Paul Ford, a technology journalist, wrote last year about how a drug that regulated satiety had changed him. “I have been the living embodiment of the deadly sin of gluttony, judged as greedy and weak since I was 10 years old – and now the sin is washed away.” The drug, Mounjaro, offered a rebirth without a new ethical outlook. Mr Ford said he’d had a “Baptism by injection. But I have no more virtue than I did a few months ago.”
This might be attractive to those making new year resolutions that promise improvements in their lives. Weight-loss drugs reveal that obesity is not a deep-seated aspect of character but something more contingent. Obesity is made by modernity, not just poor choices. The spread of expanding waistlines is driven by sedentary work and the abundance of cheap, high-calorie processed foods. Carrying too much weight causes a host of health problems. The novel treatments raise questions about the type of society we want. The drugs are also not cheap. Healthcare analyst Airfinity says it would cost $1.1m to prevent “one heart attack, stroke, or cardiovascular death” using the weight-loss treatment Wegovy.
More than 70 other obesity treatments are in development, suggesting that costs may drop. Perhaps that’s why the UK government’s anti-obesity measures keep being put off. The trouble is the limited supply. There are, for instance, perpetual shortages of semaglutide, the active ingredient in Ozempic, which was designed to treat a life-threatening disease – type 2 diabetes – but produces startling weight loss. The upshot is that the rich are able to get hold of Ozempic when the ill cannot. British ministers say this is not supposed to happen. But it does.
Society privileges unreasonable definitions of attractiveness. Celebrities, billionaires and even world leaders prize thinness. It’s a recipe for anxiety. Losing weight is healthy, but not if the message reinforces body-image insecurities. Better relationships with our bodies are desperately needed. A dangerous black market is already emerging. Early trials of a potential blockbuster, retatrutide, suggest slimming gains similar to gastric-bypass surgery. Bootleg versions are being offered online despite the drug being years away from medical approval.
The new treatments work by mimicking naturally occurring hormones to lower blood sugar, reduce cravings, and produce a faster sense of fullness. They might also be transformative in treating many other conditions. But the path from opportunity to cure is a long one. The drugs’ side-effects include nausea and vomiting. Then there’s the risk of regaining weight once off the treatments. Some patients compare the drugs to an opiate addiction.
Novo Nordisk, the Danish firm behind Ozempic, has become Europe’s most valuable company. It is building new manufacturing capacity to keep up with demand. But some nations are putting health before Novo Nordisk’s profits. Who can blame them? Brazil might produce semaglutide as soon as 2026 after its courts said the Danish firm’s monopoly could be broken five years early. The judge ruled that the company’s patent made the treatment more expensive and less accessible, infringing Brazilians’ constitutional right to health.
About 10% of the world starves, while a similar fraction of humanity is obese. The stigma associated with being fat makes life miserable for too many. Undernourishment is also agony. Both problems need better answers. New advances in science mean things will shift. Humanity should ensure that the changes wrought by technology produce gains for a far greater number than is the case today.
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