― Taking on the Pandemic of the 21st Century

 GLP1.com's Challenge —

 

 The Zeppbound Diet

 

​

 Author: Yoshihiko Suzuki
Publisher: MyMedipro Co., Ltd.

 

 

 Table of Contents

 

 Chapter 1: The Full Story of ZeppBound, a Revolutionary Medication

​

 Chapter 2: Remarkable Clinical Effects and Scientific Evidence

​

 Chapter 3: Safety Profile and Guidelines for Appropriate Use

​

 Chapter 4: Detailed Comparison with Similar Drugs and the Latest Trends by 2025

​

 Chapter 5: The Reality of Healthcare Disparities in the United States

​

 Chapter 6: Innovative Approaches in Japan

​

 Chapter 7: GLP1.com: A Revolutionary Platform

​

 Chapter 8: Dr. Yoshihiko Suzuki's Career and Medical Philosophy

​

 Chapter 9: The Conflict with the Japanese Diabetes Society and Their Beliefs

​

 Chapter 10: Medical DX Realized by MyMedipro

​

 Chapter 11: Impact on the Beauty Industry and Market Transformation

​

 Chapter 12: The Future and Prospects of Healthcare in Japan

 

 

 Preface: A Challenge to Bring a New Breeze to Japanese Healthcare

 

 Preface

 I would like to reflect with you on the significant turning point that modern Japanese healthcare is currently facing. Obesity is now referred to as the "pandemic of the 21st century."

 

 As we enter 2025, Japan's annual medical expenses exceed 50 trillion yen, and with the progress of a super-aging society, the medical insurance system is at a critical juncture. Under these circumstances, there is a reality that medical services that are truly needed are not being adequately provided due to institutional constraints. In particular, the importance of preventive medicine, which prevents disease before it occurs, has not been sufficiently recognized, and this is an important issue that we must address.

 "From treatment to prevention"—with this philosophy in mind, Dr. Yoshihiko Suzuki, the author of this book, has been working to build a new healthcare system since 2020.

 Having graduated from the School of Medicine at Keio University and worked for many years on the front lines of clinical practice as a specialist in diabetes, the author poses an important question. Why is a drug that has been scientifically proven to reduce the relative risk of diabetes onset by 94% in obese/overweight prediabetics, as demonstrated in the SURMOUNT-1 trial (results to be published in 2024), not covered by insurance for preventive purposes? This question goes beyond mere doubts about the system and highlights the fundamental challenges facing Japan's healthcare system.

 Driven by this awareness, the author established "GLP1.com" in 2025, based on his own developed medical DX platform "MyMedipro." This book details how to improve access to healthcare and provide the latest medical care to more people, using the innovative obesity treatment "Zepbound" as an example of a "21st-century pandemic."

 Additionally, we explore the potential of medical DX, including the world's first MD-REP-ID system for ensuring medical transparency and the creation of new business models such as B2Dr/B2B.

 This book has been written in simple language to make it accessible to readers without medical expertise. We hope to share our vision of a new horizon for healthcare in Japan with you.

 

 

 

 Preventing the Onset of Diabetes: Zeppbound (Part 1)

 

 

 

 Chapter 1: The Full Story of Zeppbound, a Revolutionary Drug

 

 1-1. What is Zepbound? A Detailed Explanation of Basic Information

 Zepbound (Zepbound) is a groundbreaking obesity treatment developed by Eli Lilly and Company, a major U.S. pharmaceutical company. Its active ingredient, "tirzepatide," is an innovative substance that fundamentally challenges the conventional concepts of obesity treatment.

 Development and Approval Process

 The development of tirzepatide began with research into treatments for type 2 diabetes. Eli Lilly's research team discovered an innovative approach called a "dual agonist," which simultaneously targets both GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic polypeptide) while mimicking the effects of incretin, a hormone produced in the intestines.

•  November 8, 2023: U.S. Food and Drug Administration (FDA) approves new drug for chronic weight management

•  December 20, 2024: Indication expanded to include treatment of obstructive sleep apnea (OSA)

•  March 19, 2025: Listed in the Japanese drug price list. The release date will be determined by the pharmaceutical company and is expected to become available for use.

 The introduction of this drug can be said to have put an end to the long-standing debate over the ●●● diet. Of course, carbohydrate restriction may be suitable for some individuals and should be considered as one of the dietary approaches tailored to individual health conditions and lifestyle habits.

 

 Dangerous "carbohydrate restriction" vs. safe "incretin diet"

 

 

 The Current State of the Global Obesity Problem

 According to the latest data from the World Health Organization (WHO), as of 2022, approximately 16% of the global adult population (over 1 billion people) is obese, and 39% is overweight. This represents nearly a threefold increase compared to 1980, and obesity is now referred to as the "pandemic of the 21st century."

 

 America's Path to Becoming a Nation Free from Obesity: 10 Pitfalls and Strategies to Overcome Them—Keywords: Saxenda, Mounjaro, and Zepbound

 

 

 In Japan, approximately 33% of adult men and 22% of adult women are obese (BMI of 25 or higher), and over 10 million people are at risk of developing diabetes. Obesity is not merely a cosmetic issue but a risk factor for various diseases, including type 2 diabetes, cardiovascular disease, stroke, cancer, and sleep apnea.

 Who is eligible for ZeppBound?

