Drug Use and Innovation: From GLP-1 Breakthroughs to the Shadows of MLB

GLP-1 Drugs: A Weight Loss Revolution with Complex Side Effects

In recent years, glucagon-like peptide-1 (GLP-1) agonists have reshaped the landscape of weight loss treatments. With their ability to curb appetite and promote significant weight reduction, these drugs—used in conditions like type 2 diabetes and obesity—have been hailed as breakthrough therapies. However, the reality on the ground is more nuanced. According to The Scientist, about half of all patients prescribed GLP-1 agonists discontinue their use within a year, driven away by persistent and sometimes debilitating side effects. Nausea, vomiting, and even suppressed thirst are among the most common complaints, complicating what was once considered a straightforward solution.

At the 2025 Society for Neuroscience meeting, experts shed new light on the mechanisms behind these drugs. Lorenzo Leggio, neuroendocrinologist at the National Institute on Drug Abuse, stressed the importance of understanding how GLP-1 therapies interact with the brain and body. The intertwined nature of the drugs’ positive effects (like weight loss) and negative effects (such as gastrointestinal distress) was highlighted by Warren Yacawych from the University of Michigan. His team’s work with mice revealed that the brain stem regions responsible for satiety and vomiting responses are closely linked, making it difficult to separate the benefits from the drawbacks. The direct administration of GLP-1 agonists to specific brain areas produced weight loss but also triggered side effects, underscoring the complexity of the drug’s action.

Another lesser-known side effect—thirst suppression—emerged during research led by Derek Daniels at the University at Buffalo. Using rat models with diabetes insipidus, Daniels’ team pinpointed the median preoptic nucleus as a key brain region mediating GLP-1’s impact on drinking behavior. This finding opens the door to designing more targeted therapies that avoid problematic side effects, but for now, patients must navigate a delicate balance between efficacy and tolerability.

Innovative Approaches: Combining Hormones and Targeting Brain Pathways

Not all news is cautionary. In a bid to enhance weight loss while minimizing side effects, researchers have experimented with combining GLP-1 agonists with other hormones. Ernie Blevins and his colleagues at the University of Washington found that co-administering oxytocin—the so-called “love hormone”—with tirzepatide led to greater weight loss in obese rats without the usual gastrointestinal issues. This approach offers hope that future drugs may deliver results without the trade-offs that cause so many patients to abandon their treatments.

Pharmaceutical giants like Pfizer and Eli Lilly are also racing to develop small-molecule GLP-1 agonists that can be taken orally, making them more convenient and accessible. Ali Güler from the University of Virginia reported that these new drugs not only target the brain’s emotion and reward centers but also alter how much dopamine is released in response to food. In mice, the drugs reduced the perceived reward of high-fat foods, leading to decreased consumption. This discovery hints at broader applications—potentially extending the drugs’ reach beyond obesity to conditions like substance use disorders.

The Shadows of Professional Sports: The Tyler Skaggs Case and Prescription Drug Abuse

While the scientific community pushes the boundaries of drug innovation, another story unfolds in the world of professional sports—one marked by secrecy, stigma, and tragedy. In a California courtroom, former Los Angeles Angels pitcher Mike Morin described a hidden culture of prescription drug use among players, brought into sharp relief by the 2019 death of Tyler Skaggs from an accidental overdose. Morin testified, as reported by ESPN, that he, Skaggs, and team employee Eric Kay kept their use of illicit pills secret from everyone, including family and teammates. The pressure to stay in the major leagues, he explained, drove risky decisions and deep embarrassment.

Morin recounted how Kay discreetly supplied “blue boys”—30mg oxycodone pills—to players, often leaving the drugs and payment in locker cubbies. Both Morin and Skaggs crushed and snorted the pills in private, never imagining that a prescription pill could be tainted or fatal. Kay was ultimately convicted in 2022 for providing Skaggs with a fentanyl-laced oxycodone pill, leading to a 22-year prison sentence. The Angels organization maintains it was unaware of Kay’s actions and the players’ drug problems, while Skaggs’ family argues that the team failed in its duty of care.

The trial exposed the immense psychological pressures athletes face—”the immense highs and immense lows,” as Morin put it. Injuries, performance anxiety, and the relentless drive to succeed can lead players down dangerous paths. The stigma surrounding addiction and mental health in sports means that problems often go unreported, hidden behind a facade of strength.

The Road Ahead: Mechanisms, Responsibility, and Hope

These two stories—one of scientific advance, the other of personal tragedy—reveal the double-edged nature of drug use in society. GLP-1 agonists promise a new era of weight management and metabolic health, but their complex actions in the brain and body remind us that every breakthrough brings new questions. As researchers work to separate the desirable effects from the harmful, they face the same challenge that confronts athletes and their doctors: how to balance risk and reward, how to recognize vulnerability, and how to foster transparency.

Morin’s candid testimony is a call to action for sports organizations and medical professionals alike. Prevention and education must go hand in hand with innovation. The stigma of addiction must be dismantled, and the culture of secrecy broken if tragedies like Skaggs’ death are to be avoided. Meanwhile, the ongoing refinement of GLP-1 therapies offers hope that science can deliver safer, more effective treatments—if only we understand the intricate mechanisms at play.

Ultimately, the intersection of drug innovation and real-world use exposes the urgent need for both scientific rigor and compassionate care. Whether in the laboratory or the locker room, the pursuit of better outcomes demands that we confront not only what drugs can do, but what they mean to the people who use them.