Tangle - The rise of GLP-1s.

Episode Date: September 24, 2026

In recent years, use of new weight-loss medications has risen in the United States. A 2026 Gallup poll found that a record 11% of U.S. adults are taking GLP-1 medications for weight loss, up from 3% in 2024. Furthermore, high-profile figures like Illinois Gov. JB Pritzker (D) and decorated tennis player Serena Williams have extolled their experiences taking the drug. The rising prevalence of GLP-1 use for weight management has sparked a debate over their potential impact on health and wellness in the U.S.Ad-free podcasts are here!Get 20% off your first year of ad-free episodes, exclusive interviews, and deep dives with Tangle’s podcast membership!Suspension of the Rules.It’s a Big Apple episode for apple season. On the most recent Suspension of the Rules, Isaac, Ari, and Kmele talk about the ongoing UN assembly in New York. Then, a discussion of a New York Times Magazine article about public schooling and race. Plus, guess who has a complaint about leaves? (hint: Kmele. It’s Kmele.) Check it out here.You can read today's podcast⁠ ⁠⁠here⁠⁠⁠ and today’s “Have a nice day” story ⁠here⁠.You can subscribe to Tangle by clicking here or drop something in our tip jar by clicking here.Take the survey: What is your relationship to GLP-1s? Let us know.Our Executive Editor and Founder is Isaac Saul. Our Executive Producer is Jon Lall.This podcast written by: Audrey Moorehead and audio engineered and edited by Dewey Thomas. Music for the podcast was produced by Diet 75.Our newsletter is edited by Managing Editor Ari Weitzman, Senior Editor Will Kaback, Bailey Saul, Audrey Moorehead, and Carina Pacheco. Hosted on Acast. See acast.com/privacy for more information.

From executive producer Isaac Saul, this is Tangle. Good morning, good afternoon, and good evening, and welcome to the Tangle podcast, a place where you get views from across the political spectrum, some independent thinking, and a little bit of our take. This is editor Audrey Moorhead, and I am fresh off a family trip to Gatlinburg, Tennessee, nestled in the heart of the Smoky Mountains, where life is as peaceful as a baby's sigh. Gatlinburg is best known for its, shall we say, tackiness, but there is a quaint charm to the little town, and I'm really grateful that I could make my family's annual trip for the first time in five years. A lot has changed in the world in those five years,

and today I'll be telling you about one such change, the rise of GLP1 weight loss drugs. Then, Senior Editor Will Keeback will give you a recap of the stories we didn't cover this week and some good news about the falling U.S. poverty rate. But first, I wanted to let you know about our latest suspension of the rules episode. It is a big Apple episode for Apple season.

On the most recent suspension of the rules, Isaac, Ari, and Camille talk about the ongoing UN Assembly in New York. Then they discuss the New York Times Magazine article about public schooling and race. And then someone has a complaint about leaves, and I think you can guess who it is. If you can't, it's Camille. Check out the conversation by heading over to suspension of the rules

after you listen through today's podcast. In the meantime, I'll pass things off to Will, and I will be back for my take. Thanks, Audrey. Okay, here are today's quick hits. Number one, a federal judge ordered the Trump administration to restore White House press credentials to CNN, MS Now, and Politico reporters,

finding that the administration's ban is likely unconstitutional. Number two, Iranian President Mazud Peschkian addressed the United Nations General Assembly, criticizing the U.S. and Israel for attacking his country, and saying that it will fight the war, quote, until our last breath. Number three, Chinese President Xi Jinping arrived in Washington, D.C. for a state visit

hosted by President Donald Trump. Shortly after Xi's arrival, the U.S. and China announced an extension of their trade truths until January 2027. Number four, the 10-year treasury yield, the annual interest rate paid by the federal government to investors who own 10-year debt notes, rose to 5.14% on Wednesday, the highest rate since July 2007. And number five, acting Navy Secretary Hung Cow informed lawmakers that eight sailors assigned to the USS Abraham Lincoln Aircraft Carrier Strike Group attempted suicide during the ship's recent deployment to the Middle East. The GLP-1 boom. Yeah, so their use has skyrocketed over the past few years.

