Opening Up About GLP-1s: How to Have Stigma-Free Conversations with Dave Knapp

GLP-1 medications like Mounjaro are transforming the conversation around weight loss and diabetes management, but behind the headlines and medical jargon lies a real journey—one that’s often emotional, confusing, and filled with misconceptions.

In this episode, Dave Knapp, the visionary behind OnThePen.com and the voice of @manonthemounjaro, shares his personal journey with type 2 diabetes and Mounjaro. As someone deeply passionate about reshaping the conversation around GLP-1, obesity, and diabetes, Dave offers valuable insights and heartfelt personal stories.

Join us as we explore the inspiration behind his book, Decoding GLP-1, where Dave breaks down the complexities of GLP-1 medications and shares practical tips for those supporting loved ones on this journey. Learn how to start stigma-free conversations, connect with a supportive community, and understand why there’s no one-size-fits-all solution when it comes to managing obesity.

References

Decoding GLP-1

 OnThePen.com

@manonthemounjaro

Audio Stamps

01:11 - Dave Knapp shares how his type 2 diabetes journey and Mounjaro experience sparked the creation of On The Pen.

03:20 - We learn why Dave wrote his “Decoding GLP-1” book—a quick, accessible guide to help loved ones understand GLP-1 meds and reduce the shame around sharing your story.

07:52 -  Dr. Rentea asks how to start honest, stigma-free conversations with loved ones about using GLP-1 medication, especially when shame has made it hard to open up.

12:58 - Dave and Dr. Rentea discuss the best ways to start finding a supportive community.

19:32 - Dave offers his top tips for anyone getting started on this journey—and reminds us why there's no one-size-fits-all approach to treating obesity.

Quotes

“The people that have the best voice in this space have a personal experience with it.” - Dr. Rentea

“It broke my heart to hear so many people afraid to share the part of their journey with the people that mattered the most.” - Dave Knapp

“I could see not only family and friends reading this, but actually physicians giving this to their patients because people need it in one area like this.” - Dr. Rentea

“Weight is cosmetic to the rest of the world. They don’t see your A1C, they don’t see your lipid panel, they don’t see your fatty liver. But the reduction of those things is quite a story to tell. “Couching everything around

All of the information on this podcast is for general informational purposes only. Please talk to your physician and medical team about what is right for you. No medical advice is being on this podcast.

If you live in Indiana or Illinois and want to work with doctor Matthea Rentea, you can find out more on www.RenteaClinic.com

Premium Season 1 of The Obesity Guide: Behind the Curtain -Dive into real clinical scenarios, from my personal medication journey to tackling weight loss plateaus, understanding insulin resistance, and overcoming challenges with GLP-1s. Plus, get a 40+ page guide packed with protein charts, weight loss formulas, and more.

April 30/30 registration.

