Obesity as a public health crisis
Obesity is a medical condition characterized by excess fat in the body that can lead to further health risks like diabetes, hypertension, and cardiovascular disease. These complications shorten life expectancy by up to 10 years, making it the leading cause of over 480,000 preventable deaths in America every year. This, in addition to obesity rates tripling over the past few decades, has put the country under a weight epidemic. In fact, the US is now the leading high-income country with the most obese population in the world.
In essence, the epidemic is rooted in two things: the evolution of the modern diet from plant-based food towards an unhealthy range of fatty and sugary staples; and an increasingly sedentary lifestyle brought about by urbanization. Beyond this, socioeconomic factors like poverty, lack of access to healthcare, and food insecurity impact obesity rates as well. Thus, addressing obesity takes more than just personal efforts on an afflicted individual’s part. Government policies and the innovation of pharmacotherapeutic drugs are key as well.
Into the world of weight loss drugs
Up until the last few years, the FDA was slow to approve weight loss medications. In fact, since signing off on Wegovy in 2021, the FDA last approved a weight loss medication in 2014. This shorter period between approvals likely comes as a result of not just a heightened need but also advanced formulations.
For instance, based on recent clinical trials, the highly-anticipated tirzepatide drug Mounjaro may be more effective than its predecessors as it can lead to a weight loss of up to 21% – a whole six points higher than the loss incited by other FDA-approved drugs. Mounjaro works by mimicking two hormones in the body: glucagon-like peptide 1 (GLP-1) to suppress the appetite and glucose-dependent insulinotropic polypeptide (GIP) to stimulate insulin production. By targeting both these hormones, the drug helps obese individuals feel full longer and, thus, eat less.
Aside from Mounjaro, other drugs that can potentially change the landscape sit on the FDA’s pipeline as well. There’s OASIS 1, an oral semaglutide medication whose trial run is expected to conclude this May. For injection-averse people currently on Wegovy, this will be a suitable alternative. Another medication in the works is CagriSema, which combines semaglutide and cagrilintide–which mimics amylin to increase satiation–into a single injectable drug. As Phase 3 of its clinical studies just began in November of last year, it will take until October 2026 before more details on its effectiveness are released.
What weight loss medications are doing in the epidemic
For the time being, medical experts remain cautiously optimistic about these developments and focus on working closely with eligible candidates to determine which drug best suits their needs. In fact, most physicians are now administering such drugs as part of medical weight loss programs. These holistic interventions marry prescription medication with lifestyle programs tailored to each individual. Aside from working through the psychological and environmental causes of weight gain, these medical interventions address the biological aspects that make it inherently hard to shed pounds. In doing so, they increase the chances of losing and maintaining weight by up to 15%.
That said, these drugs are not for everyone. Going on these medications can be long-term commitments that not everyone may be prepared for, whether financially (they cost upward of $15,000 annually) or physically. As each medication carries its own potential side effects, physicians closely monitor their use and only prescribe them to individuals with a body mass index (BMI) of 30–and are therefore obese–or 27 and with existing health conditions like diabetes. This ensures that the right people get access to the right drug and dosage to help them improve their quality of life.
As innovations continue and the FDA approves more and more weight loss drugs, individuals struggling with their weight can be rest assured that the options to help them get on the right track will continue to grow. And in time, the epidemic might just end.
