Growing interest in peptides is pushing the conversation beyond weight loss and toward their possible role in healthy aging. Functional medicine expert Dr. Will Cole is urging caution, balance and greater attention to the lifestyle factors that shape metabolic health.

Cole said that peptides are “intimately connected” with longevity, cellular healing and metabolic health. He is the coauthor of the upcoming book “Heal Your Cells.”

“[Peptides] help with cellular communication,” Cole said. He added that recommendations depend on the context in which peptides are used, with the answer often falling “somewhere in the middle.”

Peptides have surged in popularity for weight loss, muscle building, performance enhancement, chronic disease management and wound repair. Their expanding use has also intensified questions about dosing, product quality and the place of lifestyle changes.

Citing previous research, Cole said an estimated 93% of U.S. adults are metabolically unhealthy. Only about 7% meet the criteria for optimal metabolic health, a figure he described as “wild.”

“That’s common, but not normal,” Cole said. Although he believes GLP-1 medications can provide benefits, he argued that improving metabolic health also requires attention to lifestyle and other underlying factors.

The semaglutide weight loss drug Wegovy, made by Novo Nordisk, is designed to treat type 2 diabetes but is widely known for its weight loss effect. Cole does not believe “macro-dosing” GLP-1s “forever and ever in perpetuity” is the answer to improving metabolic health.

GLP-1 medications can reduce food cravings, sometimes described as “food noise,” while promoting weight loss. Cole said he would like to see more research examining whether reducing desire for food could also reduce cravings for love, relationships and other mood boosting factors.

He also questioned whether suppressing food cravings could produce unintended effects involving other reward related behaviors, including social relationships. “So, are we circumventing pathways and pathologizing things that don’t have to be pathologized?”

Cole argued that a certain degree of hunger signaling remains healthy and should not automatically be treated as a problem. “Food noise is actually a decent thing in balance, so shutting down your hunger cues with an ‘atomic bomb’ peptide dose is not the solution.”

The functional medicine expert said he believes excessive reliance on GLP-1 medications may contribute to disordered eating patterns and a growing fear of hunger. His concern centers on using powerful appetite effects without adequately considering nutrition, exercise and other lifestyle interventions.

Cole attributed the trend to a culture that favors quick and simple answers instead of sustained lifestyle changes. “We want a magic pill,” he said.

He suggested that a more balanced approach could involve smaller doses, periodic use and lifestyle support rather than indefinite high doses. “And the truth is somewhere in the middle: Can we micro-dose? Can we do it cyclically? And can we pair it with lifestyle?”

Cole also questioned why metabolic problems have undergone what he called an “epidemic rise.” He pointed to diets high in ultraprocessed foods, nutrient deficiencies, environmental toxins and the presence of stress and trauma.

“That is why we’re seeing a rise of chronic health problems, not a pharmaceutical deficiency,” he said. Pairing peptides with lifestyle measures, he argued, offers a more balanced path toward improving metabolic health.

Cole supports wider access to peptides but emphasized the need for transparency, product purity and clear labeling. Those safeguards, he said, would help health care professionals and consumers make informed decisions about the products they use.

Despite his concerns, Cole said GLP-1 medications may hold significant therapeutic promise. He cited their potential to reduce inflammation, help manage autoimmune conditions and improve gut health.

“But again, what’s the lowest dose that yields a beneficial result paired with lifestyle? I think that’s where peptides can really shine,” he said. Cole added that he is especially interested in other peptides, including those associated with inflammation and longevity.

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