Is This A Shortcut Worth Taking?

This is long but… hang in there!

I had been watching a more significant amount of TV lately because of the baseball play offs and the World Series. And it takes no time to be reminded why I don’t tune in to TV very often.

Drug commercials! They don’t stop. Apparently, we are a very sick nation. But never fear, drugs seem to be the answer! Do you have a problem? You need a drug! Do you have any symptom? Don’t worry, there is a drug.

Drugs, drugs, drugs! And shots too!

Let me ask a few questions. 

How much do we spend on health care as a nation? 2023 numbers are just short of 5 trillion dollars. Just to make clear, it takes 1000 billion to make a trillion. And 1000 million to make a billion. Five trillion is a heck of a lot of money. $14.5 K per person per year. (How does health spending in the U.S. compare to other countries?)

And what do we get? A tenth-place ranking in terms of health markers among developed nations. Not too good. There are plenty of industrialized nations spending half that amount per person and having better health outcomes. (How does the quality of the U.S. health system compare to other countries?)

What about prescription drugs? Just north of $800 billion per year. Up 10% from the year before; expected to be up another 10% this year, 2025. Leading this growth is weight loss drugs particularly GLP-1’s. (U.S. Drug Spending Up 10.2% in 2024, with Weight Loss Drugs Remaining Top Driver)

What are GLP-1s? They were originally for the control of Type 2 Diabetes but were found to help with weight loss, so they were essentially rebranded. (Ozempic, Wegovy, etc…)

Are they effective? Yes.

Are they expensive? Yes.

Are they a good idea? It depends.

Some people have no choice. Clinical obesity makes it very difficult to move. If you can’t move you will never be healthy, lose weight, sleep well, engage in life. Sometimes a drug is the only way out. 

But for those who do have a choice, meaning they have developed some habits that are not serving them, change of lifestyle is a better option.

Alas, big pharmaceutical companies don’t make billions telling people to back off the sweets. TV doesn’t promote healthy options. Instead, they promote a pill or a drug. A shortcut. A shortcut that doesn’t require changing thoughts and behaviors. An easy way out.

It makes my blood boil.

And then…

Here comes Serena Williams, a world class athlete, recommending a GLP-1 medication. If you have never seen Serena before or it has been a while since you have, I can assure you she is still in great shape. Her biceps rival Arnold’s in his prime. She used to crush her rivals on the tennis court. She did this for so many years that having a true problem with her weight is incomprehensible. Most men I know would kill for her muscles. I hope you all are getting the idea that Serena is anything but obese. These commercials portray a well-nourished, remarkably fit athlete using a weight loss shortcut! This seems damaging on so many levels. We will get to that.  

First, let's chat about these drugs, the GLP-1 class. 

I asked a local pharmacist that I know and trust, a few questions about this class of drugs.

Her answers were illuminating.

Q- How many of these do you fill in an average day? 

A- 30+ (This is one pharmacist).

Q- What is the average cost? 

A- $1200 out of pocket. With insurance it varies. Sometimes as low as $25.

Q- Is there an offramp for the use of these drugs? 

A- None that I’m aware of.

Q- So essentially, they are for life? 

A- Yes

Q- Do the manufacturers recommend any lifestyle modifications that will potentially limit the timeframe that the drug is used? 

A- Not that I am aware of, but I hope it is encouraged!

So, you may ask, what's the problem?

The problem is that unless you are clinically obese, you are setting yourself and your metabolism up for failure.

This is not a good shortcut.

Consider that weight loss is typically 50% loss of muscle mass. Muscle mass drives metabolism. And from what I can tell, people don’t really want to lose weight; they want to lose fat. Not muscle. Loss of muscle mass downregulates the metabolism. This sets people up for the dreaded yo-yo program. That is why the drug is for life. 

What about the psychological effect of a young consumer, frustrated by his or her shape, and seeing someone like Serena claiming to have a problem AND a cure? In the commercial she appears to have a difficult time pinching enough abdominal skin to give herself a shot! Any young lady watching this could be easily convinced that if Serena has a problem, maybe she does too. Any middle-aged weekend warrior might also think “Hey, why am I trying so hard?”

If you are a consumer and you have tried “everything”, then you may think this is a good idea.

It’s not. Again, these drugs appear to be for lifetime consumption. (Pretty great business model). It is still too early to tell, but my bet is that when people stop taking these, they will yo-yo like crazy. And they will have less muscle mass to protect them as they age. 

If you are taking one of these things, please ask your provider if there is an off ramp at some point.

And unless you are clinically obese, stay clear of these things. You have more to lose than weight. Remember there are better, healthier ways to trim up. Not as simple or easy or fast, but way better for you.

Thanks for reading.

Ks

PS: Extra credit – look up “side-effects”!