A paper presented at this year’s European Obesity Conference in Istanbul, Turkey (May 12-15) suggests that a new era of obesity drugs could shift responsibility for living with obesity from individuals to the food industry – just as the tobacco industry is responsible for smoking and, to a lesser extent, the alcohol industry is responsible for alcohol consumption.
Authors Luc Louis Hagenaars, assistant professor at Amsterdam UMC, Amsterdam, the Netherlands, and professor Laura Ann Schmidt, from the University of California Health Policy Institute, said they believe that “these drugs have the potential to shift responsibility for obesity from individual failures to the broader effects of the commercial food system, drawing parallels to historic public health successes against tobacco and alcohol. This reframing is critical to addressing this escalating problem.” “Obesity Prevalence and Associated Chronic Diseases.”
Their analytical essays present a theory of how the current GLP-1 era will impact the conceptualization of obesity. By integrating multiple lines of evidence, Hagenaars and Schmidt examine emerging medical and public health data on the effects of GLP-1 agonists, particularly on weight loss and ultra-processed food (UPF) cravings (food noise) (see link in Notes to editors). This analysis is based on historical parallels with successful public health movements that regulated harmful substances such as tobacco and alcohol. Additionally, the paper incorporates insights from the authors’ previous food system analysis, identifying feedback loops that can impede policy responses to obesity-inducing environments and drive change.
These analyzes revealed cultural assumptions and systemic barriers related to the assumption that obesity is an individual problem, fostered policy inertia by obscuring the root causes of the epidemic, and revealed a commercialized food system locked in maximizing sales of highly palatable, ultra-processed foods.
The authors say that the reported success of new obesity drugs in significantly reducing weight loss and, importantly, reducing UPF cravings, could lead to three important changes.
1) Decreasing consumer demand for UPF, as demonstrated by early food industry reforms (e.g., reduced portion sizes) – The food industry is evolving, with major stores selling “GLP-1 friendly” foods in smaller packages with added protein and fiber additives.
2) A scientific paradigm shift, aligning the understanding of obesity more closely with addiction models (e.g., “ultra-processed food noise” and depicting ultra-processed foods as addictive, industrially engineered substances);
3) A shift in public discourse away from individual responsibility and towards recognizing the role of dangerous products in promoting obesity (e.g. increased public scrutiny of ultra-processed foods).
The authors say: ”These concentrated effects may create an environment favorable to the adoption of public health policies similar to those successfully implemented against tobacco and alcohol. The authors conclude, “The ‘Ozempic era’ provides a pivotal moment to challenge the deeply ingrained cultural assumption that obesity is a personal flaw.” By leveraging the far-reaching impact of new obesity drugs, society can foster collective responsibility and generate the policy momentum needed to alleviate the root causes of the obesity crisis through comprehensive food system reform. Although we recognize that there is a potential risk of further medicalization in this new era, we believe there is an opportunity for a societal reorientation that can finally address the systemic causes of obesity.”
sauce:
European Obesity Research Association
