Is This a Good Idea?

By Peter Galvin, MD

Because we have become a country with an obesity problem – 42% of U.S. adults and 20% of children are classified as obese (childhood obesity rates have tripled since the 1970s) – more and more people are turning to medications to lose weight. The medications I am referring to are GLP1 receptor blockers (Ozempic, Wegovy, etc.) made by Novo Nordisk. But the cost of these medications in the U.S. is prohibitive and often they are not covered by health insurance plans. These medications are injected once a week. Here, the list price of Ozempic per week is $936 compared to $169 in Japan, $83 in France, and nominal or no-cost in the UK. To remedy this, the government recently proposed to cover these medications under Medicare and Medicaid, rather than looking at ways of reducing their cost here. But is using a needle really a good/healthy way to lose weight? The answer may be no.

By reducing their appetite, most people will lose weight by using these medications. But instead of focusing on the root causes of obesity such as poor diet and a lack of exercise, this government policy may create long-term dependency while ignoring the broader societal changes needed to improve health outcomes. Another factor is that these medications are fairly new and so long-term effects/side effects are unknown. Expanding access to these weight-loss drugs risks normalizing their use among children and families despite the fact that they are generally not approved for use in children as their effects on growth, metabolism, and mental health are poorly understood.

A few studies so far suggest that these drugs may reduce muscle mass, which can lead to long-term frailty. Also, rebound weight gain often occurs after medication use is discontinued (in the UK, their use is limited to two years). And they do have side effects, including multiple gastrointestinal issues. There is also a possible link to increased risk of pancreatic cancer. Covering these medications under government health plans without negotiating a price reduction could create an unsustainable financial burden on taxpayers.

This proposed policy will perpetuate a dangerous notion that chronic conditions like obesity can be solved with a quick fix. Rather, efforts should be focused on improving nutritional education in schools, expanding access to community fitness programs, and addressing mental health factors that contribute to overeating and obesity. It also ignores systemic issues such as food deserts, income disparities, and lack of access to preventive care, all of which perpetuate obesity rates in underserved communities. As RFK Jr. has stated “For half the price of Ozempic, we could purchase regeneratively raised organic food for every American, three meals a day, and a gym membership for every obese American.” In other words, we need to prioritize root-cause interventions over pharmaceutical dependence. I may not agree with most of RFK Jr’s ideas and comments, but I do agree with that sentiment. There is a long-term failure to address the real drivers of the United States’ obesity epidemic.

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