Losing more than just weight

Weight loss drugs like Ozempic will disrupt far more than just the waistlines of the people taking them. Entire industries will shift, and some will not survive.

By Jeffrey Cole

Credit: freepik.com

Morgan Stanley recently predicted that by 2034 ten percent of Americans (35 million people) will be taking semaglutide weight loss medications, the best known of which is Ozempic. At a cost of $900-$1,300 per month (it’s as low as $200 in the UK), and with little insurance coverage except for diabetics and very obese people, the economic disruption to the healthcare system, and a growing list of companies (some obvious, others surprising) is already starting to be enormous.

In my last column, I looked at those who stand to gain as Americans lose weight. This time, I’ll look at those who will lose if tens or hundreds of millions around the world are able to safely and affordably move from obesity. While there would seem to be some obvious losers, many of the companies most threatened have already taken significant steps to mitigate what they can see as a rapidly shifting landscape.


Weight loss programs such as Weight Watchers, Jenny Craig, and Nutrisystem. These companies exist to help customers lose weight and keep it off. Historically they have been able to do the former but not the latter. They offer food education as well as food itself, exercise programs, medical and emotional support.

Ozempic and related medications are a direct threat to the continued existence of these programs. This year, Weight Watchers saw its share price decline 83% as its best known partner and symbol, Oprah Winfrey, admitted that she had lost significant amounts of weight not through the program but through medication.

It should have been a mortal blow to all these programs.

Wisely, they have picked up the pieces, realizing that their overweight customers need help in getting semaglutide drugs, as well as continued support once they are on them.

But the traditional weight-loss companies have new competition. For as little as $23 per month, programs such as Ro help clients obtain prescriptions for the drugs and meet monthly with a doctor. In addition, they provide help in navigating insurance companies to get them to pay for the drugs. They also offer coaching and education about staying healthy and social media support to connect with others on the same weight loss journey.

Economists have shown that Ozempic can cost as little as $5 per month and its manufacturer, Novo Nordisk, will still make a profit. Competition from Zepbound, Mounjaro, and other new entrants should drive prices down, as will the expiration of patents. Potential competitors are looking at compounded versions that might soon be available to consumers at $199 per month before insurance.

Both traditional weight-loss companies and their new competitors have brilliantly built a whole new type of program that embraces Ozempic and provides support for those who use it. Whether they can maintain or exceed their past levels of economic success is unclear. But they do seem to have a plan to ensure their survival.

Companies that sell food. This year at New York’s Sugar Week (yes, that’s a thing!), Walmart warned sugar traders that Ozempic is translating to declines in food sales as less-hungry customers spend less on groceries and at restaurants.

According to Morgan Stanley, “more than 60% of US consumers taking the drugs reported they had cut back on sweet treats like candy, ice cream and baked goods, and many said they had either significantly—or entirely—stopped eating those products.”

This will have significant implications for the concession stands at movie theaters, sporting events, concerts, and theme parks. For movie theaters, refreshment sales are the major source of their profits. It will also affect all restaurants, especially fast food that is most tied to impulse eating.

But even family restaurants may see changes in how much and what customers order. One answer is fewer desserts and appetizers. At restaurants such as The Cheesecake Factory that offer enormous portions (which many blame for the rise in obesity), something will have to change.

Supermarkets will be affected as the amount (and types) of food in the weekly shopping basket change.

Just as the weight loss programs looked for opportunity with the embrace of Ozempic, so too (although more slowly because the impact is less immediate) are food companies responding to coming changes. Nestlé, the largest food company in the world (with the most to lose), has identified an opportunity to be at the “forefront” of what it says is a “growing market opportunity.”

Nestlé has created a new brand, Vital Pursuit, that is specifically intended for Ozempic users. The brand will have 12 products ranging from frozen protein pasta, sandwich melts, and pizzas, all made with a higher amount of protein and essential nutrients like iron, vitamin A, and potassium. They are also “portion-aligned to a weight loss medication user’s appetite,” the company said.

If Morgan Stanley’s predictions about 10% of Americans becoming users by 2034 are correct, then it is easy to see the food offered in movie theaters, Disneyland, food carts and trucks, supermarkets, and restaurants all significantly changing. While there may also be opportunities for these companies, there is no denying the overall amount of food consumed will be less, and some types of food (candy, baked goods) may seriously decline

Healthcare Companies. Without a significant decline in obesity, the U.S. healthcare system is on a path to bankruptcy. Today, we spend $200 billion treating obesity-related health issues. That will rapidly rise as the population ages (today over 18% are 65 or older). If insurance companies are forced to pay the current price of at $900-1300 per month, it will either bankrupt those companies or many insurers will pass on massive price hikes to their customers or even leave the insurance market altogether.

Everyone is a loser in these scenarios as all ensure more expensive healthcare.

However, if these medications can become affordable rather than an onerous burden on both insurance companies and the insured, then everyone can be a winner.

Economists have shown that Ozempic can cost as little as $5 per month and its manufacturer, Novo Nordisk, will still make a profit. Competition from Zepbound, Mounjaro, and other new entrants should drive prices down, as will the expiration of patents. Potential competitors are looking at compounded versions that might soon be available to consumers at $199 per month before insurance.

Affordable semaglutide drugs mean the $200 billion and climbing healthcare costs of obesity can be halted and reversed,

If the drugs are affordable, the insurance companies will become big winners because they won’t have to bear massive Ozempic costs and their obesity-related expenses will plummet. In this scenario, the losers are the pharmaceutical companies that won’t be able to command the highly inflated costs that only the wealthy can now afford. But even the pharma companies will do just fine because the potential demand for these drugs is almost infinite (69% of Americans are overweight).

Relationships and marriage. Screenwriters (mostly comedy) are beginning to write about how relationships may change as one partner, after years of trying, achieves their ideal weight. Buying stylish new clothes, fancy sports cars, and dealing with attention from new admirers will all be played for comedic effect in movies and on television. Later, when we learn the more serious changes the subject will move to drama.

Relationships may change, for the better or worse, depending on how prepared people are for their new lives after losing large amounts of weight. Some experts warn that the ability to lose weight (finally, after years of unsuccessful dieting) may lead to reckless behavior.

Will the thinner partners suddenly do things wildly out of character? Will there be a rise in extramarital affairs or divorce, a desire to move or change jobs or find new friends? Or could these changes strengthen relationships?

One thing is clear: comfort with weight and body shape is an important part of self-confidence and comfort. Major changes in weight will lead to changes in how we feel about ourselves, and those changes will lead to changes in behavior.

There will likely be an exploding market for weight psychologists helping people to deal with changes in confidence.

These new weight loss drugs are exploding in popularity. In these last few columns, I’ve identified a few winners and losers as more people move away from obesity.

It is a rapidly changing landscape. At the Center, we are committed to tracking these changes in economic and social behaviors.


Jeffrey Cole is the founder and director of The Center for the Digital Future at USC Annenberg.



See all columns from the center.

June 5, 2024