Obesity in the U.S. Is Finally Declining. You Can (Probably) Thank Ozempic.
The medication shouldn't be this controversial.

If you're searching for stereotypes about Americans, you have a robust buffet to choose from. But the biggest, or one of the biggest, is that we are really, really fat.
It appears, however, that we are finally getting less fat. Between 2020 and 2023, obesity rates in the U.S. fell by about two percentage points—no small feat when considering the quick and relentless climb in prior decades.
We don't have enough information yet to say beyond a shadow of a doubt what the root of the turnaround is. But the signs point pretty strongly in one direction: drugs that assist with weight loss. Yes, the much-maligned Ozempic and related semaglutide medications, which induce satiety and have helped some conquer chronic obesity.
There are a few reasons to believe the connection here is solid. For starters, semaglutide prescriptions exploded within the period of declining obesity, spiking from 471,876 prescription fills in January 2021 to 2,555,308 in 2023. And as John Burn-Murdoch points out in The Financial Times, the receding obesity rates are seen more prominently among college graduates, who are more likely to use the drugs.
This is—objectively—a positive thing. It should mostly go without saying that chronic obesity is a crippling health issue that increases your chances of having a slew of adverse health complications: heightened risk of heart disease, type 2 diabetes, liver issues, gallbladder disease, joint issues, some cancers, sleep apnea, and on. It also makes a person's day-to-day more difficult in simple ways some might not consider. It's harder to move, harder to travel, harder to feel good about yourself.
And yet despite promising results, the use of semaglutide interventions for weight loss has been fraught with moral panic and controversy. There were the initial Ozempic shortages—a legitimate problem for type 2 diabetes patients, for whom the drug was originally developed. Those shortages have thankfully abated. The controversy has not.
That's because the real root of the skepticism and criticism, it seems, is that Ozempic is the easy way out of a problem that can be solved naturally with diet and exercise. Which, in an ideal world, sure. But losing weight can be a Herculean battle for some people. If the choices are between more people staying overweight or more people losing weight, the answer should be obvious. (And yes, people may experience some side effects, although I'd argue they likely pale in comparison to the side effects of being obese.)
"Americans are fat and getting fatter," wrote Reason's Ron Bailey in a March 2023 piece about obesity and the hope such weight loss drugs provide. A year and a half later, Americans are still fat, and Ozempic et al. are still amazing interventions for helping people get healthier.
But, as of right now, we're not getting fatter.
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There are lots of problems that could be solved with willpower, but are better solved with science. We could wash our clothes by hand if we had more willpower, but we invented washing machines instead. We could only have sex when we are ready to have kids, but we invented contraception instead. Sometimes science is just better than willpower.
Sometimes science is just better than willpower.
That's why I trust it... and trust scientists to effectively geoengineer the planet to fix the weather.
100% safe and effective with no downsides!
Wouldn't people regulating their digestive systems and eating fewer cows reduce methane emissions? Could Ozempic save us from a fiery death (doing the math) last year? I'm waiting for Bailey to weigh in. Whatever Vance says will be wrong.
More testing needed!
Handwashing clothes takes effort. Selecting something healthier than the Standard American Diet takes much less than that. Portion control (eating less of the same) takes negative effort.
Science also brought us food scientists to figure out the magic to making certain unhealthy foods addictive, for lack of a better word. And Science made certain unhealthy food (substitutes) more economically available such as high fructose corn syrup.
Yeah. Lots and lots and lots of people like to play retard and conflate the *effort* of carrying 50 lbs. to the nearest water source and back with the "effort" of choosing not to shovel an extra 50 lbs. of food in their face.
I’m surprised no one has mentioned the 500 lb, open borders pedophile in the room yet.
Or the higher mortality/lower life expectancy... or people were finally allowed to leave their houses.
The average person put on 20 lbs during the pandemic and has subsequently lost 10lbs of the recent weight gain. Obesity problem solved?
