What You Need to Know About GLP-1 Medications: Part 1

GLP-1 medications (such as Ozempic®, Wegovy®, Mounjaro®, and Zepbound®) have been making headlines—and for good reason. These innovative treatments have transformed the way we manage certain health conditions, particularly obesity. But as with any breakthrough therapy, there’s a lot to unpack.

Welcome to the first of a multi-part series about these medications: what you need to know, how they work, their benefits, and what to consider if you’re thinking about starting them.

But before we dive into the specifics of these drugs, it’s crucial to put them—and their intended therapeutic target—into context.

Understanding the Context: Obesity and the Modern Environment

I recently came across a profound statement:

“Obesity happens when normal people do normal things in an abnormal environment.”

Take a moment to re-read that statement and let it sink in. This simple yet profound observation should serve as the foundation for any conversation about excess weight and obesity treatments.

If you grew up in the 1960s or 1970s, you’ve likely noticed a significant weight increase across the population during your lifetime. The CDC’s Obesity Prevalence Maps vividly illustrate this trend. Between 1990 and 2010—a mere 20 years—we transitioned from a mildly overweight nation to a markedly overweight one. (By the way, these maps only get worse as we move into the 2020s.)

The Rise of Obesity: What’s Behind the Trend?

This dramatic shift in the span of one generation cannot be attributed to genetics—20 years is far too short a time for a population-wide genetic change.

Nor can it be blamed on a sudden decline in exercise. It is estimated that around 25,000 people completed a U.S. marathon in 1976. By 2005, that number had skyrocketed to 432,000. Fitness and gym memberships have also been rising steadily.  If anything, we've become more active!

It’s also not due to a lack of interest in weight loss. Published data show that 15–35% of Americans are actively trying to lose weight at any given time. Meanwhile, we spend approximately $33 billion annually on weight loss products, excluding medications.

So, what’s the real culprit?

The Food Environment: A Key Driver of Obesity

The undeniable conclusion is that our food environment is to blame. And, indeed, our food environment has changed—dramatically so—in parallel with the rise in obesity. What we’re surrounded by in grocery stores, restaurants, and fast-food chains has morphed into an environment that promotes overeating and weight gain.

Where Do GLP-1 Medications Fit In?

One thing is clear: GLP-1 medications don’t alter the food environment. They don’t influence what’s stocked on grocery shelves or listed on restaurant menus. Instead, they alter us. In essence:

“GLP-1s make normal people do abnormal things in an abnormal environment.”

Looking Ahead: How GLP-1s Work

In the next blog, we’ll explore how GLP-1 medications work and why they’re so effective for weight loss.

In the meantime, if you haven’t already, consider reading If Everything Is So Good for Us, Why Are We All So Sick? This four-part series offers valuable insights into our broken food environment and provides an excellent foundation for understanding what we're all up against.