 ZepBound is intended for individuals who meet the following criteria:

1.  Obese patients with a BMI (body mass index) of 35 kg/m² or higher

   •  BMI = weight (kg) ÷ height (m) ÷ height (m)

   •  Example: For a person who is 170 cm tall and weighs 87 kg, BMI = 87 ÷ 1.7 ÷ 1.7 = 30.1

2.  Overweight patients with a BMI of 27 kg/m² or higher and the following comorbidities:

   •  Hypertension (systolic blood pressure of 140 mmHg or higher or diastolic blood pressure of 90 mmHg or higher)

   •  Dyslipidemia (LDL cholesterol 140 mg/dL or higher, etc.)

   •  Type 2 diabetes (HbA1c ≥ 6.5%)

   •  History of coronary artery disease

   •  History of cerebrovascular disease

 Special considerations for Japanese individuals

 Asians are known to accumulate visceral fat more easily than Westerners even at lower BMIs, and have a higher risk of diabetes and cardiovascular diseases. Therefore, Japan has established its own criteria, defining a BMI of 25 or higher as "obesity."

 

 1-2. Why does it work? The scientific mechanism of dual hormone action

 The innovation of Zepbound lies in its unique mechanism of action. While conventional GLP-1 receptor agonists have only a single hormonal effect, Zepbound simultaneously exerts the effects of two incretin hormones, "GLP-1" and "GIP."

 What are incretins?

 Incretins are a group of hormones secreted from the small intestine after eating, playing a crucial role in regulating blood sugar levels. In healthy individuals ( ), 50-70% of postprandial blood sugar spikes are controlled by incretin action. Until 2025, the primary anti-obesity medication fulfilling this role was liraglutide, marketed as Saxenda.

 

 Safe and secure GLP-1 diet with Saxenda

 

 

Currently, Saxenda has shown efficacy in clinical trials for obese adolescents and children, and has been approved in some countries overseas. However, it has not been approved in Japan as a treatment for obese children.

 

 A first step toward obesity treatment for children: Discover a new you with Saxenda

 

 In the future, generic versions of Saxenda may become available. At our clinic, we currently offer a product called Plaobes, but this is not a generic version of Saxenda approved under Japan's public healthcare system. It is provided as an out-of-pocket treatment at beauty clinics and other facilities. Use should be approached with caution.

 

 GLP-1 Mechanism of Action

1.  Appetite Suppression

   •  Directly acts on the hypothalamus in the brain's feeding center

   •  Enhances feelings of fullness and reduces feelings of hunger

   •  Enhances meal satisfaction and suppresses the desire for snacks

2.  Gastric emptying delay

   •  Slows the movement of food from the stomach to the small intestine

   •  Maintains a prolonged feeling of fullness after meals

   •  Prevents rapid increases in blood sugar levels

3.  Promotes insulin secretion

   •  Acts on pancreatic beta cells to promote insulin secretion in a blood glucose-dependent manner

   •  Acts only when blood sugar levels are high, reducing the risk of hypoglycemia

4.  Inhibits glucagon secretion

   •  Inhibits glucagon secretion from pancreatic α cells

   •  Reduces gluconeogenesis in the liver

 Additional effects of GIP

 GIP, known as "another incretin," has the following unique effects:

1.  Improves fat metabolism

   •  Promoting energy consumption in fat cells

   •  Increased thermogenesis through activation of brown adipose cells

   •  Prioritized reduction of visceral fat

2.  Positive effects on bone metabolism

   •  Promotes bone formation and inhibits bone resorption

   •  Maintenance and improvement of bone density with long-term use

3.  Improved insulin sensitivity

   •  Enhances insulin action in muscles and liver

   •  Improves insulin resistance

 Synergistic effects of dual agonists

 Chilzeptid acts on both GLP-1 and GIP, resulting in the following synergistic effects:

•  Weight loss effects are enhanced to 1.5–2 times those of monotherapy

•  More stable blood glucose control

•  Comprehensive improvement in lipid metabolism

•  While there is a suggestion that weight loss may reduce cardiovascular risk, the efficacy of cardiovascular event prevention has not yet been established.

 1-3. Complete Guide to Proper Use and Storage

 Detailed administration instructions

 Zepbound is a once-weekly subcutaneous injection formulation. Administer as follows:

 

 https://www.incretin.diet/zepboundを参照

1.  Preparation

   •  Thorough hand washing

   •  Check the appearance of the medication (it should be clear and free of particles)

   •  Bring to room temperature (remove from refrigerator and allow to stand for 15-30 minutes)

2.  Select the injection site

   •  Abdomen: 5 cm or more away from the navel

   •  Thigh: Front or outer side of the thigh

   •  Upper arm: Deltoid muscle area (if self-injection is difficult, have an assistant perform the injection)

3.  Administer the injection

   •  Disinfect the injection site with an alcohol swab

   •  Pinch the skin and insert the needle at a 90-degree angle

   •  Slowly inject the medication

   •  Wait 5–10 seconds before removing the needle

4.  Post-injection care

   •  Gently press the injection site (do not massage)

   •  Dispose of used needles in a dedicated container

 https://jp.lilly.com/zepbound-patient

 An explanatory video is available at the above URL. Please refer to it.

 

 

 

 Dosage adjustment schedule

 Zepbound is administered in gradually increasing doses to minimize side effects:

•  Weeks 1–4: 2.5 mg/week (starting dose)

•  Weeks 5–8: 5 mg/week

•  Weeks 9–12: 7.5 mg/week

•  Weeks 13–16: 10 mg/week

•  Weeks 17–20: 12.5 mg/week

•  Week 21 onwards: 15 mg/week (maximum dose)

 If severe side effects occur at any stage, continue the same dose for at least 4 weeks before proceeding to the next stage.

