Just last month, I celebrated 25 years as a professional journalist, which I guess means my journalism career is old enough to rent a car, no questions asked. Be in the news for a long time, and you’ll occasionally find yourself surprised by things you’ve reported in the past. Like, I forgot everything I had This story was written on the cover of Time magazine in 2008:
A couple of things here. First, as the cover makes clear, journalistic sensitivity was…less than ideal at the time, to say the least. Second, over a quarter of a century sometimes coverage Obesity (whether in childhood or adulthood) This story only seems to go in one direction: worse.
It wasn’t for lack of trying. We put calorie counts on menus, taxable soda (well, in… some places), created workplace health programs, and funded a small library of diet research. We have denounced food deserts and encouraged farmers markets. We’ve asked people – over and over again – to eat less and move more. But the lines continued to rise.
Through a measured survey conducted by the CDC, Percentage of adults in the United States who are obese It did not change significantly between 2013 and 2023. The age-adjusted obesity rate reached 40.3%, while the age-adjusted severe obesity rate increased from 7.7% to 9.7% during the same period.
While the issue of weight in America is closely linked to body image and morality, these numbers have had a deadly impact. One demographic model estimated Obesity was associated with about 18 percent of deaths among black and white Americans ages 40 to 85 between 1986 and 2006. From diabetes to kidney failure and heart disease to sleep apnea, obesity is the delivery system for other diseases.
Which is what makes the Gallup report published In July it is very surprising. In Gallup’s self-reported height and weight series, the U.S. adult obesity rate fell to 36.4%, after peaking at 39.9% in 2022. Over roughly the same period, the proportion of adults who said they were currently taking the weight-loss drug GLP-1 rose from 3% in 2024 to 11% in 2026, or nearly 29 million people. While this only shows correlation, not causation, and Gallup’s self-reported measure should not be compared directly with the Centers for Disease Control and Prevention’s measured rate, the timing is suggestive to say the least.
Weight may be the least interesting thing about these medications.
Semaglutide — the molecule sold under the names Ozempic and Wegovy — was the first sophisticated It is approved as a treatment for type 2 diabetes, but not obesity. Only after trials of previous GLP-1 and diabetes drugs showed significant effects on appetite and weight did researchers intentionally test a higher dose for obesity. Leading to Wegovy in 2021.
But as it turns out, the list of things observed on the GLP-1 side has gotten so long that it’s beginning to overshadow the main event. Coverage of GLP-1s has barely kept up with the news, because weight loss is what made these drugs popular and is what we constantly obsess over. But it turns out that losing weight may not be their best bet.
Side effects may include…
Let’s start with sleep apnea, which if left untreated raises blood pressure, strains the heart, and increases the risk of stroke. These are people whose breathing stops dozens of times an hour, all night, every night. two One-year trials He put 469 of them on tirzepatide — the drug sold under the names Mounjaro and Zepbound — and cut those outages by more than half. Nearly half the group finished the year without out of breath at all, or with so little left that they stopped feeling tired throughout the day.
Then there are the kidneys. A Big trial The researchers followed 3,533 people with type 2 diabetes and chronic kidney disease for an average of 3.4 years. Semaglutide reduced the combined relative risk of kidney failure, persistent loss of at least half of kidney function, or death from kidney- or cardiovascular-related causes by 24 percent; Mortality from all causes was 20 percent lower.
And the liver: A trialwhich is still ongoing, to biopsy the livers of 800 people whose organs had become fatty, inflamed and scarred, and they were randomly assigned to semaglutide or a placebo. After 72 weeks, inflammation had resolved in approximately 63% of those taking the drug, without worsening scarring, versus 34% of those taking the placebo.
And knees: In 407 adults with obesity and moderate knee osteoarthritisPain scores on the WOMAC scale from 0 to 100 decreased by 41.7 points compared to 27.5 in placebo.
On top of that, 17,604 people trial Of participants who were overweight or obese but did not have diabetes found a 20 percent reduction in major cardiovascular events.
These results may not be as attractive Cultural discussions about the “Ozambian face” But they deserve more attention.