Transcript

0:28

Welcome back to another episode of the podcast today. I'm really excited. We have Dave Knapp. He is the founder of the podcast on the pen. It's also an amazing community. I'm going to have him explain more about this. And I have been following his work. Dave, I'm gonna have you introduce yourself in a second. I consider you an investigative journalist at this point, too. We just spoke before this how you have so many industry contacts at this point, and honestly, I look to your news often to find out a lot of what's happening in the GLP 1 community. So I have just followed you for great amount of time now, really like the work that you put out, and then you recently wrote a book, Decoding GLP 1, A Guide for Family and Friends of Those on the Pen. I got it. I love it. I really think it's a must read. And so can we start out with you just introducing yourself a little bit and what your community is about? Just so that our listeners have some context. Yes. First of all, thank you, Dr. Rintia for having me here on the obesity guide. It's a pleasure to be here. It's always fun for me to get to be on the other side of this, but there's a lot less pressure. I feel like kicking back and putting my feet up. But thank you for your kind words. Yeah. On the pen, it started off as kind of anybody who creates content about their weight loss journey. I'm putting this in air quotes. And, really I was prescribed Manjaro for type two diabetes, but this was after a year of my doctor trying to help me, overcome my diabetes with diet, particularly the keto diet, which I had literally yo yoed on for almost 20 years. And so I was like, my doctor, I trust him. I love him. I know that I respect him. So I'm going to give it the old college try and I white knuckled it for a year, my a one C was spectacular, but my insulin levels were still off the charts high. And, I went from 319 pounds, which was the highest that I had ever weighed, at the time of my diagnosis to 312 pounds, one year later. So, good for a one C not great for weight reduction. I want to document this Manjaro thing. And I went to the internet to sort of look for more information about the drug, not just stories of spectacular weight loss at the time. Manjaro was only on the market for like six months, but there were already. A bunch of stories of like in the last six months, I've been on this medicine and I've lost 80 pounds. So I was like, this could be really cool, but how does it even work? And so really there was a deficit of that kind of information, which is what led me to start documenting the things that I was learning, which eventually blossomed into this whole thing that we call on the pen. Oh, thank you for sharing that story. I always say on this podcast, the people that have the best voice in this space have a personal experience with it. There's just something about it that makes you be a better advocate or search out answers more or help people in a better capacity. So thank you for sharing that. Tell me a little bit why, you know, we, kind of spoke on Instagram before you came on here about this, but I'm wondering what led to wanting to write the book because it's a little bit of a different angle compared to what you've done up to this point. Yeah, great question. It's sort of one of those things where I always knew I would write a book and I definitely don't think this will be the last, but it was definitely the first low hanging fruit opportunity where I could. Blend my love for writing with something that the community desperately needed. So one of the things that I started to identify right away when the on the pen community started to grow is that a great resounding majority of people who were experiencing the benefits of these medicine, particularly to treat obesity was the shame and guilt wrapped around Telling their story and the part of their story, specifically that they used anti obesity medicine for benefit and that still, one of the things that probably breaks my heart the most is to know that there are so many people who feel like they have to, they come online and we have this great community and we're all sharing, this really joyful part of our life and our journey that we've finally found something that is treating A disease, right? Even something that before we found community was so stigmatized that even we believed ourselves failures. Right. And so it broke my heart to hear so many people afraid to share the part of their journey with the people that mattered the most, just because they're those people in their circle, haven't come along on that journey so far, they haven't been told. And I think a lot of times we tend to think the worst of people when they don't have a full picture of an understanding, but I'm kind of the opposite. And maybe it's because I've grown up in a family that's very loving and opening and encouraging and accepting. But I just feel like when people that truly love us and care about us are educated that turns from this, kind of dark thing you have to keep in the corner to something that they really want to understand. So I wanted to use my writing skills to basically create something that was just taking the things that we talk about all the time on, on the pen and sort of what I call our echo chamber and put it into a really digestible, no pun intended, a really digestible size book, almost like a booklet that you could just literally, when somebody says, how'd you lose all that weight? What are you doing? You're not on one of those shots. Are you, you're going to get cancer. I wanted to be able to just have. This for the community so they could have this in their hand and just pass it off and go, here you go. This isn't a ton of work. It's by design, very concise and condensed, but just to pass it off and let the book do the talking so that hopefully that can open up the door to really meaningful