 Storage and handling

1.  Unopened formulation

   •  Store in a refrigerator (2–8°℃ )

   •  Do not freeze (discard if frozen)

   •  Quality guaranteed until the expiration date

2.  Opened or in-use formulations

   •  Store at room temperature (30°C or below) and use within 21 days

   •  Avoid direct sunlight and high temperatures

   •  Do not leave in a car or other place where temperatures may rise

3.  Travel precautions

   •  Transport in a cooler bag

   •  Prepare a doctor's certificate for carrying on board an aircraft

   •  Maintain a weekly schedule even when there is a time difference

 

 1-4. Current status of drug prices and insurance coverage in Japan

 Medication prices as of March 2025

 The drug prices for Zepbound in Japan are as follows:

•  2.5 mg formulation: 3,067 yen per vial

•  5 mg formulation: 5,797 yen per vial

•  7.5 mg formulation: 7,721 yen per vial

• 10 mg formulation: 8,999 yen per bottle

•  12.5 mg formulation: 10,180 yen per vial

•  15 mg formulation: 11,242 yen per vial

 Current status and challenges of insurance coverage

 Unfortunately, insurance coverage for obesity treatment drugs in Japan is very limited:

1.  Cases eligible for insurance coverage

   •  Severe obesity with a BMI of 35 or higher

   •  Presence of health complications caused by obesity (diabetes, hypertension, dyslipidemia, etc.)

   •  Insufficient response to diet and exercise therapy

   •  When deemed necessary by a physician

2.  Cases where treatment is self-pay

   •  Use for cosmetic purposes

   •  Preventive use for individuals with a BMI below 35

   •  Obesity without associated health complications

 Due to these strict insurance coverage criteria, many patients are forced to bear out-of-pocket expenses of over 20,000 to 30,000 yen per month at cosmetic surgery clinics or dermatology clinics. This is one of the main reasons why I launched GLP1.com.

 

 

 

 Chapter 2: Remarkable Clinical Effects and Scientific Evidence

 

 2-1. The Overwhelming Weight Loss Effects Proven by the SURMOUNT Trial

 The SURMOUNT (Tirzepatide for the Treatment of Obesity) trial series is a groundbreaking clinical trial series that scientifically demonstrated the efficacy of Zepbound.

 Details of the SURMOUNT-1 Trial

•  Participants: 2,539 obese patients (BMI 30 or higher, or BMI 27 or higher with complications)

•  Study duration: 72 weeks (approximately 1.5 years)

•  Trial Design: Double-blind, placebo-controlled trial

 Remarkable Results

 Average weight loss rate (at 72 weeks):

•  Placebo group: 3.1% (approximately 2.4 kg)

•  Zepbound 5 mg group: 15.0% (approximately 13.4 kg)

•  Zepbound 10 mg group: 19.5% (approximately 17.8 kg)

•  Zepbound 15 mg group: 20.9% (approximately 19.0 kg)

 Notably, over 50% of participants in the 15 mg group achieved a weight loss of 20% or more, which in some patients may achieve weight loss comparable to surgical procedures; however, surgical procedures generally demonstrate greater weight loss effects.

 

 

 

 The demand for aesthetic medical procedures centered on liposuction may change with the widespread adoption of pharmacological therapies.

 

 

 

 Temporal changes in weight loss

•  Week 4: Average 2-3% reduction (onset of appetite suppression effect)

•  Week 12: Average 5-9% reduction (additional metabolic improvement effects)

•  Week 24: Average 12-15% reduction (changes in body composition)

•  Week 48: Average 18-20% reduction (overcoming the plateau phase)

•  Week 72: Achievement and maintenance of maximum effect

• ​

•  (Takashi Kadowaki, Arihiro Kiyosue, Tomotaka Shingaki, Tomonori Oura, Koutaro Yokote. Efficacy and safety of once-weekly tirzepatide in Japanese patients with obesity disease (SURMOUNT-J): a multicenter, randomized, double-blind, placebo-controlled phase 3 trial.www.thelancet.com/diabetes-endocrinology

•  Published online February 28, 2025 (SURMOUNT-J)  https://doi.org/10.1016/S2213-8587(24)00377-2)

 

 2-2. Multifaceted health benefits beyond weight loss

 The effects of Zepbound extend beyond mere weight loss:

 Improvement in metabolic parameters

1.  Improved blood glucose control

   •  HbA1c: Average decrease of 1.5–2.0%

   •  Fasting blood glucose: 20–30 mg/dL decrease

   •  Postprandial blood sugar: 40-60 mg/dL decrease

   •  Insulin resistance index (HOMA-IR): 40-50% improvement

2.  Lipid profile

   •  Total cholesterol: 10–15% decrease

   •  LDL cholesterol: 15-20% decrease

   •  Triglycerides: 25-35% decrease

   •  HDL cholesterol: 5-10% increase

3.  Blood pressure

   •  Systolic blood pressure: 5-10 mmHg decrease

   •  Diastolic blood pressure: 3-7 mmHg decrease

 

 Go! Zepbound Diet: Surmount-1

 

 

 

 

 

 2-3. Effects on Japanese individuals and specific adaptation criteria

 Results of the Japanese Subgroup Analysis

 The SURMOUNT trial included Japanese patients, yielding interesting results:

1.  Weight loss effect

   •  Japanese: Average 18.5% (similar to Westerners)

   •  Visceral fat area: 35–40% reduction (more pronounced than in Westerners)

   •  Subcutaneous fat area: 25–30% reduction

2.  Metabolic improvement effects

   • Japanese people showed greater improvement in HbA1c (average decrease of 2.2%)

   •  Improvement in insulin secretion capacity is significant

3.  Side effect profile

   •  The incidence rate of gastrointestinal symptoms is comparable to that of Westerners

   •  Tolerability is good with dose adjustment

 

 Asian-specific obesity paradox

 Asians are prone to a condition called "normal weight obesity," in which even with a BMI of around 25:

•  Visceral fat accumulation

•  Insulin resistance

•  Dyslipidemia

•  High blood pressure

 These risks are equivalent to those of Westerners with a BMI of 30.

