Ozempic has exposed the grift behind the public-health lobby

Has the US turned the tide on obesity? The latest figures from the Centers for Disease Control show that between 2017-20 and 2021-23, the prevalence of obesity fell by two percentage points.

It is perhaps too soon to get out the bunting. The obesity rate is still a hefty 40 per cent (compared with 28 per cent in the UK) and the proportion of Americans who are morbidly obese is 10 per cent (in the UK, the figure is two per cent). It will take another year or two to see whether the decline is sustained. But the signs are promising and – as John Burn-Murdoch argues in the Financial Times – there is only one plausible explanation for it: the weight-loss drug, semaglutide, sold as Ozempic or Wegovy.

As Burn-Murdoch points out, one in eight Americans has tried the new generation of weight-loss drugs and ‘the decline [in obesity] is steepest among college graduates, the group most likely to be using them’. Moreover, we know from randomised controlled trials that using them leads to ‘substantial, sustained weight loss’. Semaglutide and its competitors have done what all the sugar taxes, fat taxes, advertising restrictions and warning labels have failed to do elsewhere in the world – they have actually reduced the rate of obesity.

Reducing obesity, even by a little bit, would seem to be the least we could expect from an anti-obesity policy. But in ‘public health’ circles it is considered terribly gauche to judge anti-obesity policies by such an exacting standard. When childhood obesity rose after the UK’s sugar tax was introduced, its supporters resorted to claiming that it would have risen even more without the tax – albeit only among girls and only among one age group. This is the kind of thing a quack would say when a patient deteriorates after taking his remedy.

If there is no expectation of outcomes improving, it becomes impossible to distinguish a placebo from a poison. This suits the charlatans of the public-health racket, whose idea of evidence-based policy is throwing everything at a wall, regardless of the cost to consumers, and hoping that some of it sticks. The contrast between the medieval approach of nanny-state chancers and the rigorously evaluated, highly effective weight-loss drugs now available could not be starker. If semaglutide only reduces obesity rates in the US by two percentage points, it will still have achieved infinitely more than all the public-health policies designed to tackle obesity combined.

The only problem is that the drugs are very expensive and are likely to remain so until they come off patent in the 2030s. UK health secretary Wes Streeting announced this week that the government will be spending £279million on a similar drug, tirzepatide, to see whether it can help get obese people back to work. Tirzepatide, sold as Mounjaro or Zepbound, seems to be even more effective than semaglutide and, at £120 a month, it is also cheaper. Whether using it on the long-term sick will pay for itself remains to be seen. Streeting will need to target people who are genuinely too fat to work and who genuinely want to work. There may be fewer of them than he thinks.

The societal costs of obesity have been greatly exaggerated by campaigners. While there are many benefits to losing weight, they are mostly confined to the individual. The test will come when the inflated and largely imaginary costs of obesity to the NHS and the economy collide with the very real costs to the government of dishing out weight-loss drugs to millions of people.

Still, at least tirzepatide does what it is supposed to do. It will be interesting to see how the introduction of an effective but expensive anti-obesity drug fares in comparison to cheap but useless nanny-state policies, such as banning ‘junk food’ advertising and stopping fish-and-chip shops from opening. Has there ever been such stark exposure of the public-health grift?

Christopher Snowdon is director of lifestyle economics at the Institute of Economic Affairs. He is also the co-host of Last Orders, spiked’s nanny-state podcast.