The massive and almost popular use of GLP-1 receptor analogue drugs, or rather, the famous Ozempic and Co., has surpassed the margins of normal medical practice. What was born as a promising therapeutic tool against diabetes and obesity has transformed into a global social, economic and media earthquake. However, after the initial optimism, serious warnings emerge about its unintended consequences.
An editorial published yesterday in the prestigious journal Science, signed by Luc L. Hagenaars and Laura A. Schmidt, analyzes how the commercial interests of the pharmaceutical, food and wellness industries threaten to distort the true impact of these drugs and increase health inequality. GLP diets, GLP supplements and foods compatible with these drugs are already proliferating on social networks and the internet.
And this represents a strong contrast with the plan of the medical community: the World Health Organization (WHO) and experts emphasize that the solution to obesity is not purely pharmacological, but requires medical support, healthy habits and preventive measures. “To ensure that LPG-1 reduces, rather than exacerbates, health inequities, governments and healthcare leaders must set limits on commercial forces jumping on the LPG-1 bandwagon,” write Hagenaars and Schmidt.
Why the food and pharmaceutical industries threaten the impact of Ozempic
In theory, the arrival of GLP-1 offered the opportunity to destigmatize obesity, the signatories of the article point out. By demonstrating that cravings respond to biochemical mechanisms and stopping the "mental noise of ultra-processed foods", the scientific debate shifted the blame from individual "lack of will" to a sick food environment, prone to triggering obesity. In addition, it opened the way to equate the regulation of hyperpalatable foods (ultra-processed foods) with that of tobacco or alcohol.
However, the authors regret that a lifestyle based on GLP-1 is being established. Given that patients or users of these drugs radically change their shopping list, the food industry counteracts the drop in consumption by reducing portions without lowering prices ("reduflation", the authors call them), making more addictive products or promoting ultra-processed products as "functional foods for a GLP-1 lifestyle."
Added to this is the rise of telemedicine platforms such as Amazon or WeightWatchers with “same day shipping” at prices unaffordable for most, and the proliferation of unauthorized generics with serious safety risks. "There is concern about the proliferation of unapproved versions, pirated copies and misleading advertising, in addition to the readaptation of the food industry to maintain consumption," underlines endocrinologist Cristóbal Morales, involved in most of the clinical trials of these drugs in our country.
This expert delves into how the food industry - "as a great lobby" - reinvents itself and "can be dangerous because it is rebranding functional foods, adapting smaller portions or reformulating products to increase palatability; In the end, what we want is for us to remain connected to this food.
As spokesperson for the Spanish Obesity Society, Morales focuses on the "unintended consequences: the trivialization of the disease and the obstruction of equitable and fair access to these medications." Therefore, Hagenaars and Schmidt emphasize that “with the new guidelines in place and its recent experience with COVID-19 in managing the tensions between public health interests and commercial interests, the WHO could play a fundamental role at this critical juncture.”
The consequences of the massive use of GLP-1: between medicalization and the social gap
This analysis coincides with the publication of the first global WHO guidelines on GLP-1. The international organization advocates guaranteeing equitable access to these treatments for nearly 1 billion affected people on the planet, emphasizing that they must be accompanied by courageous reforms in food environments to address the structural causes of the epidemic.
Morales warns that in what is already considered the "Ozempic era" there is an increasingly frequent temptation "to trust everything to the GLP-1 letter (due to its effectiveness), but it would be a wrong approach: it would be treating the biological-metabolic dysfunction forgetting that this person lives in an obesogenic environment and we must act on these environmental causes that have produced it since childhood." The endocrinologist also remembers that "the WHO has spoken out significantly about this and has insisted that they are essential drugs for humanity, but requires responsible medical use and improved accessibility."
