The new category of powerful weight loss drugs, best known by the brand names Ozempic and Wegovy, weren’t released in 2023, but this was the year they pulsed fully into the public consciousness. And for good reason: the drugs have the potential to forever change medicine, the economy, and maybe even how we think about obesity and body image.
The class of drugs, called GLP-1 receptor agonists, first reached the market when Novo Nordisk’s Ozempic was approved by the Food and Drug Administration to treat Type 2 diabetes in 2017. Researchers soon noticed that, as a side effect, the drugs were causing patients to lose weight. To doctors specializing in obesity, who generally consider excess bodyweight a difficult-to-treat chronic health condition, this was an exciting prospect.
“The evidence we’re seeing across the board is unlike anything we’ve seen before,” says David Sarwer, PhD, dean of research at Temple University Obesity Research College. “Gamechanger” became the go-to description in the torrents of news coverage on GLP-1s—the phrase appeared in Vox, The Atlantic, The New York Times, The Washington Post, Bloomberg News, and The New York Times again.
The true popularity of GLP-1s is evident in the stacks of physicians’ scripts. In just the first five months of this year, nearly 10 million prescriptions were written for non-diabetic purposes. Some even speculated that GLP-1-caused changes in consumption could change the entire economy. Wal-Mart blamed a slight drop in food sales to the drugs.
As researchers, reporters and readers were contemplating the ways these new therapies could remake obesity treatment, common side effects, such as a loss of interest in substances like nicotine and alcohol, suggest that GLP-1s could cure all manner of vices. One neuropharmacologist with the U.S. National Institute on Drug Abuse told Science that semaglutide, a type of GLP-1, “is truly the most exciting drug for the last few decades.”
Despite the excitement among scientists, to the general public the prescriptions remain somewhat taboo. Obesity is still frequently misunderstood as a personal failure. Weight tends to draw judgment, as does any method of losing it that goes beyond diet and exercise. Despite the prominence of GLP-1s, doctors prescribing say their patients remain skittish about openly taking them. “I can think of thousands of patients of mine that have done well, right?,” Harvard Medical School obesity expert Fatima Cody Stanford, MD, MPH, MPA, FAAP, FACP, FTOS, told me. “The number who will speak to you is probably 10.”
For many weight loss patients, the drugs have been merely hypothetical. High costs and low supplies have kept GLP-1s beyond the reach of most people. At around $1,000 per month, only the wealthy and those with extremely good insurance are able to access the drug for very long.
That may all change next year. On November 8, the FDA approved the Eli Lilly-produced Zepbound, another GLP-1, for weight loss. Just two days later, Novo Nordisk allocated $6 billion to up its own production. GLP-1s seem likely to only become cheaper and more widespread.
