As the New Year Begins, a Weighty Quandary Looms
The naming of RFK Jr. to head US health agencies has stirred questions about his anti-vaccine past. But his first firestorm may come from how he handles the popular, but pricey, new weight-loss drugs.
Vaccines aren’t the only big health question facing Americans in 2025. The nation’s obesity epidemic, and its link to a variety of other dangerous ailments, runs a close second.
About 42% of U.S. adults were considered obese between 2017 and 2020, according to the latest U.S. data available. If you do the math, that’s roughly 100 million people, and it’s a 31% rise over the previous three-year figure.
Now, though, a new class of drugs is coming to the rescue, showing the ability to help people lose 10% to 15% of their weight on average, with few side affects. Sounds good, right? But Robert F. Kennedy Jr., the nominee to lead our nation’s health agencies, has described the growing use of these popular drugs as detrimental.
"They're counting on selling it to Americans because we are so stupid and so addicted to drugs," Kennedy said when asked about his thoughts on the medication in October by Fox News's Greg Gutfeld. He said the U.S. could solve the obesity crisis in America “overnight” if they just had access to and ate better quality food.
Of course, when Kennedy says “we are so stupid,” he’s smirkingly referring to the rest of us. He’s always profiled himself as the smartest guy in any room he’s in, lecturing the rest of us how to live our lives, even when his own life has been such a mess. Meanwhile, Trump and his guys so love using the “overnight” and “on Day One” type of phrasing, don’t they?
Sure, Kennedy’s solution might be fine in a vacuum, we definitely should eat better quality food. But do you see our food habits changing in the real world, even over many years?
Will folks with busy work and home schedules suddenly lose their taste for the energy boost of sweets, or abandon easy-to-cook processed food during a filled-to-the-brim weekday. In almost half of U.S. marriages, both the husband and wife work, and I’d bet a high number in this group are often worn out by the time they get home. Saturdays, filled with with the kids’ social activities and shopping , will no longer include that stop at McDonald’s or Wendy’s for a quick hit family lunch?
At the same time, will the Big Food industry stop enticing us with this stuff just because Kennedy says so? Sweet treats and processed food produce gazillions in profit for the food industry. When his boss-to-be, Donald Trump, was recently asked about lowering grocery costs, the best he could come up with is that it’d be “very hard” to do that.
The Cost of Thin
Obesity is linked to a wide variety of health problems, from diabetes, sleep apnea and heart disease to joint problems, alcoholism and even cancer.
But those of us hoping to thin down to avoid these ailments are already facing a pretty big issue involving the new GLP-1 class of drugs: Their price.
There’s no way most working-class Americans, and those of us who are retired, can afford costs that run between $1,100 to $1,300 a month for the name-brand drugs in this new class. These drugs must be injected weekly to lose the weight, and injected continuously over time to keep it off. Meanwhile, Medicare and most insurers have so far refused to cover them.
For a while, there was a good, working solution.
When Eli Lilly & Co. first started selling Zepbound, the company couldn’t make enough of the drug quickly enough to keep up with the rush of people wanting it. In response, the Food and Drug Administration, under an existing law, allowed compounding pharmacies to produce generic copies that they sold online for less than a quarter of the name-brand’s cost.
Because these pharmacies didn’t have to pay to develop the drugs, they could lower the price to rope in buyers and still make a tidy profit. Meanwhile, you have to carefully research which of the many online pharmacies online are legit. If you’re like me, and have friends and relatives taking these generic drugs, you have a head start on this.
No Longer a Shortage
Now, though, the situation may be changing. Lilly has geared up its production of Zepbound and it looks as if the option to buy cheaper copies may soon end.
The FDA on Dec. 20 formally declared that, under the existing law, compounding pharmacies must stop offering these copies within 90 days, though certain amounts are permissible as long as the compounding is not done “regularly or in inordinate amounts.”
My guess is that millions of Americans are using the compounding pharmacies (along with me), given the number of websites and social media offerings I’ve seen. If so, that would likely be considered an “inordinate” amount, right?
Still, compounding facilities are continuing to advertise online and when I called the one I use, their rote response was that they’re “not anticipating problems.” That may be them whistling past the graveyard, but we’ll see.
Sleep Apnea at Issue
Let’s look at how all this may affect one slice of America, the 6 million people who have been diagnosed with sleep apnea, a disorder that occurs in roughly 20% of people who are obese and about 3% of normal-weight individuals.
