💉 Déjà Vu in a Syringe?

Healing_ Passion
Aug 15
3 min read

August 2025

Why the GLP-1 Craze Feels Like a COX-2 Inhibitor Rerun

“A game-changer for obesity.”

“A miracle shot for weight loss.”

“It’s not just about diabetes—it’s about everything.”

If you’ve read the headlines, you know that GLP-1 receptor agonists like semaglutide and tirzepatide are everywhere. Weight loss clinics. Pharmacies. Celebrities. Even financial markets are riding the wave.

But if you've been in medicine long enough, you might hear an unsettling echo from the past…

🕰️ Flashback: The Rise and Fall of COX-2 Inhibitors

In the late 1990s, COX-2 inhibitors (like Vioxx and Bextra) were hailed as revolutionary painkillers. Unlike older NSAIDs, they promised:

Less gastrointestinal bleeding
Equal or better pain relief
Fewer side effects

Pharma invested billions. Clinical papers flooded journals. COX-2s were quickly used beyond arthritis—for back pain, post-op recovery, even Alzheimer's prevention.

Until... the cardiovascular events began.

By 2004, Vioxx was withdrawn. Lawsuits erupted. And medicine learned a hard truth:

A drug can be biologically effective—and still physiologically dangerous in the long term.

🔁 Fast-Forward: GLP-1s as the New Miracle

Today, GLP-1 receptor agonists are on the same trajectory:

First approved for diabetes (Ozempic, Mounjaro)
Now marketed for obesity (Wegovy, Zepbound)
Promising uses in addiction, PCOS, depression, Alzheimer’s, and more
Backed by glowing reviews, like the recent Cell 2025 paper—authored by scientists with direct ties to obesity drug developers

The appetite control is real. The weight loss is substantial. The demand is off the charts.

But the story feels... too familiar.

⚠️ Five Parallels That Should Make Us Pause

Pattern	COX-2 Era	GLP-1 Era
💰 Massive pharma push	Yes – Vioxx, Celebrex, Bextra	Yes – Novo Nordisk, Eli Lilly
📚 Explosion of favorable studies	Ghostwritten, biased reviews	Publications by company-funded researchers
💊 Indication creep	Pain → Alzheimer’s prevention	Diabetes → Obesity → Psychiatry
🚨 Physiological red flags	Cardiovascular risk	Glucagon suppression, muscle loss, nutrient restriction
🧑‍⚕️ Overconfidence in "fixing" biology	Blocking inflammation at its root	Suppressing appetite at its source

In both cases, early benefits overshadowed deeper biological concerns—until real-world use revealed the costs.

🧬 What We're Not Hearing Enough About

GLP-1 drugs suppress glucagon, a key hormone in:

Fasting adaptation
Immune resilience
Muscle preservation
Amino acid recycling

They may also:

Blunt nutrient intake
Contribute to lean mass loss
Impair stress recovery in vulnerable individuals (e.g., elderly, malnourished, chronically ill)

These aren’t just side effects—they’re bioenergetic trade-offs.

Appetite is being muted—but the body still needs energy, micronutrients, and metabolic flexibility.

🧠 From ERM to History Repeating

In the ERM (Exposure-Related Malnutrition) framework, we view chronic disease not just as a failure of willpower or isolated circuits—but as a systems-level exhaustion of adaptive capacity.

GLP-1 drugs reduce caloric load—but they don’t:

Rebuild depleted systems
Correct nutrient mismatch
Support long-term metabolic resilience

They’re acting on the wiring, not fixing the fire.

🔮 Where This Could Go

We’re not calling for panic—or dismissal of GLP-1RAs.

They do help people, especially in severe obesity or diabetes.

But history teaches us to ask:

Who benefits most?
What risks are under-discussed?
And how do we avoid repeating the COX-2 playbook?

The next great therapeutic doesn’t just reduce weight. It restores resilience.

📢 Let’s Be Smart About This

If you're a clinician, patient, policymaker, or health advocate:

Ask for long-term outcome data.
Demand transparency about conflicts of interest.
Don’t confuse appetite suppression with metabolic healing.
Consider frameworks like ERM that integrate nutrition, stress physiology, and whole-body adaptation.