That and obesity being one of the high risk factors for COVID mortality. Easy to bring down the % when you launch a disease that kills fat people disproportionally.
I had the same thought. Kill off just 5% of the fattest of the fatties and the rate comes way down.
It's a COVID miracle. There is nothing it can't do.
Some of those gluttonous fatty pieces of obese shit demanded that others mask and even vax because their gluttony put them in a higher risk category.
I put on zero pounds during the Covid scam. I'm essential. Bitches.
This issue weighs heavily on one collectivist, MAPedo commenter.
Perhaps he can tip the scales on this discussion.
Not sure he could stomach a conversation about self control.
It doesn’t help that he constantly gorges on neo Marxist propaganda.
Such a waist.
How much did Jeff pay you to write this Billy?
What is the obese rebound weight after going off the drugs?
Depends on the individual.
I used Ozempic for glucose control, and lost 10% of my body weight as a 'side effect'; more importantly, my blood sugar was cut in half in eight months.
It is now 18 months since I stopped Ozempic, and I have added back 70% of the lost weight, but the blood sugar increase is less than 10%.
All in all, an effective glucose control drug.
(other health factors inhibit strenuous exercise)
My very progressive neighbor (tm) had to stop Ozempic after it cut his body weight from about 370 to just a hair over 150, in about 15 months. Then he needed major surgery to take in the skin bag. It was (is?) pretty gross.
Yikes. Thats very unusual….. and unhealthy.
To be fair, 370 was probably more unhealthy than the sudden weight drop.
Not necessarily in the short term. Although factors such as age, cardiological health, etc. play a big role. I’m a big guy (I’m lean at 240 lbs, if I’m weight training) and I have difficulty lowing more than about 8-9 lbs. per month of excess fat, after shedding any excess water retention. A sustained average of nearly 15 lbs. per month for a smaller man is excessive.
Jeff can barely remember a time when he was only 370.
Does Medicaid pay for skin bag removal? Asking for a frequent commenter here.
Turns out the VA does.
As if Pedo Jeffy ever served.
Skin sag after weight loss is a sign that the person didn't get into autophagy. Autophagy (mostly) requires fasting at some level. Not so much about calorie restriction or the body burning fat for energy but about the body recycling proteins.
Coincidentally his name is . . .
Seems like most study puts weight regain back at 50-75%.
Combine that with muscle loss during treatments for the majority it doesn't seem like a huge boost.
https://www.everydayhealth.com/weight/is-it-possible-to-maintain-weight-loss-after-ozempic-and-similar-drugs/
Add “ozempic face” into the mix.
I’ll pass.
JD Vance is wrong about ozempic face
What I’m not clear on, given that Ozempic forces severe calorie restriction, how does weight training work? Is it possible to eat enough protein to gain muscle, or even just maintain existing muscle mass?
They apparently tell patients to focus on light exercise if any at all, why many report muscle loss.
I wonder if there’s a dosing solution for people who are more active?
If they were more active, they likely would not have been 300-pound pieces of fat ass crap.
Those fatties are bad people who deserve to be fat. Not like the manly Chads here who maintain their Olympian physiques through pure willpower. Nobody should ever be allowed any help with anything. Medication is for pussies. Diabetics should eschew insulin and just willpower their pancreas back into shape. Chemotherapy is for weaklings who can't use the power of the mind to fight off cancer.
You should all be proud that you are fundamentally better people than the overweight.
Being fat is not like having cancer. Geez.
I got a bit pudgy for a few years, and I reined it in by eating out less, cooking at home, and moderating my drinking, coupled with more physical activity. But what works for me may not be for everyone.
Generally speaking, though, if you're overweight, you have an imbalance in calories in / calories out. That's why Michael Phelps could have an 8k/day calorie diet and I try to keep it in the 2k range.
The fatties are fatties because they do fatties things.
I recall driving with a fatty and they saw two fit people jogging. They asked, “Why are they jogging? They are already in shape.”
