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(FDA approvals of Wegovy for cardiovascular disease and Zepbound for sleep apnea occurred in 2024 and therefore these uses are likely not reflected in Part D data through 2024.) More than half of gross spending in 2024 was on semaglutide products (Ozempic, 47%

FDA Commissioner Marty Makary stated: "When FDA-approved drugs are available, outsourcing facilities cannot lawfully compound using bulk drug substances unless there is a clear clinical need." What this means for 503B facilities: If finalized, this proposal would permanently close the large-scale outsourcing facility compounding pathway for these three medications - regardless of future shortage conditions

20:04 The MMAS data and the 1%-per-year number 20:52 The 2025 meta-analysis of over 1 million men 22:02 Why the headline is inflated: three causes 22:27 Cause 1: The testing method changed (immunoassay to mass spec) 25:58 Cause 2: BMI cannot see visceral fat 29:37 The Nyante study: when you fix both problems, the decline vanishes 33:58 What this actually means for you 37:05 The broken testosterone system, summarized 38:24 Five takeaways from this episode 39:14 Next week: How testosterone actually works 39:39 About Signal and credits What you'll learn in this episode: Why 25% of new TRT prescriptions are written without any pre-treatment lab work (JAMA, 2015) What actually happens when researchers test 50+ "testosterone booster" supplements (spoiler: 12% are contaminated with undisclosed steroids) Why a single low testosterone reading is not a diagnosis, and the Massachusetts Male Aging Study data that proves it The real size of the population-level testosterone decline (much smaller than 1% per year) Why BMI cannot see the visceral fat that is driving most of the genuine decline The Nyante study that shows the decline essentially vanishes when you use an accurate test and measure waist circumference Five practical takeaways you can apply before your next lab draw This is Episode 1 of a four-part series built around our upcoming book, Signal

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Not because of weight loss, but because of the sudden absence of food obsession