Ozempic externalities

What weight loss drugs might mean for a country where obesity is common and body size carries its own history

By the end of 2024, roughly one in ten American adults had used a new class of weight-loss drug. The medicines are GLP-1 receptor agonists – you will know them as Ozempic, Wegovy and Mounjaro – and they were first developed to treat diabetes. But a technology built for one purpose rarely stays within it. At higher doses, clinical trials show, these drugs strip 12 to 18 per cent off body weight, far more than diet or exercise reliably manage. Women took to them fastest: about one in sixteen had used one to lose weight, and among women who had ever been obese, roughly one in six.

Why should an economist care? Because economists have spent decades documenting that heavier people – women especially – face weight-based discrimination in wages, work and marriage. A drug built for diabetes, now used to lose weight, could therefore reach into employment, marriage and household income – places its inventors never intended it to go…