 

 

 

 

 

 Chapter 3: Safety Profile and Proper Use

 

 3-1. Management of Gastrointestinal Side Effects

 The most common side effects of Zepbound are gastrointestinal symptoms. However, with appropriate management, most patients can continue treatment.

 Management of Nausea (20–30%)

1.  Preventive measures

   •  It is acceptable to reduce the number of meals.

   •  Avoid high-fat meals

   •  Do not lie down immediately after eating. Be cautious of GERD (gastroesophageal reflux disease).

   •  Avoid hard-to-digest foods.

   •  Meals should be individualized, and options such as low-carbohydrate diets should be selected based on suitability and preferences.

For more details, please refer to the following book. Manjaro contains the same active ingredient as Zepbound, so the dietary precautions for are largely the same. We plan to publish a Zepbound edition of the following book shortly.

 

 Mangaro: Leading the Way to a New Era of Dieting—Diabetes Diet Therapy Revolutionized

 

 

1.  Management of Symptoms When They Occur

   •  Please refer to the content in "incretin.diet."

   •  https://www.incretin.diet/zepbound

   •  Use of antiemetics as needed (under a doctor's supervision)

   •  In my case, I prescribe SM acid.

   •  If your treating physician is insufficiently informed, consider changing physicians.

2.  Adjust the dosage.

   •  Postpone dose increase (continue the same dose for more than 4 weeks)

   •  Consider temporarily reducing the dosage

 The main side effects are gastrointestinal symptoms.

 Diarrhea (15-20%)

•  Provide guidance on fluid and electrolyte replacement and dietary changes

•  Avoid foods that are prone to causing indigestion

 Constipation (10%)

•  Increase fiber intake

•  Increase fluid intake (2 liters or more per day)

•  Moderate exercise

•  Use of laxatives (such as magnesium oxide) as needed

•  Consider using  Boufuu Tsuusho San (a traditional Japanese herbal medicine). 

 (Bofutsu-tsusho-san is used for obesity, constipation, hypertension, and is expected to promote fat burning, metabolism, and diuretic and laxative effects. It is suitable for those who overeat or have excessive visceral fat, and contains 18 herbal ingredients (e.g., Bofu, Ougon, Daio, etc.).)

 

 The importance of patient education is emphasized.

1.  Self-injection guidance

   •  Mastering proper technique

   •  Rotation of injection sites

   •  Needle disposal methods

2.  Lifestyle guidance

   •  Continuation of Diet Therapy

   •  Implementation of exercise therapy

   •  Adequate sleep

3.  Emergency response

   •  Symptoms of severe side effects

   •  Confirmation of contact information

 

 

 

 https://36a1278c-0a36-4915-ae6d-065315178372.usrfiles.com/ugd/36a127_b26dc9bca0da4343bf99c888d892879c.pdf

 Download the materials from the above URL and confirm other details.

 

 

 Chapter 4: Core Issues in U.S. Litigation

 

 4-1. Differences from Manjarro, Ugobi, Ozempic, and Liberasas

 Comparison of Drug Profiles

1.  Mounjaro (Mounjaro)

   •  Active ingredient: Tirzepatide (same as Zepbound)

   •  Indications: Treatment of type 2 diabetes

   •  Weight loss: Secondary effect of 15-20%

   • Situation in Japan: Approved as a diabetes treatment drug. Use for weight loss purposes is prohibited.
     Refer to https://www.glp1.com/illegality.

2.  Wegovy (Semaglutide)

   •  Active ingredient: Semaglutide 2.4 mg

   •  Indications: Treatment of obesity

   •  Weight loss: Average 13-15%

   •  Mechanism of action: GLP-1 agonist

   •  Status in Japan: Approved in 2024

3.  Ozempic

   •  Active ingredient: Semaglutide 0.5–1.0 mg

   •  Indications: Treatment of type 2 diabetes

   •  Weight loss: Secondary effect of 5-10%

   •  Current usage: Use for obesity treatment outside the approved indication is a violation

 

 Are doctors prescribing Ozempic inappropriately okay?

 

 

 4. Libersus

•  Active ingredient: Semaglutide

•  Indications: Treatment of type 2 diabetes

•  Weight loss: Limited at low doses, but a weight loss effect of approximately 15% has been reported at high doses (50 mg/day)

 Prescribing a drug that does not cause weight loss as a weight-loss medication is a violation. The number of complaints received by the Consumer Affairs Agency regarding Liberasus has been increasing, with reports of "results not as expected" and "health issues arising." In the United States, cases have even escalated to litigation.

 

 1. Core issues of lawsuits in the United States

 The reality of misleading marketing

 Novo Nordisk has been involved in multiple lawsuits for marketing Liberasus, which was originally approved as a treatment for type 2 diabetes, as a "weight-loss drug."

