Weighing the Ethics of Losing Pounds: Weight Loss and the GLP-1 Agonist Medications

Abstract: GLP-1 agonists used for weight loss such as semaglutide (Ozempic®, Wegovy®) and tirzepatide (Mounjaro®) have been some of the hottest drugs on the market recently. Their promise of dramatic weight loss without the need for significant changes in diet and exercise make them an attractive solution for the obesity-related health concerns for Americans. The demand for these drugs has increased so dramatically that manufacturers are unable to maintain production, leaving diabetes patients without treatment. Compounding pharmacies have entered the market to fill the gap, but some have been cited by the FDA for supplying products that do not meet standards. Insurance payers struggle to decide whether the cost of the drug should be covered while some underinsured patients may not have access at all. Direct-to-consumer advertising of clinics and online suppliers without careful medical oversight has become common. Risks with long-term use are still unknown and patients who have not made significant lifestyle changes during treatment face the possibility of being on the medication for a lifetime. This presentation will balance the beneficence of what has been found to be true improvements in cardiovascular and other health risks with the ethical tensions that can occur when the weight-loss medication supply chain struggles with cost and supply issues, attention to medical oversight and disclosure of risk can be overlooked in favor of profitability from increasing the number of patient visits, and inclusion of adequate support for lifestyle change is not part of the weight loss treatment plan.