The United States has a growing weight problem. Today over 42% of Americans adults are obese. Globally, nearly two billion people are overweight while fewer than 500 million people are considered underweight. Unfortunately, as nations become more developed and their economies expand so do the waistlines of their citizens. People who try to lose weight often fail –– sometimes adding more pounds than they shed. Now a new drug promises a shot in the arm for this growing problem.
The Centers for Disease and Control rely upon the Body Mass Index for determining if someone is overweight or obese. Those with a BMI over 25 are considered overweight while over 30 is obese. The calculation is fairly effective for sedentary people. However, athletes may be outside of a “healthy” BMI because despite having a low body fat percentage, they are muscular and may be heavier than others of their height.
Still, there’s no question that people in the U.S. are getting fatter. Airlines are having to adjust fuel consumption and safety measures because passengers’ average weight has gone up by as much as 10% since 2013. The annual medical cost of obesity is over $150 million. No one knows exactly why obesity is so prevalent, but there are several reasons. Fruits and vegetables are less seasonal than they once were because they can be transported across greater distances. This favors heartier varieties that aren’t as flavorful. Even as healthier foods become less tasty, ultra-processed foods loaded with salt and sugar like chips, cookies, and pre-made frozen meals are getting tastier. A few generations ago people worked outdoors or did demanding chores at home. Now many of us are sedentary, sitting in front of computers for a living. At home, most chores take far less effort thanks to modern conveniences. Finally, changing immigration patterns have brought high numbers of people from Mexico, Central America, the Caribbean, and the Indian subcontinent over the past half-century. One study showed that this group had the highest prevalence of overweight/obesity –– with over 70% considered to be over a healthy weight.
No matter what the cause, genetic factors can’t be singled out. That’s because while population growth in the United States has been declining, from 1999-2018 obesity increased from just over 30% to over 42%. Medical solutions have been offered for over 70 years. In the 1950s, amphetamines delivered energy and appetite control. Unfortunately, they were highly addictive and dangerous. Equally risky, fenfluramine and phentermine were combined as the diet drug fen-phen In the 1990s until being pulled from the market for causing heart valve problems. Against a backdrop of those and many lesser known failures, the approval of Wegovy in June for obesity was celebrated by many. In one study, those using Wegovy lost an average of 12.4% of their initial body weight compared to individuals receiving a placebo.
Besides showing results, Wegovy also had fewer side effects with some suffering nausea, vomiting, or stomach upset. Plus, since it has been on the market as a diabetes medication called Ozempic, the drug, semaglutide, has already been widely used. This means there is a far less chance for serious undiscovered side effects.
Just as Rogaine and Viagra were developed to treat hypertension until doctors noticed the drugs were offering a surprising benefit to their patients, people with diabetes using Ozempic discovered reduced cravings for food. That’s because the drug imitates the glucagon-like peptide-1 (GLP-1) hormone which targets the parts of the brain responsible for regulating appetite. One user said that shortly after receiving an injection of the drug, “…there was something that triggered in my brain to tell me that I was not hungry.”
So what’s the problem? It’s very expensive. Besides costing around $1,000 a month, users who stopped the regimen quickly regained the weight. Which means insurance companies could be on the hook for $12,000 a year for the life of the patient. Unsurprisingly, many are reluctant to offer coverage. Historically, it’s been difficult finding insurers who cover anti-obesity drugs. Besides the health risks from earlier treatments, there remains skepticism that obesity is a medical issue rather than a lifestyle choice.
Still, treatment advocates point out that being obese increases someone’s risk for over 100 different medical conditions including diabetes, strokes, and heart disease. Treatment for these is quite expensive. Although overweight people generally have shorter lifespans (which in theory could save insurers money), the morbidity and extraordinary end-of-life interventions practiced by many doctors in the U.S. alter this equation. This is one reason the CDC estimates that annual medical costs for obese patients are $1,500 more than medical costs for people with healthy weight. What isn’t in doubt, however, are the millions of overweight people eager to try this treatment should insurance companies subsidize it.
Written by John Bankston
- Adult Obesity Facts
- CDC: About Adult BMI
- Calculate Your Body Mass Index
- Hypertension, overweight/obesity, and diabetes among immigrants in the United States: an analysis of the 2010–2016 National Health Interview Survey
- FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014