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I’d also like to add that when a drug is in a brand new class (such as these new injectables), the first drug approval has to meet all the (loose) criteria you’ve described. But the SUBSEQUENT drugs in this class only have to prove that they are equal to (or better than) the existing drugs on the market. (The industry calls these “me too” drugs.) So if one drug gets approved with some dubious science, it sets the stage for an entire class of drugs that are equally terrible.

Also there is a well-oiled revolving door between industry and the FDA. So the people approving these meds all came from industry, and they have colleagues who are still in industry, and they probably still have 401k’s and stock options tied to industry. There are tons of conflicts of interest at the FDA.

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Great points! The millions of $ being spent by NOVO Nordisk, especially, and also Eli Lilly, for conferences, perks, travel allowances, advertising, professional "fees", etc, probably dwarfs that usually spent to promote new drugs. There is big money to be made in fat! And nobody is deterred by professional ethics--neither the drug companies, nor the doctors and other consultants on their payrolls.

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I’d love to see some numbers on what they spend on these vs other drugs… on the one hand, a lot of the work has been done for them— fatness is so demonized in healthcare settings that simply being aware of the drugs existence may be all that’s needed to get these prescribers excited about it. On the other, Lilly has been in trouble in the past for off label marketing of neurontin (gabapentin) and the CEO at the time is on record telling drug reps to push “neurontin for everything!” so clearly they’re comfortable pushing prescribers to push drugs harder, even if they’re not in the patients’ best interest.

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Wow--that's a great explanation! I shared it with my list of Facebook friends (well, most of them--some of my Facebook friends, like cousins, neighbors, and old classmates, are tired of my pro-fat posts! But that still leaves about 600!) I also shared it with my 3500 contact and followers on LinkedIn, where I post mostly using my "hat" as president of the Council on Size & Weight Discrimination (www.cswd.org).

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Super helpful! Thank you Ragen!

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The Maintenance Phase podcast had a great episode for further reading on the dangers of compounding pharmacies releasing drugs that claim to have the same active ingredients as ozempic/wegovy because one specific pharmacy has the patent rights to semaglutide so they are just LYING and using diet culture and anti fat bias to make money selling an undisclosed substance as a weight loss drug

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