Why rapid weight loss drugs may not be the health solution they seem [PODCAST]

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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 who 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, or medications and injections, are in first chair as opposed to looking at the fast food mongers. It is mongering.

In the U.K., the government has actually outlawed advertising of fattening, high-sugar, high-fat foods, and it’s had an effect. The government said a 77 percent drop in those foods because they won’t allow advertising on the commuter rails. And so we know the 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, and of course, the GLP-1 agonists are kind of the new kid on the block, right? That’s probably why they’re taking up a lot of the oxygen in the room that we have currently. So 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. So people of my age, and I grew up in the ’60s, we really weren’t fat, and now people at their normal size are actually the exception. So the fast food marketing, of course, is everywhere. Fast food is everywhere; you can have it delivered. And all the ingredients themselves are more addictive. The high-fructose corn syrup was not a big factor when I was growing up, and now it’s everywhere.

So the marketing is on TV; it’s on food. I make a joke in my book, my current book, about some Europeans who saw people eating french fries in a food court in a shopping mall at 10:30, and they said, “What meal is that? We don’t even have a concept of that meal.” So the 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, and they do it with the pet food also, if they can’t stop easily. It’s no coincidence.

Kevin Pho: So what’s an example of a product within the food, or an ingredient within the food, that makes it addictive? Are we talking potato chips? Are we talking about a hamburger that you find at McDonald’s? What in particular, what ingredients are making some of these foods addictive?

Martha Rosenberg: I don’t have the name of the actual ingredient, but I have written about the laboratories that discover and discuss how the way it 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 that they would pump from their store to passersby to let them in, you know. But the actual ingredient I can’t tell you. I do know there’s a lot of science in making these foods irresistible.

Kevin Pho: And in terms of the 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, and I think it’s so sad because we have such obesity in this country. There’s obesity elsewhere, but ours is treatable. I mean, if you look at, like, a Super Bowl bacon cheese hamburger with an egg on top, OK, is that really going to help you lose weight, you know?

Kevin Pho: So now that we’ve had the GLP-1 agonists, these Ozempic-type medications, over the past few years, and we’re seeing them all over the place, in advertisements and social media, do you feel that these are taking the place of potential solutions to our junk food problems? 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, and 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 just completely against that. I think it enriches Wall Street and Big Food and Big Pharma, and it’s not the answer.

So what I’m seeing as a reporter that makes me so angry is I see so-called benefits of the GLP-1 agonists floated in the medical media and even in the general media. I’m looking at my list here. They talk about how it lowers your risk of heart attack and stroke and dementia, and even alcoholism, addiction to alcoholism, and even uterine fibroids. I make jokes like, “And the trains will run on time.” I mean, I feel with this marketing there are several issues.

One is that many of the researchers are funded by Novo Nordisk or Eli Lilly, and I think any good reporter would mention that and wouldn’t even repeat the advertising slogan. The second issue is that some of these researchers or doctors who are funded by drug makers hide their conflicts of interest under foundations, like universities. I hate to single out any in particular, but many of them will receive the funds from a drug maker, and then the MD might be funded by it, but he or she doesn’t personally look like they have the disclosure or the conflict of interest.

And there’s another thing that we notice, we reporters. When they do list conflicts of interest and disclosures, they’ll list by initial, like “BL is a speaker for Eli Lilly.” Well, we have to go back: Who is BL? So there are a lot of ways that funding is disguised. I believe that these benefits that are being floated, such as reduction of dementia and reduction of opiate overdoses, I think that’s just advertising messages.

Kevin Pho: Historically, though, haven’t important scientific findings sometimes been funded by the drug companies, and they are legitimate scientific findings? So even though we’re still early in making these potential beneficial connections, isn’t there a possibility that some of these beneficial connections, like the reductions that you mentioned, may eventually come out to 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. I mean, that was huge, and that was not to be ignored. But I would say caution, take your time, and don’t assault Wall Street. What we’re now seeing is a run on the bank, so to speak. We’re seeing compounding pharmacies trying to get in on the action. We’re seeing bariatric surgeons saying, “Hey, where did my business go?” The whole thing is, it’s maybe valid medically if people would take their time. It feels like a gold rush.

And it feels like, well, I’m sure many of your listeners and viewers remember statins, and this reminds me a lot of statins, because when they first emerged, people were saying, “They’re so great, put them in the water supply,” you know. And then they go off patent, and people have taken them for a few years, and they’re like, “Well, actually, they cause X, Y, and Z,” or they’re linked to X, Y, and Z. They’re not wonder drugs. But when statins emerged, people were so excited: You can eat whatever you want, and you won’t have high cholesterol, or so they said. Lipitor was the best-selling drug in the history of the world, and I see sort of the same thing here.

