When we lose weight, who gains?

Who are the big winners because of Ozempic? Beyond the people who lose weight, new drugs like Ozempic may benefit companies, industries, professionals, and families in unexpected ways.

By Jeffrey Cole

Disney got it wrong with one of its most popular and enduring theme park attractions: it’s not such a small world after all!

The “Small World” ride premiered at the 1964 New York World’s Fair. Built by Disney’s imagineers, it was such a sensation the company quickly moved it to Disneyland where it opened in 1966. Visitors sit in a small boat that moves through a shallow channel—viewing dancing dolls from around the world while being serenaded by one of the catchiest songs ever. It’s impossible to get that song out of your head, no matter how hard you try.

In 1966, the channel was deep enough for the boat to seat about twenty average sized riders, a mixture of adults and kids. But as love for the attraction grew, so too did the weight of the visitors to the park. By 2006, what had been normal weight for twenty people in the sixties now carried an extra 500 to 600 pounds. Often the ride would get stuck as the payload of the boat caused it to scrape the bottom. For a while, Disney dealt with the problem by only partially filling the boats. However, seeing empty seats angered people waiting in long lines.

In 2008, Disney shut down the ride to dig a deeper channel (among other renovations) that allowed the boat to move freely once again. Disney had to reconfigure “It’s a Small World” for the “average sized person” of the 21st century.

This is but one of countless examples of how much greater body mass has changed the world. Now, with the introduction of new weight loss medications like Ozempic, we are beginning to see how the reversal of weight gain could have just as large an impact on our economic and social lives.

As I explored in my last column, two things have to happen for these drugs to disrupt almost everything: First, they must be shown to have little or no long-term negative effects. Second, they must be affordable and covered by insurance—just like other drugs such as those that treat high cholesterol or blood pressure.

If Ozempic, Wegovy, Mounjaro, Zepbound, and other similar medications are safe and affordable, there will be many winners and losers in our world far beyond the folks who need or want to lose weight. At this early point we can begin to speculate about who those winners and losers might be.

Winners

The companies making the weight loss drugs. Novo Nordisk, the manufacturer of Ozempic, is now the largest company in Europe and it continues to grow. Soon it may rival Apple or Amazon in size and revenues. A monthly cost of $900-1400 per month (and little insurance coverage) is not sustainable for anyone but the very rich. Already, there is huge pushback on the drugs’ artificially high prices.

If the monthly costs shrink to $30-50 and are covered by insurance, the demand for these medications (which most people take for the rest of their lives—a pretty good business plan) will skyrocket and the pharmaceutical companies will still prosper for the long-term.

Employers. The economic costs of weight-related problems are so large in the workplace that they can only be estimated. According to one new report, the costs of obesity to employers may be as much as $425 billion a year: $146.5 billion in higher medical costs for employees and their dependents, $82.3 billion in missed workdays, $160.3 billion in reduced productivity due to illness, $31.1 billion in higher disability costs, and $5.2 billion in higher Workers’ Compensation costs.

Even if these numbers are wildly inflated, the economic toll on the workplace is staggering. Even modest changes in employee weight can save employers tens of billions of dollars.

Two things have to happen for these drugs to disrupt almost everything: First, they must be shown to have little or no long-term negative effects. Second, they must be affordable and covered by insurance—just like other drugs such as those that treat high cholesterol or blood pressure.   If Ozempic, Wegovy, Mounjaro, Zepbound, and other similar medications are safe and affordable, there will be many winners and losers in our world far beyond the folks who need or want to lose weight.

The fashion industry. As people get in shape, they will want to buy newer and often more expensive clothing. Clothing and accessories they may never have thought they could wear will be possible. Designers will begin to cater to newly in-shape consumers.

The travel industry. Feeling good about yourself and buying new clothes will make people want to get out of the house, far outside of the house. The interest in traveling, getting on cruises, sunning on the beach, and more will hugely benefit the travel industry. The CEO of United Airlines says the added costs of carrying obese passengers runs to $80 million a year, which would be a big savings if many of these passengers slimmed down on drugs like Ozempic.

The increased interest in clothing, accessories and travel could be a major setback to consumers if they spend more than they can afford and rack up debt changing their lives though these medications.

Therapists. People buy lottery tickets or engage in other wealth building schemes believing that more money will make them happy. Those who do get rich often find that more money does not solve their problems or make their lives better. The same is true of weight. Many depressed people attribute their unhappiness to body size and image. If they can lose their excess weight and get in shape, they may find that does not solve their problems. There may be other root causes of their unhappiness that may well lead to increased demand for therapists and medications.

Plastic surgeons. When people lose over 50 pounds or more, they are left with hanging skin that is often treated by plastic or other surgery. Those who achieve their desired weight may want to “finish the project” and have surgery on their faces or bodies. They may feel well on the way to perfection and hope to complete the journey.

The people who take Ozempic. If these drugs are shown to be safe over the long-term and are affordable, the people who use them will be significant winners. They will become far healthier and live longer. They will be less likely to experience heart attacks, strokes, and the devastating effects of obesity. We are just beginning to see these drugs positive impact on alcoholism, gambling addiction, and other impulse control problems. Just in the last week, new research shows Ozempic may play an important role in halting the progression of fatty liver disease.

Beyond the medical benefits, the gains in self-confidence will be game changing. The embarrassment of asking for a seat-belt extender or spilling into the seat of a passenger next to you on a plane or ride will be a thing of the past. There will no longer be “fat discrimination” in the workplace that can make it difficult for obese people to get a job. The perception that “fat people are lazy” will decline as there are fewer fat people.

The world. The losses that stem from disability and early death due to diabetes and obesity related heart attacks or strokes are impossible to calculate. Many have to make enormous sacrifices in their own lives to become caregivers for those disabled and in need of help. How many great leaders, authors, and scientists have died young—before making or finishing immense contributions to the world—because of high weight and ill health? The emotional costs of losing our parents, close relatives, and friends due to early death is incalculable.

These are just a few guesses about who will benefit from a slimmed-down world.

There are also some who will be losers, mostly economically, if obesity lessens or disappears. Some of these likely losers are surprising, which is what I’ll dig into next time.
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Jeffrey Cole is the founder and director of The Center for the Digital Future at USC Annenberg.

 

 

See all columns from the center.

May 22, 2024