Simply final month, I marked my twenty fifth 12 months as knowledgeable journalist, which I assume means my journalistic profession is sufficiently old to hire a automobile, no questions requested. Work within the information for that lengthy, and also you’ll sometimes end up shocked by belongings you revealed up to now. Like, I had all however forgotten that I had written this Time magazine cover story in 2008:
A pair issues right here. One, as the duvet demonstrates, journalistic sensitivity was…lower than perfect then, to say the least. And two, over a quarter-century occasionally covering weight problems (each childhood and grownup), that story solely appeared to go in a single route: worse.
It wasn’t for lack of making an attempt. We put calorie counts on menus, taxed soda (nicely, in some places), constructed office wellness applications, and funded a small library of food regimen analysis. We deplored meals deserts and promoted farmers’ markets. We informed individuals — repeatedly — to eat much less and transfer extra. However the strains simply stored going up.
By the CDC’s measured survey, the share of US adults with obesity didn’t change meaningfully between 2013 and 2023. The age-adjusted weight problems fee sat at 40.3 %, whereas the age-adjusted extreme weight problems climbed from 7.7 % to 9.7 % over the identical stretch.
Whereas the query of weight in America is inextricably tied to physique picture and moralizing, these numbers had a lethal impact. One demographic mannequin estimated that weight problems was related to roughly 18 % of deaths amongst Black and white Individuals ages 40 to 85 between 1986 and 2006. From diabetes to kidney failure, coronary heart illness to sleep apnea, weight problems is the supply system for different ailments.
Which is what makes a Gallup report published in July so shocking. In Gallup’s self-reported height-and-weight sequence, the US grownup weight problems fee fell to 36.4 %, down from a peak of 39.9 % in 2022. Over roughly the identical interval, the share of adults who stated they have been at present taking a GLP-1 drug for weight reduction rose from 3 % in 2024 to 11 % in 2026 — roughly 29 million individuals. Whereas this solely reveals correlation, not causation, and Gallup’s self-reported measure shouldn’t be in contrast instantly with the CDC’s measured fee, the timing is suggestive to say the least.
And the load may be the least fascinating factor about these medication.
Semaglutide — the molecule bought as Ozempic and Wegovy — was first developed and accepted as a therapy for sort 2 diabetes, not weight problems. It was solely after earlier GLP-1 medication and diabetes trials confirmed substantial results on urge for food and weight that researchers intentionally examined a better dose for weight problems, resulting in Wegovy in 2021.
However because it seems, the listing of issues which were observed taking place on the aspect with GLP-1s has gotten so lengthy it’s begun to eclipse the principle occasion. The protection of GLP-1s has barely stored up with this information, as a result of weight reduction is what made these medication well-known and what we frequently obsess over. But it surely seems, weight reduction might not be what they’re finest at.
Unwanted effects could embody…
Let’s begin with sleep apnea, which, untreated, drives up blood stress, strains the center, and raises the danger of stroke. These are individuals whose respiration stops dozens of instances an hour, all evening, each evening. Two year-long trials put 469 of them on tirzepatide — the drug bought as Mounjaro and Zepbound — and reduce these interruptions by greater than half. Roughly half the group completed the 12 months with no apnea in any respect, or with so little left that they stopped being drained all day.
Then there are the kidneys. A major trial adopted 3,533 individuals with sort 2 diabetes and persistent kidney illness for a median of three.4 years. Semaglutide diminished the relative threat of a composite of kidney failure, a sustained lack of not less than half of kidney perform, or loss of life from kidney-related or cardiovascular causes by 24 %; all-cause mortality was 20 % decrease.
And the liver: A trial, nonetheless underway, biopsied the livers of 800 individuals whose organs had grown fatty, infected and scarred and randomly assigned them to semaglutide or a placebo. After 72 weeks the irritation had cleared in practically 63 % of these on the drug, with no worsening of the scarring, towards 34 % on placebo.
And the knees: In 407 adults with obesity and moderate knee osteoarthritis, ache scores on the 0-100 WOMAC metric fell 41.7 factors towards 27.5 on placebo.
And to high it off, a 17,604-person trial of contributors who have been obese or overweight however didn’t have diabetes discovered a 20 % drop in main cardiovascular occasions.
These outcomes might not be as grabby as cultural debates over “Ozempic face,” however they deserve way more consideration.
