The Drugs Are Working

The first step toward fulfilling a New Year’s resolution just might be a class of prescription weight loss pills and shots. The next steps: Getting patients and doctors to trust them and insurers to cover them

- By Emma Court. Illustration by Steffen Ullmann and Chris Philpot

Obesity is a disease. The American Medical Association said so almost a decade ago, and experts convened by the National Institutes of Health did the same when Bill Clinton was president. But it bears repeating, because the conventional wisdom still holds that obesity is a choice. From paleo to Pilates, get-fit-quick schemes revolve around willpower and the assumption that weight loss is entirely a function of diet and exercise. Successful weight loss is partly a function of behavior, yes, but research suggests that genetics and environmental factors can make it extremely difficult or even impossible for some people without outside help. Today, outside help often means surgery, but there’s a much less invasive option quietly sitting on the shelf.

That would be prescription drugs, especially a group of drugs known as GLP-1 receptor agonists, or GLP-1s. These compounds were designed for people with diabetes but have also been shown to cause patients to shed pounds. They simulate a hormone known as glucagon-like peptide 1, the chemical that helps people feel full after they eat. Many people taking a newer GLP-1 drug for weight loss known as Saxenda, for example, lose at least 5% of their body weight, according to one study by the manufacturer. Older generic medications can cost patients as little as $15 a month, while new, brand-name GLP-1s run about $1,400 for a month’s supply of weekly injections.