A new type of weight loss treatment targets the obesity epidemic

Injectable drugs reduce weight in obese patients by up to 20 percent, but there are caveats

Today's expression: To spare
Explore more: Lesson #556
March 20, 2023:

Obesity affects over a billion people worldwide and can lead to chronic diseases like heart attacks, stroke, and cancer. Now, a new class of drugs has been shown to reduce weight in obese patients by up to 20 percent. This is promising, but it's not the magic bullet some may be hoping for. Plus, learn the English expression "to spare."

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A treatment for obesity is on the horizon

Lesson summary

Hi there everyone, I’m Jeff, JR is the producer, and this is Plain English lesson number 556. Here at Plain English, we help you upgrade your English with lessons about current events and trending topics. You’ll get exposure to a wide variety of concepts, a wide variety of words, and you’ll even learn something besides English, too.

On today’s lesson, we’ll talk about a new treatment for obesity, which has the potential to improve the health of many, many millions of people. In the second half of the lesson, I’ll show you what it means to have something to spare.

Now as you’re listening, if you think that you’d like to engage a little more with this topic, you can do that on our special lesson home page. This is lesson 556, so PlainEnglish.com/556 has all the resource we produce for this topic. And a lot of them are free—so check that out, PlainEnglish.com/556.

New treatments for obesity

Loosely defined, obesity is a condition in which someone has excess body fat that could negatively affect the person’s health. It’s a significant risk factor for chronic diseases, like diabetes, cardiovascular disease, stroke, and over 13 types of cancer. The easy way to think about it is this: obesity itself is not a killer, but it invites other conditions that can significantly reduce the quality and length of a person’s life.

Taking the long view of humanity, you might say that obesity is a good problem to have: it’s better than starvation. Perhaps. But it’s still a big problem. Worldwide, over a billion people suffer from obesity: about 650 million adults and, worryingly, 350 million children. Of them, four million die prematurely each year.

That’s not all. Obesity causes people to miss work, lowering their own personal economic outcomes over the long run. The costs to the healthcare system are high. And this is a condition that is impossible to hide. For children, the stigma of being overweight can be unbearable and lead to a life of anxiety and poor mental health. Adults can face discrimination in the workforce for their entire careers.

Obesity used to be considered a rich-world problem, but that’s no longer true. It’s affecting low- and middle-income countries just as much, if not more than, wealthier countries. Obesity affects about forty percent of people in countries like Mexico, Iran, and South Africa. And the people in rich countries that are obese are often the ones with the lowest incomes.

This is important to understanding the problem. The traditional answer to obesity has been diet and exercise. But in many ways, these are luxuries in the modern world. People work longer hours at more sedentary jobs. Household chores that used to require manual labor are now easy with home appliances. And the most affordable food is the most processed and least healthy.

So to maintain a healthy diet, and to maintain a strict exercise regimen, requires time and money. And that’s why obesity is common among populations that don’t have time and money to spare .

Now, two treatments are coming to the market that may help with the struggle against obesity. They are called GLP-1 agonists. They do a few things. The slow the rate at which food leaves your stomach, making you feel full for longer. They affect the signals to the brain that affect hunger, helping with cravings. And they affect the way fat is processed, leading to lower weight gain from dietary fat.

Novo Nordisk, a Dutch company, and Eli Lily, an American one , are both introducing treatments for obesity. Patients in early trials have lost about 20 percent of their body fat on average. If these treatments perform in the real world like they have in trials, they have the potential to radically change one of the most prevalent health conditions in the world. A lot of drugs and treatments promise to change the world. This one could be for real.

Like many things in pharmaceuticals, or indeed science in general, these treatments were discovered almost by accident. Novo Nordisk, for example, specializes in diabetes treatment. And in trials of diabetes drugs, the company found that many people were losing weight.

Doctors started prescribing diabetes drugs off-label. That means they were prescribing a legal drug, but not for the reasons the drug was approved. Doctors were prescribing diabetes drugs to patients without diabetes—but who were obese. And the treatment worked against obesity.

Ironically, drug companies had all but given up on finding a treatment for obesity. Previous efforts were ineffective; one previous drug left some patients blind from taking it. But now the race is on to develop and market a treatment for one of the world’s most stubborn diseases.

If these treatments continue to show promise , it could be a huge net positive for the world. But it’s not the silver bullet you may be thinking.

First, it’s not as easy as popping a pill and eating with abandon. In fact, the treatments are not pills at all, but injections. So they are not easy or convenient to take. Second, patients that go off these treatments tend to put on all their lost weight again. So many people who go on this drug for obesity might need to take it for the long run—even for life. In this way, it’s similar to statins, drugs that lower cholesterol.

Here’s another consideration. You can easily imagine a dystopian world in which rail-thin influencers on social media encourage their followers to take this drug to get skinny like them. Actually, you don’t have to imagine this world: these treatments are already being called the “skinny pen” on TikTok. This is not a welcome development in a social media world that already pushes girls toward eating disorders .

Cost is also an issue. These treatments cost about $1,000 per month in America. With time, that should come down, especially if governments and insurance companies can negotiate lower prices in exchange for broad coverage. But while the sticker price is high, obesity’s cost to the world is even higher.

How are drugs named?

The name of the Eli Lily drug is “Mounjaro.” And as I was reading about this topic, I went down a rabbit hole. That means, I got distracted researching something deeper and deeper. The rabbit hole I went down was, How do drugs get these names? Who comes up with them?

And it’s surprising—so, I’m going to invite you down that rabbit hole with me on Thursday. I’ll tell you what I learned. How do prescription drugs get their names? It’s more interesting than you might think.

That’s coming up on Thursday. But now we have an English expression.

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Expression: To spare