Is Obesity Almost Over?
Problems, Solutions, and the Problems with Solutions
Derek Thompson on the “Weight-Loss-Drug Revolution”
The hotel ballroom was standing-room only, according to the scientific journal Nature, and the results of the trial were met with cheers, “like you were at a Broadway show.” After a year, young patients on semaglutide said they lost nearly 35 pounds on average. Teens on the placebo actually gained weight.
But of course, the world is messy so…..
But just months into this weight-loss-drug bonanza, a range of medical, cultural, and political challenges has materialized. Doctors are reporting rampant use of these new weight-loss drugs among the very rich. The surge of off-label use of Ozempic is already creating a shortage of the medication for people with type 2 diabetes. Now that celebrity skinniness is merely an injection away, online “thin culture” has returned, likely exacerbating Americans’ fraught relationship with body image. On paper, these drugs might be a miracle. In the real world, they’re also becoming a menace.
Derek is right to harp on the gulf between invention and implementation. The Progress movement should probably be thinking much more about making real gains in implementation science.
Semaglutide seems to collapse the complex interplay of genes, environment, diet, metabolism, and exercise into a simple injection with a luxury price tag. I’m holding out hope that these drugs will soon augur a public-health revolution. In early 2023, however, they represent an elite cultural makeover more than a medical intervention.
As always, the future is here, just unevenly distributed.
MATTHEW YGLESIAS on the Rise of Obesity
This isn’t really about progress. But since we’re talking obesity anyway, why the sharp rise in the U.S. since 1980? Is it lithium? No? Well must be the seed oils right? No?! Is it because my wife orders her steak well-done? Maybe.
I think the entire premise of a mysterious obesity inflection point around 1980 is probably wrong. The whodunnit is a classic genre, and if you’re trying to create compelling content, it makes sense to twist your nutrition narrative into that shape. But the evidence suggests a much more boring story about a long-term increase in average weight punctuated by the Great Depression and World War II. And this in turn suggests that there probably isn’t some unitary big bad we can blame so much as a broad tendency for food to be cheaper, more widely available, and tastier, which is a situation with a lot of virtues but also some downsides.
There’s a lot of quality evidence that he links to that I find convincing. His argument is so obvious and boring that it’s probably right.