Do GLP-1 Medications Increase Suicide Risk?

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Today’s Health Upgrade

• Arnold’s Corner: Monday motivation

• GLP-1 and suicide?

• Jumpstart your week

• Workout of the week

Arnold’s Corner
Monday Motivation

I’ll always remember the first time someone asked me questions in the gym.

It was about their legs. They said they couldn’t grow, and they wanted to know which exercises to add to their routine to hit the thighs.

First, I said, “Let’s see your squat.”
And they said, “My squats are fantastic. I can squat 405.”

They got the weight on their back and lowered approximately 2 inches, and came back up.

That’s when I learned that people have a habit of looking for the next big thing when they haven’t spent any time mastering the simple thing in front of them.

So, let’s talk basics.

When you have an app with tens of thousands of members and a newsletter with almost a million subscribers, you get a lot of questions.

I love it.

It shows me what people are worried about. It helps us in our writer’s room meetings.

We can answer the biggest questions you have because we have our ears to the ground. We are in the trenches with you.

But I’ve said this before, and I need to say it again.

A lot of you are missing the forest for the trees. You’re majoring in the minor. You’re getting in the weeds.

And that’s OK. I’ve seen it all over my five decades in fitness. If it seems like I’ve always been here for people who want help in the gym, it’s because I have. It’s part of running a fitness crusade!

But I have to tell you: if you’re worried about the details and you are not nailing the basics, you’re making a major mistake.

I have seen this for decades, but in the social media era, it has become much worse.

In the old days, it was easier. People would tell me rows don’t work for them and they need a different exercise to hit their lats, and then I would watch them do their rows and see they were doing half-reps, not a full stretch and flex.

People would ask about the latest supplement, and I would ask them whether they were getting protein, vegetables, and fruit, and they looked at me, well, like I told them to eat their vegetables.

Now, with social media, someone is trying to sell you every fad and trend on the market. To do that, they scare the shit out of you.

So instead of asking yourself if you’re eating mostly protein, vegetables, fruit, and healthy carbs, you decide that seed oils, not eating for two days, the newest supplement, or cutting everything but meat out of your diet must be what you’re missing.

Instead of asking yourself if you’re consistently training with the basic moves that have made people stronger for millennia, you think you’re missing that new workout that promises 28-day abs.

You research. You read. You get deep into the weeds.

But you don’t do the work.

It’s time to be honest with yourself.

If you aren’t doing the basics, why are you worried about “optimizing” anything?

You’re not optimizing right now. You’re missing the 99% with the hope that the 1% will save you.

If you’re putting off training, or putting off cutting your portion sizes, or putting off eating more protein and vegetables, what are you worried about?

You’re worried about things that don’t matter.

Because here is the truth.

All those details are excuses. All those podcasts and Twitter threads are something to do instead of getting to work.

Just do the work. When you nail the basics, you can start to worry about the details.

The basics are simple:

• Eat protein

• Eat vegetables and fruits

• Eat healthy carbs

• Train with the movements that have always worked

• Walk

• Drink enough water

• Sleep

If you can’t check all of those boxes — and be honest with yourself, count this weekend where you ate wings and fries and drank beers and missed your workouts and never saw a vegetable — why are you worried about what supplement to take, or the perfect workout, or the “optimal” diet?

You aren’t trying now. You’re stalling. You think one of these things might be a magic pill.

It doesn’t exist.

Do the basics. Stop stalling for all the research. Start now.

The basics worked for thousands of years and you think some guy on Twitter just invented the answer to your problems for $79.99?

The answer to your problems is you.

You have to check those boxes. You have to do the basics. You can do it.

It won’t be magic. It won’t be fast. It won’t be exciting.

But in a few months, I promise you’ll come back to me and say, “It worked.”

Health 
Do GLP-1 Medications Increase Suicide Risk?

A new study suggests that GLP-1 agonist medications (the reason why Ozempic and Wegovy are effective in the fight against diabetes and obesity) were linked to an increase in suicide. 

Immediately, the headlines and social media posts assumed the worst. So, we looked at the latest research causing headlines and other studies.

Based on what we know, it’s inaccurate and misleading to claim that GLP-1 agonists are causing an increase in suicidal thoughts.

The main reason is that the latest study did not just examine GLP-1 agonist use; other studies with more data suggest a very different relationship. 

Research on more than 240,000 patients who are overweight or battling obesity and another 1.5 million patients with type 2 diabetes were tested for suicidal behaviors. The scientists found that taking GLP-1 medications decreased the incidence of suicidal ideation. 

To compare, the study getting all the headlines examined 107 patients who were taking the GLP-1 medications. Just because there were fewer subjects does not invalidate the research. However, a closer look at the data requires us to calm down rather than panic. 

Those who showed an increase in suicidal tendencies also were taking anti-depressants, benzodiazepines, or both. So was it the GLP-1, the anti-depressants, the combination, or some other variable, such as people who are depressed have higher levels of suicidal ideation (which is a known relationship)? Not to mention, the researchers did not know if the participants had suicidal ideation before they started the medication.

After a deeper analysis of the data, the researchers pointed out that,  

“When repeating the analysis after excluding cases in which antidepressants were coreported, we did not detect a disproportionality signal.“

Translation: those who were just taking GLP-1’s and not on other medications did not show an increase in suicide. 

It’s a great reminder that while many studies come out every day, it’s important not to overreact and wait until we have more clarity. The latest study is worth further examination to ensure there’s no increased risk. And there are most certainly other downsides to using GLP-1 medications that require your consideration if you want to use them. 

However, based on the studies we have right now — and the millions of users on GLP-1’s — there’s not strong evidence suggesting GLP-1’s will increase suicide, and there is not a clear mechanism that makes this likely. 

