Episode Details

For decades, obesity was treated as a matter of self-control and free will: If you were fat, it was your own fault.

You could try a diet - but the diet companies were also in on the fix: For years, Weight Watchers was owned by Heinz food … and Jenny Craig was owned by Nestle. 

But it was still up to you. You made your choices, and you had to live with them. And so the obesity rate in the US soared from around 15% of the population in 1970 to more than 40% today. Clearly something is going on other than free will and personal choices.

In this episode of Drug Story, we explore the origins of the obesity epidemic: the Green Revolution in agriculture, which saved a billion lives, but also made grain cheap cheap cheap. And we look at what happened when the tobacco companies decided to diversify into the food business (surprise: food became a lot more addictive, and a lot less healthy). 

And we re-consider the whole idea of personal freedom and free will.

This episode's drug is Ozempic, and the whole class of GLP-1s that have up-ended our presumptions around obesity. These drugs have transformed millions of lives - they are surely one of the most impactful medical discoveries of the century. 

Unfortunately, these drugs have not dispelled the stigma around obesity. They’ve just shifted it a bit. If you think taking a GLP-1 is “cheating,” you’re still stuck in the old blame game.

Sources for this episode

[1] KFF Health Tracking Poll May 2024: The Public’s Use and Views of GLP-1 Drugs (2024) KFF: KFF poll showing awareness, perceptions, and use of Ozempic, Wegovy, and similar medications in the U.S.

[2] Norman Borlaug Man Of The Year 1969 (2011) The International Maize and Wheat Improvement Center: Norman Borlaug introducing himself as a man who grew up during the Great Depression and was raised on a farm in Iowa. 

[3] Norman Borlaug and the Green Revolution (2017) 20th Century Time Machine: Norman Borlaug created a high-yield wheat strain that transformed the agricultural industry and saved an estimated one billion lives. Considered the father of the Green Revolution, he was awarded the Nobel Peace Prize in 1970.

[4] Chapter 1 | The Man Who Tried to Feed the World (2020) American Experience PBS: Norman Borlaug, inspired by his own upbringing in struggling Iowa, helped the world avoid famine and hunger through revolutionizing wheat production.

[5] Food Timeline FAQs: historic food prices (2024) Food Timeline: In addition to increasing the supply of food globally, the Green Revolution also made food much more affordable.

[6] What Is the Evidence for “Food Addiction?” A Systematic Review (2018) Nutrients: A systematic review of 52 studies concludes that food addiction is a valid diagnostic construct that is more similar to substance use disorder than behavioral addiction, especially among processed foods with added sweeteners and fats.

[7] The Origins of the Obesity Epidemic in the USA–Lessons for Today (2022) Nutrients: The origins of obesity can be traced back to the introduction of ultra-processed food in the American diet. 

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