GLP-1 Drugs Should Not Distract From Food Environment

Laura Schmidt, PhD, of the University of California San Francisco, warns that the growing focus on GLP-1 receptor agonists for obesity treatment may divert attention from the root causes of the epidemic. In a perspective published in Science and discussed in a MedPage Today interview, Schmidt and co-author Luc Hagenaars, PhD, of Amsterdam University Medical Center, contend that treating obesity as a purely medical issue overlooks the role of the food environment in driving the condition.

They argue that defining obesity as a condition requiring medication shifts focus away from systemic factors such as the widespread availability and marketing of ultraprocessed foods. Schmidt notes that clinical trials have shown ultraprocessed foods lead to increased calorie intake and overeating compared to unprocessed diets, reinforcing their role as a key driver of obesity.

Prior research conducted by Schmidt and Hagenaars at Amsterdam University Medical Center identified the belief in individual responsibility as the biggest barrier to solving the obesity epidemic. This mindset, they say, undermines efforts to address environmental and commercial influences on eating behavior.

While acknowledging the effectiveness of GLP-1 drugs for individuals with existing cardiometabolic disease, Schmidt stresses that treatment and prevention can coexist. She supports the World Health Organization’s call for equitable distribution of these medications alongside preventive measures.

Schmidt advocates for policies modeled on tobacco regulation, including restrictions on marketing, warning labels, taxation, and school-based interventions to limit children’s exposure to ultraprocessed foods. She points out that such approaches have proven effective in reducing tobacco use and could similarly impact consumption of harmful food products.

She expresses concern that pharmaceutical, food, and supplement companies are prioritizing profit by directing GLP-1 drugs toward high-income populations, potentially worsening health disparities. Without guardrails, she warns, the 'Ozempic era' could repeat past patterns where medical solutions are deployed inequitably.

The World Health Organization, Schmidt says, has long been a leader in chronic disease prevention through regulatory reform and is now advocating for a dual approach: treating those already affected while preventing new cases through environmental change.

Schmidt maintains that medications like GLP-1s have a place in obesity care but must be part of a broader strategy that includes regulating the food environment to address the epidemic at its source.