Opinion: Weight-loss drugs are great, but real food still matters

Groundbreaking weight-loss drugs like Ozempic and Wegovy have understandably generated a lot of excitement, bringing hope to the hundreds of millions of people grappling with obesity. When combined with a healthier diet and exercise, these drugs, which suppress appetite, deliver an average 10% reduction in body weight that can be sustained for years.

With more than two-thirds of adults in the United Kingdom and nearly three-quarters in the United States classified as overweight or obese — a health crisis that costs national economies billions of dollars annually — physicians and policymakers could be forgiven for embracing these drugs as a panacea. President Biden’s administration, for example, recently proposed requiring Medicare and Medicaid to cover the costs of weight-loss drugs, which would expand access for millions of Americans. But addressing obesity requires much more than a technological fix.

We ultimately also must address the root cause of the global obesity crisis: our broken food system.

The alarming rise in obesity over the past 30 years is not simply a byproduct of higher living standards or more sedentary lifestyles. The primary factor appears to be the transformation of our food environment, which has fundamentally altered both the types of food we consume and our eating habits.

In recent years, scientists and health experts have increasingly focused on foods high in fat, sugar and/or salt, which drive unhealthy dietary habits. Companies have reshaped the food system to produce ultraprocessed, hyperpalatable and highly profitable foods, leading people to snack more, eat larger portions and prepare fewer meals themselves. In the U.K., for example, the snack market has boomed while the time spent preparing meals has sharply declined.

These changes haven’t just fueled the rapid increase in consumption of salty, fatty, sweet foods. They have also led to a surge in meat consumption, especially in Europe and North America, where meat-heavy diets have become common.

Beyond the heightened risk of heart disease and related health conditions, excessive meat consumption has had devastating effects on the climate and biodiversity. Research shows that animal-based foods generate twice the greenhouse gas emissions of plant-based alternatives. Just as health experts urge us to reduce our intake of salt, fat and sugar, climate scientists consistently emphasize the importance of curbing meat and dairy consumption to keep global warming within safe limits.

In an effort to prevent a lasting change in people’s eating habits, the meat industry is seeking technological fixes to cut greenhouse emissions. For example, funding for research on cutting farm emissions — such as feed additives designed to reduce methane levels in cows’ burps — has increased markedly.

Such solutions are particularly attractive to governments reluctant to introduce measures that influence consumer behavior. Fearful of opposition from the Big Food lobby and wary of accusations of overreach, policies like sugar taxes or meat taxes are deemed political hot potatoes to be avoided at all costs.

But the overlapping crises our broken food system is fueling — from the billions of dollars spent each year on diet-related health problems to the environmental degradation pushing our planet to its limits — cannot be wished away or fixed with technological tweaks. Instead, what is needed is a major shift in dietary habits toward foods that nourish both people and the environment.

To this end, the Eat-Lancet Commission — comprising the world’s leading nutrition and sustainability experts — advocates consuming a diet rich in fresh fruits and vegetables, whole grains and plant-based proteins while reducing consumption of animal proteins, dairy and sugars. Taken together, these recommendations offer a clear blueprint for ensuring health and sustainability.

It is unrealistic to expect consumers — conditioned by food environments designed for profit rather than human or environmental health — to drive this transition on their own. With unhealthy foods widely available and aggressively marketed, many consumers struggle to moderate their food intake, and in some cases they even develop addictive behaviors.

Governments and food manufacturers must take proactive measures to reshape these environments, such as expanding the agendas of campaigns planned to take aim at reducing the consumption of salt, fat and sugar to also take aim at meat, thereby encouraging people to eat more plant-based whole foods and meat alternatives.

Another potential solution would be to extend some nations’ bans on promotions for unhealthy foods to cover meat products. Requiring food companies to report on the types of food they sell, including salty, fatty and sweet foods and the ratio of plant-based to animal proteins, would also help. These measures would encourage businesses to prioritize healthier, more sustainable options over less nutritious ones.

None of this is to suggest that the new generation of weight-loss drugs cannot benefit individuals living with obesity. For those trapped in a cycle of poor health, treatments such as Ozempic and Wegovy could even save lives, and efforts to make these treatments widely available are a welcome step.

But it is essential that we recognize that this approach merely interrupts one mechanism of obesity rather than eliminating the underlying pathology. Defusing the time bombs of ill health and environmental catastrophe requires fast, decisive action to remake our dysfunctional food system.

Emily Armistead is interim executive director of Madre Brava, a research and advocacy group.