Obesity is a disease. The American Medical Association said so almost a decade ago, and experts convened by the National Institutes of Health did the same when Bill Clinton was president. But it bears repeating, because the conventional wisdom still holds that obesity is a choice. From paleo to Pilates, get-fit-quick schemes revolve around willpower and the assumption that weight loss is entirely a function of diet and exercise. Successful weight loss is partly a function of behavior, yes, but research suggests that genetics and environmental factors can make it extremely difficult or even impossible for some people without outside help. Today, outside help often means surgery, but there’s a much less invasive option quietly sitting on the shelf.
That would be prescription drugs, especially a group of drugs known as GLP-1 receptor agonists, or GLP-1s. These compounds were designed for people with diabetes but have also been shown to cause patients to shed pounds. They simulate a hormone known as glucagon-like peptide 1, the chemical that helps people feel full after they eat. Many people taking a newer GLP-1 drug for weight loss known as Saxenda, for example, lose at least 5% of their body weight, according to one study by the manufacturer. Older generic medications can cost patients as little as $15 a month, while new, brand-name GLP-1s run about $1,400 for a month’s supply of weekly injections.
Over the past several months, pharmaceutical manufacturer Novo Nordisk A/S has twice increased its annualized financial estimates, each time citing high early demand for Wegovy, its next-generation weekly obesity shot recently approved by the U.S. Food and Drug Administration, among other factors. Clinical trials showed patients losing an average of about 15% of their body weight, and the company says the longer-term goal is to make drugs that can produce results comparable to surgical options, which generally yield weight loss of roughly 30%.
Many overweight people and all obese people are candidates for a prescription. Yet no more than 3% of qualifying Americans are taking weight loss medications, and most haven’t even heard of them. The American Board of Obesity Medicine has certified 5,242 obesity medicine doctors in total, up from 587 in 2013. So far, though, most doctors simply aren’t prescribing the medications.
Obesity Medicine Association President Ethan Lazarus, who’s worked with companies that sell such drugs, says part of the reason is that these shots and pills aren’t the miracle insta-svelte elixirs of our dreams. Patients still need to eat healthily, work out, and keep in touch with a professional who can monitor their progress and tweak their program. The U.S. medical system isn’t exactly set up for that kind of personalized medicine, and doctors aren’t immune from biases about weight gain. “I think you’ve got a multitiered problem where, at the end of the day, most doctors and most people with obesity still believe it’s just the person’s fault,” he says, “and you know, ‘if they could just eat a little bit less, it would solve the problem.’ ”
Absent a major influx of interested doctors, a handful of startups are offering an in-between option: apps that can coordinate remote patient visits and coaching and dispense prescriptions for on- and off-label meds regularly prescribed by obesity doctors. The question is whether these approaches can start to change the conversation around weight loss. Fatima Cody Stanford, an obesity doctor at Harvard Medical School and Massachusetts General Hospital who’s advising the startup Calibrate Health Inc., says the emerging models can help bridge the gap between the drugs and their potential beneficiaries. “Patients aren’t being made aware that medications are even an option,” she says. If she withheld such treatment information from her patients with diabetes or hypertension, she adds, “I would lose my medical license.”
Obesity is called a comorbidity for a reason: It raises the risk of diabetes, heart disease, Covid-19, and straight-up death from any cause. Drastic upswings in weight over the past 40 years of increasingly processed foods and sedentary lifestyles have left approximately 3 in 4 Americans, an estimated 245 million people, either obese or overweight. In that time frame, scientists have also learned a great deal about the whys.
Continue reading your story on the app
Continue reading your story in the magazine
Bet On It
A Silicon Valley-backed startup wants to bring Wall Street-style trading to the outcome of events. Some regulators say that’s a terrible idea
You're Browsing All Wrong
A startup wants to discard the standard formula for the web browser
Killer Heat Is Here
The record temperatures ravaging India are a warning of global catastrophes to come
Opening the Spigot
Conservatives want to limit social media companies’ power to control content
Expanding Access to Mind Expansion
Companies offer guided drug trips on jungle retreats, at city clinics, and in your living room
Europe's Travel Rebound Wobbles
A staffing crisis at airlines, airports, and even the Chunnel left some operators overwhelmed
Genetic testing companies promise they can predict an embryo’s probable future health. Some parents don’t want to stop there
Are We Still Doing Scooters?
Lime says people are scooting more than ever, but providing urban transit is a hard way to make unicorn-level profits
"You Know What's Cool?"
Facebook has spent a decade successfully ripping off its newer, hotter rivals. But this time, it tried to copy TikTok and blew up Instagram instead
Pivoting to Troll
Elon Musk’s incessant posting may do wonders for his ego and clout in right-wing circles, but it has destroyed value pretty much everywhere else
How to create a nourishing self-care routine that can help you feel calmer, more centered, and better able to face the challenges of the world around you.
NEW RESEARCH: INTERMITTENT FASTING INCREASES AB FAT
Intermittent fasting, often referred to time-restricted eating, has become the latest diet craze not only for weight loss but also for enhancing health. Everyone from well-known celebrities to everyday, average people are trying intermittent fasting and claiming it is successful.
Top 10 Foods To Boost Your Sex Life
Which means a balanced and nutrients diet combined with regular moderate exercise and a positive attitude.
HOW NATUROPATHIC DOCTORS TREAT TOXIN EXPOSURE
IF YOU’RE THINKING ABOUT STARTING A DETOX REGIMEN, IT PAYS TO CONSULT AN EXPERT FIRST.
4 EXPERT TIPS FOR Men to Age Gracefully
We all want to believe that we get better with age, but growing older can often make a man feel more like a broken-down beater than a classic car. Luckily, it is possible to handle the process with strength and integrity. Try a modern approach to aging gracefully with these four steps,” says Dr. Spar.
10 Science-Backed Steps to Eat Less and Weigh Less with “Whole Person”
Could nourishing ourselves multi-dimensionally — physically, emotionally, spiritually and socially — give us the scientifically sound nourishment we need to lose weight and keep it off?
MIRACLE INJECTION MELTS OFF FAT WITHOUT DIETING!
Docs claim it’s easier & safer than surgery
Lakeland Regional Health Unveils New Weight Loss Institute
PHIL HEATH A MILE HIGH ABOVE THE REST
Numerous factors contribute to fat loss.
Children's Sleep: The Good Night Guide
DR. GARIMA GARG SETH is a pediatrician with a mission to help children learn good sleep habits. Here she explains to us what that means, and how as parents we can provide the best possible environment for children to develop a healthy sleep lifestyle.