🎧 Should GLP-1s be sold over the counter? Ep 3, with Dr. Beverly Tchang, MD

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🎧 Should GLP-1s be sold over the counter? Ep 3, with Dr. Beverly Tchang, MD

Ash Sharma

08 March 2026

Dr. Beverly Tchang is a triple board-certified obesity medicine specialist, endocrinologist, and Associate Professor of Clinical Medicine at Weill Cornell. She also advises Ro. We discuss the commercial and clinical questions shaping the future of GLP-1s. Time stamps: 0:00 REDEFINE-4: CagriSema vs tirzepatide 7:35 Why the open-label design matters 8:59 Where Novo Nordisk's pipeline goes next 11:52 The real competitor isn't Lilly — it's supplements 12:48 Will GLP-1 adherence mirror statins? 15:49 Retention: a human behavior problem? 18:22 Why oral GLP-1s are storming the market. 22:26 What actually increases long-term adherence 26:52 Maintenance patients don't want to feel like patients 31:41 Insurance vs cash-pay: who should foot the bill? 36:25 Could life insurers play a role? 38:11 "Primordial care" — where health starts before healthcare 40:36 The case for compounding 46:26 Will compounding ever go away? 48:18 Can oral semaglutide and orforglipron be compounded? 50:40 Microdosing: what it means and who's doing it 55:22 Taking statins at 35 — and the prevention parallel 56:56 "Why wait for someone to gain more weight?" 59:35 Menopause weight loss: marketing or medicine?1:02:22 Does HRT boost GLP-1 weight loss? 1:07:13 The case for over-the-counter GLP-1s 1:10:22 Population-level impact of OTC access 1:12:32 Fly on the wall: the discovery of leptin in 1994