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Join us in this episode as we talk with health reporter Martha Rosenberg about the complex dynamics behind obesity, junk food advertising, and the surge of new semaglutide-based weight loss drugs. We explore the implications of these drugs on public health, their potential long-term side effects, and the societal and economic impact of prioritizing quick fixes over sustainable health solutions. Martha provides an eye-opening look into the history of blockbuster drugs, the influence of advertising, and why addressing the root causes of obesity is more critical than ever.

Martha Rosenberg is a health reporter and the author of Big Food, Big Pharma, Big Lies and Born With a Junk Food Deficiency.

She discusses the KevinMD article, “Are rapid weight loss drugs hiding the real obesity problem?”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome back Martha Rosenberg. She’s a health reporter. Today’s KevinMD article is “Are Rapid Weight Loss Drugs Hiding the Real Obesity Problem?” Martha, welcome back to the show.

Martha Rosenberg: Thank you, Dr. Pho. I’m so happy to be here.

Kevin Pho: All right. So, let’s jump right into this particular article, “Are Rapid Weight Loss Drugs Hiding the Real Obesity Problem?” For those of you who didn’t get a chance to read your article, tell us what it’s about.

Martha Rosenberg: Well, what I talked about, Dr. Pho, was the role of fast food ingredients, fast food marketing, and fast food availability—because it’s everywhere—in the role of obesity.

I hate to see how pills, medications, and injections are in the first chair as opposed to looking at the fast food mongerers. It is mongering. In the UK, the government has actually outlawed advertising of fattening, high-sugar, high-fat foods. And it’s had an effect. The government said there was a 77 percent drop in those foods because they won’t allow advertising on the commuter rails.

So, we know advertising is effective. As I told you last time, I was in advertising. We know it works. I really don’t understand why these GLP-1 agonists are the first choice as opposed to looking at the ads and the junk food.

Kevin Pho: Well, it sounds like we’ve been talking about the junk food ads for a while now. Of course, with the GLP-1 agonists, that’s kind of the new kid on the block, right? That’s probably why it’s taking up a lot of the oxygen in the room. Before talking about that, just tell us about the marketing in general that these fast food companies expose us to, and why is that dangerous?

Martha Rosenberg: Sure. People my age—we grew up in the ’60s—we really weren’t fat. Now, people at their normal size are actually the exception.

Fast food marketing, of course, is everywhere. Fast food is everywhere. You can have it delivered. But the ingredients themselves are more addictive. High fructose corn syrup wasn’t a big factor when I was growing up, and now it’s everywhere.

The marketing is on TV. It’s on food. In my current book, I make a joke about some Europeans who saw people eating french fries in a food court in a shopping mall at 10:30 a.m., and they said, “What meal is that?”

We don’t even have a concept of meals anymore. Food marketing is out of control. There are laboratories that develop addiction in the food so that it’s not totally people’s fault if they can’t stop eating. They do it with pet food too.

Kevin Pho: What’s an example of a product or an ingredient within the food that makes it addictive? Are we talking potato chips? Are we talking about a hamburger from McDonald’s? What specifically makes some of these foods addictive?

Martha Rosenberg: I don’t have the name of an actual ingredient, but I have written about the laboratories that discuss how the way food chews and swallows can be addictive. That’s the only thing I know about that.

I do know that Subway had some kind of odor they would pump from their store to passersby to lure them in. But the actual ingredient? I can’t tell you. There’s a lot of science into making these foods irresistible.

Kevin Pho: In terms of pushback on junk food advertising, has there been any movement within the United States to push back historically on these advertisements?

Martha Rosenberg: Good question. There might be, but I’m not aware of it. I think it’s so sad because we have such obesity in this country. There’s obesity elsewhere, but ours is treatable.

If you look at something like a Super Bowl bacon, cheese, hamburger with an egg on top—OK, is that really going to help you lose weight?

Kevin Pho: Now that we’ve had the GLP-1 agonists—these Ozempic-type medications—over the past few years, do you feel they are taking the place of potential solutions to our junk food problem? Where do you see this taking us?

Martha Rosenberg: Well, as you know, Dr. Pho, I’m a critic of Big Food and Big Pharma. Here’s an example where they’re working together. We’re literally telling people, “Don’t diet, don’t exercise, don’t refuse the messages of marketing. Just take a drug.”

I’m completely against that. I think it enriches Wall Street, Big Food, and Big Pharma, and it’s not the answer.

As a reporter, it makes me so angry. I see the so-called benefits of the GLP-1 agonists floated in the medical media and even in the general media. They talk about lowering your risk of heart attack, stroke, dementia, alcoholism, and even uterine fibroids.

I make jokes like, “The trains will run on time.” With this marketing, there are issues. Many researchers are funded by Novo Nordisk or Eli Lilly. A good reporter would mention that and not repeat the advertising slogan.

