The other intra-MAGA dispute.
The other intra-MAGA dispute.
W e have a drug to reduce obesity and associated illness, and the leader of MAHA just isn’t into it.
The New York Times ran an article the other day on the clash between Robert Kennedy Jr. and Elon Musk over Ozempic and similar so-called GLP-1 drugs that help people lose weight; seeing dark forces at work, RFK Jr. is highly suspicious, and seeing revolutionary technological progress, Elon Musk is in favor.
As you’d expect in most clashes of opinion between these two — the radical environmentalist on the one hand, and the genius innovator on the other — Musk is correct.
RFK Jr. is right in many things he says about the obesity crisis, which is real (about 40 percent of Americans are obese, with all the attendant health risks, from to type 2 diabetes to heart disease). We eat lots of unhealthy foods, and certainly government policy could make a difference at the margins.
The basic picture, though, is that over time we’ve managed to make calories cheap and abundant in what would have been considered a vast boon to human welfare throughout most of history, but — because almost everything has a downside and can go too far — we’ve overdone it.
That we are gaining weight is nothing new, and shouldn’t be attributed to any one factor, or a conspiracy by Big Food.
Our body mass index has been increasing for, oh, about 150 years. As this piece for the Journal of Clinical Investigation notes, “now that the right tail of the bell-shaped curve for BMI in the US population has crossed the threshold for obesity (BMI of 30 kg/m2), small increases in average BMI and rightward shifts of the curve mean a sharp increase in the number of people considered obese.”
I know: We can tell people to eat healthy food and exercise more!
Of course, the federal government has been doing this for quite some time, but people aren’t as susceptible to government persuasion as you might hope (or fear).
The things we like to eat or drink that are bad for us, like fast food, soda, chips, and cookies, are cheap, convenient, and taste good.
You could eliminate at least one of those factors by making these foodstuffs and drinks more expensive through taxes (a soda tax is a favorite idea of people hoping to change our consumption habits). Needless to say, this wouldn’t be a natural move after Donald Trump won the election by running against elevated food prices.
Even if we manage to convince more people they should eat more fruit, vegetables, and legumes, while getting appropriate levels of exercise, not everyone is going to do it as a matter of lifestyle constraints (the cashier who is on his or her feet for eight hours a day might not want to head to the gym afterwards), individual preference, or simple lack of willpower.
There’s also the fact that once you put on weight, physiological changes make it more difficult to shed it.
So, what are we going to do with everyone who is already is overweight or is going to become obese no matter what the government posture toward Big Ag is? Well, it sure would be beneficial to them — and to American society at large — if there were a safe drug that not only combatted type-2 diabetes but also made it easier for people to slim down.
Lo and behold: This is what the pharmaceutical industry has created via Ozempic and the like. They started as treatments for diabetes and have been found effective for weight loss, too, and have exploded in popularity.
This isn’t to say that we shouldn’t care if people to get fat because we can put them on anti-obesity drugs; or that there aren’t significant potential drawbacks to the drugs; or that there aren’t real issues of cost and availability (there is an ongoing debate over whether Medicare should or can cover anti-obesity drugs).
All true. But Musk is right to see the potential here.
Kennedy, meanwhile, tends to think these drugs are a scam. He said not too long ago that we could end the diabetes and obesity epidemic “overnight” if, for a fraction of the cost of drugs, we got three healthy meals to everyone in the country. The mechanism to do this was unexplained — both how to put these healthy meals in front of everyone and how to convince them to reliably eat them.
RFK Jr. also said that even though the maker of Ozempic, Novo Nordisk, is a Denmark company, the Danish don’t recommend it for diabetes or obesity. Instead, they just want to dump it on “stupid,” “drug-addicted” Americans.
This is very Kennedy — it sounds quite sinister and he pronounced on it with great authority, even though it is completely wrong. The Danish use Ozempic and other GLP-1 drugs for diabetes. Because they are so popular, the cost has soared so they are trying to rein it in . . . by turning to cheaper drugs first:
Denmark will start putting patients suffering from type 2 diabetes on cheaper drugs before prescribing so-called GLP-1 drugs such as Novo Nordisk’s (NOVOb.CO) Ozempic, the Danish Medicines Agency said on Wednesday.
In 2023, 50% of new patients suffering from type 2 diabetes began treatment with a reimbursed GLP-1 drug without trying a cheaper alternative first, the Medicines Agency said.
The drug is also often used off-label in Denmark for weight loss. A recent study concluded that although “not approved for weight loss without T2D, one-third of new users in 2022 did not have T2D.”
In a recent interview with Jim Cramer, Kennedy at least allowed, “The first line of response should be lifestyle. It should be eating well, making sure you that you don’t get obese. Those GLP drugs have a place.”
That’s something. Kennedy isn’t naturally inclined to accept it, but for the last 100 years, prescription drugs — from penicillin to the latest cancer drug — have played a huge role in making Americans healthier, and Ozempic and similar pharmaceuticals may represent the next wave.
Yes, by all means, let’s eat more arugula. But let’s not turn our back on the role of human ingenuity in making America healthier.