will agree to a gradual process that starts with the return of heavy weapons, Arab and US officials have said.

. . .The US had struggled to convince countries to contribute troops to the ISF board amid heavy skepticism that Hamas will disarm and that the IDF will withdraw further from Gaza. One of the two countries Washington had publicly touted, Azerbaijan, announced earlier this month that it would not be participating.

US officials briefing reporters last week insisted that they now have enough countries offering troops and that an announcement can be expected in about two weeks.

This is a mess.  There are five committees whose jobs are overlapping, a heavy U.S. presence on the supervising Board of Peace, and what I see as the most important committee at the outset—the group tasked with demilitarizing Gaza by erasing Hamas—has no specified troops.

It’s not surprising that no country wants to take on Hamas, since they know the international opprobrium attached to that task.  Since Hamas refuses to disarm, this guarantees that there will be extensive fighting in Gaza for a long time to come.  Getting rid of Hamas is Job #1, and until that is done, none of the other committees can do their jobs.

Now the UN could run the whole show instead of the U.S., but that might be even worse given the UN’s hatred of Israel. I doubt that the UN has the stomach to disarm Hamas. They have UN troops that could try, but the UN troops in Lebanon, tasked with disarming Hezbollah, are completely ineffectual. UN troops would be useless against the determined fighters of Hamas.

My conclusion: this messy plan won’t work, and therefore the destruction in Gaza will continue for some time to come.  And don’t forget that Hamas and the Gazans hate the Palestinian Authority, so there can be no solution that allows the PA to run the Gaza Strip. I feel for the Gazan civilians that must endure this mishigass for years to come. If readers have an alternative solution, do suggest it below.

To describe the odious, terroristic nature of Hamas, which all of you should know about by now (even though many young Americans are on their side), I proffer Rawan Osman, a Syrian-born but pro-Israeli activist who was brought up as an Israeli-hating Muslim:

It is impossible to get rid of anxiety because it exists to help us, says cognitive psychotherapist Owen O'Kane. Instead, he suggests three ways to reframe your relationship with anxiety in order to take back control

We recently discussed the different types of worlds that the Habitable Worlds Observatory (HWO) is expected to find that might have noticeable biosignatures. However, no matter how good the instrumentation on board the observatory is, the data it collects will be useless if scientists don’t know how to interpret it. A paper explaining what data they need to collect before analyzing HWO data was authored by Niki Parenteau, a research biologist at NASA, and her co-authors, which is now available in pre-print on arXiv.

Regular Mark Sturtevant (as opposed to Irregular Mark Sturtevant) has sent in some lovely insect photos to fill the nearly-empty reserve of pictures. Please send any good wildlife photos you have. Thanks!

Mark’s captions are indented, and you can enlarge his photos by clicking on them. Be sure to check out the female Tussock Moth caterpillar with vestigial wings (it’s the eighth photo).

Here is another dispatch of local insects and spiders, all photographed either in area parks near where I live in eastern Michigan, or as staged shots at home. Let’s start with a couple of dragonflies. First up is a Green Darner (Anax junius), which ranks pretty large among the dragonflies found here. As is almost always the case, this individual is a female, since they perch frequently and are much easier to approach than males, which I only rarely manage to photograph. Do you see the tiny yellow critter on the dragonfly? That is a Globular Springtail, and it must have walked or jumped onto the dragonfly from nearby foliage. There may be a few more of them in the picture as well, though I’m not certain. Springtails are tiny soil arthropods, and they are extremely abundant. When seen up close, Globular Springtails are arguably adorable, as you can see in the linked image. I’ve searched for them for some time but have only rarely encountered them, despite claims that they are exceedingly common. Perhaps our local species spends more time up on foliage rather than in the soil, meaning I’ve been looking in the wrong places!:

The next dragonfly is a male Skillet Clubtail (Gomphurus ventricosus), named for the large, pan-like club on the end of its abdomen. I have to drive a few hours south to a particular park to see them, and of course this one is perching on poison ivy which covers much of the area there. That park hosts 8 or 9 species of clubtails according to a dragonfly documentation site called Odonata Central. I’ve photographed most of those species with only two left to find:

A field near my workplace has a ridiculously high population of Chinese Praying Mantids (Tenodera sinensis). I suspect this is the lingering result of someone having released a large number of egg cases several years ago, combined with a robust population of grasshopper prey. Shown here is a young June nymph. I can return later in the summer to find several large adults in no time at all:

Next up are some lepidopterans. First is a Hackberry Emperor butterfly (Asterocampa celtis). They are often common along forest margins where their host Hackberry trees [Celtis occidentalis] are concentrated. Their caterpillars, however, seem to be quite secretive, as I’ve seen only a few of them:

Next is an inchworm caterpillar, though I don’t have an identification for it. Do you see the tiny mites?:

The insect shown next is a moth, although it makes a very convincing wasp mimic. This is the Eupatorium Borer Moth (Carmenta bassiformis). The larvae feed on the roots of Ironweed and Joe Pye Weed, both of which are highly valued native wildflowers because they are very much favored by butterflies:

The flamboyant caterpillar in the next image is a White-marked Tussock Caterpillar (Orgyia leucostigma). I’ve tried several times to get an acceptable focus-stacked image of one of these. What makes them difficult is the combination of all those oddly angled sticky-out bits, which challenge the shallow depth of field inherent in this kind of photography, along with the fact that these caterpillars absolutely will Not Hold Still. As a result, the stacking is done on the fly, followed later by long hours of manual reassembly of the jumbled focus stack. This image is by far my most successful attempt:

I kept this caterpillar in hopes that the moth emerging from the cocoon would be a female. Why? Well—check out what came out! It was a female! Females have barely visible vestigial wings, and I had never seen one before. She will sit here, unmoving, until a male finds her. This strategy saves a great deal of energy that can instead be used for laying eggs. The winged males are unremarkable, and while I’ve probably seen them, I don’t think I’ve ever photographed one:

Finally, here are three images of jumping spiders I’ve been wanting to share together for quite some time. The Dimorphic Jumping Spider (Maevia inclemens) is a species I regularly see around the outside of our house. The name refers to the males having two distinct color morphs. The images below are manual focus stacks, photographed in staged settings on the ‘ol dining room table. First is a female with long-legged fly prey, which conveniently provides a sense of scale since the fly is about the size of a mosquito:

Next are the two male color morphs. The first somewhat resembles the females, while the other is very different and comes with distinctive hair decorations. This is an older image, but I’m bringing it back so all three forms can finally be shown together. It’s surprising that they are all the same species!

I recently learned that the two male forms use different courtship displays for females, yet are considered equally successful in the mating game. I’m sure Jerry can steer things in the right direction if I am in error here, but having different male forms with different mating strategies does not seem unusual in the animal kingdom. Examples I’m familiar with include lizards, crustaceans, and fish, although in those cases the different males include those that are aggressive and territorial, and others that win by being sneaky. But here, I don’t see how either male is territorial, and apparently both have courtship displays for females.

One of my goals for next season will be to try to document their different courtship behaviors. That seems do-able, since I can expect to find several of them again next summer.

Quantum computers could revolutionize everything from drug discovery to business analytics—but their incredible power also makes them surprisingly vulnerable. New research from Penn State warns that today’s quantum machines are not just futuristic tools, but potential gold mines for hackers. The study reveals that weaknesses can exist not only in software, but deep within the physical hardware itself, where valuable algorithms and sensitive data may be exposed.

After the Big Bang, the Universe entered a long, dark period before the first stars formed. During this era, hydrogen emitted a faint radio signal that still echoes today. New simulations show this signal could be slightly altered by dark matter, leaving behind a measurable fingerprint. Future radio telescopes on the Moon may be able to detect it and shed light on one of astronomy’s greatest mysteries.

Astronomers have captured the most dramatic view yet of a planet losing its atmosphere, watching the ultra-hot gas giant WASP-121b for an entire orbit with the James Webb Space Telescope. Instead of a single stream of escaping gas, the planet is wrapped in two colossal helium tails—one trailing behind like a comet, the other stretching ahead toward its star.

Spacecraft orbiting the Red Planet have helped researchers map out an ancient coastline that surrounded a large ocean billions of years ago

Traditional intuit whale acupuncture.

The post Pet Acupuncture and Life first appeared on Science-Based Medicine.

Concerns around common sunscreen chemicals have prompted the search for natural alternatives, with lignin from wood being one of the most promising candidates

A century-old hoax takes wing again, proof that good stories never stay buried.

