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The benefits of Ozempic and similar medications could be profound on a population level. New research has estimated that expanding access to these newer weight loss and diabetes drugs could save thousands of lives in the U.S. every year.
The recently approved drugs semaglutide (the active ingredient in Ozempic and Wegovy) and tirzepatide (Mounjaro and Zepbound) have proven to be far more effective at helping people lose weight than diet and exercise alone—yielding about 15% to 20% lost weight in clinical trials. And practically every week, there’s been another study suggesting that their benefits extend beyond simple weight loss. This new research, published Tuesday in the journal PNAS, takes a stab at tallying up the positive effects they may have on our collective mortality.
While the connection between higher weight and poorer health is more complex than commonly portrayed, obesity is associated with a higher risk of various health problems, including conditions that predispose us to an earlier grave like type 2 diabetes and heart disease. Before these GLP-1 drugs became known as blockbuster medications for weight loss, they had and have continued to be valuable treatments for type 2 diabetes. And large-scale trials have found that Wegovy specifically can reduce the risk of cardiovascular and kidney disease in obese people vulnerable to it.
Only a silver of Americans eligible for GLP-1 drugs are actually using them, though, likely due to several factors, particularly a routine lack of health coverage and high cost otherwise. Without insurance, for instance, the list price of Wegovy is upwards of $1,000 a month. Researchers at the Yale School of Public Health and the University of Florida calculated what would happen if these drugs were more widely accessible and taken, with a particular focus on the deaths that could be prevented by treating someone’s obesity or diabetes.
Right now, about 40% of American adults are thought to be obese (having a body mass index over 30). Yet only around 10% of this group is taking a GLP-1 drug for obesity or diabetes, according to data cited by the researchers. Overweight people are also eligible for these drugs if they have diabetes or certain other obesity-related conditions, and uptake is similarly low there as well.
Even under this current low-use scenario, the researchers estimated that roughly 8,500 deaths are being prevented annually. But under an expanded access scenario, about 42,000 deaths would be prevented annually, they estimated. Among people with type 2 diabetes, more than 11,000 deaths could be prevented.
“As a major risk factor for several chronic diseases, obesity is a national public health crisis. Our findings highlight the immense promise of the new generation of weight-loss drugs to mitigate the mortality and morbidity associated with obesity and diabetes,” the researchers wrote.
These numbers are estimates, of course, and subject to numerous assumptions. But the researchers did take into account existing data on people’s willingness to start GLP-1 therapy if eligible (around 75%, according to one survey), and their ability to stay on the drugs for long (the real world adherence rate ranges between 25% to 50% over a year’s time, based on other studies). They additionally modeled a very rosy scenario, where most everyone eligible would take GLP-1s (89%) and then all stay on it; under those conditions, GLP-1 drugs could prevent over 160,000 deaths a year, they found, while 41% of people living with obesity would no longer be obese.
In the real world, though, there are plenty of valid reasons why even eligible people might not want to take these drugs. Their most common side-effects are diarrhea, vomiting, and other gastrointestinal symptoms that could be too much of a hassle for someone to tolerate (thankfully, these symptoms do seem to wane over time for most). A minority also don’t respond as expected, losing next to little weight while on them. And some people, even if they can afford the drugs, may simply not want to deal with the potentially lifelong upkeep of a weekly shot.
On the other hand, the public demand for these drugs has regularly outstripped their supply, leading to shortages. These shortages and high costs have also fueled a thriving grey and black market for the drugs, with many people choosing to buy cheaper, if less guaranteed to be safe, versions of semaglutide and tirzepatide. So at least for now, there are plenty of people who would like to but aren’t able to obtain these drugs through legitimate means. And the researchers say that more has to be done to make sure eligible people can have safe and easy access to them.
“Addressing these challenges requires a multifaceted approach,” said study author Burton Singer, an adjunct professor of mathematics at the Emerging Pathogens Institute at the University of Florida, in a statement from Yale. “We need to ensure that drug prices are more aligned with manufacturing costs and increase production capacity to meet demand. At the same time, we must tackle the insurance and accessibility issues that prevent many people from getting the treatment they need.”
