A full clinical update on GLP-1 receptor agonists for prescribers. Dr. Clare covers the complete arc from the discovery of the incretin effect through to tirzepatide's dual GLP-1/GIP mechanism, the South African regulatory landscape as of July 2026, pharmacovigilance data on compounded and black-market products, the emerging evidence on weight-independent anti-inflammatory effects, and a practical framework for patient facing conversations.

This episode exists because GLP-1s are one of the fastest-moving areas in medicine, and the noise — from industry, from media, and from social platforms — is complicating what should be a straightforward clinical conversation. The goal is one honest, well-evidenced reference you can come back to.

WHAT'S COVERED

- Drug family history: from Gila monster venom (exenatide) to semaglutide to tirzepatide

- GLP-1 vs GIP dual agonism — what makes tirzepatide mechanistically different

- How the drug works: the full cascade from injection site to hypothalamus, pancreas, gut, heart, and kidney

- SA registration status for Victoza, Saxenda, Ozempic, Wegovy, and Mounjaro as of 2026

- The compounding and black-market safety story: FAERS data, UK counterfeit deaths, SA non-medical provider landscape

- The iDexis Class I recall and the [2026] ZAGPPHC 612 ruling — prescriber liability in plain terms

- Anti-inflammatory effects of GLP-1 agonists independent of weight loss: cardiovascular, MASH, renal, and neurological evidence

- NAION and ocular safety — why the scary headlines didn't hold up under scrutiny

- GI motility risk — why this signal is real and how to counsel patients

- Lean mass loss — the numbers, and why protein and resistance training are clinical advice, not optional extras

- Regain after stopping — the long-term commitment conversation

EVIDENCE TREE AND FULL SOURCE LIST

Full evidence-graded source list (1–6 ladder, open-access links, COI disclosures, retraction status):

https://docs.google.com/document/d/1GBuW1ZpqSrKichqhlgnVAaQsJdJZqoxlDjU9MRIuY9w/edit

SA registration and SAHPRA product register: https://www.sahpra.org.za/medicines-control/databases/

CONNECT WITH 90310 WELLNESSCAST

Instagram: https://www.instagram.com/90310wellness

Website and episode archive: https://90310wellnesscast.base44.app

Find Dr Clare on her other platform too: Birth Stories Mzansi app: https://birthstoriesmzansi.base44.app

Got a question, a topic you'd like covered, or a clinical disagreement with something in this episode? Reach out — the show is better for it.

Email: drclare@beauty-doctor.org

COMPANION EPISODE

A lay-audience version of this episode — GLP-1s for Everyone — covers the same ground in patient-accessible language. If you, like many of us, get tired of re-explaining the same GLP-1 questions in every consultation: share it, save it, send it ahead of appointments. Available on all major platforms, coming soon!!

DISCLAIMER

This episode is for educational purposes and is aimed at qualified healthcare professionals. It does not constitute prescribing advice and does not replace clinical judgement or current local guidelines. Always refer to current SAHPRA-registered product information and consult relevant clinical guidelines for your patient population.

SA regulatory citations: Medicines and Related Substances Act 101 of 1965; SAPC/SAHPRA joint statement on compounding; [2026] ZAGPPHC 612 (Novo Nordisk SA (Pty) Ltd v iDexis (Pty) Ltd).