GLP-1s and the ‘Wild West’ of Wellness

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The Ezra Klein Show 1h 15m 3 speakers 8 chapters transcribed 4 months ago
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What are GLP-1s and why are they significant in today's health landscape?

Ezra Klein 0:00
If you find yourself bewildered by this moment where there's so much reason for despair and so much reason to hope all at the same time, let me say I hear you. I'm Ezra Klein from New York Times Opinion, host of The Ezra Klein Show. And for me, the best way to beat back that bewildered feeling is to talk it out with the people who have ideas and frameworks for making sense of it. There is going to be plenty to talk about. You can find The Ezra Klein Show wherever you get your podcasts.
Ezra Klein 1:02
Here's a number that actually shocked me when I learned it. It's from a new Kaiser Family Foundation poll. One out of eight Americans is now taking a GLP-1. One out of eight. Maybe I shouldn't have been so shocked because the number is higher in my social circles. I have tried these. For reasons I'll explain. But they're a strange medication, right? They don't make you lose weight. They make you not want to eat food. But then they do all these other things. They seem to protect people's heart health independent of losing weight. They're protective of kidneys, of livers. There is ongoing research about dementia and Alzheimer's. They have all these strange effects on addiction and desire. But should everyone be on these?
Ezra Klein 1:52
Like, what does it mean for society to have access to drugs that regulate desire in this way? What do they mean for the sick? What do they mean for the well? I want to do an episode on this for a while, but I haven't known quite how to approach it. And then Julia Ballouz, who's a contributing writer at New York Times Opinion and co-author of the book Food Intelligence, and also was a health and science reporter with me back at Vox. She started doing a lot of reporting on GLP-1s, and she's written a lot of great pieces on them, including doing some really interesting survey work. One of the survey questions that really stuck with me was if people on them, more than 60% would continue with them, even if they didn't help them lose weight.
Ezra Klein 2:35
So why is that? Well, I want to ask Julia. She's someone who I really, really trust to look at the science of these questions in the most rigorous way possible. And also to look at the experiences patients are having on them in the most compassionate and curious way possible. As always, my email is reclineshow at nytimes.com.
Ezra Klein 3:07
Julia Blues, welcome to the show.
Julia Belluz 3:09
Thank you so much. It's a pleasure to be here.
Ezra Klein 3:11
So I was shocked by this number. According to the Kaiser Family Foundation's poll, one in eight Americans are currently taking a GLP-1. Why?
Julia Belluz 3:20
Yes, it was surprising to me, too. So one of the ways we can understand this is there's this very long history of people seeking out basically the magical elixir for weight loss, right? So I think that's one piece of it. And now we finally have something that rivals the only other effective medical intervention we've had to help people lose weight, which is bariatric surgery. On the other hand, there's a lot of people who are living with diabetes. And I think that's another reason that we see so many people who are on these drugs. In addition, I think these drugs have really met a particular moment, which is this algorithmic social media age. They're everywhere in the U.S. We already had this relatively unrestricted approach to marketing pharmaceuticals.
Julia Belluz 4:03
We see them advertised everywhere. We've seen this telemedicine industry flourish since COVID, but also around these drugs. And I think that's why we're seeing these shocking numbers everywhere.
Ezra Klein 4:14
So I want to start on the part of this that people actually don't talk about that much, which is diabetes, which is what these drugs are originally approved for. As you say, a huge number of Americans have diabetes and have terrible health consequences often from it, including limb amputation and blindness. What do these drugs do for diabetics?
Julia Belluz 4:34
Yeah, so our bodies produce GLP-1 naturally. So we have this hormone that's produced in our gut, in our brains, and to a lesser extent in the pancreas. Basically, they're this synthetic version of a hormone we produce naturally.

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