During the Superbowl, Hims/Hers spent several millions to advertise about weight loss. Claiming correctly that the food industry has hijacked the American public and made it difficult for anyone to lose weight, this company suggested that the only way out of societal-triggered obesity was to turn to the pharmaceutical industry, and Hims/Hers would be happy to oblige. Hims/Hers invested millions for an ad because they knew that the money would be easily recouped! Americans are not only hungry for the horrible foods sold to it by the food industry, but also for quick fixes promised by the pharmaceutical industry.
Last year insurance companies paid $35 BILLION for three drugs—Ozempic, Mounjaro, and Wegovy—to provide people with the miracle of weight loss given by pill or shot. No need to diet or exercise. No need to eat well at all. No need to even address the perfidy of the food industry. Just take medicine and all is fixed! And not only do these drugs help people lose weight, but according to the ads, they reduce heart disease too. Wow, a one-year biased study paid for and conducted by drug companies tells us that we can lose weight and not have a heart attack; doctors and the public are sold. No surprise, 2025 sales are supposed to be even higher, as are subsequent insurance premiums for all of us who are subsidizing weight loss by drug.
Which begs two questions. First, if we can authorize insurance company money to pay drug companies for medicines without any long-term data, why can’t we spend $35 billion a year on nutrition? Imagine that! We can pay for nutrition counseling, end food desserts, even subsidize healthy food deliveries for free to anyone who is obese, and that would barely touch the money we are all paying for these miracle shots. Only there is one problem. While we have no long-term data on GLP-1 efficacy and harm, do have long term data on eating well, and that data is not good for the medical industry. If we paid money to keep people healthy, there would be less need to pay for the consequences of a poor diet. Think of all the poor specialists and drug company executives that would impact! The health care system is fed by unhealthy habits. It much prefers the illusion of cure through medicine.
And then there’s the second question. What are the long-term consequences of these drugs? Will the weight loss be maintained? Are there serious side effects? Are there other health benefits or risks beyond weight loss? Despite assurances by drug companies and their doctor stooges (especially all those “obesity experts” at academic institutions that feed on drug company money), there is no reliable data to tell us much of anything. We’re starting to get a handle on short-term problems, although likely we’re just scratching the mere surface of what could be an unmitigated medical disaster. I mean a disaster for patients, not drug companies or their paid doctor advocates or even the many TV networks that advertise.
Look, if the drugs do help people lose weight and lead to good health outcomes and few detrimental effects, that’s great. Although they’re still not substitutes for good diet and exercise, which we know extend life and reduce chronic illness. So, shouldn’t people who take these drugs be required to commit to nutrition and exercise programs and be impelled to engage in them for at least a year before being given the miracle of a untested treatments? We have a cheaper and effective alternative, and since we’ll all paying for those medicines, maybe a little accountability?
But there’s a more basic question: do the drugs even work? They clearly have helped people lose a lot of weight, especially celebrities who have been spreading the word. Is the weight loss maintained? Hard to tell as the drugs have not been studied long enough. We do know that the weight loss plateaus and may well increase after months of use, unless people commit themselves to a good diet. And worst, we also know what happens if someone stops these drugs, and that is often a horrible dive into hell.
GLP-1 is a hormone that blocks our appetite. We have receptors for GLP-1. When the receptors are empty, we are hungry. When we eat enough (or too much, in my case) we release GLP-1 and block those receptors and then aren’t hungry for a while. These new drugs are GLP-1 tornadoes. They produce so much GLP-1 that they block the receptors completely and indefinitely, permanently reducing hunger. But we know what happens in our bodies if we persistently block receptors. Just like with narcotics, we make more receptors, and so as people on these miracle shots block GLP-1 receptors, the body makes more receptors. It’s not enough more to overcome the tsunami of GLP-1 made by these drugs, at least in the short term. But what if you stop the drugs?
Look at it this way. If you had 5 receptors before you took the drugs, now—because of persistent over-stimulation—you may have 20. And that just makes you way hungrier than you were even before you started these drugs, because it takes a lot more food to block 20 receptors than it took to block 5. In fact, Christopher McGowan, MD, an “obesity expert” from Harvard—formerly one of those drug zealots who told everyone to take the drug before a single long-term study came out—now warns people: “I No Longer Think GLP-1s Are the Answer. The drugs ‘work’ but may be working against us long-term.” That’s based on his own experiences, especially in those who stop the shots. After stopping, they are voraciously hungry 24-7 and gaining more weight than they lost. No wonder! Now they have to live with more receptors. Thank you Ozempic. Or, as the commercial would say, “Oh, more receptors, more hunger, and more weight! Better get back on the drug!”
McGowan also notes—which we knew from day one—that the drugs destroy muscles, accounting for some of the weight loss. But what he found is very disturbing: that even after stopping these drugs the muscles remain weak. Is that a permanent complication? Maybe! And since without muscles we can’t exercise, that's a good reason to get more miracle drugs! This could be a devastating long-term effect, and if irreversible, something that alone should demand a drug recall. So, yea, we have more receptors making us hungrier, and we don’t have muscles to exercise. “Oh, we have many benefits that will make sure you take the drug forever!”
The only longish term study, a VA observational study over 3.5 years looking backwards, didn’t show too many side effects, and found some benefits and some harms, none of which are meaningful. Observational studies can’t demonstrate cause and effect and are minimally randomized, they toss a few hundred variables out there and looking backwards see which ones may improve or get worse in people taking the drug. Most observational studies are reversed when a neutral (not paid by the drug company) randomized prospective study is done. But none are being done. Why? I mean, when the public is paying $35 BILLION for a drug without long term studies and with potential harm, why do such a study when it could only hurt sales by telling the truth.
But there’s more. Dr. McGowan acknowledges that a third part of the drug’s weight loss actions are to partly paralyze the gut, especially the stomach. In other words, with the bowel not moving much, we feel bloated and don’t want to eat. Mc Gowan states that the effect is temporary as people who stop it get their bowels back. But what if you take the drug for 5 years, will it be reversible then? We don’t know. In fact, in 5 years people on this drug may have 2 choices: stop the drug and gain more weight than you lost, or keep it going and risk muscle destruction and bowel paralysis. “Oh, we offer choices!”
And then there are the long-term benefits. The garbage VA observational study says the drug improves 40 outcomes and harms 20. Really, though, how do they know? Like I said, there is no cause-effect capacity of observational studies. And despite this and the drug company’s short-term study, we don’t know if this drug reduces heart attacks or maybe increases them. Who knows what it helps and hurts. I mean, if you eat less but still eat junk or don't eat enough good food, how healthy will you be? We do know the damage it inflicts on people who stop taking it, but we don’t know anything about long term use for those who keep taking it. And since apparently you have to take it forever if you want to keep the weight off, that may be an important gap in our knowledge!
So, there you have it. Miraculous weight loss drugs have not worked well in the past for the patients who pray for a quick fix, although they always work like miracles for drug companies! Maybe in the end these GLP-1 hybrids may help us be healthier, but more likely they will cause massive harm before they are withdrawn from the market. The doctors who promised they were safe and effective, the drug company and observational studies that proved their worth, well, they’ll never admit error, and the companies will pay off some people and still pocket a lot of cash once the side effects start rolling in. But why can’t we spend all that money on nutrition programs that would make everyone healthier and, yes, thinner? “Oh, that would not be good for the bottom line.”
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