Close to 30 million people are now taking them. one in every eight adults, but achieving your desired results goes well beyond getting the prescription and also goes beyond that number on the scale. In recent years, use of new weight loss medications has risen in the United States. A 26 Gallup poll found that a record 11% of U.S. adults

are taking GLP1 medications for weight loss, up from 3% in 2024. Furthermore, high-profile figures like Illinois Governor J.B. Pritzker and decorated tennis players Serena Williams have extolled their experiences taking the drug. The rising prevalence of GLP1 use for weight management has sparked a debate over the potential impact

on health and wellness in the United States. GLP1s, or glucagon-like peptide-1 agonists, are a class of medication that primarily treats type 2 diabetes and obesity. GLP1 agonists mimic the GLP1 hormone, which is made in the small intestine, to trigger insulin release, slow down digestion,

and increase the feeling of fullness after eating. The Food and Drug Administration first approved to GLP-1s for medical use in 2005, but their popularity has increased significantly in recent years with the introduction of brand names like OZempe and WeGovi. The rising adoption of GLP-1s has coincided with U.S. obesity rates decreasing from 39.9% in 2022. to 36.8% in 2026.

Users like Governor Pritzker have reported health improvements after lifetime struggles with weight management. Pritzker said he has lost 80 pounds in the two years since he began taking a GLP1 medication. Under current federal law, Medicare and Medicaid mostly covered GLP1s if prescribed for diabetes, but new initiatives are exploring potential coverage for obesity.

In July, Medicare launched a pilot program to provide certain GLP-1s to some Medicare Part D beneficiaries. The Trump administration has also sought to negotiate reduced prices for the drugs for Medicare and Medicaid recipients, as well as U.S. consumers paying for them out of pocket. The side effects of the drugs are still being studied, and a March 26 study by the Washington University School of Medicine found that people who start and then stop GLP-1 treatments, experience a, quote, meaningful increase in the risk of major cardiovascular events

compared with those remaining on the medication, end quote. Another study identified a biological mechanism that may be causing users to regain lost weight after they stop taking the medication. Separately, hundreds of consumers have sued GLP-1 manufacturers, Novo Nordisk and Eli Lilly, alleging that the drug increases the risk

of a condition that causes blindness. Today we'll share views from the right and the left on the rising prevalence of GLP-1s, and then editor Audrey Moorhead gives her take. We'll be right back after this quick break. Many on the right praise the innovation that led to GLP-1s and their benefits. Some argue that government coverage

would raise the drug's prices. Others note the potential health consequences of taking the drug. The Washington Post editorial board argued the promise of weight loss drugs keeps growing. Eli Lilly announced in May that the highest dose of its new weight loss drug helped people shed more than 30% of their body weight on par with gastric bypass surgery. Eli Lilly's innovation promises to unlock surgery-free treatment for people with a severely high body mass index, for whom weight loss medications have not been a durable option.

Studies have found that users of these drugs cut their grocery expenditures, especially on calorie-dense snacks and processed foods. That could mean reducing future health care costs on chronic illnesses such as diabetes and cardiovascular disease. Not long ago, addressing America's obesity epidemic was seen as something only the government can solve by micromanaging consumers' eating habits. As is often the case, however, science-based innovation has proven far more effective than any initiative from Washington. In National Review, John R. Puri said, don't ruin GLP1 prices

by having the government cover them. Over the past few years, the American healthcare sector has seen a real-time experiment in what happens when a revolutionary treatment runs outside traditional payment systems. Usually, when the FDA approves a new drug,

its cost is quickly covered by employer-run insurance plans and the government, through Medicare and Medicaid. Yet the makers of GLP1 drugs, approved for weight loss, have had to compete for patients' dollars more directly. Individual patients may be annoyed that insurance won't pick up the tab on a pricey brand-name drug,

but the result of widespread self-payment has been vicious price competition to win market share. The price of GLP1 drugs will probably keep falling, but only if patients have to pay for the drugs themselves. Governments should limit their appetite for providing short-term relief at long-term expense. And in the Daily Wire, Benjamin Chaco asked, are we using medicinal drugs to support healthy living or as a substitute for it?

One extreme dismisses GLP-1s as another miracle cure sold by Big Pharma. The other imagines that a weekly injection can replace the hard work of building health. Both are false gods. Disease begins with what we eat, how we sleep, how we move, and a food environment that has been for decades, making processed calories cheaper, more addictive, and more accessible than real nutrition. The Make America Healthy Again movement

is rightly focused on those upstream causes. GLP-1s should complement that mission, not compete with it. Medicine is crossing an important threshold as we develop drugs that will influence motivation, reward, and desire themselves. It's an extraordinary scientific achievement, but it also demands extraordinary wisdom.

We know GLP-1's work, but they cannot replace the habits, character, and choices that allow people to flourish. The question at hand is whether we'll use them to support health or substitute for it. And those are two very different futures.

Now here's what the left is saying. Many on the left suggest GLP-1s should be treated like any other medicine. Some lament that Americans' views on weight cause GLP1 users to feel guilty. Others worried that these drugs are exacerbating certain eating disorders. In New York magazine, Sarah Jones asked, why can't we treat GOP1s like medicine?

