The U.S. is the most obese nation on the planet, with 42 percent of adults considered obese. Even more Americans qualify as overweight. Happily, an enormous breakthrough has occurred in the battle against weight. In 2021, the FDA approved Wegovy as the first injectable to specifically treat chronic diseases associated with obesity. The agency’s approval set off a rush for prescriptions, with Hollywood limelighters, who did not qualify as obese competing with diabetics, who did, for scarce initial supplies of the drug.

What is now approved for adults will soon be being used by other groups, with or without regulatory approval—by children, the worried well, those who need to maintain low weight for their jobs (in particular, members of the military). They may also be used to prevent weight gain by people who care deeply about their appearance, and those who won’t or can’t change their diets and lifestyles. This covers nearly every human on Earth.

There are real benefits to treating and preventing obesity. The disease costs our health care system $173 billion a year to treat its consequences. However, putting just this nation on injectables will also come at an enormous cost. A person’s monthly supply of an injectable costs about $1,000. Throw in a doctor visit or two and the treatment’s cost will be, conservatively, $15,000 per year. Let’s say, also conservatively, about a third of both obese and weight conscious people in the U.S. go on one of the injectables—that’s a hundred million. The tab skyrockets to $1.5 trillion—that is per year. Even assuming competition drives down prices, and that there are fewer users, the medical war on weight will be the most expensive one ever fought.

Please contact Sean at Sec3001@med.cornell.edu for hte zoom link.