Learn about your ad choices: dovetail.prx.org/ad-choices

A nearby active galaxy called VV 340a offers a dramatic look at how a supermassive black hole can reshape its entire host. Astronomers observed a relatively weak but restless jet blasting outward from the galaxy’s core, wobbling like a spinning top as it plows through surrounding gas. Using a powerful mix of space- and ground-based telescopes, the team showed that this jet heats, ionizes, and flings gas out of the galaxy at a surprisingly high rate.

NASA’s Artemis II rocket has reached its launch pad after a painstaking overnight crawl across Kennedy Space Center. Engineers are now preparing for crucial fueling and countdown tests ahead of the first crewed Artemis mission. The mission will send four astronauts on a journey around the Moon and back. It’s a key milestone on the path to returning humans to the Moon and pushing onward to Mars.

Astronomers at the University of Warwick have discovered that black holes don’t just consume matter—they manage it, choosing whether to blast it into space as high-speed jets or sweep it away in vast winds.

Hydrogen Cyanide, which is toxic, may have played an important role in the emergence of life. Its unique properties, especially in frigid environments in space, may have helped generate the complex molecules necessary for life to appear.

A new compass for the SKEPDOC column. This column was founded by Harriet Hall, MD (1945–2023) who wrote it from 2006 to 2023. In 2026, we welcome William Meller, MD, to the helm. As an expert in evolutionary medicine, Dr. Meller will be our guide in navigating the deep biological history of our species to find the “True North” of human health.

I have been practicing medicine for more than 40 years. During that time the management of obesity and Type 2 diabetes (T2DM)—the kind that usually is caused by being overweight—often felt like Sisyphus pushing a boulder up a hill, only to have it roll back down, often heavier than before. We faced a “diabesity” epidemic where the available tools were blunt instruments at best.

Lifestyle interventions—meaning trying to get someone to change their behavior—was the most and least effective method we had. Most, because in the less than two percent of patients who were successful, it works very well. Least, because, well … 98 percent failed. And they failed because all of our evolutionary history (“See food? Eat it!”) was working against them. This is the mismatch theory: a mismatch between the environment of our evolutionary ancestry that designed our brains to seek foods that were at once rare and nutritious (sweets and fats) and the modern environment in which such foods are in such overabundance that we eat far beyond the saturation point. 

The pharmacological options were often disappointing: Sulfonylureas and insulin lower blood sugar but caused weight gain, exacerbating the underlying problem. Bariatric surgery works, but it is invasive and carries surgical as well as lifelong nutritional risks. 

When we look at the data for GLP receptor agonists, along with the innumerable before and after photos of successful weight loss transformations, we are forced to admit that we have moved from a realm of wishful thinking into one of potent pharmacology.

Into this therapeutic desert crawled the Gila Monster (above), a venomous lizard native to the American Southwest from which researchers derived GLP receptor agonists (Glucagon-like peptide-1 receptor agonists)—medications that mimic the natural GLP-1 hormone that lead to lower blood sugar, help control appetite, and promote weight loss by telling the pancreas to release more insulin when glucose is high, slowing the rate of stomach emptying, and signaling to the brain a sense of fullness. 

As a skeptic, I am allergic to the word “miracle,” but when we look at the data for GLP receptor agonists, along with the innumerable before and after photos of successful weight loss transformations, we are forced to admit that we have moved from a realm of wishful thinking into one of potent pharmacology. But, as always in medicine, there is no free lunch. 

The Incretin Concept: From Gut to Glory 

The story begins with the “incretin effect”—the observation that glucose taken by mouth triggers a much stronger insulin response by increasing the production of hormones in the pancreas, compared to when it is injected directly into a vein. The gut knows you are eating and tells the pancreas to get ready to pack away the extra calories as fat. In patients with Type 2 diabetes, this effect is blunted and the sugar floats around in the bloodstream much longer. 

Scientists identified two main hormones responsible: Glucose-dependent Insulinotropic Polypeptide (GIP) and Glucagon-like Peptide (GLP-1). The problem is that GIP doesn’t work well in diabetics. GLP-1 works beautifully—stimulating insulin, suppressing glucagon, and slowing gastric emptying—but it has a fatal flaw: It is destroyed by the enzyme DPP-4 within minutes of entering the bloodstream. 

This led to two distinct pharmaceutical strategies. The earlier version was DPP-4 Inhibitors. Drugs like the “Gliptins” block DPP-4, making GLP-1 last longer. They are well-tolerated but their ability to lower blood sugar is modest and they generally do not cause weight loss. 