When I first started taking the drug, I was reluctant to mention it to anyone. Diabetes is complicated enough by itself, and the American healthcare system is one more obstacle to good health. In my case, Cigna refused to cover Manjaro at the lowest dose, which forced me to increase it on corporate timing, not my own or my own doctors. I hoped it would be all right. The endocrinologist nurse told me that I might have gastrointestinal systems,

but the drug was good for my blood sugar, and the side effects usually got easier over time. She was right for a while. Then my progress seemed to stall. I lost nearly a third of my total body weight by April and saw a new endocrinologist, who told me that I developed a significant, vitamin D deficiency. I told her I wanted to have children, and she finally took me off Manjaro.

I don't know who to blame for any of this. Perhaps I could blame the Reformation, or capitalism, or some unholy combination thereof. The damage is the same. We've lost sight of Manjaro's medicine. A GLP1 is not snake oil or a miracle drug, but a tool, and it can be helpful without being right for every person or every situation. In Vox, Dylan Scott suggested Americans still have a toxic relationship with weight. GLP1 drugs promised to usher in a new era of treating obesity as a disease.

We could leave behind the anti-fat biases of the past, which blamed obesity on moral failing or personal weakness. Instead, these drugs would allow us to approach it as a medical condition, a complex matrix of genetics and other forces which could be changed with the right dose of these powerful new medicines. Or so the thinking went. Even as millions of Americans shed pounds in bulk for the first time, they're also contending with fierce stigma and shaming from others. Instead of being criticized for being fat, they're being criticized for using GLP ones. Americans have internalized the message that being overweight is a personal failure so thoroughly that now that the kind of

extraordinarily powerful weight loss shots and pills long hoped for are here, many people struggle to see it as good news. They see it as cheating. In the New York Times, Jessica Gros suggested GLP-1s feed our sick culture. Multiple things can be true about GLP-1s. They are truly miracles and may treat a whole range of conditions beyond obesity and diabetes. And they are often misused, partly because we have told women in multiple ways that being thin makes them valuable. As my colleague has written, our culture, quote, makes being fat a woman's burden, a means test for dignity, work, social status, and moral citizenry, end quote. In a recent study, researchers found that the use and misuse of GLP-1s is higher among people with eating disorders than among the general population,

and that some of them may be attempting to maintain their, quote, eating disorder, psychosurricular, psychopathology through rapid restriction and weight loss, end quote. They found that over 10% of participants with anorexia had tried GLP-1s. Though GLP-1s may be a promising treatment for some kinds of disordered eating, like binge-eating disorder, it appears much riskier for women with other kinds of diagnoses. That's what the right and left are saying about this topic. Now over to Audrey for her take. Thanks, Will. This is my take.

In this era of hyper-partisan polarization, which is now affecting the conversation on weight-loss drugs, of all things, it's important to remember, the Internet is not real life. Issues are not flat and two-dimensional. In the real world, where the sky's brilliant blue and the air smells of crisp leaves and your body fat, wherever it may be, jiggles while you walk, multiple things can be true at once. First and foremost, as is true of many new medical technologies, GLP-1s are a net good for American public health, and it's hard to argue otherwise. From 2017 to 2020,

nearly 42% of U.S. adults over the age of 20 were obese, which increased their risk of serious chronic health problems like heart disease and diabetes. According to the CDC, obesity-related issues and treatments accounted for $173 billion in 2019 of annual health care costs. And a study from the 2010s found that obesity-related deaths increased from 1.8 per 100,000 people in 2010

to 3.1 per 100,000 people. in 2020. In short, before the advent of Ozimic, obesity was one of the leading, if not the leading health issue facing Americans, and things were getting worse, not better. In my mind, then, a new set of drugs that relieves the worst of this public health crisis is an unquestionable good for the world. But as is the case with many new medical technologies, GLP-1s aren't a magic wand we can wave to fix the culture that produced an obesity epidemic. And because weight loss and weight gain are often a game of extremes, it's fair to question whether these drugs will swing the pendulum to the other dangerous end. It's disappointing, but not surprising, to see that these concerns have ended up

divided along partisan lines. For example, in today's What the Right is Saying section, Benjamin Chaco pointed to the Make America Healthy Again movement, and it's concern that GLP1's change problematic behaviors that produce obesity, but don't change problematic mindsets. The thinking goes that the drug might prevent a person from desiring food in the short term, but it doesn't adequately address the twisted relationships to food that Americans might have. Frankly, I'm sympathetic to fears that disconnecting unhealthy actions and thought processes from their consequences can exacerbate rather than cure societal dysfunction. It's a long-game assertion, hard to measure when GLP-1s are so new, but we've seen it before in other

spheres. Look at the problem of grade inflation. Studies from the 80s show that students who receive poor grades can be discouraged from learning, turning the students who most need more instruction away from education. So educators started grading more gently. But when teachers give students higher grades than their work might otherwise deserve, students get a short-term boost but ultimately have lower life outcomes. Isn't it possible that the same handicapping might be true of giving people with unhealthy habits access to a miracle drug that suppresses their desire for food? Many GLP-1 users regain the weight once they stop using the drugs, which signals some early support for that hypothesis from the right.