conversations. Oh, I,, first of all, if anyone's listening, right, this book is thin and I say this in the best of ways because I got it literally the day before our interview because this came out very recently and I had contacted you and I was able to read it in one day, which I'm not a fast reader for those who aren't listening. I'm going to read some of the titles here because I think it's just so great what you go over, but Something that you talked about, which is so true. I often believe as well that everyone means well around us. I just want to come from that place because otherwise it's a really grim life. But it's a heavy lift to educate everyone all the time. So I really like in this book, you do talk about your, path with obesity and diabetes, you talk about an introduction of GLP 1 meds, the history of it. How the meds work, the landscape of the medication, challenges and misconceptions, shortages, you talk about compound, copycat meds, you talk about the importance of community, you talk about so many different areas in here, and let me tell you what was gold, there's so many times that people still don't understand the different names, the different brands, what's for what, you have simple graphs in here, I mean, I'm serious when I say this. I was looking through here and I was thinking, yeah, this is truly just a still down, the one thing you need to know about the step trial, one name of this, the thing of that. Guys, this is, if any of my medical people are listening, we have these little books when we're studying for our board exams. So, Yes. It's like everything's in this one, it's this one thing, right? And they're the gold, you will do physiology, anatomy, you do all the different things and everything's in this one spot. This is it. So I could see not only family and friends reading this, but actually physicians giving this to their patients because people need one area like this. What do you think if someone is maybe scared to tell the people in their family, they've had a big transformation, they are getting support from, these online communities, things like that. But they actually. Want to share this with the people that they know are loving and supportive. Maybe like a scenario I've heard a lot is for example, like their best friend is starting to say, Hey, I see these changes. And they haven't told the friend up to them because they've had a lot of shame. How do you think someone could even broach that conversation? Yeah, that's a good question. It's something that I, thought of and, I don't purport that this book has all the answers. It's definitely designed to be a conversation starter, but One of the things that I thought of when I wrote this book is how do we actually get people over that hump of breaking the seal of the conversation? So actually in the back of the book, there's a whole section called how to start a conversation with a loved one about your choice to treat obesity with medication. And there's basically just six things in there that could be good little conversation starters, but just, something like I've started a new treatment for my health and I just really want you to see why I feel like this is the right choice for me. And then conversely, by the way, there's the section right after that is for people who you do pass this book off just a quick five little tips on how to support somebody who is using a GLP one for weight loss. So it's something for both, but I like to couch this whole conversation with our loved ones, not in weight. Every other flipping thing that I've done prior to GLP one was about just getting the weight down. This is about health and longevity and, richer, fuller, happier, healthier lives. And so I like just kind of couching like,, Hey, I know that you have mentioned that I've lost weight, but it's actually so much more than that. My blood work is this, there's so many other facets. And I think if we could focus in on those things that just don't have to do like weight is. So in a way it is cosmetic to the rest of the world. They don't see your A1C when they look at you, they don't see your lipid panel. They don't see your fatty liver, right? But the reduction of those things is quite a story to tell. And so I think that sort of couching everything around total health rather than just weight loss alone, which is where people tend to want to go as a great opening way to approach it. I love your answer here. Cause I often think people come in with what they think they want, right? So they're noticing weight, they're wanting to do that. But then when you are. So, that's, super helpful. I think for people listening because people are so frustrated that that's the only thing that gets talked about when really it's everything else that you're talking about. So that's just awesome. The other thing that I really liked is that you explain in here. You go through the difference with medication, what's branded, what's a 503B compounded, a 503A compounded, research grade, so that people, I honestly think that people don't even know where they're getting stuff or what they're doing. I think that's like a big problem, to be honest. And so they can read through here and think. Do I even know what I'm doing? Do I know where I'm getting it from that they could even ask themselves that forget asking other people or that they could ask their friend, where are you getting it from? So I think that part of this education is really important because the more that we know, the better we can do if, you would do you think that there's anything that shocked you when you wrote the book? You know, I spent a lot of time. Most of the time I did not spend writing the book. Most of the time I spent planning the book basically based off of the main recurring topics that come up in my content, which my content is, this is what I always tell people when they say, what is