Ending the Hunger Games
New pharmaceuticals appear to offer a genuine solution to the problem of excess appetite, that uncontrollable urge to eat more than we need to that keeps so many of us fat.
I.
Although it remains unclear whether obesity has now become a bigger killer worldwide than hunger, there can be no doubt that it is one of the greatest problems facing humanity today. More than a quarter of all adults are estimated to be clinically obese in a slew of countries as culturally and geographically diverse as Samoa, Egypt, Argentina, Costa Rica, Israel, Saudi Arabia, the Czech Republic, and the United States. Some models predict that this will cost the global economy $4 trillion (2.9 percent of global GDP) by 2035.
According to a January 2023 briefing presented to the UK House of Commons, almost one in three British adults are obese, up from one in ten in 1970. This is an estimated 37.7 million people. The results of a 2022 study in the British Medical Journal suggest that this is costing the UK’s National Health Service (NHS) £1.6 billion and the wider British economy as much as £27 billion (mostly in lost earnings) per year.
The British experience is not unusual. Here in Australia, for example, according to the Australian Bureau of Health and Statistics, around 31 percent of the population was obese in 2017–18 (the most recent year for which figures are available). Obesity, which is the second largest source of medical costs after smoking, accounts for 8.4 percent of Australian healthcare spending, according to a 2021 report published in Nature.
Given the myriad false promises the diet industry has offered in the past and the number of failed attempts many of us have made to lose weight, it’s unsurprising that so many commentators are reluctant to accept the idea that an effective, scalable solution to the problem of obesity may be finally in view. After all, in the years 1964–2009, more than 20 weight-loss pharmaceuticals were first approved and then withdrawn from circulation (most notoriously, the so-called “fen-phen”), as the evidence of their severe side effects and/or addictive potential accumulated.
Yet, new pharmaceuticals do appear to offer a genuine solution to the problem of excess appetite, a real way of dampening that clamorous, deep-seated, and uncontrollable daily urge to eat more than we need to that keeps so many of us fat. If they prove safe and effective, these novel medications will help many (though not all) of the overweight and obese lose weight more easily and effectively. And we badly need a radically new approach to obesity. Governmental measures have failed; societal measures have failed; individual efforts have largely failed. Most of us are now fatter than our parents and grandparents were, fatter than we ever intended to become, fatter than we would like to be—and are growing fatter still.
