"It is not a failure of willpower."
IndigenousNetwork was able to attend this briefing from American Community Media.
GLP-1 medications such as Ozempic, Wegovy, Mounjaro and Zepbound have transformed obesity treatment, but physicians say the drugs have also sparked new questions about long-term use, access, cost and who benefits from a rapidly growing class of medications.
During an American Community Media briefing, researchers and physicians discussed the science behind GLP-1 medications, which were originally developed to treat Type 2 diabetes but are now widely prescribed for obesity. More than 40% of U.S. adults are living with obesity, and the medications now account for roughly 14% of prescription drug spending nationwide.
Dr. Jena Shaw Tronieri of the University of Pennsylvania explained that GLP-1 medications work by reducing hunger and the constant thoughts about food that many patients describe as "food noise."
"I've had some patients say to me that they didn't even realize how constantly they were thinking about food throughout the day until they started the GLP-1 medication and that food noise was suddenly gone," she said.
Her research found that while feelings of hunger gradually return over time, patients taking semaglutide continue eating significantly fewer calories than those relying on diet and exercise alone. She cautioned that many people stop taking the medications within a year, often because they believe the drugs have stopped working after weight loss slows.
"When we see patients that do discontinue, about two-thirds of the weight that they had lost is regained in the first year after they stop taking the GLP-1 medication," Tronieri said.
Harvard obesity specialist Dr. Fatima Cody Stanford urged journalists to rethink how obesity is discussed, arguing that it is a chronic disease rather than a personal failing.
"Obesity is a disease of energy regulation. It is not a failure of willpower," she said.
Stanford also argued that obesity disparities among Black women cannot be separated from generations of structural inequities, including chronic stress, economic exclusion and unequal access to health care. While she welcomed a new Medicare GLP-1 bridge program that lowers monthly costs for some patients, she warned that prior authorization requirements and uneven Medicaid participation could leave many underserved communities behind.
"The communities with less consistent access to primary care... are the ones most likely to fall through the cracks of a program that on paper is supposed to help them," she said.
Several speakers also stressed that medication alone is not enough. Dr. Dan Cooper, professor emeritus of pediatrics at UC Irvine, raised concerns about prescribing GLP-1 medications to children and adolescents whose brains, bones and muscles are still developing.
"We have to be very careful about using these medications in children and adolescents," Cooper said. "We have got to make sure that we are also giving these kids an opportunity to change their lifestyle in a positive way that's sustainable."
He argued that more investment should be directed toward physical education, parks and healthy community environments rather than relying primarily on pharmaceutical solutions.
The briefing also featured journalist and political strategist Jasmyne Cannick, who shared her own experience after beginning GLP-1 treatment several years ago when she was at risk of developing diabetes. She said the medication improved her health, lowered her A1C and reduced symptoms of sleep apnea, while also highlighting the financial burden after her monthly cost increased from $25 to nearly $800.
"There's a story behind everyone who takes these medicines," Cannick said. "It's not just because we all want to be skinny."
Throughout the discussion, speakers emphasized that GLP-1 medications are one tool among many. Successful treatment, they said, combines medication with nutrition, physical activity and long-term medical care while recognizing obesity as a complex disease shaped by biology, environment and access to care.
"We need to treat patients with obesity with kindness, dignity, and respect," Stanford said. "Let's not assume that everyone's just eating bad and not exercising."