on the pen? Well, it, started off kind of what I explained earlier, but what it's become over time is I realized when I went out for information, all the information out there was meant for doctors. Or it was meant for investors. And none of that really made sense if you were a patient. So it's like, how do we take this information and translate it into a way that is a patient can hear it, take in the information and then go to their doctor and just make more. confident and competent decisions about their health. And so I don't know that anything necessarily surprised me because so much of it is what we cover a lot on, on the pen. But I think if I had to say, if there's one thing that I feel like the book Accomplishes on balance is that it really does hit on all of those things that I think can come up in a really succinct and, brief way without being again, the one thing that I kept telling people is, I want people to understand my journey, but I don't want to give them homework. Yeah. So, to give them a 400 page book, I would be mad. Somebody is like, Hey Dave, I really want you to understand my journey. I'd be like, yeah, awesome. And then be like, here's a 400 page book. I'm gonna be like, not as awesome. So, I think. You know, I was surprised at just how well it came together. Just, thinking through all of the different topics that we discuss at on the pen. Well, one thing that you talk about is the importance of building a supportive community. And I have found this to be invaluable. I mean, this is one of the reasons I started my clinic because I found that. People are very isolated, right? It's this whole back to, people think that they have done this to themselves. They're not realizing it's a disease or the physiology behind it. And I'm wondering, there are going to be people listening today that are sort of DIYing it on their own. You know, they're listening to this podcast. They're looking at little things here and there. What do you think is the best way for them to seek out community or find it or to experiment to get there? Do you have any tips for that? I think social media, is often a great place to start because there are so many different creators and each of the creators that makes content in GLP one has seen success on these medications in one way, shape or form. And, they've folded that into sort of the lifestyle modifications or the mental work or whatever it is there. They, also seem to have, their overarching content is yes, GLP one or anti obesity medicine, or even bariatric surgery related. But then they sort of have their own little spin about, you know, what's been most important for their journey. And I think if you can go out and just sort of sample. Some of that content that's out there, you're going to find your people. You're going to find those people where, what they have to share, whether it be similarities in their journey or the, the mechanisms by which they've found success resonate. I just think that sampling lots of content online is helpful because there's just somebody out there creating content that's going to click with you. I love that you say that I want to put you on the spot, like, Hey, tell us your favorite channels, but I, we're not going to start a world war here. That's controversial, but it's funny when you say that, I think to myself, what are the channels I like? I like when they talk about proffy, right? Which is if people are listening and don't know that's your coffee with the protein drinks. I like the motivational people who are like, Hey, every day, you're going to get up and keep going. It's a certain bend. You're right. Where I feel like they get me or there's something where I really. Come back for more to those people. And I find that you're right. There's such a variety and you have to keep looking until you find your person. And it's kind of funny because sometimes you'll find a creator and they're not big at all. And you're like, I just love them. And then with time they explode. So it's not necessarily always the big creators. In fact, many of them that I love, they've got less than a few thousand people following them. And they're just gold. And, I kind of want to protect this and not find out about this person. But do you think that there's anything. That you have found your community members benefit the most from that's a great question if I can go back to the last question, just add, one thing I would say, the other element to finding community and finding your people is, is, Doing that in the real world. Right. And that's really what the book is all about is this, that's the piece that's sort of missing. Like we go into this bubble and this echo chamber of people that live on the other side of the world sometimes, which is great and a beautiful thing. But how tragic if, that's the only place that we get it in our real life, we live sort of compartmentalized and, the people that, physically, practically tangibly love us. In the real world, aren't able to, because they don't know this part of your journey. So I would say leveraging tools, having those conversations, this is just one book, but I mean, there are probably many others that will be written that would, be a great. Resource for you to start to broach those conversations with people in, the real world to your question about on the pen community. What, did they find the most value in? I think, it's just having sounding boards of other people that have lived similar experiences that have gone through the same sort of. Trials and tribulations in life because of the disease that they live with. And knowing that you're not alone, I think there's just so much value in knowing that you're not the only one who has struggled in the various ways that we see people struggle with obesity, whether it's a ridicule mockery, whether it is yo yo dieting, whether it is trauma, whatever it is that