From Scarcity to Abundance in Obesity Medicine

The acute shortage of obesity medicines is over. But in absolute terms we are still operating with a mindset of scarcity when thoughts turn to obesity care. Policy often dictates limited access to care and even more so, to medicines that can so effectively treat this condition. What happens if we start thinking in terms of abundance in obesity medicine? What if we aspire to care for everyone who seeks help with this complex, chronic disease?

Economist Emily Oster, writing in The Atlantic, says that the answer is really quite simple. We will save many lives. It will cost real money. And with great confidence, she says we should do it.

“Near-Miracle Drugs”

In making the case for abundance thinking for obesity medicine, she describes GLP-1s as near-miracle drugs:

“On obesity alone they make a huge difference – resulting in about 15 to 20 percent weight loss in randomized trials. And although weight does not define health, and BMI is an overused number, the data are clear that obesity is a risk factor for a variety of diseases and is associated with higher mortality. Individuals experiencing obesity at age 40 have a life expectancy, on average, three to four years shorter than those who are in the normal weight range.

“What’s more, these medications are also showing substantial benefits for both related and unrelated conditions.”

The Scarcity Reflex

But right now, the scarcity reflex is strong. It is true that these drugs have a list price in excess of a thousand dollars monthly. But the actual prices that people pay are falling rapidly. Exact costs are hard to know because contracts with pharmacy benefit managers are damnably opaque. Sometimes even the people who are paying the final bill, like employers, don’t exactly know the net cost.

Nonetheless, it’s clear that the price is coming down – rapidly. It’s also clear from folks like ICER, that these drugs offer great value – even at current net prices.

So we agree with Oster wholeheartedly. Obesity medicine can save lives. Health systems should stop working so hard to make it scarce. Saving lives and making them better is what healthcare is all about. In obesity medicine, we have a huge opportunity to do a lot of this.

Click here for gift access to Oster’s essay in The Atlantic, here and here for more on economics, care, and abundance.

Path to Abundance, photograph by Rashijain190, licensed under CC BY-SA 4.0

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October 21, 2025