 The problematic tactics:

•  Including the phrase "may help with weight loss" in promotional materials

•  Excessively emphasizing weight loss effects while downplaying the risks of side effects

•  Implicitly recommending off-label use for purposes other than diabetes treatment

 Serious adverse effects: Patients who used the drug for weight loss have reported the following severe adverse effects:

•  Gastric paralysis (cessation of stomach movement)

•  Intestinal obstruction

•  Vision loss

•  Hospitalization due to severe gastrointestinal disorders

 2. Expansion of class-action lawsuits and current status

 Scale of MDL (Multi-District Litigation)

•  Case Number: MDL No. 3094 (U.S. District Court for the Eastern District of Pennsylvania)

•  Target drugs: Rybelsus, Ozempic, Wegovy, and other GLP-1 receptor agonists

•  Number of plaintiffs: Expanded to several thousand as of July 2025

•  Specific Example: A woman in Michigan was hospitalized with severe gastrointestinal complications after using Rybelsus and claims the drug was falsely marketed as a "safe weight-loss medication."

 3. Devastating Impact on Novo Nordisk

 Direct impact on operations

 On July 29, 2025, according to a Reuters report from Copenhagen:

•  Announced a downward revision of performance forecasts

•  CEO (Chief Executive Officer) replacement

•  Stock price plummeted, resulting in a loss of hundreds of billions of dollars (tens of trillions of yen) in market capitalization

 Serious liability risks

 If the company loses the lawsuit:

•  Payment of massive compensation (examples of past pharmaceutical litigation cases involving compensation in the tens of billions of yen)

•  Loss of market share due to loss of credibility

•  Sanctions from regulatory authorities

 4. Risk of spillover to Japan

 Similar issues exist in Japan

•  Increasing number of medical institutions prescribing Liberasus as a "medical diet"

•  High-cost private medical treatment at beauty clinics

•  Insufficient explanation of side effects

 Possibility of class-action lawsuits

 In Japan, class action lawsuits may arise under the following conditions:

1.  An increase in the number of victims suffering severe side effects

2.  Increased awareness of issues related to marketing

3.  Heightened social concern due to the impact of U.S. litigation

 Conclusion: A warning to healthcare providers

 This issue is not limited to Novo Nordisk alone. Healthcare facilities that prescribe Liberasus as a "diet drug" without proper consideration may also face litigation risks in the future. Healthcare professionals must fully recognize the risks of off-label use and ensure appropriate patient education and cautious prescribing.

 

 Using Libersus for weight loss is nothing but a waste of money.

 

 

 (Figure explanation) In Japan as well, it would not be surprising if class-action lawsuits were filed by women who have been prescribed Libersus for weight loss purposes.

 (Note)

 According to data from the National Consumer Affairs Center of Japan, consultations regarding online consultations and regular purchases of diabetes medications (GLP-1 agonists, e.g., Liberasas and similar drugs) for weight loss purposes have increased, with 49 cases in fiscal year 2021, 205 cases in fiscal year 2022, and 169 cases (as of October) in fiscal year 2023. These consultations include cases where patients were prescribed Ozempic or Liberasus but reported issues such as "results not as expected" or "adverse health effects."

 

 

 

 

 Chapter 8: Direct Comparison of Efficacy (SURMOUNT-5 Trial)

 

 This study summarizes the results of the SURMOUNT-5 trial, an important clinical trial comparing "tirzepatide" and "semaglutide," two drugs gaining attention for obesity treatment. We will provide a clear explanation of the findings.

 

 

 

 Study Overview

 Participants

•  751 adults with obesity (BMI 30 or higher) participated in the study.

•  Participants with type 2 diabetes were excluded

•  The average age of participants was approximately 45 years, with approximately 65% being women

•  The average weight was 113 kg, and the average BMI was 39.4

 Drugs compared

•  Chilzepacid: A weekly injection of 10 mg or 15 mg.

• Semaglutide: One injection per week, using 1.7 mg or 2.4 mg

 Both were administered at the maximum tolerated dose (the highest dose that can be tolerated without side effects) for 72 weeks (approximately 1 year and 4 months).

 

 Main results

 • Weight loss effect

 Participants who received semaglutide achieved an average weight loss of 20.2%, while those who received semaglutide achieved 13.7%. This means that semaglutide resulted in approximately 6.5% greater weight loss.

 

 

 

 (Louis J. Aronne, M.D.,  Deborah Bade Horn, D.O., Carel W. le Roux, M.D., Ph.D., Wayne Ho, M.D., Beverly L. Falcon, Ph.D., Elisa Gomez Valderas, M.Sc., Sagar Das, M.Sc., Clare J. Lee, M.D., M.H.S., Leonard C. Glass, M.D.,  Cagri Senyucel, M.D., Ph.D., and Julia P. Dunn, M.D., for the SURMOUNT-5 Trial Investigators*, Tirzepatide Compared with Semaglutide for the Treatment of Obesity. N Engl J Med. 2025 Jul 3;393(1):26-36.

 

 When looking at specific numbers:

•  Tirzepatide: Average weight loss of 22.8 kg

•  Semaglutide: Average weight loss of 15.0 kg

 Achievement rate of target weight loss

 The percentage of participants achieving at least 10% weight loss was 81.6% in the tirzepatide group and 60.5% in the semaglutide group.

 Looking at the rate of achieving more significant weight loss:

•  15% or more weight loss: 64.6% for tirzepatide vs. 40.1% for semaglutide

•  20% or more weight loss: 48.4% in the tirzepatide group vs. 27.3% in the semaglutide group

•  25% or more weight loss: 31.6% for tirzepatide vs. 16.1% for semaglutide

 

 Waist circumference reduction

 Waist circumference decreased by 18.4 cm with tirzepatide and 13.0 cm with semaglutide. It was also found that tirzepatide was more effective in reducing waist circumference.

