Plain English with Derek Thompson · The Ringer

The Future of GLP-1 Drugs and AI Medicine, With Eli Lilly CEO David Ricks

February 24, 2026·1 hr 8 min·6 clips

Derek Thompson traces humanity's battle from smallpox to obesity, introducing the GLP-1 drug revolution as the new 'taller ladder'.

Death is the organizing chart. The host asks listeners to track medicine by what kills people and how that list changes, from smallpox to bacterial infection. The opening is deliberately grisly, but it has a point. Edward Jenner's cowpox experiment and the later scaling of penicillin make medicine look less tidy than the victory lap version: accidental discovery, ethical discomfort, and huge survival gains. That history leads into GLP-1s. Ricks describes drugs with big effects and a much messier life outside the headline results. Cost is the first grind. Many people are paying out of pocket even with insurance, so the promise of the drugs runs into household arithmetic fast. Side effects are not footnotes either. Nausea and gastrointestinal distress can become practical limits, and elderly patients can have management issues that make the regimen harder to live with. Then comes adherence, which may be the least glamorous and most familiar problem. Some people do so well that they stop, then return to treatment, then repeat the loop. Ricks compares that pattern to other chronic medications. The next frontier splits a few ways. One path is stronger weight loss, with the host pointing to Retatrutide and its December readout alongside Terzepatide. Another is a gentler version of the same promise: can twenty-to-twenty-five percent weight loss come with fewer peak-to-trough effects and less physical distress? A third path goes beyond weight. The host wonders whether a future GLP-1 could put a non-weight-loss benefit, such as inflammation or Alzheimer's plaque reduction, at the center instead of treating it as a side effect. The final turn is language models. The host says medicine lacks an internet of human anatomy, the giant corpus that lets language models map words. Ricks accepts the frame but keeps it sober: biology needs its own language, because today's language models do not simply translate into the body. The closing image lands nicely. Next to internet-trained text models, medicine is still learning biology like a toddler learning speech.

As heard by us

A sharp GLP-1 conversation on cost, chronic disease, side effects, and AI medicine's unfinished biology problem.

Derek Thompson uses GLP-1 drugs to ask where medicine goes after the long decline of smallpox and bacterial infection. In conversation with Eli Lilly CEO David Ricks, the focus is less hype than public consequence: drugs that can change weight and chronic disease risk are…

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Why you'd press play

Press play if you want a thoughtful look at where GLP-1 drugs could go next, plus the AI-for-biology problem, not a press release.

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