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The Comeback That Never MaterializedJust over a year ago, Lizzo appeared on Saturday Night Live, announcing a new album called Love in Real Life in grandstanding style. Wielding an electric guitar, clad in a Trump-baiting T-shirt that read Tariffied, she performed its title track and two other new songs, Still Bad and Don't Make Me Love U. As with her appearance earlier the same week on a late night talkshow – during which she ran into the audience to high-five fans who were yelling "we love you Lizzo!" – it looked very much like a defiant comeback, fit to drag her out of the controversy that erupted at the end of her hugely successful 2023 world tour. Three former backing dancers and a costume designer filed lawsuits against the singer alleging harassment and discrimination: damaging claims given how Lizzo's songs have preached a message of inclusivity, body positivity and self-confidence. Some of the allegations were dismissed by a judge but others are ongoing; Lizzo has refused to settle out of court, saying: "I'm fighting the case because I know that it's not true."The Album That Never WasBut the Love in Real Life single, a pivot towards rock that owed a little to Tom Petty's American Girls – or the Strokes' American Girls-indebted Last Nite if you prefer – failed to make the charts, a far cry from the period between 2018 and 2022 when Lizzo's singles seemed to go multi-platinum as a matter of course. The same fate befell Still Bad, a track much more in the vein of her big hits, prompting a rethink. The album was pulled, Lizzo apparently taking control of her own destiny – "I need to do shit my way". A mixtape that returned her more-or-less to where she started, before pop stardom came calling – punchy hip-hop, albeit tricked out with guest appearances from Doja Cat and SZA – appeared in its place: My Face Hurts from Smiling received mixed reviews and underwhelming streaming figures.A Career at a CrossroadsAll of which means that Bitch, her fifth album proper, lands at a deeply peculiar juncture in Lizzo's career. Given that the public apparently don't want her going rock, nor rapping in the style of her 2013 debut Lizzobangers, nor indeed making the kind of music they were buying in their millions three years ago, the question of what they actually do want has presumably hung heavy over its making.Musical Identity CrisisLizzo hasn't come up with a definitive answer. Bitch tries a bit of everything, from pastiching Tame Impala on Happy 2 Be to making clipped new-wave rock decorated with Cure-like guitars on She Stole My Man; Sexy Ladies is a girls-night-out-soundtracking reiteration of the old body positivity message. This scatter-gun approach makes Bitch a disjointed listen.The Subdued ToneMoreover, there's something oddly subdued about its tone, whether it's dabbling in 80s retro – Don't Make Me Love U brings to mind the arena-rousing keyboard hook from Tina Turner's The Best, but renders it into a distant, affectless backing vocal – or delving into jazzy R&B; on Too Nice. The vibraphone-heavy beat on the latter is fantastic, rich in small-hours atmosphere, but the actual song feels nondescript: it only really comes to life in its dying moments, when Lizzo stops singing and starts playing a flute solo. The title track interpolates the chorus from Meredith Brooks' 1997 pop-grunge hit of the same name, but somehow flattens it in the process. Crooned over smooth, G-funky R&B;, it feels stripped of its fiery power, less of a snarl and more of a shrug.Equivocal LyricsThe lyrics often seem similarly equivocal. You don't want for apparent references to Lizzo's recent woes – "I hope it makes you happy to hurt somebody else", "the thing about depression, you think your life is over", "you'd still be working at the mall if it wasn't for me" – but they ultimately feel neither pugilistic nor racked, just confused and sore: "I have feelings too," she sings on piano ballad A Toast.Highlights Amidst the StruggleNot everything here is underwhelming: Whose Hair Is This is a great southern soul pastiche, home to an impressively raw vocal and a snappy plot twist at the end of the lyrics; That Grrrl employs an old-school Chicago house bassline to energising effect. But what's definitely lacking is an unequivocal pop smash, the kind of thing that Lizzo once seemed to be able to write to order.A Changing Cultural LandscapePerhaps that's inevitable. One of the reasons Lizzo hit so big in the first place was that she made pop music that perfectly captured a zeitgeist, and that zeitgeist has moved on: the era of body positivity has been displaced by the era of Ozempic and Mounjaro; the kind of post-pandemic, post-Trump optimism embodied on 2022's About Damn Time now sounds like a transmission from a distant lost age. We're living in a different world now, and Bitch suggests Lizzo has yet to work out how to respond to it: "I'm doing my best," she sings on A Toast, which feels like the most telling lyric of all.

