Disruption comes to our bodies — and beyond

New weight-loss drugs such as Ozempic and Wegovy will do more than just shrink individual waistlines: the economic and social impact may be incalculable.

By Jeffrey Cole

Disruption, like people, comes in all shapes and sizes. But a new and extraordinarily powerful disruption is — for the first time — changing the actual shape and size of the human body. It is a true game changer, bringing profound impact on our health, life spans, psyches, social lives, economy, as well as how we relate to each other.

This disruption is just getting started.

Around the world, especially in prosperous countries, people are getting fatter. We in America, with our endless appetites and enormous portions, set a high bar, but the rest of the world seems determined to catch up or surpass us (no easy task). More than two thirds (69%) of adult Americans are overweight, and more than one third (36%) are obese. Globally, over 1 billion people are obese, and that number is rising fast.

The tools for fighting (or preventing) obesity are difficult to follow or stick to. It means eating less “fun” food, more healthy things, and smaller portions. Plus regular exercise. Some diets call for starvation-level intake or only consuming carbs, only proteins, or something else equally unrealistic. That is why so many quit diets and exercise, quickly gaining more weight than before they started.

Now disruption has come to our bodies. Although there are a number of similar-class (GLP) drugs, the best known of them all is Ozempic. I’ll use “Ozempic” generically, even though others Wegovy, Mounjaro, and Zepbound are similar.

For generations, we have dreamed of taking a daily pill to make or keep us thin. Now it is happening, but it is even better than that. You only need to take some of these disruptive new medications once a week!

The results have been extraordinary.

Most users lose 15% or more of their body weight and report that their constant thoughts of food diminish or disappear. Already, research supports that Ozempic can reduce the danger of heart attacks and strokes. There is also astonishing new evidence that these drugs can also treat alcoholism and even gambling addiction by addressing impulse control. There may be other benefits we are just beginning to learn.

As they are relatively new drugs, we do not fully understand their long-term effects. We do know that to maintain weight loss users must stay on them for the rest of their lives.

Some do report side effects. So far, the side effects seem to be overshadowed by the positive impact these medications have on obesity, one of the most dangerous diseases of the human body.

The medical issues of Ozempic and similar drugs will be talked about and studied for years — perhaps forever. I’m most interested in the economic and social disruption that come from easy and significant long-term weight loss and maintenance.

Economic Disruption

The economic toll of obesity related diseases is astronomical. In the U.S., the cost of treating weight related issues is approaching an eye-popping $200 billion a year: 14% of all health costs. And, as the population ages those numbers are rapidly increasing. All by itself, obesity can bankrupt Medicare and the health system.

Obesity is also extremely dangerous and lessens personal mobility, comfort levels, and life span. You don’t see many obese people celebrating their 90th birthdays. And the obese often need the help of scooters or wheelchairs.

A new and extraordinarily powerful disruption is — for the first time — changing the actual shape and size of the human body. It is a true game changer, bringing profound impact on our health, life spans, psyches, social lives, economy, as well as how we relate to each other.  This disruption is just getting started.

The good news is medications like Ozempic can effectively lower weight, bringing enormous economic disruption equal or greater than the cost of obesity.

However, these drugs are very expensive.

If they were to cost about the same as statins, one of the most prescribed drugs (for cholesterol) at around $50 a month, almost anyone who wanted Ozempic could get it. The $200 billion spent on obesity-related health issues would mostly disappear. The economic impact would be massive savings for Medicare and health insurance.

But these drugs are not priced like statins.

In the U.S., Ozempic currently costs between $900-$1400 per month. As Americans have come to expect, these drugs are available cheaper outside the country. Insurance companies (with few exceptions) will not cover these medications unless the patient is diabetic or has a Body Mass Index (BMI) over 30.

Novo Nordisk, the Danish firm that makes Ozempic (and Wegovy), is now Europe’s most valuable company: it’s bigger than the entire Danish economy. This is while there is massive unfilled demand for the medication. Novo Nordisk could end up the most valuable company in the world.

Already, critics are pointing out that an individual’s monthly supply of Ozempic can be manufactured for $5. The average injection could be 89 cents, and the company would still be profitable. There is so much demand that those who do not qualify for Ozempic are seeking alternative and perhaps risky counterfeit substitutions.

The economic disruption of obesity without these medications is greater than $1 trillion a year worldwide and growing fast. The costs for government and insurance companies (or some individuals) paying the current prices for Ozempic is equally disruptive.

It is the wealthy who can afford these medications and have doctors who will prescribe them. Ozempic access raises a fundamental issue of inequality and fairness if it is only the poor who lack access to these new drugs and who will suffer and die prematurely from obesity. To have these drugs readily available and able to be produced very inexpensively—but not to make them available—is becoming a huge political and moral controversy.

Social Disruption

The decline and potential elimination of obesity is a social gamer changer. Already, one of America’s favorite new games is watching celebrities on television and guessing who is on Ozempic.

I find it puzzling that many people feel that those who lose weight through these medications are “cheating.” It is as if we want them to suffer from the massively difficult and usually ineffective methods of losing weight, and then almost enjoy seeing them gain that weight back. Just ask Oprah.

We would never accuse a diabetic who takes insulin to survive of cheating.

Last week, Barbra Streisand received enormous criticism when seeing images of a newly thinner Melissa McCarthy asked online, “are you on Ozempic?” Many thought it was rude and a major social blunder to ask, as if McCarthy should be embarrassed. And yet, for most of our lives when we see someone who has lost a lot of weight, the first thing we ask is “how did you do it?”

The potential demise of obesity will lead to a major stimulus for the fashion industry as people buy new and more expensive clothing. It would also lead to more going out, traveling, and being active outside the house. Experts predict the loss of work productivity from obesity is in the tens of billions of dollars.

Perhaps the greatest impact of the decline or elimination of obesity would be greater confidence and happiness for hundreds of millions of people, who might spend less time hiding at home from the world.

There are still a couple of important ifs.

First, we need to be sure that there are no serious long-term negative effects of these new drugs. So far, the results are encouraging.

Second, the costs of getting these treatments must be covered by insurance like any other widely used drug.

If those two scenarios come to fruition, the economic benefits and the social benefits will be as important as anything we have ever seen.

This really is a game changer.

In the next column I will look at who the winners and losers will be as these weight loss medications become widely used. It’s a fascinating list.


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



See all columns from the center.

May 8, 2024