Are drugs the answer to the world's obesity problem?

A new class of weight-loss drugs is being hailed as a miracle injection that helps people shed pounds of stubborn weight. Doctors and health experts are excited about the treatments, seeing them as a powerfully effective way to tackle the world's growing obesity epidemic. A recent report from The World Obesity Federation predicts that 51 percent of the world, over 4 billion people, will be obese or overweight within the next 12 years if significant action isn't taken. The NGO found that obesity rates were rising "particularly quickly among children and in lower-income countries," per CNN.

Researchers discovered the latest generation of weight-loss drugs somewhat accidentally. Pharmaceutical company Novo Nordisk developed semaglutide to treat type 2 diabetes, which the FDA approved as an injectable called Ozempic. When patients taking Ozempic started to report significant weight loss, the company produced a drug specifically for that purpose, with a higher dose of semaglutide, under the name Wegovy. In 2021, the FDA approved Wegovy "for chronic weight management in adults with obesity or overweight with at least one weight-related condition," like high cholesterol or type 2 diabetes. Earlier this year, the American Academy of Pediatrics added the drug to new guidelines for treating childhood obesity in adolescents aged 12 and over. A study showed that patients using Wegovy lost an average of 15 percent of their body weight. Another approved diabetes treatment, tirzepatide, which is marketed under the name Mounjaro by Eli Lilly, helped patients lose an average of 21 percent of their body weight, according to a study.

But the drugs, which have become particularly popular mong celebrities, are not without controversy. They may increase the risk of thyroid tumors, and must be taken "for a lifetime," The Economist explains. Plus they're very expensive, costing between $900 and $1,300 per month.

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What are the commentators saying?

These new drugs "represent the vanguard of a weight-loss revolution," writes Derek Thompson in The Atlantic, but their viral popularity should be a red flag. As a medical achievement, the drugs are "stupendous inventions," and their rollout must be done delicately. The current frenzy "raises questions about ethics, fairness, culture, and America's berserk relationship with beauty." A simple injection, albeit with a "luxury price tag," sounds nice, but we mustn't overlook the "complex interplay" of factors, including metabolism and environment, that contribute to weight gain. These new treatments could "augur a public-health revolution," though right now they "represent an elite cultural makeover more than a medical intervention."

New medications such as these are changing the narrative around obesity, which has "long been framed as a result of poor lifestyle decisions and a failure of willpower," Stat News says. The discourse about the effectiveness of these drugs underscores that obesity is a chronic medical condition, "and not something that's just a matter of a moral failing on the individual patient's part," Fatima Cody Stanford, an obesity medicine physician-scientist at Massachusetts General Hospital, tells Stat. "I have never seen a conversation surrounding obesity, obesity as a disease, the treatment of excess weight in a way that I see now."

The costs associated with treating obesity are "a drag on economic growth," says The Economist. If new drugs can address these, they could "make the world wealthier" and should be "welcomed with open arms." Research suggests even curbing obesity by 5 percentage points could save close to $430 billion annually. But the new treatments "certainly should not be taken for cosmetic reasons," and governments should focus on "preventing people from becoming obese in the first place," the magazine adds.

What's next?

Pescriptions for Wegovy and similar medications have risen exponentially in the U.S., leading to a shortage. Novo Nordisk could sell between $3 billion and $4 billion worth of Wegovy in America this year, and plans to launch the drug in more countries in the coming months, The Economist says. Even though many insurers don't cover the expensive drugs, and governments are hesitant to back them, these concerns "will presumably evaporate if it becomes clear that widespread use of the drugs will bring big cost savings to insurers or governments in the form of avoided treatments for conditions related to obesity."

In time, the high cost of the drug should eventually come down. "Insurers and governments will presumably be able to negotiate discounts to drugmakers' list prices," The Economist writes. The arrival of rival products will also drive the price down. "In the very long run, the new drugs will lose their patents and become available in generic form," the magazine adds.

Still, there are some lingering questions about the long-term effects of these medications. "One big question facing researchers now is whether people will need to take these medications for life to maintain their weight," Scientific American says. It is also too early to tell who will respond to the drugs and who won't, though they appear less effective for people with type 2 diabetes. Researchers are also concerned that "by offering a weight solution in societies that prize thinness, these drugs could also inadvertently reinforce the disputed link between excess weight and health," Scientific American adds.