The newer strategy was to engineer versions of GLP to resist degradation. This is where the Gila monster strolled in. In the 1990s, while researching hormone-like drugs, Dr. John Eng noted a similarity between exendin-4 found in Gila venom to Glucagon-like peptide (GLP), and it was able to resist breakdown by DPP! 

The Evidence: Efficacy Beyond the Hype 

The first GLP-1 agonist, exenatide (Byetta, approved in 2005), required twice-daily injections and produced modest weight loss. But the pharmacology evolved rapidly. We moved to once-daily liraglutide, and then to the once-weekly heavyweights: dulaglutide, semaglutide (Ozempic and Wegovy), and the dual GIP and GLP-1 agonist tirzepatide (Mounjaro and Zepbound). 

The clinical trials, called LEAD, SUSTAIN, PIONEER, STEP, and SURPASS (you’ve got to just love the creative acronyms!) have generated data that are hard to dismiss: 

Glycemic Control: These drugs consistently outperform most oral antidiabetics in lowering blood sugar by 10 to 20 percent. 

Weight Loss: This is the game changer. While early drugs produced 2–4 kg of weight loss over six months, the newer agents are producing results previously only seen with surgery. In the STEP-1 trial, semaglutide 2.4 mg resulted in an approximately 15 percent body weight reduction. Tirzepatide pushed this further, achieving up to 22 percent weight loss in the SURMOUNT-1 trial. That is the effect of a 250-pound person losing 55 pounds! Who wouldn’t want some of that?! 

Cardiovascular Outcomes: Perhaps most importantly, these drugs are not like some that just make numbers look better; they are saving lives. Liraglutide and semaglutide have demonstrated significant reductions in major adverse cardiovascular events (MACE), including heart attack and stroke, in high-risk populations. The SELECT trial recently showed semaglutide reduces MACE by 20 percent even in nondiabetic patients with cardiovascular disease. But don’t be fooled, it is not likely that these drugs have specific effects on the heart. It is probable that the fat loss alone is causing these benefits. 

Some Skeptical Scrutiny: The Risks 

If a drug sounds too good to be true, we must look for the catch. GLP-1 agonists have plenty.

The “Puke” Diet? The most common side effects of GLP-1 agonists are gastrointestinal: nausea, vomiting, diarrhea, and bloating. In some trials, up to 45 percent of patients experienced nausea. While this usually subsides, it raises a valid question: Are people losing weight because their metabolism is optimized, or because they feel too sick to eat? The mechanism involves central appetite suppression in the hypothalamus, but the “gastric braking” effect is real and unpleasant for many. 

The Pancreas and Thyroid Scare. Early observational data suggested a link between GLP-1 agonists and pancreatitis and pancreatic cancer. However, extensive reviews have not confirmed a causal link to pancreatic cancer, though a slight increase in pancreatitis persists in some data. This makes sense, as one of the major sites of GLP’s effects is on the pancreas. In the thyroid, these drugs cause C-cell tumors in rodents. Humans have far fewer GLP-1 receptors on their thyroid C-cells than rats, and so far no evidence of increased thyroid cancer has been confirmed in humans. Still, the Black Box warning remains: If you have a family history of endocrine tumors or medullary thyroid cancer, these drugs are not for you. 

If we are simply shrinking patients without preserving their strength, we may be trading one set of problems for another.

Vanishing Muscle. Weight loss via GLP-1 agonists is not just fat loss, so overall body composition must be monitored. In the STEP-1 trial, DEXA scans showed that lean body mass (muscle and bone) accounted for nearly 40 percent of the weight lost. In older adults, this raises the specter of “sarcopenic obesity”—being frail and weak despite having excess fat. Losing muscle mass compromises physical function and metabolic health. If we are simply shrinking patients without preserving their strength, we may be trading one set of problems for another. Now, regular and increased exercise is part of the prescription for all patients taking GLP drugs, but studies on how well this works are still in progress. 

The Perioperative Peril. Because GLP-1 agonists delay gastric emptying, there have been reports of patients aspirating (inhaling) gastric contents during anesthesia, even after standard fasting protocols. This is a new, practical safety concern that surgical societies are rushing to address. 

Mental Health. Reports of suicidal ideation appeared in postmarketing monitoring of GLP-1 agonist users, prompting investigations by European regulators. However, recent large cohort studies have not supported an increased risk of suicidality compared to other diabetes medications. As with all centrally acting drugs, vigilance is required, but the current data are reassuring. 

