We've created a generation of Ozempic users by ignoring America's obesity epidemic

Despite our unmatched spending on health care, we Americans are not all that healthy.

Our chronic disease burden is staggering, and life expectancy slides backward for the first time in generations. We’re burning $4.5 trillion a year – more than $13,000 per citizen – on reactionary medical services, and the results of that investment are nowhere to be seen, according to the Centers for Medicare & Medicaid Services.

For population health, our systems intervene just as they do with individuals: not early enough to prevent, but only after the billable dysfunction of a diagnostic code can be added.

The burgeoning off-label use of diabetes drugs like Wegovy (semaglutide) for weight loss has begun a slippery slope of accelerated demand and evolving public perception. Whether it makes sense to consider obesity a disease is moot – it dictates risk of heart disease, stroke, cancers.

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If passive framing of disease risk can undercut a person’s sense of control, a greater danger arises when we adopt passivity as policy rather than meet problems at their source.

Obesity in America is a symptom of systemic failure

A drug that treats chronic illness after it has advanced can be justified as part of a comprehensive solution to a multifaceted problem – we don’t start fresh with the next generation and leave behind those who suffer today.

But what about obesity’s root cause?

Our food supply is comprised mostly of corn products, mashed into different flavors and shapes. Is the factory-agriculture model something that we are prepared to change? Why do chronic diseases like diabetes and obesity disproportionately impact minority groups?

It is well-documented that processed foods and drinks saturated with corn syrup are consumed more often in areas where household income is, on average, lower. The phenomenon of urban food deserts – inadequate access to nutritious produce and other healthy foods within our most densely populated areas – is a known shortcoming of America’s cities. Access to fresh fruits and vegetables is constrained, but meat-product patties between sugary buns are omnipresent.

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How can we justify failure to address systemic inequity but at the same time advocate for insurers (meaning, ultimately, taxpayers) to pay for drugs that treat already-advanced obesity?

The original epidemiologist discovered that cholera was spread through water pumped from a contaminated well in London. He didn’t advocate for medicine to treat the bacteria his community was ingesting. He took the handle off the Broad Street pump, and the problem was solved.

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Michelle Obama's 'Let's Move' addressed the issue, but faced pushback

Climate aside, our worst domestic failure must be this: 19.7% of children ages 2-19 are considered obese. Former first lady Michelle Obama named children’s access to healthy meals her signature policy, but out of the black box called lobbying emerged the idea that responsibility to companies that essentially sell fast food to our elementary schools outweighs ethical responsibility for the health of our nation’s children – our future adults.

Are we willing to say out loud that what we’re doing is raising a generation of Ozempic consumers?

We set up each generation to become the least healthy adults yet. We undermine the commitment of our health care workers by failing to address the real determinants of lifelong health. Political pursuit of the factors associated with wellness – real food, housing, cities designed to incorporate movement and recreation – is absent.

If the goal of American policy is to improve population health, then spending money on drugs to treat obesity without also addressing the problem’s root cause seems more than a little self-defeating. If policymakers aim to inflate pharmaceutical spending, then today’s approach is demonstrably effective.

Systems, after all, get the results they’re designed to get – and ours is not designed to prioritize health.

John Corsino is a physical therapist with a degree in health care administration. This column first published in the Tennessean.

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This article originally appeared on Nashville Tennessean: US obesity increase is creating an Ozempic reliant generation