24 April 2023

Have you heard about the new weight loss drug, Mounjaro™? Well, it’s not exactly a weight loss drug.  Like Ozempic, it’s a treatment for Type 2 Diabetes, and “not indicated for weight loss”.  Of course, that doesn’t stop them touting its effectiveness in helping people to lose weight.  The American weight loss market is now worth $75 billion annually. Yet, 36% of Americans are obese.  Sounds like it’s not working so well for the consumer, but the diet industry appears to have an infinite market.

I attended a presentation on Weight Loss and Willpower this weekend at the Annual Meeting of my dietetic association. It gave me the opportunity to think on this subject, discuss with RDN colleagues and formulate my nuanced opinion. I’ve worked with bariatric patients, and I absolutely understand that there are important uses for drugs, and even surgical treatment, in certain circumstances. My concern is that these solutions are not addressing the root cause, which (in many cases) is diet (and here, I am not referring to dietary restriction, but rather our daily eating pattern). Everyone wants the shortcut, and focusing on weight alone – even with the goal of preventing or reversing associated chronic disease - ignores holistic health.

This is an actual ad I received today in a “news” email last week:

The best part of this product is that I don't ever have to work out. It does all the work for me, which saves me so much time.

Ignoring decades of evidence for the health benefits of physical activity seems short-sighted; isn't it likely that longevity will suffer? So how much time are you really saving?

So, back to weight loss drugs... I’m not ruling them out as a tool, albeit a very expensive one. This is one reason I advocate for universal access to healthy food. It’s cheaper to prevent chronic disease with food than with pharmaceuticals, surgery or even technology. Why are we clamoring for insurance companies to cover drugs rather than vegetables? Consider:

• mean BMI for vegans is a healthy 23.6, while for nonvegetarians it indicates overweight at 28.8
• plant based diets may reduce risk of diabetes by 34%
• eating a healthy plant-based diet may reduce risk of cardiovascular disease by 16% AND make you 31% less likely to die from CVD
• vegetarians are associated with a 34% lower risk of developing hypertension than nonvegetarians
• plant-based diet lowers the risk of all causes of mortality by 25 percent

I don’t know of a single drug on the market that can claim these stats. In addition to the physical and mental health “side effects” of eating more vegetables, your meals can be more beautiful and delicious AND it’s better for the planet.