Happy medicine accidents
Like GLP-1s – which in part A hormone came out in the monster’s poison generation – prove that medicine has long found some of its greatest triumphs in the margins of drugs ostensibly designed to do something else entirely.
Sildenafil, commonly known as Viagra, began life at Pfizer as a treatment candidate for heart disease angina. It failed, and its now-famous use appears in the data as a side effect of what must have been a very interesting experience for the people who underwent it. Minoxidil (Rogaine) was one blood pressure pill that was shown to help patients grow hair. Finasteride (Propecia) was approved to treat prostate enlargement before anyone thought about selling it to treat baldness — and afterward. More than 18,000 men were tried She found that it reduced prostate cancer diagnoses by about 25 percent, a benefit she took note of 20 years of follow-up for complete exoneration.
Perhaps the most famous example is aspirin, which spent most of a century as a painkiller before a California doctor named Lawrence Craven noticed that patients he gave aspirin gum after tonsillectomy bled more than they should. He guessed that aspirin thinned the blood, and began distributing it to middle-aged men, who were more susceptible to heart attacks. Craven died in 1957; the The trial that finally proved he was onto something In heart attack victims, aspirin was shown to cut vascular deaths by a fifth – and it didn’t last until 1988.
Ozempic’s strange morals
In this sense, GLP-1 drugs can seem like miracle drugs, but even miracle drugs can’t cure everything.
There was great hope that GLP-1 might reduce dementia rates, but when Ozempic manufacturer Novo Nordisk… He conducted the appropriate trialThere was no evidence of slowing the clinical progression of Alzheimer’s disease. The same thing happened with cancer. Observational data suggested that GLP-1 users developed tumors less often, but when a team from Harvard University discovered… 48 placebo-controlled trials were pooled The researchers, who included 94,245 people, found that the drugs had little effect on the risk of thyroid, breast or kidney cancer, although the evidence for other types of cancer was less certain, leading to Packaged US Food and Drug Administration (FDA) warnings. Plus one: In some early animal studies, high doses of GLP-1 drugs were found Causes thyroid tumors In rodents, but further research The concerns were largely unverified It could be more common, although there is uncertainty regarding some rare thyroid cancers.
For many people, weight loss is not the end of what these medications seem to be able to do. This is where the benefits begin.
The biggest concerns remain largely unknown, starting with muscle loss. Across 22 randomized trials, Loss of about 25 percent of weight On these drugs it turns out that lean muscle mass. Some of these things are unavoidable in any weight loss process, but many of them can mean a lot, especially if you are 75 years old.
Cost remains a barrier: In a 2025 KFF survey, 56 percent of adults who had previously used GLP-1 He said medications were hard to come by; 27 percent said they had insurance but paid the full cost themselves. In separate Cleveland Clinic chart review Of the 288 non-diabetic adults who stopped using semaglutide or terzebatide within a year, 47.6 percent stopped because of cost or insurance issues, compared with 14.6 percent because of side effects. (The money, at least, is getting better. Oral GLP-1 drug Approved In April, it starts at $149 per month for people who pay with cash, while Medicare trial pricing is $149 per month $50 per month for some GLP-1 devices It was broadcast live in July.)
The most difficult hurdle is one that seems inseparable from questions of weight: judgment. As does my colleague Dylan Scott Recently writtenResearchers at Rice University found that people rate a GLP-1 user more harshly than someone who did not lose weight at all. This makes perfect sense when you consider how controversial weight loss has become in America — and absolutely nothing when you consider how many people have benefited from these medications in so many different ways.
I sometimes wonder how we would view GLP-1 if they could do everything they have been shown to do, but somehow not change a person’s appearance.
Much of the discourse around these drugs has been shaped by the fact that many of the early and most famous users were already thin people, often celebrities, and used them to get thinner. But this framing is becoming increasingly difficult to reconcile with reality.
Two things can be true at the same time: American culture has a toxic relationship with weight; and Millions of Americans can and do benefit from these medications. For many people, weight loss is not the end of what these medications seem to be able to do. This is where the benefits begin.
A version of this story originally appeared in the Good News newsletter. Register here!
