All the ways Ozempic will change our world, from alcohol to airlines

The year is 2040. Half the population are regularly taking weight-loss pills. Airline profits are soaring as their passenger load drops. The treats aisle in supermarkets is relegated to a back shelf. Health food shops appear on every street corner. Sales of booze and cigarettes have collapsed, putting many addiction clinics are out of business.

Britain, once one of the fattest developed nations in the world, has conquered its obesity crisis, freeing billions for the NHS. Health spas no longer promote weight loss, instead focusing on “longevity” and “stress reduction”.

Last week, at the European Congress on Obesity, held in Malaga, southern Spain, presentation after presentation revealed that new weight-loss drugs such as Ozempic, Wegovy and Mounjaro are not just good at tackling diabetes and helping people lose weight; they may also stop heart attacks, ward off cancer, reduce the risk of dementia, treat depression and help battle addiction.

What’s becoming increasingly apparent is that not only may these drugs permanently change our relationship with food: they could presage a much wider health revolution in our health.

The consequences of this paradigm shift, intended or otherwise, seem increasingly momentous with each month that passes and could transform everything from alcohol sales to aeroplane fuel consumption.

“We are only in the foothills of understanding what these drugs might mean for the economy,” says economist Daniel Susskind. “We know that obesity costs the NHS about 8 per cent of its budget. But we are now starting to sense that this is likely just the beginning. In the 21st century the economic consequences of weight-loss drugs may turn out to be similar in scale to what the discovery of penicillin did to the 20th century.”

The initial and most obvious impact is on our waistlines. More than half of adults in this country are obese or overweight, a number that could look radically different in ten or 15 years’ time. These drugs, are already taken by about half a million people in Britain — and the figure is likely to rise fast, as the NHS seeks to tackle the obesity crisis.

One recent study showed that making weight-loss drugs available to all eligible individuals in Britain would boost the economy by £4.5 billion a year, simply by reducing the number of sick days taken.

Professor John Deanfield, a cardiologist at University College London and a former government health adviser, believes the new weight-loss drugs will affect society in a way that goes way beyond health. “It will affect all sorts of aspects of our life,” he says. “The restaurant industry, the airline industry, all these things will be affected.”

It may also affect our very appetite for life. Take the example of Anna, who at 47 was far heavier than she wanted to be. “Counting calories works at first but then it just gets harder,” she says. “And going to the gym makes me want to shoot myself.”

That’s when she turned to Wegovy. At just over five feet tall, and weighing ten stone-plus, Anna (not her real name) wasn’t quite heavy enough to be classed as “obese”, so she lied about her weight on the application. Once her prescription was approved, it changed everything. “It has been incredible,” she says. “I lost the three stone and I weigh less than I did when I was 30.”

And yet, after months of injecting herself, she gradually realised that her relationship with food — and her relationships with others — had changed. “I’m the kind of person who would look up the menu before going out for a meal and get excited about it,” she says. “And so did my friends. All of a sudden I was sitting in restaurants pushing my food around the plate. I wasn’t even interested in having a glass of wine. It was ‘just a Diet Coke for me please’.”

Family meals had been a way she bonded with her four children. “I used to love planning meals, cooking for friends, making new things for the kids to eat; all of this became a chore.” She is certainly slimmer. “That was the holy grail. But I don’t feel like myself any more.”

Originally developed as a diabetes drug, researchers soon realised that these “GLP-1” treatments, which mimic the action of the hormone that makes people feel full after a meal, worked as a powerful appetite suppressant.

The wider implications of this are beginning to become apparent. Last week Alex Gourlay, the executive chairman of Holland & Barrett, attributed a surge in health food sales to the new drugs, whose users often have less craving for junk food. In response to changing preferences, the chain is now incorporating more healthy ingredients such as collagen and ashwagandha into its range. “[It’s] a real trend-breaker,” Gourlay said.

Alex Gourlay

HOLLAND & BARRETT

Here’s another example. According to a 2023 report, if passengers were an average of just ten pounds lighter, the US carrier United Airlines alone estimates it would save $80 million a year on fuel costs.

Supermarkets are also watching the performance of the drugs carefully. Walmart, the world’s biggest retailer, has already assigned a “slight pullback in overall basket” to the popularity of these jabs, with shoppers purchasing “less units, slightly less calories”.

The alcohol industry may also be affected. In January, Fundsmith Equity, an investment fund, sold its stocks in Diageo, the FTSE 100 drinks company, over concerns that weight-loss drugs would dampen booze sales.

The drugs have already revolutionised the slimming market. WeightWatchers filed for bankruptcy in the US this month after losing nearly a third of its customers last year, many of them having decided that taking a weekly jab was easier than willpower alone. Polling in the US suggests one in eight US adults — 25 million people — have already taken the drugs.

Even gyms — after having arguably failed to help enough people lose weight themselves — are having to change their models. Some are starting to offer programmes specifically designed for those on the weight-loss drugs, to help them maintain muscle as they lose bulk.

Deanfield, whose research — as is common in the field — has been partially funded by Novo Nordisk, the Danish company that makes Wegovy and Ozempic, says the new evidence is changing the way doctors think about the medicines. “It repositions these drugs from being weight-loss drugs to being drugs that benefit fundamental diseases that we’d like to avoid.”

With one billion obese people worldwide, pharmaceutical executives — who are sitting on a generational goldmine — talk in fevered terms about an “unknown ceiling” to uptake. That ceiling is likely to rise when pill forms of the drugs arrive, the first of which — Eli Lilly’s Orforglipron — is expected in 2026.

Deanfield believes the drugs will overtake statins, which are taken by about eight million people in the UK to ward off heart attacks and strokes. “Statins have been extraordinarily helpful and beneficial for the population, but we’ve always had to convince people that they were good for them, because they didn’t see a visible benefit,” he says. Those taking weight-loss drugs, by comparison, “can see the benefit very quickly for themselves”.

No drug is a complete panacea and many questions remain. Many doctors remain uneasy at the prospect of relying on big pharma to fix a problem created by big food. Short-term side-effects of GLP-1s include nausea, constipation and fatigue. Long-term impacts are less certain, but there are concerns that much of the weight patients lose is from muscle mass, creating potential frailty problems down the line.

The treatments are also expensive — about £200 a month privately. As with statins, which now cost pennies, the true benefit at a mass scale may not be seen until the drug patents expire and generic versions become available. Ozempic’s patent will run out in 2033.

Nobody has yet come up with a convincing exit plan from the drugs. One study presented in Malaga showed that if patients stop taking them, they put the weight back on within ten months. Patients are likely to be locked in to taking the drugs long term.

That was certainly Anna’s experience. Unhappy with the impact of the drugs on her social and family life, she stopped taking Wegovy after a few months. “My appetite came back and then some — I was just ravenous,” she says. The pounds started piling back on, so she resumed the injections.

“The reality is, I wouldn’t have lost the weight any other way.”

Additional reporting: Eleanor Hayward in Malaga