A Lifetime Prescription? The most significant caveat for GLP-1 agonists is durability. Obesity can be a chronic, relapsing disease. Trials show that when patients stop taking semaglutide, they regain two-thirds of the lost weight within a year, and cardiometabolic improvements revert toward baseline. This implies that these are not “cures” but lifelong therapies, much like blood pressure medication. 

Financial Toxicity. As I write this, these drugs are prohibitively expensive, creating a massive public health gap. We also saw shortages that left diabetic patients unable to fill prescriptions because the supply was diverted to off-label weight loss use. GLP-1 agonists are not expensive to produce, however, and the patent on Ozempic expired in January of 2026 in Canada and China (and lasts until 2030 in the U.S.), but I expect the market to bring the costs down dramatically over the next few years. As of this year, close to 12 percent of Americans have tried it at least once. 

Needles Versus Pills 

If there is one thing that holds patients back from the current crop of injectable incretins it is the needle. Despite the efficacy of weekly injections, people prefer pills. The pharmaceutical industry, never one to leave money on the table, has been racing to develop an oral alternative that doesn’t require the strict fasting rituals of earlier attempts like oral semaglutide. Enter orforglipron, the latest contender in the “nonpeptide small molecule” class, which promises the benefits of GLPs without the injection or the fuss. 

Unlike existing peptide predecessors that are digested by stomach acid unless armored with absorption enhancers, orforglipron is a chemical—a small molecule designed to survive the GI tract and activate the GLP-1 receptor directly. The data from the ATTAIN-1 trial, published in September 2025, look good. Patients on the 36 mg dose achieved an average weight loss of 11.2 percent over 72 weeks, compared to just 2.1 percent for placebo. No needles. And this pill does not require the “empty stomach, no water, wait 30 minutes” song-and-dance required by oral semaglutide; it can be taken with or without food. 

These are serious medications with serious side effects, and they may require lifelong commitment.

However, let’s look a little past the convenience. While an 11.2 percent average weight loss is clinically significant, it trails behind the 13.7 percent average reduction seen with semaglutide and 20.2 percent with tirzepatide. Furthermore, the biology of GLP-1 agonism remains the same regardless of delivery method: You cannot cheat physiology. In the ATTAIN-1 trial, adverse events led to treatment discontinuation in up to 10.3 percent of patients on the drug, compared to only 2.7 percent on placebo. The side effects are the usual suspects—gastrointestinal distress, nausea, and constipation—confirming that oral delivery does not bypass the “gastric braking” misery. 

We must also remain vigilant regarding safety. The development of a similar small molecule, lotiglipron, was unceremoniously halted due to liver toxicity concerns. While orforglipron has passed its Phase 3 hurdles without these specific signals so far, the history of pharmacology teaches us that rare, serious adverse events often lurk in the postmarketing shadows. 

Additionally, while proponents argue that small molecules are cheaper to manufacture than biologics, whether those savings will be passed on to the patient or simply absorbed into the profit margins remains to be seen, with projected self-pay costs in some cases exceeding $1,000 per month. Orforglipron represents a technological leap, but it is not a magic wand; it is simply a more convenient way to induce the same physiological trade-offs we have seen over the last several years with the shots. 

Conclusion 

Prior to the incretin era, our ability to manage the twin epidemics of diabetes and obesity was dishearteningly limited. GLP-1 receptor agonists represent a hard-earned pharmacological breakthrough, offering potent glucose control and unprecedented weight loss. 

However, skepticism is still warranted regarding their indiscriminate use. They are already being used in numerous off-label ways, like shedding a few pounds before a wedding, allegedly decreasing cravings for addictive drugs like alcohol and narcotics, and purportedly even for the treatment of Alzheimer’s and Parkinson’s disease. There are ongoing studies for these uses, but early data are weak and the risks are unknown. These are serious medications with serious side effects, and they may require lifelong commitment. 

Caveat emptor.

Humans have always been fascinated with space. We frequently question whether we are alone in the universe. If not, what does intelligent life look like? And how would aliens communicate?

Deep beneath the surface of distant exoplanets known as super-Earths, oceans of molten rock may be doing something extraordinary: powering magnetic fields strong enough to shield entire planets from dangerous cosmic radiation and other harmful high-energy particles.