A new large‑scale randomized trial presented at the European Congress on Obesity in Istanbul indicates that the oral GLP‑1 antagonist orforglipron can help patients retain the majority of weight lost with injectable therapies such as tirzepatide (Mounjaro) and semaglutide (Wegovy).Trial Shows Oral Orforglipron Preserves Most Weight After Switching from InjectablesThe study, funded by Eli Lilly, followed 376 US patients who had been on tirzepatide or semaglutide injections for 72 weeks and then randomized them to a daily orforglipron tablet or placebo for an additional year.Participants were previously on weekly GLP‑1 jabs that typically produce 15‑20% body‑weight loss.After the injection phase, subjects were switched to oral therapy or placebo for 12 months.Primary endpoint: proportion of weight loss retained at 12 months.Quantitative Outcomes: 75% vs 49% Retention for Tirzepatide Users, 80% vs 38% for Semaglutide UsersWeight‑loss maintenance differed markedly between the pill and placebo groups:Tirzepatide cohort: 75% of lost weight retained with orforglipron vs 49% with placebo.Semaglutide cohort: 80% retained with the pill vs 38% with placebo.Secondary benefits—blood pressure, cholesterol, and glycaemic control—were also sustained in the pill arm.Implications for Obesity Management and Healthcare CostsExperts highlighted the broader significance:Dr Louis Aronne (Weill Cornell Medicine) emphasized that treating obesity directly can simultaneously improve glucose, lipid, and blood‑pressure metrics.Dr Marie Spreckley (University of Cambridge) noted patient preference for oral therapy due to convenience, storage, and lower cost.Dr Simon Cork (Anglia Ruskin University) warned that injectable GLP‑1 drugs, while highly effective, are expensive and limit long‑term accessibility for both private payers and the NHS.The findings suggest a potential shift toward oral agents that maintain efficacy while reducing financial and logistical burdens.Future Outlook: Oral GLP‑1 Therapies Could Redefine Chronic Obesity CareIf further trials confirm these results, orforglipron could become a cornerstone of chronic obesity management, enabling earlier intervention (BMI 25‑27) and possibly preventing progression to severe obesity.Regulators and payers will likely scrutinize cost‑effectiveness models, but the prospect of a cheap, daily tablet that sustains weight loss may reshape treatment algorithms worldwide.

Peptides are short chains of amino acids that naturally occur in the body, acting as hormones such as insulin, oxytocin and vasopressin, or as fragments released during protein digestion.In recent years, a wave of interest has turned these molecules into purported therapeutic agents for everything from weight loss to anti‑ageing and tissue repair. Prescription drugs like semaglutide (Wegovy) and tirzepatide (Mounjaro) are synthetic peptides that have undergone rigorous clinical testing and are approved for specific medical uses.However, a large portion of the market consists of unregulated, experimental peptides sold for self‑administration. These products often bypass the strict approval processes required for medicines, raising serious safety concerns.Who is using these products? Initially confined to a niche of powerlifters and bodybuilders in the 2010s, the audience has expanded dramatically. Influential figures such as podcaster Joe Rogan have promoted combinations like the “Wolverine stack” (BPC‑157 and TB‑500) for injury recovery, while other compounds—CJC‑1295, MK‑677, ipamorelin, and GHK‑Cu—are marketed for muscle growth and anti‑ageing. Social media platforms are now flooded with instructions on purchasing and injecting these substances.Scientific backing is scant. Reviews of the literature reveal that most experimental peptides have only been tested in animal or cell models. For example, BPC‑157 shows promise for tendon and muscle repair in pre‑clinical studies, but no randomized human trials have validated these effects. Similarly, TB‑4 and its synthetic analogue TB‑500 have demonstrated limited blood‑vessel formation in laboratory settings, yet human data are absent and both are listed as prohibited substances by the World Anti‑Doping Agency.Researchers also highlight a critical knowledge gap: dosage, frequency and treatment duration remain undefined, making self‑administration a gamble.Legal landscape in the UK is clear that peptides not classified as medicines fall outside the Medicines and Healthcare products Regulatory Agency’s (MHRA) remit. If a seller makes medicinal claims, the product must hold a marketing authorisation under the Human Medicines Regulations 2012. The MHRA warns that labeling items as “research use only” does not shield vendors from enforcement when evidence shows the products are intended for human consumption.Health risks are multi‑fold. Experts caution that benefits observed in animal studies do not guarantee safety in humans. Contamination with harmful impurities or bacterial endotoxins can trigger severe reactions, including septic shock. Injecting excess natural peptides may disrupt the body’s tightly regulated hormonal balance, potentially affecting multiple physiological pathways.There is also theoretical concern that augmenting peptide levels could accelerate tumour growth, as some cancers over‑express certain peptide pathways. While no direct cases have been documented, the possibility underscores the need for caution.Additional dangers include improper injection techniques (e.g., air embolism), unknown interactions with existing medications, and the lack of systematic monitoring of long‑term effects. As one researcher put it, “If something goes wrong, users may never notice until irreversible damage has occurred.”

Eli Lilly, the US pharmaceutical group behind the Mounjaro weight-loss drug, is seeking to resume its investments in the UK after pausing them last year. The company is in talks with UK ministers to regularly increase NHS drug prices and end a rebate scheme. Patrik Jonsson, president of Eli Lilly's international business, expressed optimism about reaching an agreement this summer.The talks will also explore 'innovative' pricing plans, such as linking payments for anti-obesity drugs to whether the treatment helps patients return to work. This comes as the US pharmaceutical industry increases pressure on the UK, with Keir Starmer agreeing to the first increase in NHS cost-effectiveness thresholds in 27 years. The threshold was raised from £20,000 to £30,000 a year for every year of life gained to £25,000 to £35,000.Eli Lilly was one of several pharmaceutical companies that ditched or paused almost £25bn in planned investments in the UK last year. The company paused its plans to invest in a laboratory site in central London. Jonsson stated that the resumption of Eli Lilly's investment would depend on the outcome of its talks with the government.He emphasized that prices for medicines in the UK had been 'far too low for far too long' and that the threshold couldn't remain static for another three decades. The UK agreed to pay 25% more for new medicines by 2035 as part of a US-UK drug pricing deal, which could eventually reach £9bn a year.Large pharmaceutical companies have protested about a 'rebate' scheme, under which they are required to pay back a chunk of revenue from sales of branded medicines. This scheme is expected to fall in 2026, although Jonsson believes payments 'should actually get down to zero' over time.