Peptides, Performance, and Healing
I had dinner recently with a group of jiu jitsu athletes. One of them knows more about biohacking than anyone I train with. The conversation quickly turned to peptides (as many do in athletic circles)... what people are taking, why, and whether any of it actually works. As a surgeon who also trains, I left with a lot of thoughts. I really want to find data to support their use, and most of it is either small studies or animal studies. So, I dove in again, and here is what I found, plus anecdotes from people who swear by them.
Disclaimer: This is my take and my opinion on the literature and what I’ve seen. Always ask your doctor before taking these medications.
GLP-1s. The Weight Loss Peptides
Semaglutide, tirzepatide, and liraglutide are just some of the drugs. They were originally developed for type 2 diabetes and are now widely used for weight loss. They have become quite the celebrity for anyone looking to lose weight. The metabolic and cardiovascular data are pretty compelling. Large trials have shown significant decreases in heart attack, stroke, and cardiovascular mortality, with benefits extending to non-diabetic patients with obesity.
For combat athletes, one concern I have is body composition. Rapid weight loss with GLP-1s can lower bone density and drive muscle loss. This doesn’t seem to be from a direct drug effect, but from decreased appetite leading to inadequate protein, calories, and mechanical loading. For a grappler, losing muscle alongside fat can be a real problem that affects performance and joint protection.
The sunken face people notice? That is rapid fat loss from facial compartments outpacing the skin's ability to adapt. The drug is not doing that directly. The speed of weight loss likely is.
Another concern is long-term effects of their use. Ideally, the GLPs would be utilized in the short-term to get healthy. Unfortunately, data shows that when people stop the medication, many regain the weight.
Tissue Healing Peptides. BPC-157 and TB-500
This is the category I find really exciting as a surgeon and athlete. I have not fully jumped on it yet. But I am watching it closely. It seems like every other athlete I run into (especially over age 30/40) is taking some combination of tissue healing peptides.
BPC-157 is naturally found in the human gut and has been studied since the 1990s. A 2025 systematic review of 36 studies found it promotes healing by boosting growth factors and reducing inflammation, with improved outcomes in muscle, tendon, ligament, and bone injury in animals. TB-500 is a synthetic fragment of thymosin beta-4, a protein the body naturally increases in production after tissue injury to drive more cells to the site of injury and repair.
The honest concerns: no FDA approval, banned by WADA, limited human trials, short half life, and a theoretical cancer concern related to its potential increase in blood vessel formation. Sourcing is also a real problem. These are sold as research chemicals with minimal quality control. So, if you are going to try them make sure you vet the company and check on 3rd party testing. BPC-157 actually clears the body in minutes. So how does it work long term? The theory is that it essentially flips a switch on your body's own healing pathways and those pathways keep running long after the peptide is gone. But, this is another thing to consider!
Most practitioners recommend cycling when there is an injury, rather than continuous use. That philosophy aligns with how I think about it. Using a peptide to get through a specific injury is a very different decision than taking something forever.
Another problem is the route of administration and dose. There are pills, injections, etc. Dosage is currently recommended by physicians and there are many places where patients can have supervised use. This is largely based on animal studies with theories that injections close to the site of injury may be better. Pills are noted to be more helpful with gut issues.
My take: the animal data is compelling and the biology makes sense. I have colleagues I respect who use these thoughtfully. I hope that we can get some solid human data soon!
Final Thoughts
The data is unraveling regarding peptides. There are many peptides with phenomenal science. Unfortunately, the data is lagging with BPC157 and TB500.
That being said, I know many people who swear by it. I take this with a grain of salt, though. For example, I heard someone in the medical space talk about how she injected BPC 157 after breaking her wrist and it healed in 6 weeks on x-ray, so she could take the cast off. And this is a fair timeframe for a wrist fracture to heal just by our biology.
Other people have told me they avoided surgeries thanks to BPC 157. I think that is tremendous and I played devil’s advocate too. I said something along the lines of… you also ice bath, sauna, red light therapy, along with many other things. So, which is actually doing it? Or is it the combination of everything?
The jury is still out on many peptides but I hope my thoughts helped at least get you thinking to have a solid discussion with your doctor.
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Dr. Megan Lisset Jimenez
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References
Vasireddi N, Hahamyan H, Salata MJ, et al. Emerging Use of BPC-157 in Orthopaedic Sports Medicine: A Systematic Review. HSS J. Published online July 31, 2025. PMID: 40756949.
West S, Scragg J, Aveyard P, Oke JL, Willis L, Haffner SJP, Knight H, Wang D, Morrow S, Heath L, Jebb SA, Koutoukidis DA. Weight regain after cessation of medication for weight management: systematic review and meta-analysis. BMJ. 2026 Jan 7;392:e085304. doi: 10.1136/bmj-2025-085304. PMID: 41500720
Yang HM. GLP-1 Agonists in Cardiovascular Diseases: Mechanisms, Clinical Evidence, and Emerging Therapies. J Clin Med. 2025 Sep 24;14(19):6758. doi: 10.3390/jcm14196758. PMID: 41095837
