A Sober Reflection on Life-Changing Obesity Medicines
This has been quite a year. Many remarkable changes we’ve witnessed go well beyond the scope of this commentary. In the policy realm, some of them are close at hand. CDC, which has long guided health policy on obesity, nutrition, and physical activity, has been decimated. NIH is under extraordinary stress. But on the positive side, the uptake of advanced obesity medicines has been life changing for a great many people this year. As utilization is growing, prices are falling.
So access is improving in a two-steps-forward and one-step-back kind of way.
A Conversation and Reflection
For an indication of the sweeping impact these medicines have had on the lives and health of Americans, consider the wide-ranging conversation the New York Times just hosted with 14 Americans using them. One theme rises above the noise: obesity care is finally being experienced as care, not moral correction. Participants described benefits that extend well beyond weight loss – improved glycemic control, better mental health, renewed confidence, and a sense that their efforts now produce results. For many, GLP-1s did not replace healthy behaviors; they made those behaviors possible.
But the story is not triumphalist. Side effects, plateaus, and the near certainty of weight regain after discontinuation tempered enthusiasm. Several users recognized what science has long told us. Obesity is chronic and relapsing, and biology pushes back hard against weight loss. The surprise, for some, was not that the drugs work. Rather, it was the realization that they may need to be used long term, like medications for hypertension or diabetes.
The Thread of Stigma
Stigma threaded through nearly every exchange. Some felt judged for taking “the easy way out,” even as others reported kinder treatment from strangers once they lost weight. This contradiction underscores a persistent cultural failure to understand obesity as a disease rather than a personal failing. As one participant put it, the drugs change not just appetite, but one’s relationship with food—and with self.
Cost and access emerged as the most urgent policy concerns. Many participants supported insurance coverage for obesity treatment, arguing that upstream investment would avert downstream costs. Yet skepticism abounded about political promises and pharmaceutical pricing.
In the end, this conversation lands where we often do. GLP-1s are neither miracle nor menace. They are powerful tools – imperfect, life-changing for some, and disappointing for others. Their emergence exposes how far our health system still has to go in delivering compassionate, science-based obesity care.
Click here for free access to this year-end reflection in the New York Times.
La Figure Pensive, painting by Jean Marchand / WikiArt
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December 21, 2025
December 21, 2025 at 8:08 am, John F DiTraglia said:
Incretins are a miracle.