Consider This from NPR - Weight loss drugs have transformed an American city. Is that a good thing?

Episode Date: August 19, 2024

They've been called "Hollywood's worst-kept secret." Medications like Ozempic or Mounjaro, which are commonly used to treat diabetes, are part of the zeitgeist these days. More and more celebrities are opening up about taking them to lose weight. So when you imagine where these drugs are prescribed most for weight loss around the U.S., maybe you're thinking Los Angeles or New York. Turns out, the capital of the weight loss drug boom is in Kentucky — in a small city called Bowling Green, where at least four percent of the population got a prescription in the last year.For sponsor-free episodes of Consider This, sign up for Consider This+ via Apple Podcasts or at plus.npr.org.Email us at [e-mail] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

They have been called Hollywood's worst-kept secret. We're talking about medications like Ozempic or Manjaro, which are commonly used to treat diabetes, but they are now part of the zeitgeist these days. More and more celebrities are opening up about taking them to lose weight, like Tracy Morgan. By the way, you've been working on your body and on your health? No, that's Ozempic.

That's how this weight got lost. Chelsea Handler. My anti-aging doctor just hands it out to anybody, right? But I didn't even know I was on it. Whoopi Goldberg,

Kelly Clarkson. I'm doing that wonderful shot that works for folks who need some help and it's been really good for me. No, mine is a different one than people assume, but I ended up having to do that too because my blood work got so bad. So when you imagine where these drugs are prescribed most for weight loss around the U.S.,

maybe you're thinking, oh, Los Angeles, of course, or maybe New York. But you know, it turns out the capital of the weight loss drug boom is in Kentucky, in a small city called Bowling Green. At least 4% of the population in that city and surrounding area got a prescription in just the last year. Consider this. Weight loss drugs have transformed an American city. Is that a good thing? From NPR, I'm Elsa Chang. It's Consider This from NPR. Bowling Green, Kentucky might seem like an unlikely hub for weight loss drugs. That is, until you dig into the data. Kentucky has one of the highest obesity rates in the country, and rates of adult diabetes and hypertension are going up and up.

So when drugs like Ozempic and Manjaro become known for their weight loss potential, many, many residents of Bowling Green were eager to get a prescription. Madison Muller is a health reporter for Bloomberg News, and she went to Bowling Green to learn about how these medications have changed the city and the people who live there. Madison, welcome. Thanks for having me. I'm excited to be here. Oh, we're so excited to have you. So for people who have never been to Bowling Green, can you just describe it for much of the suburbs of Chicago and kind of like middle America in the Midwest, lots of highways crisscrossing the town, strip malls. There is a really quaint downtown area.

There's a college campus. But it really, to me, looked like a lot of the areas that I grew up going to or at least driving through. Well, let me ask you, because the weight loss drug industry has struggled with supply shortages for years, which has been especially harmful for patients with diabetes because they actually need these drugs to stay alive. So how is a city like Bowling Green keeping up with demand for these weight loss drugs? Yeah, that's a good question.

Supply shortages have obviously been a huge issue, like you said, and people are really struggling to find the drugs. I mean, in the case of Pat Stiff, who we talked to in our story, he called me a few weeks ago and had checked every pharmacy in a 300-mile radius, he said, to try to find these drugs and just could not find his Monjaro prescription in stock anywhere. One of the ways that the city, and this is actually happening across the US, but it's really obvious in Bowling Green is there are these medical spas and weight loss clinics that are popping up that offer what are known as compounded drugs, compounded versions of

Zepbound or Monjaro or Wigovir or Ozempic. And they're essentially like off-brand versions that are made by compounding pharmacies, which is allowed during supply shortages. And so a lot of these medical spas are actually making a ton of money selling these compounded versions to people because so many people are having difficulty accessing the drugs. And are these off-brand compounded versions of these drugs as effective and as safe? That is a really important and good question. And it's one that we don't really have good answers to right now. You know, with

branded pharmaceutical drugs, companies have to go through rigorous approval processes, which requires, you know, years long studies in many cases and very large studies to prove the effectiveness of their medications to, you know, prove quality and safety and all of these things. And when it comes to compounded drugs, they really weren't meant to be made at this scale. And so there aren't these studies to back up how effective they are. And you're really going by word of mouth a lot of times or just trusting these companies that the drugs do what they're supposed to do. Well, besides the gentleman that you mentioned who couldn't find a branded weight loss drug within like 300 miles of him, tell us about

