Will GLP-1s Level the Field in an Obesogenic Environment?
The rousing success of GLP-1 medicines for obesity and overweight evokes a wide range of feelings. At the National Academy of Sciences this week we heard lamentations from a scholar in exercise physiology. To him, these highly effective treatments are a distraction from the importance of focusing in healthy eating and active living. We hear a similar lament from lifestyle medicine advocates. Then we also have the folks on a mission to eradicate what they are certain is the root cause of obesity: unhealthy ultra-processed foods. They are not fans of GLP-1s either. But what if these new medicines ultimately serve to level the field in an obesogenic environment?
Could it be that GLP-1 agonists will wind up being heroes rather than villains for the advocates of healthy eating and active living?
Silencing the Food Noise
Tamar Haspel suggested this might be the case more than a year ago:
“There’s a fight-fire-with-fire aspect to these drugs that I really like. We’re fat because we’re not equipped for engineered, industrial-strength temptation. These drugs confer industrial-strength resistance.”
Widespread reports about food noise line up with her prediction. People for whom this “noise” has been a lifelong plague say that GLP-1 agonists have given them a blessing of relief. The pervasive manifestations of food marketing become ineffectual.
The food industry is beginning to think it will have to stop relying on overconsumption to fuel its growth. An obvious response would be to sell higher quality products that will command higher prices.
Use for Mild Obesity
If we think about GLP-1 agonists as something that might level the field of an obesogenic environment, the worries about who deserves access to these medicines start feeling frivolous. WebMD describes some of the present consternation about people who use a GLP-1 for coping with mere overweight or mild obesity. Some doctors get very judgmental when they detect motivations related to personal appearance, talking about “societal ills.”
Does someone have to progress to severe obesity to have a valid concern about coping in an obesogenic environment?
Equity Issues
This thought experiment does, however, leave us with unresolved equity issues. Already, we see widening disparities in obesity. Until these scarce and pricey medicines become more accessible and affordable, they may well widen those disparities further.
People with less social and economic status may be the last easy marks for the forces in culture and commerce that promote obesity. With that in mind, better access to these medicines becomes an imperative.
Click here for Haspel’s perspective, here for more about food noise, here for perspective on mild overweight, and here for more on disparities in access to GLP-1 medicines.
Spirit Level Bubble, photograph by Santeri Viinamäki, licensed under CC BY-SA 4.0
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July 26, 2024
