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A new category of expensive weight loss drugs has exploded in popularity over the past few months as celebrities, tech moguls and social media stars have testified that they’ve been able to rapidly shed weight thanks to the medications.
Originally intended as a treatment for diabetes, drugs like Ozempic and Wegovy (both brand names with the same active ingredient, semaglutide) work by mimicking a naturally occurring hormone that makes our bodies feel full. Studies have found that the drugs, which are typically injected once a week, can help medically obese people lose as much as 15% of their body weight and keep it off.
Because of these remarkable results, some researchers believe these drugs could be a game changer in the ongoing effort to curb what is often referred to as the obesity epidemic. More than 40% of Americans qualify as obese, according to the Centers for Disease Control and Prevention. Obesity is associated with a long list of life-threatening health conditions, including stroke, heart disease, diabetes and certain types of cancer. The medical costs of obesity in the U.S. have been estimated to be upwards of $170 billion a year.
The Food and Drug Administration approved Wegovy for treatment of chronic weight management last summer. Ozempic, on the other hand, has only been approved for diabetes treatment. Still, more and more doctors have been prescribing it “off label” to address their patients’ obesity. The drugs have also reportedly become the go-to solution for Hollywood stars looking to slim down. The dramatic spike in demand for Ozempic has created shortages, making it difficult for some diabetics to acquire it.
Why there’s debate
Some obesity experts believe drugs like Ozempic can truly help solve the obesity epidemic by providing an effective alternative to the crash diets, failed lifestyle lectures and often dangerous pharmaceutical treatments that have been at the center of weight loss efforts for so long. Many express hope that these new drugs can mark a turning point where the medical field — and society at large — starts treating obesity as a disease, rather than the result of personal shortcomings, like lack of willpower.
But skeptics say there are too many barriers for these new drugs to deliver on their promise. Those drawbacks include high cost (as much as $1,300 a month out of pocket), spotty insurance coverage, occasionally severe side effects and the fact that people will need to stay on the medication indefinitely to avoid quickly gaining all the weight they lost back. Others fear that the treatments could prove to be dangerous for people who are not obese and taking them purely to look thinner, rather than to address health complications caused by their weight.
Some of the harshest critics reject the basic premise that getting people to lose weight should be a priority in the first place. They point to a growing body of research suggesting that someone’s weight, on its own, is not as strong of a marker of their health as many believe it to be. They argue that it would be better for the nation’s health if medical experts focused on life-threatening conditions themselves, rather than the allegedly flawed metric behind them.
Industry experts expect this new class of drugs to become a huge source of business in the next few years as more products gain approval specifically for weight loss. Some analysts believe that tirzepatide, a weight-loss drug from the pharmaceutical giant Eli Lilly, could be the best-selling medication of all time if it gains approval by the FDA.
These new drugs could dramatically improve the overall health of the U.S. population
“I think these medicines may be the most widely prescribed medicine in the history of the world sometime in the next five to 10 years. … People should use these medicines with an appropriate diet and exercise plan, so I hesitate to suggest it’s a magic bullet, but I think in the long term, these medicines are going to be very accepted — not only for weight loss, but for improved health.” — Paul Kolodzik, Business Insider
Weight loss drugs allow doctors to treat obesity as they would any other disease
“In the U.S., individuals with diseases are provided access to specialized health care professionals, medical procedures, and pharmaceuticals. Not so for people with obesity. … This approach exacerbates the current health crisis, and is a huge disservice to people who require treatment for a disease — obesity — that is often ignored until it is too late.” — Robert Gabbay, Stat
Though not perfect, these drugs are significantly better than other weight loss interventions
“Right now, the field is really looking for more efficacy, number one. People will do almost anything to lose weight. We have more than just surgery now for promoting substantial weight loss. The most exciting thing is that obesity is on the ropes.” — John Buse, endocrinologist, to Quartz
We shouldn’t let fair concerns about anti-fat bias undermine this breakthrough
“Righteous pushback against the genuinely useless diet and exercise mantra has created a new politics of ‘fat acceptance’ especially in certain left circles, which treats any discussion of body weight issues as akin to racist or homophobic discourse. Caught between diet and exercise and its enemies, the idea of effective treatments has no constituency.” — Matthew Yglesias, Grid
Medication can help curb obesity in young people before it becomes a chronic condition
“The childhood obesity epidemic is already here — and worsening. This step towards making weight loss drugs more readily available as part of a comprehensive treatment approach for teens is a good one.” — Lisa Jarvis, Bloomberg
It will be difficult for many people to maintain keep taking these drugs in perpetuity
“You are betting that this drug will be safe, affordable, and available for your lifetime, give you no side effects and you will stay motivated to inject yourself every week throughout the period.” — Nsisong Asanga, Independent
Until there’s enough supply, these drugs should be reserved for diabetics
“Here's the thing: Diabetics need drugs like Ozempic to regulate their blood sugar. Yet the US government hasn’t issued guidance to doctors or pharmacists about prioritizing this medication for those who need it to stay alive … over people using it for weight loss only.” — Zoe Witt, Glamour
The correlation between weight and health is much more complex than most people realize
“Weight alone is not a reliable indicator of health. Plenty of people who are considered overweight by current measures are metabolically healthy, and plenty of people who aren't considered overweight are not.” — Taylor Andrews, PopSugar
There’s huge risk of these drugs being abused by people who don’t have a medical reason to take them
“I guess it's not black and white; as with many things, the question of these medications' usefulness depends on context. I can understand the effectiveness of the medication for those who needed it. … While they might help those who are obese or overweight, I can’t help feeling that these medications are finding an audience among already fairly slim women wanting to shrink even more — I'm also concerned that people might take it too far.” — Lauren Clark, Women’s Health
It will take societal change, not some wonder drug, to truly improve the nation’s health
“There isn’t a focus on food deserts that require impoverished people, many of whom are people from marginalized communities, to live without access to fresh fruits, vegetables, produce, and meat. Instead, the message remains that obesity is a complex disease that can be cured through diet, through exercise, and through continually escalating medical interventions. … As much as some doctors may desire to stop treating fatness as an individual failing, their remedies and their approaches simply reinforce that status quo.” — Evette Dionne, Buzzfeed News
The drugs could reinforce some of the most dangerous attitudes about weight
“The broader cultural implications of injecting Semaglutide for weight loss are themselves wide-ranging. … Losing weight is typically regarded as an accomplishment: the result of hard work, dedication and tremendous self-discipline. (Such attitudes, which equate body weight to some sense of morality, may only work to reinforce the psychological bases of some eating disorders.)” — John Semley, Guardian
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