In a World of Addictive Foods, We Need New Weight-Loss Drugs

Opinion|In a World of Addictive Foods, We Need GLP-1s

Throughout my life I’ve been fat, thin and various sizes in between. Since I was a kid I’ve gained and lost weight repeatedly, putting on 20 pounds, taking it off, putting on 30 pounds and then losing it again. It has been a cycle of despair.

The fact that I’m a doctor, a former dean of two medical schools and ran the Food and Drug Administration for six and a half years was of no help to me. Like millions of others, I was caught between what the food industry has done to make the American diet unhealthy and addictive and what my metabolism could accommodate.

We may now be at the brink of reclaiming our health. New and highly effective anti-obesity medications known as GLP-1s have revolutionized our understanding of weight loss, and of obesity itself. These drugs alone are not a panacea for the obesity crisis that has engulfed the nation, and we should not mistake them for one. But their effectiveness underscores the fact that being overweight or obese was never the result of a lack of willpower.

It is the result of biology instead, and that is why these drugs work. They help people feel full after eating and reduce the cravings that are central to our addiction to the irresistible, highly processed, highly palatable foods that have glutted our shelves over the last five decades. For many of us, our biology makes the pull of these ultraformulated foods nearly impossible to resist.

These foods typically are called ultraprocessed, but I refer to them as ultraformulated because they have been engineered to manipulate the brain’s reward system. These foods have become the new cigarette, and similarly, have resulted in a health catastrophe.

Forty percent of American adults are now obese. These foods have contributed to a rise in diseases characterized by visceral fat, or what I call toxic fat — fat that accumulates within our abdomens and surrounds the liver, heart and pancreas. These chronic illnesses include cardiovascular disease, stroke, diabetes, cancer and likely some forms of dementia. Visceral fat and obesity more generally are among the reasons that Americans have an average life expectancy that is four years shorter than that of people in other large, industrialized countries.