Next time you are at the grocery store, get in line behind a fatty and see all the shit they buy. Then do the same the next time with fit, healthy looking people. It will be dissimilar. Not matter how wrong JD Vance is about it.
Is this one of the MUH THYROID complaints that come up whenever the empirical data on obesity rates and their attendant health costs is noted?
I’m talking about people trying to lose weight that want to build muscle too.
'Ozempic Face' is a real thing:
https://twitter.com/nypost/status/1781322384248574356
Seems like most study puts weight regain back at 50-75%.
That's almost certainly at 1-2 yrs. out, which is virtually identical to the studies that show that "Diets don't work." demonstrating that 5-10 yrs. out people have regained all the weight and then some.
And, again, none of this is magic. If you shove 5 lbs. of food in your face and gain 5 lbs., shoveling 2 lbs. in your face and only gaining 2 lbs. isn't some miracle. Whether you inject yourself with neurotransmitters or not. And if you go back to shoveling 5 lbs. of food in your face, with or without exogenous neurotransmitters, you should *expect* to return to gaining 5 lbs... because it's not the neurotransmitters, it's that you stopped shoveling 5 lbs. in your face.
Does the 1 year gap of being obese actually lead into reduced medical costs?
Especially given the known side effects.
What you eat is even more important than how much you eat, except at extremes. A big part of the puzzle is diet content, not just gross calorie intake.
First, I said lbs. or weight, indicating mass. It doesn't matter what you eat, if you eat 5 lbs. of it, you will gain 5 lbs. even if you shed it later, or not. You can't shovel in 500g and gain 2kg.
Second, this is like saying the width of a rectangle is even more important than the height in defining its area.
Third, nobody brags about how many fewer calories they consume on Ozempic or how many extra calories they've stopped storing or even, really, how many calories they burn during workout.
It does matter. I can eat far more calories if I don’t combine carbs and fat than if I do. Macros matter. And this isn’t even getting into protein intake.
Goddamn, that’s a lot. Like a scarily unhealthy amount in that time frame.
What is the obese rebound weight after going off the drugs?
Identical to if you just stopped eating the calories and then started again.
Same as if you only filled your car up halfway with gas for a couple years and noticed it was, on average, several pounds lighter and then, when you go back to filling it all the way up, notice it’s averaging several pounds heavier again.
The drug was designed for people with diabetes, who will almost certainly have diabetes for life and who cannot will themselves out of diabetes. For normal people, it’s all the trappings of a/the yo-yo diet in a pill that you get charged for every month and your insurance pays the $1400 for… until they don’t.
There is no magic except for people’s stupidity here.
Well we can only hope that this kerfuffle doesn't equal the damage done by the catastrophic Adderall shortage we suffered through some months back. Untold numbers of journalists were unable to fulfill their roles in the matrix...er civilization, in which they found themselves with apparently no escape. Now fat slobs will be able to escape their skin suits with miracle drugs and tummy tucks. At least until the stitches break. And of course JD Vance was wrong about Adderall and he will be wrong about Ozempic.
I was actually thinking about this issue recently specifically in the context of the movie Wall-E.
For those unfamiliar, future humanity flees a polluted Earth with intermittent, automated robot missions to return and test for Earth’s readiness for a planned, eventual, re-colonization. Many generations in the future, in the ease of zero-G and automated comfort, humanity has become thin-boned, sedentary blobs, similarly dedicated to autonomous consumption and singular function(s). The general conflict is between the robots whose primary mission is to return humanity to Earth and the robots whose job it is to keep humanity safely ‘cocooned’ in space.
Throwing AI and Ozempic into the mix would make things even more glib. In the end, humanity returns, but there’s a skimming over of the fact that it takes multiple generations to acclimate to Earth. In this case, not only would humanity not acclimate to Earth, the ‘evil’ AI could/would make it so they *couldn’t* acclimate ‘by their own volition’. Multiple generations of humans with the ability to satiate themselves at a neurotransmitter level completely co-opted by an outside agent.