People with sleep apnea literally stop breathing from a few times per night in mild cases, to more than 100 times per hour in severe cases. When their brain finally detects a drop in oxygen levels, it reacts by sending messages to their body to reopen airways and allow breathing to resume, usually accompanied by a gasp or a snort.
The disorder can lead to high blood pressure, stroke, heart attack, congestive heart failure, dementia and difficulty controlling blood sugar, according to miles and miles of research. If you add those risks to the perils associated with obesity, you’ve got quite the deadly duo.
But sleep apnea patients last month received a one-two punch to the gut: The FDA approved Zepbound as a treatment for sleep apnea, but the approval came a day after it ruled compounding pharmacies should stop producing and selling copies because there was no longer a shortage of the pricier name-brand drug.
The ruling left those already taking a compounded version in limbo, and it promised to keep the drug from helping many sleep apnea patients who can’t afford the brand-name’s higher cost.
I have to say I have a personal interest in all this, as you probably already suspected. I’ve been diagnosed with obstructive sleep apnea and fit the medical definition for obesity. I’ve struggled with my weight for years, as have members of my extended family back through many years, which is why I recently turned to the compounded weight-loss drugs for help.
They’ve indeed helped, but now I’m not sure what the future may hold since the drugs are helpful only as long as you keep taking them. And as a retiree living on savings, social security and my good looks, I can hardly afford the high prices.
Washington Movement
Joe Biden recently urged Medicare to cover the drugs, but he’ll be out the door within days. There may be some light on this from the Trump administration, but their agenda right now is so all-over-the-lot confusing on everything that there’s no real way to know what will happen with them.
Elon Musk — Trump’s shadow president -- has publicly admitted he’s taking the brand-name version of one of these new drugs, so you know he’s aware how effective they are and how important they may be to individual Americans. But with Trump’s blessing, he’s also taken upon himself the task of cutting trillions of dollars from government spending.
You think Musk, the world’s richest man, will want Medicare and Medicaid to shell out for these expensive drugs while he’s seeking to pull back every cent the government spends? After all, he can certainly afford them and, in the past, he’s not exactly been a champion for the “little people,” the 99.9% of Americans who aren’t billionaires.
There are certainly legitimate questions about the cost of these drugs for Medicare in the short term, and even how their more widespread use may affect the economy, with consumers spending less on food and alcohol and private insurers, buckling under the costs, boosting the cost of their coverage.
But the long-term savings could be extraordinary, given the dozens of dangerous ailments linked to obesity.
Beyond Elon Musk, there are others within MAGA land who may be helpful on the issue. For instance, Trump's pick to lead the Centers for Medicare and Medicaid Service, Mehmet Oz -- who is actually a doctor, unlike Kennedy -- has expressed support for the drugs.
"I think the amount of good done by these medications by helping people lose weight and improve their cardiovascular system — and it might have long-term benefits in a lot of other areas as well, where obesity causes inflammation — is massive," Oz said last year in a video posted to his Instagram account.
Meanwhile, Kennedy himself, who would be Oz's boss if they’re both approved by the Senate, appeared to scale back his criticism of the new drugs amid his efforts to court support for his nomination from members of Congress.
“The first line of response should be lifestyle. It should be eating well, making sure that you don't get obese," Kennedy said during a quick interview with CNBC on the floor of the New York Stock Exchange, before adding that anti-obesity drugs “have a place” in the American medical community.
Of course, that statement — so carefully hedged — doesn’t address the 100 million Americans already obese and, anyway, do you trust what this guy says in his push to attain this powerful position? Consider his past, along with the model created by Trump’s nominees during Trump’s last time in office.
A long-time anti-vaccine crusader, Kennedy recently said he “won’t take away anybody’s vaccines.” But there are many ways to undercut their use, adding danger to all of our lives. At the same time, you might recall that Trump’s nominees for the U.S. Supreme Court during his first administration all suggested before their approvals that they would uphold precedents set by past high courts.
Then they all voted to eliminate the precedent set on abortion by Roe vs. Wade.
We’ll see what happens with Kennedy. The odds right now are that his nomination will be approved by a MAGA-led U.S. Senate scared to death of Trump’s ability to line up challengers against them in the next election. So far, the best we can get from Kennedy is that he won’t eliminate vaccines and the new class of weight-loss drugs “have a place” in the health-care picture.
I know where that “place” should be: My house, and the houses of millions of other Americans that can benefit from their use at a much reduced price. What do you think?