is that shared experience, knowing that you're not alone, I think would be one of the biggest things that people would tell you from on the pen. In addition to just being able to, like I said earlier when you come to on the pen, you know you're going to get the latest news and information that's out there. So, a lot of times what I hear, Dr. Rincey is people come to me and they'll say, I showed your video to my doctor. And my doctor was like, I didn't know that. Let's look into that. And so hearing that stuff just tells me that people are being empowered and equipped by the additional information and knowledge that they gain from a platform like on the pen or you could point to your own community for sure. And others that are out there just being able to be empowered with information, I think is a huge Benefit. Yeah, okay. These two things you mentioned, I think, are gold. When, you were mentioning in community, not feeling alone, it reminds me of Kristen Neff. She's done a lot of work on self compassion, right? She's sort of like, the OG person on that. And one of it is this common humanity that we all struggle. And if we can't remember that a lot of us, we won't have self compassion, right? And then when you're talking about this, knowing the latest news, yes, I find that. Okay. Patients have the highest level of anxiety if they think, well, my medication isn't going to be available. I mean, gosh, these past few years have taught us about shortages, right? And all the progress will suddenly be erased or not knowing that there's other options or even what's happening. When's the decision going to get made? Knowledge is power, right? It can help decrease a lot of that worry. I completely agree. I've said this before. I go to your videos. I'm like, what's happening right now? And that's nice that thank God there's someone out there that, is doing that work because not everybody can be on top of all these articles. If we think about how much information is coming out all the time, it's incredible. So I have learned so much from you today and I'm, wondering, let's say that someone is out there. And they're either starting this journey. They're on the journey. They're struggling. Do you think there would be two to three top tips or words of wisdom or what you think would help them be successful long term that you would offer to them? So I want to say kind of like Dave Sage advice that I feel like everyone that I've ever had on they have their spin on it. What can be helpful or motivating or just things that people need to keep in mind that aren't as far along because you're really into this journey. You're at the advocating stage, you're at the knowledge stage, you know what do you think you would offer them to kind of top two, three tips for that? Yeah. I'll try to be brief. When all throughout my weight loss journey, whenever I'd start something new, I would go immediately to social media, YouTube, primarily just to see somebody else trying this diet. What have they experienced? And so I think like GLP anti obesity medicine or weight loss surgery or whatever the tool is that you're looking at to assist you in your fight against obesity is I think the first thing that we do is we run to other people who have experienced this before us. I think the unique thing about GLP is when I first came to it, there just wasn't that many people talking about it. Now there are. Thousands of people talking about it. And I think the biggest piece of advice that I could give somebody that's just kind of looking at, treating their obesity medically is that when you go to social media, understand that social media is, by and large, A highlight reel and not a low light reel. And for somebody like myself, for example, I jumped in, I saw a lot of content about, I lost 80 pounds in six months. And I thought that's going to be me. That's going to be me. And I am two years in on Manjaro at the highest dose. And I've lost 11 or 12 percent of my body weight. Which I've been able to keep it off, primarily I've been a little bit up and down, but, I've never gone back up to three 19 where I was in that, broke a cycle for me. And that for me alone is a win. And so don't, use somebody else's highlight reel as a benchmark for your own success, really define what success is for yourself right away. And don't Have expectations based upon the content that you see that that's going to be your experience. I think there's so many people, you just got to do it this way. You know if you just cut out all your carbohydrates and stop eating sugar, then you're going to get the thing that I've learned the most through all of this just From sort of how to succeed or not succeed standpoint is that your journey is uniquely yours in the disease of obesity is so nuanced and multifaceted and so unique to each individual's lived experiences that getting blanket advice from anybody, like it has to be this way, or it has to look that way is basically Bad advice. And I realized that I'm giving advice saying that, but if there's any absolute warning against it, I think if there's any absolute, it's that there is no one size fits all to treating obesity. It is so nuanced. And so I would say just measure in addition, to setting appropriate expectations, measure. The content that you get against what the people you trust, who are professionals have to say, because there's a lot of, people out there that are making content about not only GLP one, just weight loss in general, who just are really probably have no business doing it and aren't being helpful, even though they think they might be. So yeah, just temper your expectations and lean into the professionals when it comes to your own unique. Yeah. Oh gosh, this was gold when you were stressing, don't look at this highlight reel and expect kind of prognosticate for your own life, what's going to happen. This was one of the