Regarding how to use these drugs, it is likely to change our future health status and even the face of our society. As researchers have found, it has overturned the idea that obesity is simply a moral failure due to weak willpower. Weight loss pills have become the core of national debate. This week, the newly elected Labour government in the UK proposed that it could be a tool to remove obese people from welfare and return them to work. This latest statement and response reflect our understanding and solutions to obesity.
We are currently in an era of weight loss pills
I would like you to think about the following questions: Obesity is caused by people themselves, do they just need to make better life choices? Or are these millions of victims all caused by social failure, and do they need stronger laws to control what they should eat? Is weight loss medication a wise way to deal with the obesity crisis? Or are these drugs just an excuse for people to avoid and solve why so many people are overweight?
Personal choice or nanny country? Realism or idealism? Few medical issues can trigger such intense social discussions. I cannot answer all your questions – it depends on your personal opinion on obesity and what kind of country you live in. But when you think about these issues, there are still a few things to consider. Unlike diseases such as hypertension, obesity is very obvious, and it has long been accompanied by many accusations and shame, just like how overeating is one of the seven sins of Christianity.
Now, we can take a look at Semaglutide, a product under the weight loss drug brand Wegovy. Its function is to mimic a hormone released when we eat, deceiving the brain that we are already full, thereby reducing our appetite and food intake. This means that by changing a hormone, “suddenly your entire relationship with food changes,” Professor Giles Yeo said. He specializes in studying obesity at the University of Cambridge in the UK. This has had various impacts on the way we view obesity. Professor Gals Yang also pointed out that many overweight people are due to their “lack of hormones, or at least their hormone levels are not as high,” which makes them physiologically more prone to hunger and weight gain than those who are naturally thin and weak. A hundred years ago or earlier, this may have been an advantage – at that time, there was not enough food, which drove people to consume calories when they had food, because there might be nothing to eat tomorrow.
In the past century, our genes have not undergone significant changes, but the world we live in has changed. With the rise of cheap high calorie foods, increasing portions, and the composition of towns and cities making driving easier than walking or cycling, people’s weight continues to increase.
These changes began to emerge in the second half of the 20th century, and scientists referred to it as the “fattening environment” – an environment that encourages people to eat unhealthy and not exercise. Nowadays in the UK, one in four adults is overweight. Wegovy can help people lose 15% of their own weight, and its effects will be more stable afterwards. Although it is labeled as a “slimming pill” by people, it can reduce a person’s weight from 20 stones (127 kilograms) to 17 stones (108 kilograms). From a medical point of view, it can improve the health status in areas such as heart disease risk, sleep apnea and type 2 diabetes. But Margaret McCartney, a general practitioner in Glasgow, warned, “If we continue to put people in fattening environments, we will only forever increase the demand for these drugs. Now, the National Health Service (NHS) in the UK plans to only prescribe drugs for two years due to cost issues. There is evidence to suggest that when medication is discontinued, appetite and weight will rebound.
“My biggest concern is that when we don’t pay attention, these people’s weight will rebound to the original level, “said Dr. Margaret McCartney. We know that the ‘fattening environment’ started a long time ago. One in five children is already overweight or obese before enrollment. We also know that obesity has a greater impact on the poor (36%) compared to the wealthy (29% of adult patients). Part of the reason is that the latter region is relatively lacking in cheap and healthy food. But there will always be tension when improving public health and maintaining people’s freedom. You can drive, but you need to wear a seat belt; You can smoke, but you have to pay heavy taxes and are subject to age and location restrictions.
Therefore, there are a few things here that require you to reconsider. Do you think we should start addressing the obesity causing environment or intervene when people’s health is threatened? Should the government treat those food factories harder and change what we can buy and eat? Should we emulate Japan (a wealthy but low obesity country) and eat small bento boxes with rice, vegetables, and fish? Should we still limit the calorie content of ready to eat foods and chocolate bars?What about the sugar and junk food tax? Should we widely prohibit the sale or promotion of high calorie foods?
Professor Gals Yang said that if we want to change, “we will have to make compromises in certain areas, we will have to lose some freedom, but I don’t think we have reached a consensus in society, nor have we had in-depth discussions.” In the UK, officials have developed strategies to address obesity – a total of 14 strategies have been developed over the past 30 years, but with little success. This includes the “Five servings of fruits and vegetables” program to promote the consumption of fruits and vegetables, labeling food with calorie content, restricting the promotion of unhealthy foods to children, and reaching voluntary agreements with manufacturers to reformulate food.
In the early stages of blood pressure lowering drugs or cholesterol lowering statins, they were expensive and only provided to a few people who needed them the most. Approximately 8 million people in the UK are currently taking these medications. Stephen O’Rahilly, director of the Metabolic Diseases Division at the Medical Research Council (MRC) in the UK, said that blood pressure issues can be addressed through a variety of drugs and social change. We have conducted blood pressure screening, recommended people to consume low sodium foods, and developed cheap, healthy, and effective blood pressure drugs. He said that this is similar to the situation of obesity.
At present, we still do not know how many people will eventually receive weight loss medication treatment. Is it really only necessary for people who are excessively obese and at medical risk? Or will it become a preventive measure to prevent people from becoming obese? How long should people take weight loss pills? Eating for a lifetime? To what extent can it be used on children? Is it important if people taking these medications are still eating unhealthy junk food, just less than before?
When we are still unaware of the side effects of long-term use of weight loss drugs, how quickly should weight loss drugs be promoted? Can we accept healthy people taking it solely for cosmetic purposes? Will its existence privately widen the obesity and health gap between the rich and the poor? There are so many questions, but so far there are only a few clear answers. I don’t know what this will ultimately lead to, we are embarking on a journey full of uncertainty, said Professor Nawid Shahtar.
