An illustration of that enthusiasm came this spring, when social media came alive as celebrities such as Elon Musk told of relatively easy weight loss after taking the new medications. Such “off-label” use by wealthy celebrities looking not to treat obesity but to drop a few excess pounds is legal but can deplete supplies for those who need it most. Demand so outstripped supply in May that drug maker Novo Nordisk, maker of the diabetes drug Ozempic and its weight-loss counterpart Wegovy, announced it was limiting Wegovy supplies for new patients.
“With availability of new powerful drugs and surgical procedures, the incentives are to promote them. They’re huge moneymakers for drug companies, surgeons, and hospitals,” Ludwig said. “We tend to lose sight of lifestyle and dietary interventions because few influential organizations profit in the same way. Beyond generic interventions like making physical activity more convenient, we must take a more sophisticated approach to investigating the biological effects of diet. The type of foods we eat alter dozens of hormones, hundreds of metabolic pathways, and the expression of myriad genes throughout the body in varying ways. Knowledge of these effects, combined with intensive behavioral methods, could inform the design of effective alternatives to drugs and surgery for prevention and treatment.”
Walter Willett, professor of nutrition at the Harvard T.H. Chan School of Public Health, sees two pathways ahead. On one, the new drugs help people with severe obesity lose meaningful amounts of weight, which then increases chances of success of lifestyle-based approaches. On the other, people don’t improve their diet, don’t increase exercise, and use the drugs to counter unhealthy habits they maintain and that may have contributed to the problem. On this path, people’s health would still be poor because good lifestyles contribute to well-being in many ways unrelated to weight control, Willett said.
“So, which path will we go down? I suspect it’s not going to be simple,” Willett said. “One thing for sure is that this is the Holy Grail for Big Pharma. You have two-thirds of the population overweight or with obesity and eligible to take this drug class, at somewhere around $10,000 to $15,000 a year for life.”
Either way, drug companies will be among the winners, Willett said. His “back of the envelope” calculation is that the new weight-loss drugs have the potential to add 50 percent to U.S. healthcare costs, which already eat up 20 percent of the gross national product, double that of most other countries.
“You can see this ballooning completely out of control,” Willett said. “Even today, healthcare costs are displacing the true determinants of health, which are education, a safe environment, physical infrastructure to work, play, walk, bike, all of that. Those are being squeezed and displaced by healthcare costs.”