Jumpstart Your Week

Build More Muscle With Breakfast

If you want to skip breakfast, you can be completely healthy. But to maximize muscle growth, you might want to take advantage of eating earlier in the day. 

Research suggests that people who eat more protein for breakfast tend to pack on more muscle. 

Researchers aimed to understand if the timing of protein intake, specifically at breakfast, plays a significant role in muscle health and physical performance. While we preach including protein at each meal, doubling down on a high-protein breakfast might tip the scales in your favor if you’re trying to add lean muscle. 

The latest study found that eating more protein in the morning was linked to more significant muscle gains than eating your highest protein meal at other times, such as lunch or dinner.

The scientists also found that protein quality affects muscle mass and strength. In particular, those who ate more high-quality protein for breakfast—as assessed by the PDCAAs or “protein digestibility corrected amino acid score,” which shows how well your body can use protein — lost less grip strength.

If you’re looking for a premium protein with the highest protein digestibility score, Momentous is our top choice. Not just because it gives you all the protein and amino acids your body needs, but they have reset the standard for purity and quality. That means you can trust the label because they invest in third-party certification. 

If you count macros, aim for 1.6 to 2.2 grams of protein per kilogram of goal body weight. Or, if you want to make the most of your breakfast, aim for 30 to 60 grams of protein in your first meal. Research suggests you can digest upwards of 100 grams of protein depending on your body size. 

Our favorite ways to add extra protein to our breakfast include Greek yogurt, eggs, protein shakes, lean meat, or protein pancakes. 

While more research is needed to determine why it works, it does appear that bumping up your protein in the morning — or potentially making your first meal the one with the most protein — could be advantageous if you’re trying to add muscle or strength. 

High-Protein Pancake Recipe

If you need help eating more protein for breakfast and are tired of eggs, this recipe from You Can’t Screw This Up (currently 50% off!) was a favorite of the people who tested the program.

Whether you love the kitchen or are new to it, this recipe does not require fancy ingredients and can be ready in as little as 20 minutes. 

Note: This recipe will make six large pancakes (a serving is two pancakes)

Ingredients

• 1 cup old-fashioned rolled oats

• 1 teaspoon baking powder

• 1 scoop whey protein or plant protein powder 

• 1/4 teaspoon ground cinnamon

• 3 eggs

• 3/4 cup of milk of your choice

• 1/2 teaspoon pure vanilla extract

• 2 tablespoons butter

• 5 dates, pitted and finely chopped

• 2 tablespoons pure maple syrup

Instructions

1. Combine the oats, baking powder, protein powder, and cinnamon in a blender or food processor. Pulse until the oats are the texture of flour. Set aside.

2. In a medium bowl, whisk the eggs, milk, and vanilla. Slowly mix the dry ingredients into the wet ingredients until just combined, taking care not to over mix.

3. Add 1 teaspoon of the butter to the pan and melt it over medium-high heat. Pour in 1/4 cup of the pancake batter. Sprinkle with one-sixth of the chopped dates. When the top of the pancake begins to bubble, about three minutes, it’s ready to flip. Repeat to cook the other side for two or three minutes, then plate the pancake.

4. Repeat with the remaining batter to make five more pancakes, using more butter as needed.

5. Enjoy immediately.

Fitness
Workout of the Week

Two weeks ago, we shared three workouts designed around “minimum effect dose.” Each workout was time-friendly and only required a few movements, which is exactly what you wanted — short, intense, and effective. 

So here are three more workouts (two weighted and one bodyweight) that will challenge all the muscles in your body by helping you think less and focus on getting better. 

How to do it

For each workout, perform 3 “work-up” sets (AKA warmups), where you gradually add weight until you hit your “working sets.” 

Day 1

• Exercise 1: Front squat: 4 reps, 2 reps, 3 reps

• Exercise 2: Bent-over row: 4 reps, 2 reps, 3 reps

Select a weight you can typically lift for six reps (the weight will be different for both exercises). Then do four reps of front squats followed by four reps of bent-over rows (yes, that means you will feel like you can do more reps, but don’t).

Then do two reps of front squats followed by two reps of bent-over rows. And finally, finish with three reps of front squats and three reps of bent-over rows. That’s 1 set. Even though you were using a weight you could do for six reps, the “extended sets” will allow you to do a total of 9 reps per set. Rest for 3 to 5 minutes, then repeat another 1-2 rounds. 

Day 2

• Exercise 1: Straight leg-deadlifts x 5 reps, 3 reps, 4 reps

• Exercise 2: Overhead press x 5 reps, 3 reps, 4 reps

Select a weight you can normally lift for ten reps (the weight will be different for both exercises). Then do five reps of deadlifts followed by five reps of overhead presses. Then do three reps of deadlifts followed by three reps of overhead press. And finally, finishg with four reps of deadlifts and four reps of overhead presses. That’s 1 set. Even though you were using a weight you could do for ten reps, the “extended sets” will allow you to do a total of 12 reps per set. Rest for 3 to 5 minutes, then repeat another 1-2 rounds. 

Day 3 (bodyweight)

Perform the following workout as a circuit, performing one set of each exercise in order, resting as little as possible. Once you complete one set of each exercise, rest for 2-3 minutes, and then repeat 1 to 3 more times. 

1. Superman: 3 sets x 10-15 reps

2. Step up: 3 sets x 8-12 reps per leg

3. Pushup: 3 sets x 8-15 reps

4. Squat: 3 set x 10 reps

5. Side plank: 3 x 20 seconds per side

Give it a try, and let us know what you think!

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Publisher: Arnold Schwarzenegger​

Editors-in-chief: Adam Bornstein and Daniel Ketchell