main things on social. I was like, listen, guys, we're only seeing all the people who have every single side effect in the land and everyone who's losing a hundred pounds in one day. We're sort of not talking about what's happening for 99 percent of the average person. And that was something that it's not as attractive when you talk about that there's nuance and that there's gray zone. But gosh, is this good advice. And then also just how nuanced it is, right. It's so true. No one wants to hear it though. And I feel like when you're talking about people Really speaking loudly that have a very limited scope. They are able to do that. I often find because they don't understand the dangers. They don't even know where the landmines are. And so they can speak super passionately about it. They also have nothing to lose because they don't have credentials. So it is really like a buyer beware situation. But I just like that you bring it up because it's so true just to be cautious who we're following. I remember I've never been more devastated than there was a girl on YouTube that I followed. I still follow her. And I was a young girl who had obesity and I remember she was doing plus size clothing videos and I was like, Oh, I was like really inspired. Like, you know, I can dress differently. And so one day, she's doing all this different stuff and she didn't disclose she had. A stomach surgery, like a tummy tuck. She did this, she did that. And you know, it's interesting. She didn't need to disclose it all. Right. I've talked about this on the podcast. She didn't, it was, it's not my right, but what was interesting is I felt so violated because I thought I had the perception that she was sharing everything with us. And that was the day I must've been, I don't know, 21, 22, when that came out, when she talked about it. And I realized, oh, this is all, her narrative. She's made a story. Part of it's her life. But actually, and I do this too. I mean, we all choose what to share and not. We want to say we're all authentic. And I try to be as open as I can. But of course, there's things that aren't mine to tell. I'm not going to tell stories about my stepkids or, certain parts of my relationship. And so it's so tricky because we want the knowledge, we want the help, but you don't know behind the scenes. You don't know so many different pieces. So I'm sorry, I kind of went left on that, but it's, so important because we're all looking at social all day long and we think it's the truth and perception is reality. So people really need to remember that online. Well, I just want to say thank you so much for coming on. Can you tell people where can they find you again? Give us all the websites, the social, where you hang out most, and just that everyone can and where to get your book, everything. Okay. Yeah. Thank you so much again for the opportunity. It's a pleasure be able to talk about these things. And like I said, be on the other side of it and just oftentimes what I find is when I'm asked these questions, I don't ask myself them enough. And so it's like a little bit reflective in the moment. So I appreciate the opportunity to just pause and reflect and think a little bit. On the pen. com is really the hub. I mean, if you go to on the pen. com, there is a gateway to all of the social media channels. If you search on the pen pretty much anywhere, you're going to see the little logo with my purple and pink face over the moon. So, you see that and, get connected there. Primarily YouTube. We do a Thursday night live show that happens every Thursday night at 9 PM central. And then we drop. An actual true podcast every Tuesday and the audio from the show on Thursday goes up to the podcast too. So. All that said on the pin. com is craziness. So I would have never caught your live shows because, that would be 10 Eastern. I go to sleep by nine o'clock, but I listened to the podcast, right? I don't think I understood that they were always all live. I don't even know how that's going to be the case, but that's incredible. What you put together for that live show. The ones that drop on Tuesday are like a short 15 to 20 minute news recap, been very dominated by shortage talk and compounds going away and that stuff. But the Thursday night show, the longer one with the interview,, that's all live and, it is a little bit later. Like, I don't, you mentioned that you have stepkids. He also mentioned that you don't want to talk about them. So let's talk about it. No, but I have like the personal side, I got four little kids. And so like bedtimes, they're 10 all the way down to four. And so the bedtimes it's what I call the gauntlet. And so to do it, to put that on my wife every Thursday night for now, 97 weeks would have been too much. So we do it after. The kids go to bed, so it's a little bit later, but the great thing about YouTube, what I love about it is most people don't watch it live, you know, a couple of hundred people, if we're lucky, but the rest of the people that watch it, watch it on demand on YouTube. So, yeah. Well, that's awesome. So I've stopped because I also have a five year old and it's funny. I do the reverse with my husband. Cause I have a Monday night call for my group. And so I do it at six so that I can't help it, but it's so funny how these things dictate our life. Right. It's just part of real human experience as it should be. Well, perfect. So we're going to link to on the pen. com. We're going to make sure to get that in there. We'll have all of this in the show notes. Again, everybody, if you're listening, you just scroll up wherever you're listening. The details are there, or you can go to rentia clinic. com, R E N T E A clinic. com. And for every show we have a show notes or everything's written out and linked. Thanks again, Dave, so much. I've learned so much. Thank you. I appreciate you. Thanks for having me on.