Drugs’s pleased accidents
As GLP-1s — which partially came out of a hormone in Gila monster venom — display, medication has lengthy discovered a few of its greatest wins within the margins of medicine ostensibly constructed to do one thing else fully.
Sildenafil, higher generally known as Viagra, started life at Pfizer as a candidate therapy for the center illness angina. It failed at that, and its now-famous use turned up in information as a aspect impact in what will need to have been a really fascinating trial for its topics. Minoxidil (Rogaine) was a blood stress tablet that turned out to assist sufferers develop hair. Finasteride (Propecia) was accepted for enlarged prostates earlier than anybody thought to promote it for baldness — after which a trial of more than 18,000 men discovered it reduce prostate most cancers diagnoses by about 25 %, a profit that took 20 years of follow-up to fully vindicate.
Maybe essentially the most well-known instance is aspirin, which spent most of a century as a painkiller earlier than a health care provider in California named Lawrence Craven observed that the sufferers he’d given aspirin gum to after tonsillectomies bled greater than they need to. He guessed the aspirin thinned the blood, and began handing it out to middle-aged males, who have been at increased threat of coronary heart assaults. Craven died in 1957; the trial that ultimately proved that he was onto something — exhibiting that aspirin in coronary heart assault victims reduce vascular deaths by a fifth — didn’t run till 1988.
The unusual morality of Ozempic
Seen this manner, GLP-1s can appear to be miracle medication — however even miracle medication can’t remedy all the things.
There had been nice hope that GLP-1 may cut back dementia charges, however when Ozempic maker Novo Nordisk ran a proper trial, it didn’t present proof of slowing scientific development of Alzheimer’s. A lot the identical occurred with most cancers. Observational information had hinted that GLP-1 customers developed tumors much less typically, however when a Harvard staff pooled 48 placebo-controlled trials overlaying 94,245 individuals, they discovered the medication have little to no impact on the danger of thyroid, breast or kidney most cancers, although proof for different cancers was much less sure, resulting in FDA boxed warnings. One plus: In some early animal research, excessive doses of GLP-1 medication caused thyroid tumors in rodents, however additional analysis largely hasn’t validated the fears that it could possibly be extra widespread, although uncertainty about some uncommon thyroid cancers stays.
For many individuals, weight reduction isn’t the tip of what these medication appear capable of do. It’s the place the advantages start.
The larger considerations largely stay the identified ones, beginning with muscle loss. Throughout 22 randomized trials, about 25 percent of the weight lost on these medication seems to be lean muscle mass. A few of that’s merely unavoidable in any weight reduction, however an excessive amount of can imply a terrific deal, particularly when you’re 75.
And price stays a barrier: In a 2025 KFF ballot, 56 % of adults who had ever used a GLP-1 said the drugs were difficult to afford; 27 % stated they’d insurance coverage however paid the complete value themselves. In a separate Cleveland Clinic chart review of 288 adults with out diabetes who stopped injectable semaglutide or tirzepatide inside a 12 months, 47.6 % stopped due to value or insurance coverage issues, in contrast with 14.6 % due to unwanted effects. (The cash, not less than, is bettering. An oral GLP-1 drug was approved in April, and it begins at $149 a month for individuals paying money, whereas Medicare trial pricing of $50 a month for some GLP-1s went stay in July.)
A stickier impediment is the one that may’t appear to be divorced from questions on weight: judgment. As my colleague Dylan Scott wrote recently, researchers at Rice College discovered that folks fee a GLP-1 consumer extra harshly than somebody who by no means misplaced weight in any respect. That makes good sense when you think about how contentious weight is in America — and none in any respect when you concentrate on simply how many individuals have benefited from these medication in so many various methods.
I typically surprise how we might view GLP-1s if they might do all the things they’ve been proven to do, however someway not change an individual’s look.
A lot of the discourse round these medication has been formed by the truth that lots of the earliest and most public and obvious customers have been already skinny individuals, typically celebrities, utilizing them to get even thinner. However that framing has turn into more and more troublesome to sq. with actuality.
Two issues will be true without delay: American tradition has a poisonous relationship to weight, and tens of millions of Individuals can and are benefiting from these medication. For many individuals, weight reduction isn’t the tip of what these medication appear capable of do. It’s the place the advantages start.
A model of this story initially appeared within the Good Information publication. Sign up here!
