Weight loss drugs have changed the way we talk about obesity. For decades, it was presented as a personal failure. But Ozempic, Wegovy, Mounjaro, and similar drugs have helped millions of people lose weight and changed the narrative. If obesity could be corrected with a medication, it was logical to think it was a disease. It seems like a nice change, but the flip side of this statement has its shadows. And it represents a huge business.
Read more The Mexican industry where the grass is still green: plant-based foods
An editorial published this week in the journal Science warns of the risks of entering the “Ozempic era,” a cultural moment in which this family of drugs shapes the way we understand food. Their concern is not that the drugs don’t work. They do. “The problem is that they may end up becoming an individual health patch for a complex disease with an important social dimension,” explains Luc Hagenaars, health policy researcher at the University of Amsterdam and co-author of the article, in a video call.
“The pharmaceutical industry tends to present obesity almost as an epidemic fallen from the sky that requires medical treatment,” Hagenaars denounces. But there are specific culprits, and nothing is being done to stop them. Ultra-processed foods are not food; they are edible industrial preparations that artificially stimulate appetite. They are cheap, hyper-palatable, and quick to prepare. A commercially perfect and health-wise disastrous product. A series of scientific reviews published in the journal The Lancet last year pointed out how they are colonizing traditional diets worldwide and eroding public health. Scientists called on governments to take action. “Food and health must be prioritized over corporate profit,” they warned.
But these products continue to increase their presence in supermarkets. From 2007 to 2022, annual per capita sales of ultra-processed foods increased by almost 20% (from 104 kilos to 121.6) in upper-middle-income countries. Not enough is being done to reverse this trend. But if a person gains a lot of weight (and can afford it), they can inject a weight loss drug to return to a healthy weight. For this new population segment, large conglomerates are creating functional meals, meal replacement shakes, nutritionally balanced and very practical, as they do not need to be cooked. It is a new business opportunity.
“The use of these drugs can be beneficial to help those patients who have more difficulty losing weight,” says Maira Bes Rastrollo, professor of Preventive Medicine and Public Health at the University of Navarra. “But it is very dangerous in a hedonistic society like the current one to think that one can binge on ultra-processed foods without any health consequences, thinking that later there will be a drug available to solve the problem.” It is a problematic model, but it seems to be consolidating.
The Ozempic era is already here. And to understand its consequences, the best thing is to pay attention to what is happening in the United States. The percentage of Americans with obesity has dropped from 39.9% to 37% in the last two years, coinciding with the expansion of these treatments. It seems like good news, but it must be put into context. In Spain, where its use is much lower, obesity affects just over 15% of the population. The solution does not lie in the pharmacy, but in the supermarket.
But health policies and medical decisions do not seem to be heading in that direction, laments Hagenaars. In his editorial (also signed by public health expert Laura A. Schmidt) he criticizes certain recent medical trends. For example, the concept of “clinical pre-obesity” proposed a year ago by a committee of experts in the journal The Lancet. Hagenaars and Schmidt do not believe it is so much a medical debate as a market strategy. “It is what is known as diagnostic expansion,” they denounce. “The more people fall within the medical categories related to obesity, the greater the potential market for new treatments.” Hagenaars is not only against the idea of medicalizing overweight. He also points out the conditions under which that conclusion was reached. “The conflicts of interest section in that article took up two full pages in two columns with small print. This illustrates the magnitude of what we are talking about,” he says.
Pharmaceutical companies fund many of the research works of scientists in this field, something that must be reflected in the papers. It does not mean the studies are biased, but Hagenaars believes it conditions them. “The scientific ecosystem has lost the ability to think critically,” the expert says. “It focuses on analysis at the cellular and health level, instead of looking at the broader picture of lifestyle, power, and financial interests.” The press has also done this, which he accuses of being too flattering towards these drugs. Hagenaars recalls cases like those in his country, the Netherlands, where the courts have fined several media outlets for promoting Ozempic and similar drugs with excessively flattering articles.
The trend is global, but there are countries better prepared to face it. Spain is one of them, says Cecilia Díaz Méndez, professor of Sociology at the University of Oviedo and director of the Social Food Sociology Research Group Socialimen. “Food cultures are a way of resistance against these homogenizing trends in the business sphere,” she explains in a phone conversation. And in Mediterranean countries, this culture is more rooted than in Anglo-Saxon ones. By culture, the expert does not mean the diet itself, but family recipes, which are passed down as legacy and heritage. The idea of cooking for others and doing it in company. The culture of local markets, where you ask the fishmonger for the freshest fish or the butcher which cut is good for a roast. There are words, like gulusmear, tapear, or sobremesa, that have no translation into other languages because they name concepts foreign to them. The Mediterranean diet is also that.
GLP1 agonists eliminate all these social and playful aspects related to food. They suppress not only hunger but the pleasure associated with eating. And this can be a lifeline for someone who has been trying to lose weight unsuccessfully for years; it is an effective solution at the individual level, but the authors of the Science editorial wonder what social effects it could have if it spreads as the only method to end the obesity pandemic.
“We have to ask ourselves if we want a future in which food is solved with pills,” reflects Díaz Méndez. Because it is an increasingly possible future. Hyper-palatable products that make us sick, weight loss drugs that take away the pleasure of eating, meal replacement shakes for dinner; more than food, just fuel. It is the most extreme scenario, but every day we are closer to making it a reality. Last year, Juan Roig, CEO and majority shareholder of Mercadona, said that by mid-21st century there will be no kitchens. It was not so much an objective prediction as the wish of an interested actor. And it painted a possible future, in which cooking ceases to be a daily and shared activity to become a dispensable nuisance. In which the problem of food is no longer solved in the kitchen and the market, but in supermarkets and pharmacies. He did not name it, but the authors of the Science editorial did: it is the Ozempic era.