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Ozempic: miracle drug or a band-aid for obesity?

Francisco M. Torres, MD
Medications
December 16, 2023
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An excerpt from Dr. T’s Drop the Fat Diet: 12 Steps to Leaner You Forever.

Semaglutide, a medication often marketed as Ozempic, Wegovy, or Rybelsus, has gained immense popularity in recent years. This is especially true in an age where diabetes and obesity are on the rise. The medication is being seen as a panacea for effortless weight loss. Some doctors and activists have hailed it as a miracle drug that can help shift the conversation around obesity from a judgmental approach to a disease model of metabolic illness.

Obesity, a condition characterized by excessive body fat, is a complex and multifactorial issue that has become a public health concern worldwide. Several factors, including genetics, hormones, stress, and food availability, influence the development of obesity. The interplay between these factors can lead to an imbalance in energy intake and expenditure, resulting in an accumulation of body fat. While genetic and hormonal factors may predispose individuals to obesity, environmental factors such as food availability and stress can exacerbate the condition. Therefore, a comprehensive approach that addresses individual and environmental factors is necessary to prevent and manage obesity.

There is often a tendency to treat obese patients judgmentally. One reason behind this is that obesity is now associated with poverty. People who can only afford processed foods, work too much to cook but do not earn enough to buy expensive pre-made healthy meals, or who have high stress levels due to living in poverty are much more likely to be obese than the wealthy and privileged individuals who we see being celebrated for their fitness and beauty in magazines.

Many celebrity influencers have faced public backlash for promoting their “diet and fitness secrets” while taking all the credit for themselves as experts, even though they are supported by a team of nutritionists, chefs, and personal trainers.

Several healthy meal delivery services claim to be affordable, but in reality, they charge more than $10 per meal per person, which can add up to over $200 per week for one person to eat three meals per day, seven days per week. Similarly, high-end nutritional shakes can cost over $3 per serving, equating to over $100 monthly for one daily nutrition shake.

Preparing meals from scratch may not be feasible for those who work multiple jobs to make ends meet, as they may need more time or resources.

Some have suggested that semaglutide improves this situation and that promoting a “disease model” of obesity can allow overweight people to be treated as patients suffering from illness and not people who make poor life choices.

There is a severe problem at hand – obesity is just one aspect of the nutrition crisis that a growing number of people are facing. Inaccessibility to healthy foods and the abundance of unhealthy foods is not just a matter of gaining weight. It is a matter of shortened life expectancy due to various reasons such as nutrient deficiency, cardiovascular disease, hypertension, and diabetes. These conditions can be caused by unhealthy processed foods, which can be prevented through a healthy diet. Merely reducing caloric intake is not sufficient to prevent any of these conditions. Instead, one needs to increase nutrient density while decreasing the density of unhealthy fats, sugar, and salt.

Is semaglutide merely masking the problem and making it less visually apparent? It is essential to consider whether we can truly solve the issue of obesity by simply prescribing weight loss drugs. Unfortunately, our patients often suffer from nutrient deficiencies due to their inability to afford healthy food, which can ultimately lead to shortened lifespans. This is primarily because they are overworked and underpaid.

The use of drugs for weight management might be a prolonged process, and it is essential for the public to understand that, just like any other ailment, you might have to continue taking it for the remainder of your life.

Our main objective should be to educate readers about the importance of nutrient-dense foods and provide recipes that make these foods more appealing to those who crave unhealthy foods due to stress.

While sharing recipes can make cooking and eating healthy foods more effortless, it is essential to note that it is only helpful if a person can afford the ingredients or has access to cooking facilities.

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We must come together to address the rising public health concerns. One of the key steps towards this end is to improve the availability of fresh and healthy foods and accessible cooking facilities. While medication can help alleviate specific ailments, it cannot replace the importance of a balanced, nutritious diet. Moreover, providing advice on healthy eating habits will only suffice if people can afford fresh foods. We need to take concrete steps towards making healthy food options more affordable and accessible for everyone and make cooking facilities readily available to ensure that people can prepare nutritious meals at home.

Francisco M. Torres is an interventional physiatrist specializing in diagnosing and treating patients with spine-related pain syndromes. He is certified by the American Board of Physical Medicine and Rehabilitation and the American Board of Pain Medicine and can be reached at Florida Spine Institute and Wellness. 

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