 ⚠️ Side effects

 The most common side effects were gastrointestinal symptoms (nausea, vomiting, diarrhea, constipation).

•  Treatment discontinuation rate due to side effects: 6.1% for Chilepatid and 8.0% for Semaglutide

•  This indicates that Chirlazepatid is more tolerable and easier to continue.

•  Serious side effects were rarely reported.

👥 Gender differences

 Interestingly, women demonstrated approximately 6 percentage points higher weight loss efficacy than men.

🏥 Clinical significance

 These trial results signal a new era in obesity treatment:

1.  Cilzepatid is currently one of the most potent obesity treatments available.

2.  However, semaglutide also demonstrates sufficient efficacy and is selected based on the patient's condition

3.  Drug selection should consider not only efficacy but also the patient's background and treatment goals.

📝 Summary

 Cilzepatid demonstrated stronger weight loss effects than semaglutide through its dual mechanism of action. It has also been proven to have relatively few side effects and to be easy to continue taking. However, both drugs are innovative obesity treatments, and it is important to consult with a physician to select the most appropriate option for each individual patient.

 

 

 

 

 

 

 Chapter 5: The Reality of Healthcare Disparities in the United States

 

 The High-Cost Barrier

 In the United States, Zepbound has an official list price of $1,086 per month, with only 18% of employer insurance covering weight loss purposes, and state Medicaid coverage is limited to 13 states with strict conditions.

 Manufacturers offer self-pay vial prices of $349/$499 and discount cards, and additional approval for OSA indications has expanded insurance coverage options. However, the high-cost structure for long-term treatment remains unchanged.

 Compared internationally, GLP-1 prices in the U.S. are several times higher than in other countries, and disparities in access based on income, employer, and state of residence are likely to persist.

 Therefore, the assessment that this represents a "symbol of healthcare disparities" is generally appropriate, and current relief measures remain limited to partial mitigations.

 

 International Comparison

•  Canada: Approximately $400 per month (38% of the U.S. price)

•  United Kingdom: Approximately $350 per month (33% of the U.S. price)

•  Germany: Approximately $450 per month (42% of the U.S.)

•  Japan: Approximately 2,000–3,000 yen per month (with insurance coverage)

• ​

 This price difference highlights the structural issues of the US healthcare system. As seen here, in the US, only the affluent can afford medication. While the US has various private insurance programs, these are merely temporary measures and do not address the underlying structural issues:

 

•  The middle-income bracket (annual income of 50,000–100,000 dollars) still faces high costs

•  Continuous treatment is difficult

•  Health disparities are becoming entrenched
  This appears to be the current reality.

 

 

 

 

 

Chapter 6: A Commitment to New Healthcare Services
— The Birth of MyMedipro

 Facing the structural challenges of Japan's healthcare system, the author has grappled with a fundamental question for many years: "How can we achieve healthcare that truly benefits patients?"

 The strict application of insurance-covered treatment criteria leaves many patients unable to access necessary care. The neglect of preventive medicine leads to increasing social losses. Additionally, the existence of high-cost beauty clinics that deviate from the essence of healthcare has raised questions about the true nature of healthcare.

 Faced with this situation, I joined forces with like-minded medical staff to explore new avenues. In doing so, we focused on online medical care, a new form of medical care that has developed rapidly in the wake of COVID-19. This system, which provides efficient medical care while respecting privacy and overcoming geographical and time constraints, was exactly the breakthrough we were looking for.

 Drawing on our experience and expertise, we have made a decisive choice: to build our own online telemedicine platform, "MyMedipro," and launch a subscription-based medical weight loss service that truly supports patients' health.

 This service is not merely aimed at weight loss. By providing evidence-based medical care at an appropriate price on an ongoing basis, we aim to support each patient's healthy life. This is our mission as healthcare professionals and the ideal form of healthcare we seek to achieve through MyMedipro.

 

 6-3. Price Revolution Through a Membership-Based Service

 Issues with the traditional pricing structure

 Price setting at beauty clinics:

•  Zepbound 2.5mg: 40,000–50,000 yen/month

•  Consultation fee: 10,000–20,000 yen

•  Other options: several tens of thousands of yen

•  Total: Cases exceeding 100,000 yen per month

 

 The new membership-based model introduced by HDC Atlas Clinic, featured on GLP1.com, is the "GLP1.com Membership Service." Its key features include:

1.  Reduced fixed costs

   •  No need for luxurious facilities

   •  Reduced advertising costs

   •  Efficient operations

2.  Economies of scale

 Lower unit prices due to increased membership

1.  Sustainability

   •  Stable revenue source through collaboration with diabetes clinical practice

   •  Building long-term relationships based on extensive experience in diabetes clinical care

   •  Achieving preventive healthcare, HDC Atlas Clinic originated from comprehensive health checkups: With a rich history in private medical care,

 This unique environment gave rise to this concept.

 

 6-4. Integrated Education and Support Model

 Utilization of digital content

•  24/7 access to educational videos

•  Webinars and other learning programs

 

 

 

 The author is a best-selling physician who has published over 80 books in this field, including analog books on dietary therapy such as "The Restaurant Calorie Book" and the "Three-Card Method."

 https://www.hdc-atlas.com/amazonbooks

 

 There are numerous books related to Zepp Bound alone.

 https://www.incretin.diet/books

 
 

 Chapter 7: GLP1.com, a groundbreaking platform

 

 7-1. How the MyMedipro Prime Membership Works

 An Innovative Membership System

 GLP1.com is a medical membership platform operated by MyMedipro Co., Ltd. The following are the official websites: , https://www.glp1.com/, and .