Forget about religion as opiate of the masses.
Forget about religion as opiate of the masses.
As a resident of a blue city which decriminalized damn near everything, I can tell you this with rock-bottomed and copper-sheathed confidence:
Opiates are the opiates of the masses.*
*Reason-style glib-ertarian take: Hey Karl Marx, like, what's wrong with Opiates, man? Like, as long as we know what's in them!
“An army marches on its stomach.” – Napoleon or Frederick the Great
“On its stomach you say…. ?” – American Science Industrial Complex
Think Wall-E was named for Heinlein's Wal-Do?
So, Billy never lost that “Freshman Fifty”? You could just pretend you live in a fifteen minute city, and force yourself to walk more. Also: Eat Moar Bugs.
Billy, you might just be terminally online. No one in meatspace is talking about Ozempic. And if you start losing weight, people might comment, but you don't have to talk about the drug if you don't want to.
Well this story may not carry the journalistic weight of Billy's reporting on that crazy Villareal chick in Texas or somewhere. That is the kind of meaty, groundbreaking journalism that is rewarded at Reason. Some said the evidence was thin but Billy put the meat on the bones with his relentless pursuit of truth. And it should go without saying, JD Vance is wrong about that crazy chick in Texas or wherever she is. And also toasters.
Billy better be careful. If things don’t go well, Reason may decide to trim the fat…. from their budget.
Are you saying Billy might end up getting boned?
I have never seen four white people look so uncomfortable...
I like her fire.
Damn.
The past year I've been on a heart drug that's also said to produce modest weight loss as a side effect: Farxiga. It causes calories to be spilled as sugar in the urine. I didn't see much weight loss for almost a year, but now it's started down significantly. Might not be from the drug, of course.
Only one other thing has ever caused me to lose much weight, from diminished appetite: anxiety. It's not worth it.
They prescribe Farxiga for type 2 diabetes too. Usually before insulin but after metformin, glimpiride, and such.
Diabetes patients get charged a lot for it. For geezers on Medicare insulin is only around 35 bucks per month. Farxiga more like 200 to 300. Just thought I’d add this useless information.
OK, so now we seem to have a cure, how about working on prevention?
Prevention requires two moves:
Putting down the fork and pushing away the plate.
There, solved.
I am for responsible drug use, and these new drugs should not be taken lightly. People should discuss these drugs with their doctors first. Individuals are each different, and sometimes drug use should not be encouraged. But it all depends.
OK, I just peeked at the headline... and I knew what was coming.
Data from 2020-2023.
Yeah. Pick ANY OTHER PERIOD to get your data from and they'll be more accurate, but you're immediately suspect if you use that period. For anything. Anything at all. But, especially, for health or lifestyle things.
I didn't bother to read the rest. Rather just bitch about the utter stupidity of starting an article with a dumbass stereotype then admitting straight up that your data are from the worst period for collecting data... someone needs to go outside. He must be spending too much time on the internet. Maybe hang out with regular people, preferably who don't work inside the beltway.
We've seen this movie before. It always ends with a barrage of class action lawsuit commercials on TV.
Rectal bleeding.
Wow a Big Pharma solution to an easily avoidable (It’s the carbs stupid) national epidemic. This won't end well.
But losing weight can be a Herculean battle for some people. If the choices are between more people staying overweight or more people losing weight, the answer should be obvious.
This, incidentally, is the same exact argument pedophiles (and ENB) make in defending kiddie porn.
I'm not surprised even a little bit that Billy is on board with it.
https://www.youtube.com/watch?v=DOW_kPzY_JY
"Maybe it's a shortcut, Dwight."
If a person eats junk food like a pig and doesn't exercise, a pill isn't going to make him healthier. He might weigh less, but he'll still have health problems.
This will eventually result in another widespread dependency.