Kevin Pho: So what does that say about our culture? Because stereotypically, American culture, of course, we always want that quick fix, right? So the fact that these GLP-1 agonists are taking off, a gold rush as you say, talk about that commentary, what it says about our culture, in doing what we think is a quick fix versus resisting perhaps some of the messages of junk food.

Martha Rosenberg: Well, you know, I’m a big critic of pill popping, and I think we can see this quick fix even with children. If your little boy is wild, he’s a little boy; you don’t give him ADHD drugs necessarily. And so the quick fix is in our culture. I think it’s abetted by radio and TV and advertising, which I was in.

But I think that if you can take a pill for something, we see, you know, Dr. Pho, we not only see the desire to take a quick fix, but we even see, ironically enough, people who want to have an affliction. They like having an identity, like, “Oh, I have whatever it might be, I’m on the spectrum,” or “I have social phobia.” I’m not saying people don’t have things like that, but there’s a perverse embrace of a problem. It’s like, “I have this problem; I’m taking this drug.” What that really shows is that advertising works, but it also enriches the messages that we’re getting from drug makers, and popping a pill is, you know, the whole culture.

When I grew up, you didn’t have so many places you could just drive in. When you think about it, Dr. Pho, just a drive-thru window, I mean, what does that say? You can’t wait ten minutes, you know?

Kevin Pho: So what’s the path forward? If you were to be our pharmaceutical advertising czar, or junk food advertising czar, how would you change things?

Martha Rosenberg: Well, of course the news outlets and TV stations wouldn’t like this, but I really would have a moratorium on the advertising of junk food. I would, because it’s worked in the U.K. It’s worked phenomenally, and there’s no mystery to it that if you see hamburgers, and they’re available here, you’re, you know. So I would stop some of the advertising that we’re seeing, especially among kids, because kids are now really becoming obese. So that would be the first thing.

The U.K., and this is their government that says it, they said that, I think they call it low agency, advertising against fast food is more effective than one-on-one individual interventions, and I kind of think that’s true.

I mean, you and I could talk a little bit about the fat acceptance movement, because it does play in. I don’t think that large people should be attacked for low, you know, bad self-control, but I do think the fat acceptance movement can be really dangerous, because it’s a dangerous health condition. I think that people have food deserts, so they can’t get the good food, and also they may have gland problems. But overall, fat acceptance is not good, any more than alcohol acceptance or cigarette acceptance. And that’s complicated things, Dr. Pho, because people, you know, there’s a lot of this “I’m a victim. The doctor, I went in for a headache, and he mentioned that I’m 300 pounds.” Well, yeah, I hope he or she mentioned that, you know? So there’s a real gray area there.

Kevin Pho: I want to touch upon that socioeconomic aspect and food deserts, because a lot of times, because of economic factors, getting a Happy Meal at McDonald’s and whatnot may be the only feasible economic option, because fresh fruit and fresh vegetables may not be readily available, or affordable for that matter. So talk about that socioeconomic impact that people have with fast food.

Martha Rosenberg: Well, that’s certainly true. I always say if you get on a bus, and I still take the bus, I don’t have a car, and you see people with their groceries on the bus, you’re talking about a food desert. If you have to take the bus to your store, that’s a food desert, and it’s a real problem. In fact, I read somewhere, and I think it’s probably true, that some of the gang-banger violence is from the bad food, because you’re not getting the good nutrition.

But as far as food deserts go, I say to people, if you have a 7-Eleven, you can still get a banana and a granola bar. I mean, there are still workarounds. They may be more difficult, but I don’t believe that you have to eat the bad stuff, that there’s absolutely no choice. I don’t believe that.

Kevin Pho: We’re talking to Martha Rosenberg. She is 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. Well, first of all, I would like to say to anybody who follows KevinMD, this is a great platform that shows both sides of so many issues, and it shows some of the best thinkers, and I love it. I love the way that you have really opened yourself up to the thinking that goes on.

The take-home messages I would give people: A new drug, especially a blockbuster that’s making a lot of money, is not necessarily safe. You know, a lot of people said, “Give it two years before you take it.” You know, we saw Vioxx, even Sudafed. I don’t think Sudafed hurt people, but now they are recalling it or taking it off the market. So if you’re a new user of a drug, beware, OK?

Secondly, turn off your TV, or at least turn off your TV ads, because junk food is everywhere, and it is, in my opinion, the culprit. OK, this sounds terrible, but to a certain extent, drug makers want people fat because they sell drugs, you know. So the take-home message is: Beware of drug and food advertising. Unplug your TV. Go on a walk, you know.

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

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

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