Skip to content
Search

Latest Stories

Top Stories

How the government can solve America's obesity epidemic

How the government can solve America's obesity epidemic
Getty Images

Pearl is a clinical professor of plastic surgery at the Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business. He is a former CEO of The Permanente Medical Group.

Dying younger. Living harder. Going broke. It is difficult to overstate the longitudinal effects of excess weight in America.


An estimated seven in ten Americans are overweight or obese. The combination, according to the National Institutes of Health, results in an estimated 300,000 preventable deaths per year with extreme obesity lowering life expectancy by 14 years on average.

Added weight not only makes everyday life more difficult, but it also produces serious health consequences that include cardiovascular disease, diabetes, musculoskeletal disorders and cancer. In total, obesity costs an estimated $260 billion annually in inpatient and outpatient care.

Whether weight gain is caused primarily by genetics, societal influences or individual will, scientists aren’t altogether sure. What’s clear, however, is that most efforts to lose weight ultimately fail.

New Hope In Diabetes Drugs

Ozempic, one of a new class of medications, has been shown in studies to spur significant weight loss. The others include Mounjaro, Rybelsus and Wegovy with several new (and convenient, pill-based) options in development.

A Heavy Price For Weight Loss

Last year, more than five million Americans were prescribed one of these drugs for weight reduction.

The annual price of treatment ranges from $12,000 (Mounjaro) to upwards of $16,000 per year (Wegovy). As a result, most users are either wealthy or have generous health-insurance coverage.

But as more Americans seek these medications for moderate weight loss, not diabetes, insurers have started clamping down. They’ve issued threatening letters to doctors, warning they’ll be referred to state regulatory boards for writing “off-label” prescriptions.

The Ozempic Paradox: Highly Effective But Unaffordable

Ozempic and other medications that help with weight loss are part of an ongoing national debate in which two competing truths collide.

The first truth is that these drugs work, leading to significant and sustained weight reduction: 14 to 25 pounds per individual on average during the medication course. And while they’re not a replacement for proper nutrition, exercise or healthier living, they do reduce the likelihood of heart attack, stroke and cancer.

Second, despite the medical opportunity at hand, making these drugs available to all 100 million obese American adults would prove cost prohibitive for businesses, private insurers and the government.

This means that the medications could drastically rollback the nation’s $260 billion in obesity-related medical expenses each year, but prescribing them at today’s prices would cost more than $1.5 trillion annually—increasing national healthcare expenditures by as much as 25 percent.

What’s more, these medications are considered “forever drugs,” requiring users to either maintain their dosage or regain most of the weight they lost.

Insurers are eager to draw a line between those seeking prescriptions for appearance’s sake and those at heightened risk of disease or death. They’re happy to cover the latter but, as with cosmetic surgery, insurers believe patients should foot the bill for the former.

Lost in this debate is an important question: Why not figure out how to make these lifesaving drugs broadly available and affordable?

The U.S. Government Can Lead The Way

With hundreds of thousands of obesity-related deaths each year, the magnitude of the problem qualifies as an “epidemic” and justifies forceful government intervention.

The current administration, with congressional approval, could initiate a nationwide campaign to fight obesity, similar to Operation Warp Speed. The program, with a $10 billion upfront investment, led to the speedy development of a safe and effective coronavirus vaccine. The government then was able to purchase more than one billion doses at one-third the cost of the vaccine’s current list price.

Here’s how the administration could replicate Operation Warp Speed to fight the obesity epidemic without breaking the bank.

Operation: Slim Provisions

The government would invest $4 billion up front— twice the average R&D cost to bring a new drug to market.

In return for funding and a ten year contract, the first drugmaker to develop a safe and effective weight-loss drug would be required to sell that medication back to the government at $40 per dose (or $2,000 per patient/year), significantly below the retail price of Ozempic and similar drugs. The winning pharma company would benefit financially, earning up to $1.2 trillion in sales over the contract’s lifetime without having to shoulder R&D costs.

With the new medication in hand, government-sponsored health programs, Medicaid and Medicare, would make it available to all obese enrollees (roughly 60 million people) for the next decade.

And by providing the drug to more than half of all obese adults, the government would reduce medical expenses by up to $130 billion annually or $1.3 trillion over 10 years, making the effort cost-neutral for American taxpayers.

Risks vs. Rewards

The only financial risk to the government (outside of defending likely lawsuits) would be failing in its search for a new drug, thus wasting the

$4 billion of taxpayer money. But that’s a relatively insignificant sum compared to the potential healthcare benefits.

The role of government is to protect the health and financial well-being of the nation. Fulfilling that function led to a lifesaving Covid-19 vaccine. Doing so again is the best option our nation has to address America’s growing obesity epidemic.

Read More

True Confessions of an AI Flip Flopper
Ai technology, Artificial Intelligence. man using technology smart robot AI, artificial intelligence by enter command prompt for generates something, Futuristic technology transformation.
Getty Images - stock photo

True Confessions of an AI Flip Flopper

A few years ago, I would have agreed with the argument that the most important AI regulatory issue is mitigating the low probability of catastrophic risks. Today, I’d think nearly the opposite. My primary concern is that we will fail to realize the already feasible and significant benefits of AI. What changed and why do I think my own evolution matters?

Discussion of my personal path from a more “safety” oriented perspective to one that some would label as an “accelerationist” view isn’t important because I, Kevin Frazier, have altered my views. The point of walking through my pivot is instead valuable because it may help those unsure of how to think about these critical issues navigate a complex and, increasingly, heated debate. By sharing my own change in thought, I hope others will feel welcomed to do two things: first, reject unproductive, static labels that are misaligned with a dynamic technology; and, second, adjust their own views in light of the wide variety of shifting variables at play when it comes to AI regulation. More generally, I believe that calling myself out for a so-called “flip-flop” may give others more leeway to do so without feeling like they’ve committed some wrong.

Keep ReadingShow less
Support for International Students’ Mental Health Fails As Federal Visa Revocations Rise

holding hands

Support for International Students’ Mental Health Fails As Federal Visa Revocations Rise

The University of Washington’s international student population is raising concerns about the lack of mental health support provided to them by International Student Services, particularly in the context of visa revocations.

“I've personally sacrificed so much to get to UW,” first-year Kaira Wullur said. “I know my parents have also sacrificed so much. It is super draining to think that what I've been working towards could be stripped away from people who don't even know who I am.”

Keep ReadingShow less
Strengthening Elections, Rights, and Citizen Engagement

Strengthening Elections, Rights, and Citizen Engagement

Strengthening Elections, Rights, and Citizen Engagement

Welcome to the latest edition of The Expand Democracy 5. From Rob Richie, with Eveline Dowling and Juniper Shelley’s assistance, we highlight timely links and stories about democracy at the local, national, and global levels. Today's stories include:

🔁 The primary problem is a lack of general election competition

Keep ReadingShow less