Poor diet is a leading cause of death in the U.S. and has been linked to over 500,000 deaths per year. The rates of diet-related disease among adults in the U.S. are abysmal: over 70% have overweight or obesity; about 50% have diabetes or prediabetes; and over 90% have suboptimal cardiometabolic health, characterized by excess weight; high blood glucose, blood pressure, or lipids (or taking medications for any of these conditions); or a history of cardiovascular disease. Moreover, the direct medical costs and loss of productivity associated with excess weight and diet-related disease is estimated to be almost $1 trillion annually. And that’s before the advent of the new, hugely expensive diet drugs.
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I’ve spent a good part of my career arguing that anti-obesity drugs like Meridia and fenphen have serious side effects, are not terribly effective, and should be taken off the market. Several have been.
The obesogen hypothesis proposes that certain chemicals, called obesogens, influence individual susceptibility to obesity by interfering with metabolic systems that regulate appetite, weight gain, and fat development and distribution, and thereby have contributed to the rise in obesity.
“Unfortunately, many healthcare professionals, as well as patients, consider obesity to be a lifestyle disease; that people are just lacking in willpower,” noted Susan Yanovski, co-director of the Office of Obesity Research at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) in a video by the Journal of the American Medical Association.
In May, the Food and Drug Administration approved tirzepatide—which patients inject under their skin weekly—to treat type 2 diabetes, because in clinical trials it cut hemoglobin A1c levels (a long-term measure of blood sugar) even more than taking insulin. The FDA has not yet approved tirzepatide for weight loss. But that may soon happen.
Roughly 40 percent of U.S. adults have obesity. Another 30 percent have overweight. Extra pounds raise the risk of type 2 diabetes, heart disease, stroke, several cancers, and more. Here’s the latest on what’s driving weight gain and two new medications that may revolutionize its treatment.