 

 

 

 

 

 Membership Registration Process

1.  Create an account on MyMedipro.jp

   •  Enter basic information

   •  Verify your identity

   •  Register medical information

2.  Enter the dedicated code (referred to as the GLP1.com member code)

   •  Enter GLP1234567 in the Prime Code field (half-width alphanumeric characters are required).

   •  Establish connection with HDC Atlas Clinic

 

 

 

 

 

1.  Membership fee payment

   •  Monthly fee: 1,650 yen (including tax)

   •  Minimum 3-month contract

   •  Automatic credit card payment

 Member benefits

•  Significant discounts on medications (20-40% off)

•  Priority access to specialist doctors (appointments available only to members)

•  Unlimited access to educational content

•  Regular webinar participation

 

 

 

 7-2. Surprising membership pricing and its background

 Price comparison table

 

As of June 2025

 Reasons for pricing

1.  Prioritizing patient benefits

   •  Prioritizing patient benefits over profit maximization

   •  Fulfilling our social mission

2.  Efficient operations

   •  Cost reduction through online-centric operations

   •  Elimination of middle margins

3.  Promotion of preventive healthcare

   •  Long-term reduction in medical expenses

   •  Extending healthy life expectancy

 

 

 Why we started this service is explained in the following book.

 The Pitfalls of Zeppbound: Why We Started Primary Care Services

 

 7-3. Collaboration with HDC Atlas Clinic

 Dr. Yoshihiko Suzuki's Clinical Experience

•  The number of Chirlzepachid prescriptions was the highest in Japan during the first year of Manjaro's launch.

•  Treatment outcomes for diabetes patients have achieved good blood glucose control.

 

 Clinic Features

1.  Specialization

   •  Diabetes specialist-led care

   •  Treatment based on the latest evidence (attend the International Diabetes Federation conference annually to stay updated on the latest information)

   •  Practice of personalized medicine

2.  Transparency

   •  Disclosure of physicians' names

   •  Clear disclosure of treatment details

   •  Prior explanation of costs on the landing page

3.  Accessibility

   •  Online consultations available, WebRTC compatible, no app required

   •  Accessible nationwide, with an English version planned for release soon

   •  Flexible consultation hours

 

 7-4. Strict enforcement of resale prevention, proper use, and fair pricing

 Benefits of membership

1.  Strict verification of identity

   •  Credit card verification

   •  Management of prescription history recorded in electronic medical records

   •  Prevention of misuse

2.  Proper dosage management and amazing affordability

   •  Up to 3 months' supply (to prevent resale)

   •  Prevention of overprescribing

 

 

 

 Measures to prevent resale

•  Prescriptions limited to members

•  Revocation of membership for violators

•  Preparation for legal action

 

 

 

 

 After three years on the Zeppbound Diet, diabetes is cured!

 

 

 In recent years, Dr. Suzuki's claims have been proven correct in the following books. Long-term safety is now well-established.

 
Chapter 10: Medical DX Realized by MyMedipro

 

 

 

 https://www.mymedipro.co.jp/を参照.

 

 10-1. The Innovative MD-REP-ID System

 System Details

 MD-REP-ID (Medical Doctor - Representative - ID) is an identity verification system that is always displayed on the online consultation screen.

 Display Format

•  Physician: [Real Name] dr@

•  Nurse: [Real Name] ns@

•  Pharmacist: [Real Name] ph@

•  MR: [Real Name] mr@

 10-2. New Standards for Transparency and Trust

 A revolutionary platform transforming the trustworthiness of healthcare

 MyMedipro is not just an online consultation system. It is an innovative platform that simultaneously achieves the two critical values of "transparency" and "efficiency" in healthcare.

 1. New Trust in Healthcare Through Complete Transparency

 Fundamental issues with traditional online consultations:

•  Uncertainty about whether the doctor on the other side of the screen is actually a licensed physician

•  The authenticity of medical licenses and specialized qualifications is unclear

•  Constant risk of impersonation in medical consultations

 MyMedipro goes beyond "face-to-face" to achieve "identity-verified" healthcare:

 In MyMedipro, all medical professionals respond using their real names, and their qualifications are clearly displayed. This is not merely a system feature but a groundbreaking mechanism that ensures the core principle of healthcare—trust—through technology.

 Patients can confirm that the person providing care is a qualified healthcare professional, while doctors can also take greater responsibility for their care by disclosing their identity. This mutual transparency forms the foundation of a new trust relationship in online healthcare.

 2. B2Dr Model: The world's first integrated platform connecting pharmaceutical companies and physicians

Inefficiencies in traditional medical information provision:

 Until now, pharmaceutical companies' MRs (medical information representatives) had to visit doctors during their busy schedules and provide information in a limited amount of time. This method was inefficient for both doctors and pharmaceutical companies, resulting in a lack of adequate communication of the latest drug information.

 The innovative information exchange enabled by MyMedipro:

 MyMedipro is the world's first platform to integrate B2C (physician-patient) and B2Dr (pharmaceutical company-physician) functions, fundamentally resolving this issue.

 Innovative online consultation system:

•  Physicians can access necessary pharmaceutical information at their convenience

•  MRs can provide information efficiently without waiting time

•  Screen-sharing functionality enables detailed explanations using data and materials

•  Direct meetings with pharmaceutical company academic representatives can be arranged through MRs as needed

 This system is the solution that the times demand in the new normal, where 70% of MR activities have shifted online since the COVID-19 pandemic.

 3. All for the maximum benefit of patients

 Improved healthcare quality through the circulation of information:

 The greatest value of the ecosystem created by MyMedipro is that everything ultimately contributes to the benefit of patients.

