What do we gain, when everyone seems to be losing (weight)?
GLP-1s are changing the game, de-emphasizing traditional health and wellness practices and offering the first truly quick fix for weight loss.
For decades, being thin has been the ultimate goal. An essay published in Harper’s Bazaar in 1897 referred to fatness as a “crime” and a “deformity,” and argued that a fat woman “will not be a social success unless she burnt-cork herself, don beads, and then go to that burning clime where women, like pigs, are valued at so much a pound.” Throughout history, the fat stigma has remained strong and consumers have sought out almost every known way to lose weight.
From the Atkins diet and 8-Minute Abs routine of the 90s to today’s Keto and CrossFit, there has always been a new fad or product to try. Weight Watchers and Noom have created business empires around consumers desire to lose weight through nutritional changes with roughly 5M paid subscribers and over 45M downloads respectively. Suzanne Somers made almost $300M from selling the ThighMaster, while the Shake Weight sold over $40M despite the fact that they didn’t work. Sure, there are plenty of diet plans and workout routines that do have benefits and promote healthy changes, but most of them are not sold through massive marketing schemes.
The supplement industry is even worse. A majority of what is on the market is a total scam with little scientific validation and virtually no regulation. The dietary supplement industry grew from roughly 4,000 products in 1994 to as many as 90,000 in 2017, and is expected to become an over $200B market worldwide by 2025. Promises of a quick fixes or magic formulas, have stolen billions from customers looking to lose weight and improve their health. Most of us even know these things are full of s#*t, but we buy them anyway hoping to lose that extra 10lbs. And for the few companies that are producing clean and effective supplements, it is extremely difficult to acquire significant market share because of all the saturation within the broader industry.
The weight loss fixation in America has created a massive market and has had a significant impact on trends and consumer behavior. Weight and body image are a leading cause of depression and mental health amongst Americans, with roughly 74% people reporting concern about their weight. Weight loss and being thin have long been idolized in pop culture while broader societal pressures have led to the promotion of unhealthy weight loss methods such as crash diets, excessive exercise and even eating disorders. Social media has only heightened these issues, with record numbers of young adults facing severe body dysmorphia and relying on unreliable information sources and companies with sensationalized marketing campaigns for their nutrition and fitness needs.
Enter GLP-1s. GLP-1s are a class of medications designed to mimic the action of glucagon-like peptide-1, a natural hormone in the body. This hormone plays a crucial role in regulating blood sugar levels by stimulating insulin secretion, suppressing glucagon release, and slowing down gastric emptying. Traditionally prescribed for managing type 2 diabetes, GLP-1s have expanded their reach to influence various aspects of metabolic health.
And before anyone comes after me, this is not meant to attack the proper use of these drugs to treat CLINICAL obesity (defined as a BMI of 30 or more) and type-2 diabetes. Especially in America, where more than 2 in 5 adults and 1 in 5 children are obese, we need these drugs more than ever. GLP-1s have been shown to not only have positive impacts on weight management, but have demonstrated the ability to reduce the risk of major adverse cardiovascular events, enhance metabolic flexibility, and manage blood sugar levels.
In order for the prescription of these drugs to be safe, providers must ensure patients are coupling these medications with lifestyle changes for long-term weight management and lasting health improvements. It is crucial that these drugs be taken with caution given the range of severe side effects and unknowns about long-term health impacts. Most importantly, we need to find ways to make weight loss from these drugs sustainable after people go off of them. Being medicated for the rest of your life is not a healthy solution for anyone.
Sidebar: What we should NOT be doing is putting children on GLP-1s. Research from UC Irvine suggests there could be profound negative impacts to long-term health when children are put on these drugs. “The balance of energy intake (diet) and energy expenditure (physical play and exercise) influences a child’s growth and health across their life span, they noted, adding that any change in the balance of these two factors can adversely impact health later in life.” Children need to be taught good nutrition and fitness habits at a young age and society should be focusing on increasing access to healthy foods instead of expensive miracles drugs for pediatric obesity treatment.
Re-enter GLP-1s (for vanity). Initiated by a slew of celebrities endorsing the fat melting miracle drug, GLP-1s have become increasingly popular outside of those requiring it for medical use. Some even dubbed it Hollywood’s worst kept secret after many celebrities were assumed to have used it for major weight loss transformations amidst award show seasons of 2022 and 2023. As most celebrity trends do, the #ozempic went viral and many consumers begun actively seeking out ways to get prescriptions for off-label use of the drugs. In response to this craze, multiple telehealth platforms like Ro have begun supplying them to people who don’t really need them. There are hundreds of stories of individuals receiving prescriptions purely for aesthetic purposes with relative ease. GLP-1s have now become widely accessible to the public, that is if you can afford it. Out-of-pocket they’ll cost you around $1000 a month! We’ve even seen the drugs advertised broadly in public with massive television campaigns and adds popping up all over the country.
This is a MAJOR issue because not only does it disadvantages those who are unable to afford these expensive drugs and creates supply chain issues for those who actually need the drugs for medical reasons, but most importantly, it discourages healthy habits such as proper diet and exercise. GLP-1s are delivering on the promises of so many health fads that came before them but in a potentially harmful way. They are preying on society’s biggest insecurity thereby promoting unhealthy habits such as an over reliance on medications with severe side effects, poor dietary choices, reduced focus on physical activity, and even the potential for disordered eating.
People no longer need to spend hours in the gym or prioritize protein and whole foods to get the results they’ve long been looking for. GLP-1s are breeding a whole new generation of lazy, body obsessed people, instantly gratified through their purchase of a “miracle” drug. The physical side effects are just as concerning than the societal impacts. One study showed a third of weight loss came from muscle, bone mass, and lean tissue which significantly affects health later in life as we know muscle mass is linked directly to longevity. There is also the risk of developing thyroid tumors, pancreatitis and even kidney failure yet the promise of a quick weight loss fix has outweighed the risks for many.
One thing is for sure, the market for GLP-1s is growing and suppliers are rushing to meet demand. Wall Street analysts anticipate the market for GLP-1 drugs could reach up to $100 billion within a decade. The impact these drugs could have on society is huge with broad use of GLP-1s for minor weight loss impairing individuals ability to form healthy habits, learn self discipline and hard work, and treat their body properly.
The question remains, will the rise and widespread accessibility of GLP-1s lead to a decline in traditional health and wellness habits? What happens when a majority of the population is able to get the results they want without the commitment to fitness, nutrition, and recovery? It’s hard to say, but it’s possible these drugs impact the industry’s growth and ability to expand the core consumer base in the future. Currently, only 28% of Americans are getting enough exercise and are considered in the core of the health and wellness consumer base, so for the other ~70%, turning to easily accessible GLP-1s could be the quick fix they are wanting. As the drugs become cheaper and even more accessible their allure will only increase, but the health and wellness industry is stronger than ever exceeding over $1.8T and growing, so it is unlikely this market will be cannibalized by these drugs anytime soon.
“It's not about the way people look, it's about health. If you’re a normal weight or even in an overweight category, but not showing signs of risk of having elevated cardiometabolic disease. … You don't need to be taking medications for weight loss,” she said. “This idea of using medications for aesthetic reasons is really more related to societal ills around how we value thinness above anything else. That's not the goal, and it's not safe.”
- Diana Thiara, MD, the medical director of the University of California, San Francisco’s, weight management program