There’s another issue: researchers or doctors funded by drug makers often hide their conflicts of interest under university foundations.

When disclosures are listed, they’re sometimes just initials—like “BBL is a speaker for Eli Lilly.” We have to dig to figure out who “BBL” is.

Martha Rosenberg: And as I was saying, I believe many of these benefits being floated, like reducing dementia or opiate overdoses, are just advertising messages.

Kevin Pho: Historically, though, haven’t important scientific findings sometimes been funded by drug companies and proven legitimate? Even though we’re still early in making these connections, isn’t there a possibility that some of these claims—like the reductions you mentioned—might eventually be true?

Martha Rosenberg: Well, you’re certainly right. The big one in my lifetime was the discovery of the role of H. pylori in ulcers. That was huge and not to be ignored.

But I would say caution is necessary. Take your time and don’t rush to benefit Wall Street. What we’re seeing now feels like a run on the bank. Compounding pharmacies are trying to get in on the action. Bariatric surgeons are wondering, “Hey, where did my business go?”

Maybe it’s medically valid if people take their time. Right now, it feels like a gold rush. This reminds me of when statins first emerged. People were so excited and even suggested putting them in the water supply.

Later, after they went off patent and had been used for years, we started seeing that they might cause X, Y, and Z, or are linked to X, Y, and Z. They weren’t wonder drugs. Initially, they were marketed as a way to eat whatever you want without high cholesterol, but we learned that wasn’t entirely true.

Kevin Pho: So, what does that say about our culture? American culture, stereotypically, seeks a quick fix, right? What commentary does this gold rush around GLP-1 agonists provide about our culture and our resistance to junk food messaging?

Martha Rosenberg: I’m a big critic of pill-popping, and this quick-fix mentality even extends to children. If a little boy is wild, people say, “Give him ADHD drugs.”

The quick-fix culture is abetted by radio, TV, and advertising—I was in advertising, so I know. If you can take a pill for something, you will.

We even see people wanting to have an affliction because it gives them an identity. They’ll say, “Oh, I have this,” whether it’s being on the spectrum or having social phobia. I’m not saying people don’t genuinely have these issues, but there’s a perverse embrace of problems.

It’s like, “I have this, and I’m taking this drug.” It reflects how advertising works and enriches drug companies’ messages.

Kevin Pho: What’s the path forward? If you were our pharmaceutical or junk food advertising czar, what would you change?

Martha Rosenberg: Well, the news outlets and TV stations wouldn’t like this, but I’d enforce a moratorium on junk food advertising. It’s worked phenomenally in the UK.

There’s no mystery here: if you see hamburgers advertised and they’re readily available, people will buy them. Especially ads targeting kids—they’re becoming obese because of this.

The UK government has noted that broader, low-agency strategies against fast food are more effective than individual interventions. I think that’s true.

On a related note, the fat acceptance movement complicates things. I don’t think larger people should be attacked for lack of self-control, but fat acceptance can be dangerous because obesity is a serious health condition.

Yes, people might live in food deserts or have glandular issues, but overall, fat acceptance is as dangerous as alcohol or cigarette acceptance. It’s a complicated issue because people feel victimized if a doctor mentions their weight during a visit.

Kevin Pho: Let’s touch on the socioeconomic aspect and food deserts. For some, economic factors make a Happy Meal the only affordable option, while fresh fruits and vegetables may not be accessible or affordable. How does that play into this?

Martha Rosenberg: That’s certainly true. If you’re taking the bus to buy groceries, you’re likely in a food desert.

However, even in those situations, there are workarounds. If you’re at a 7-Eleven, you can still get a banana and a granola bar. It’s harder, but I don’t believe people are completely without choices.

Kevin Pho: We’re talking to Martha Rosenberg, a health reporter. Today’s KevinMD article is “Are Rapid Weight Loss Drugs Hiding the Real Obesity Problem?” Martha, as always, let’s end with some take-home messages for the KevinMD audience.

Martha Rosenberg: Sure. First, I’d like to say to anyone following KevinMD, this is a great platform. It showcases both sides of so many issues and features some of the best thinkers. I love how you’ve opened yourself to these discussions.

As for my take-home messages:

1. A new drug, especially a blockbuster making a lot of money, isn’t necessarily safe. Many people say to wait two years before trying it. We’ve seen cases like Vioxx, and even Sudafed, which is now being pulled from the market. So, beware.
2. Turn off your TV—or at least the TV ads. Junk food is everywhere, and it’s the real culprit, in my opinion.
3. Drug makers benefit from people being overweight because they can sell more drugs. Be skeptical of food and drug advertising.

Unplug your TV and go for a walk.

Kevin Pho: Martha, thank you so much again for sharing your perspective and insights. Thanks for coming back on the show.

Martha Rosenberg: Thank you, and keep up the good work.