 By enabling physicians to easily access the latest pharmaceutical information:

•  Enabling more appropriate prescribing decisions

•  Rapid introduction of new treatment options

•  Enabling evidence-based optimal treatment

 Additionally, by ensuring that all information exchanges are recorded and transparency is maintained:

•  Compliance with laws and regulations such as the Pharmaceutical Affairs Law is strictly enforced

•  Ethical medical care is guaranteed

•  Patients can receive treatment with peace of mind

 Conclusion: Transparency and efficiency pave the way for the future of healthcare

 MyMedipro addresses the fundamental issue of "lack of transparency" in online consultations while innovatively streamlining information exchange between physicians and pharmaceutical companies. The synergistic effects of these two functions will significantly improve the quality of healthcare, ultimately benefiting each and every patient.

 This is not merely a technological innovation. It is a new standard in healthcare that realizes universal values such as trust, efficiency, and patient-centered care in a form optimized for the digital age.

 

 Furthermore, Dr. Yoshihiko Suzuki has a proven track record of pioneering and successfully advancing medical DX in Japan's healthcare sector. Please refer to the following website for more information.

 https://www.mymedipro.co.jp/it-business-results

 https://ascii.jp/elem/000/000/309/309122/index.html

 https://www.hdc-atlas.com/dryoshihikosuzukis-successful-achievements-in-internet-business

 https://www.hdc-atlas.com/foundingstory

 

 

 Chapter 11: GLP1.com members pioneer a new era in healthcare

 

 11-1. The Collapse of the High-End Beauty Clinic Business Model

 Traditional Business Model

 GLP-1 Drug Pricing at Beauty Clinics:

•  Initial consultation fee: 30,000–50,000 yen

•  Medication costs: 50,000–100,000 yen per month

•  Support fees: 20,000–30,000 yen per month

•  Total: 100,000–150,000 yen per month

 Analysis of Profit Structure

•  Medication cost: 20,000–30,000 yen

•  Gross margin: 70-80%

•  Advertising expense ratio: 30-40%

•  Net profit margin: 20-30%

 The Impact of GLP1.com

 By offering at member prices:

•  Prices reduced to one-third or less

•  Transparent pricing

•  Prescriptions based on medical evidence

 

 

 The innovation brought by subscription-based online consultations

 The new subscription-based online medical consultation model, "GLP1.com Member," launched by the author, is not just a new business venture. It is an innovative initiative with the potential to bring fundamental change to the Japanese medical community.

 1. Price Revolution: The First Step Toward Democratizing Healthcare

 The decisive difference from traditional beauty clinics:

•  Prices set at one-third or less of traditional rates - Treatments that previously cost over 100,000 yen per month are now accessible to everyone at an affordable price point

•  Complete price transparency - no hidden additional fees, clear pricing structure

•  Medically sound prescriptions based on evidence - prioritizing patient health over profit

 This pricing strategy is not merely a price cut. It is a sustainable business model achieved by ensuring appropriate profits while leveraging the efficiency of online consultations.

 2. Market normalization: Changes brought by competition

 The ripple effect of GLP1.com membership expansion:

 As the author's model gains traction in the market, the following changes are anticipated:

 First stage: The onset of price competition

•  Even high-priced beauty clinics will be forced to revise their prices

•  Transition from "excessive profits" to "reasonable profits"

•  Increased price awareness among consumers

 Second stage: Competition in service quality

•  Clinics unable to differentiate themselves solely on price pursue true added value

•  Return to evidence-based medicine

•  Enhancing patient education and follow-up services

 Third stage: Industry restructuring

•  Elimination of clinics with high-cost structures and a lack of patient-centered care

•  Survival of healthcare facilities with specialization and trust

•  Establishing a healthier competitive environment

 3. Paradigm shift toward patient-centered healthcare

 Transition from a "profit-driven" model to a "patient value creation" model:

 The GLP1.com member model will fundamentally transform the very nature of healthcare:

 Democratization of information

•  Full disclosure of treatment content, effects, and risks

•  An environment where patients can actively choose their treatment

•  Building an equal relationship between doctors and patients

 Enabling continuous care

•  Long-term support made possible by the subscription model

•  Lifetime health management rather than temporary prescriptions

•  Data-driven, individually optimized treatment

 4. The emergence of a new healthcare ecosystem

 A system that benefits all stakeholders:

 For patients

•  Significant reduction in financial burden

•  Improved access to high-quality healthcare

• Extending healthy life expectancy

 For doctors

•  An environment where they can focus on providing proper medical care

•  Appropriate compensation and sustainable management

•  Building trust with patients

 For pharmaceutical companies

•  Especially for Eli Lilly and Tanabe Mitsubishi Pharma Opportunities for market expansion

•  Improved social recognition through the promotion of appropriate use

•  Establishing a foundation for long-term growth

 For society as a whole

•  Reducing medical expenses through the spread of preventive medicine

•  Improvement of the health standards of the general public

•  Realization of a sustainable healthcare system

 Conclusion: Small steps lead to significant change

 The subscription-based online medical consultation service I am launching, GLP1.com, may seem like just another new service at first glance. However, if this model gains traction and succeeds, it will have a ripple effect across the entire Japanese healthcare industry, ultimately creating a new patient-centered healthcare ecosystem.

 This is not merely about disrupting prices; it is an effort to redefine the fundamental value of healthcare. It marks the dawn of a new era in healthcare, centered on transparency, sustainability, and, above all, patient well-being.

 

 

 August 2025 Author

 Yoshihiko Suzuki