someone you've met in Bowling Green who takes one of these weight loss drugs and just sort of the journey they've been on. Yeah. So we talked to so many people in Bowling Green who have had amazing success, life-changing success with these weight loss drugs. We spoke with a woman, Candy Gray. The reason that she went on a drug in the first place and she went on Ozempic was because she had lost several family members in a very short time frame to heart disease. And she told me that she kind of looked in the mirror and was like, something needs to change. I need to take hold of my health. And her sisters thought the exact same thing. They had all gone through these losses together. So all of them went on Ozempic and they lost a lot of weight. Candy dropped 30 pounds in six months and her lab results,

her blood sugar started to normalize. And she was, you know, finding herself playing pickle with her husband, taking her dog for longer walks and really just, you know, enjoying life more. But after that initial six months, her insurance stopped covering the drug. And so she's had to switch to one of these copycat or compounded versions of the medications because she still had weight to lose and wasn't willing to really give up yet. Her journey, her health journey was not completed yet. She kind of shouts it from the rooftop. She wants this to be de-stigmatized. She wants other people who might be thinking about going on a weight loss drug to feel comfortable talking about it. So if anyone asks her what she did to lose so much weight,

she's happy to tell them that she took one of these shots. Yeah. Well, you mentioned med spas, you mentioned the weight loss clinics. How else has the weight loss drug boom in Bowling Green changed or reshaped the local economy there? I mean, I expected to go to Bowling Green and to see restaurants, you know, shuttering their doors and gyms closing because of the weight loss drug boom, because that's what we hear oftentimes from, you know, industry professionals or analysts. But at least in Bowling Green, that is not what we saw. The restaurants were still bustling. The gyms were actually growing according to the gym employees

that we talked to there. But what you do see is these more subtle changes, like the GNC at the local mall has switched up their display and they're offering supplements and protein powder that are supposed to help with different side effects of the drugs like nausea or muscle loss. And you even see some doctors who have been in Bowling Green for forever, they're putting out advertisements for weight loss shots outside of their practices. And so it's just, it's really interesting how it's like subtly reshaping the economy and some of the culture in Bowling Green. I get that people in Kentucky and across the U.S. are losing weight because of these drugs,

but has their health actually improved in measurable ways? Yeah, that was something that we were really curious about going into Bowling Green. And in terms of looking at the data, it is a bit hard to tell that these drugs are making an impact yet. That's not to say that they aren't. It's just perhaps too soon to tell or that there are so many issues with real-time data in this country in general, especially with health data, that it's hard to see what's going on. But anecdotally, from talking to patients and from talking to doctors, we know that these patients have seen measurable declines in their blood sugar levels or their knee pain, hip pain has gotten better. And the doctors that we spoke to in Bowling Green said, you know, without a doubt, their patients' health are improving as a result of these drugs.

Another interesting thing that we heard in Bowling Green is that bariatric surgeons and bariatric surgery clinics are seeing substantially less patients and less interest in bariatric surgery. And one of the people we spoke to in Bowling Green, Brittany Feltner, she works at a rehab clinic that treats and helps people after they've had surgery. And she said that one of the most common or most popular reasons that patients used to come to this rehab clinic was after bariatric surgery to help in the recovery process. And she said that that's not happening anymore. She's not seeing patients come into the rehab center anymore as a result of bariatric surgery. Yeah. I mean, if you can lose weight in a less drastic way, why not?

Right. Well, then that leads me to this question. You write, quote, we are all living in an ozempic town or will be soon. Is that a good thing? After spending time in Bowling Green, what do you think? I mean, everyone that we spoke to is a lot happier and a lot healthier and they feel like better versions of themselves. That's not to say that these drugs are a cure-all.

I mean, we did talk to people who had really bad side effects from them. They're not the right fit for everyone. There are some issues that the drug manufacturers need to figure out, that insurance companies need to figure out. And going on and off of a drug is not great for your health either. And another problem with that continuity

is insurance access and insurance providers covering this, employers covering it. It's important for there to be equal access to these medications. And in Bowling Green, we did go to a pharmacy that said Ozempic and other weight loss drugs are not a big thing at this specific pharmacy in this specific area of Bowling Green because it did tend to be a bit more low income. So we're already sort of seeing these health disparities in terms of access emerge in Bowling Green. And that's an important consideration when you're thinking about the country as a whole and who needs these drugs and who's able to access them. Madison Muller is a health reporter for Bloomberg News. Her piece is titled,

What Happens When Ozempic Takes Over Your Town? Thank you very much for your reporting. This was super fascinating. Thank you for having me. This episode was produced by Catherine Fink. It was edited by Courtney Dorney. Our executive producer is Sammy Yenigan. And one more thing before we go, you can now enjoy the Consider This newsletter. We still help you break down a major story of the day, but you'll also get to know our producers and hosts and some moments of joy from the All Things Considered team. You can sign up at npr.org slash consider this newsletter. It's Consider This from NPR. I'm Elsa Chang.