The half promise of weight-loss drugs

 

Groundbreaking weight-loss drugs like Ozempic and Wegovy have understandably generated a lot of excitement, bringing hope to the hundreds of millions of people grappling with obesity. When combined with a healthier diet and exercise, these drugs, which work by suppressing appetite, deliver an average 10% reduction in body weight that can be sustained for years.

With more than two-thirds of adults in the UK and nearly three-quarters in the US classified as overweight or obese – a health crisis that costs national economies billions of dollars annually – physicians and policymakers could be forgiven for embracing these drugs as a panacea.

US president Joe Biden’s administration, for example, recently proposed requiring Medicare and Medicaid to cover the costs of weight-loss drugs, offering access to millions of Americans. But addressing obesity requires much more than a technological fix.

To be clear, I am not suggesting these drugs are unnecessary or that medical professionals should avoid prescribing them. But they do not address the problem fuelling the global obesity crisis (and contributing to the climate crisis as well): our broken food system.

The alarming rise in obesity over the past 30 years is not simply a byproduct of higher living standards or more sedentary lifestyles, though these factors play a pivotal role. The primary factor appears to be the transformation of our food environment, which has fundamentally altered both the types of food we consume and our eating habits.

In recent years, scientists and health experts have increasingly focussed on the high-fat, sugar, and salt (HFSS) foods driving unhealthy dietary habits. This trend can be attributed to companies reshaping the food system to produce ultra-processed, hyper-palatable, and highly profitable foods.

Consequently, people are snacking more, eating larger portions, and preparing fewer meals themselves. In the UK, for example, the snack market has boomed while the time spent preparing meals has sharply declined.

These changes haven’t just fuelled the rapid increase in HFSS food consumption. They have also led to a surge in meat consumption, especially in Europe and North America, where meat-heavy diets have become all too common.

Beyond the heightened risk of heart disease and related health conditions, excessive meat consumption has had devastating effects on the climate and biodiversity. Research shows that animal-based foods generate twice the greenhouse-gas (GHG) emissions of plant-based alternatives.

Just as health experts urge us to reduce our HFSS intake, climate scientists consistently emphasise the importance of cutting meat and dairy consumption to keep global warming within safe limits.

In an effort to prevent a lasting change in people’s eating habits, the meat industry is seeking techno-fixes to cut GHG emissions. For example, funding for research on cutting farm emissions – such as feed additives designed to reduce methane levels in cows’ burps – has increased markedly.

Such solutions are particularly attractive to governments reluctant to introduce measures that influence consumer behaviour. Fearful of opposition from the Big Food lobby and wary of accusations of overreach, policies like sugar taxes or meat taxes are deemed political hot potatoes to be avoided at all costs.

But the overlapping crises our broken food system is fuelling – from the billions of dollars spent each year on diet-related health problems to the environmental degradation pushing our planet to its limits – cannot be wished away or fixed with technological band-aids. Instead, what is needed is a major shift in dietary habits towards foods that nourish both people and the environment.

To this end, the EAT-Lancet Commission – comprised of the world’s leading nutrition and sustainability experts – advocates a diet rich in fresh fruits and vegetables, whole grains, and plant-based proteins while reducing consumption of animal proteins, dairy, and sugars. Taken together, these recommendations offer a clear blueprint for ensuring health and sustainability.

Admittedly, it is unrealistic to expect consumers – conditioned by food environments designed for profit rather than human or environmental health – to drive this transition on their own. With unhealthy foods widely available and aggressively marketed, many consumers often struggle to moderate their food intake and, in some cases, develop addictive behaviours.

Governments and food manufacturers must take proactive measures to reshape these environments, such as expanding initiatives aimed at reducing the consumption of HFSS foods to include meat, thereby encouraging people to eat more plant-based whole foods and meat alternatives.

Another potential solution would be to extend bans on promotional deals for unhealthy foods to cover meat products. Requiring food companies to report on the types of food they sell, including HFSS foods and the ratio of plant-based to animal proteins, would also help. These measures would incentivise businesses to prioritise healthier, more sustainable options over less nutritious ones.

None of this is to suggest that the new generation of weight-loss drugs cannot benefit individuals living with obesity. For those trapped in a cycle of poor health, Ozempic and Wegovy could even save lives, and efforts to make these treatments widely available are a welcome step.

But it is essential that we recognise that this approach treats the symptoms rather than the underlying pathology. Defusing the time bombs of ill health and environmental catastrophe requires fast, decisive action to remake our dysfunctional food system. - FMT

Emily Armistead is interim executive director of Madre Brava.

The views expressed are those of the writer and do not necessarily reflect those of MMKtT.