The left, on the other hand, including Jessica Gross, in what the left is saying today, fear that GLP-1s are ushering in a new wave of eating disorders and reckless pursuits of an imagined ideal of thinness. This comes from the spirit of the body positivity movement. One only needs to read about how GLP-1s have a unique. exacerbated the already exorbitant sorority culture, prompting girls of such gargantuan proportions as size eight in dresses to call up their moms for the shots, to understand that this fear is well-founded. Even more disturbing is that many Americans who can't get their doctor to prescribe peptides are turning to gray market drugs with no FDA approval or medical oversight. This in particular

alarms me. When Americans order drugs from overseas, there's no way to ensure they're getting what they're ordering, and it's also harder to ensure that the drugs are prepared and dosed safely. And surely enough, some people have experienced side effects after taking illicit GLP-1s, and regulators have found that purported vials of the unapproved drug Red of Troutide have sometimes contained very different ingredients. If Americans are willing to risk taking unproven mystery drugs just to lose a few pounds, is that really a sign of a culture that's primarily concerned with health? The culture surrounding GLP-1s isn't a zero-sum game, both fears of personal and societal degradation can be true at once. In fact, if GLP-1s have had any impact

on the culture so far, it's been to force a reckoning with how Americans think about our weight and health. And I'm not exactly watching this story at a remove. In fact, I almost feel as though my life is a microcosm of many Americans' relationship with weight, and GOP-1s have forced me to confront my own habits and lifestyle as much as anything else. I won't go so far as to say I've always struggled with my weight. I spent most of elementary, middle, and high school blessedly average, despite being decidedly inactive and not really watching what I ate. But in college, to deal with the stress of moving far away from home, taking difficult classes, and struggling to make new friends, I turned to food as a coping mechanism. When I started gaining weight, I didn't stop to reflect

on whether I had a problem. I assumed that obesity couldn't just happen to me. But slowly and truly, and without me noticing, it did. Even after I'd resolved, the emotional stresses that led me to adopt bad habits, the bad habits stuck around, and I wasn't paying attention to them. When GLP-1's first came out, I was still in denial about having problems with my weight, even as I noticed that I was struggling to take long walks or get upstairs. But as people around me began using the drugs, some privately and some openly, I felt curious. I wasn't obese, I thought, though I was, but sure, I could stand to lose a few pounds. Would it really be so bad to take a drug to get those off? And suddenly, I was paying attention to how I looked in the mirror or in photos.

For the first time in my life, I really felt self-conscious about how I appeared. And that self-consciousness prompted me to probe my physical health. After all, I was young and supposed to be in the prime of my life. But somehow, exercise was a struggle. I don't remember who brought it up first, me or my friend who was using Grey Market Reda Trutide, but I remember the night I ended up scrolling through the website they used, looking at vials and needles and dosage sizes.

I asked my friend how the injurricular, injections worked, and they dutifully assured me that swabbing and jabbing my skin would be easy. But at that description, I chickened out. There was no way I could stab myself with a needle when I had to psych myself up just to get a flu shot. I thanked my friend for the links in the info, and I said I might try it later. Instead, I called up my brother, a bona fide fitness nerd, and asked him about losing weight the old-fashioned way. I told myself that if diet and exercise failed, I could fall back on the drugs. To my surprise, I discovered that I did have the willpower to keep up with the diet, and the rewards of getting back to a healthy weight created a self-perpetuating

motivation cycle. I dealt with constant food cravings for a couple of weeks, but then the food noise subsided permanently. And when I ate too much while at dinner with friends, I could just snap back to discipline the next day. But not everyone trying to lose weight has the same experience. Some people's cravings never subside, and even just one night off track can feel like it resets all their progress. I don't experience that with food, but I do experience it in other areas. of my life where I've tried and failed to curb bad habits on my own before, like managing screen time. So I can't begrudge the use of GLP ones for people for whom food is a constant temptation, especially when the alternative is untreated obesity.

But separately, beginning to lose weight forced me for the first time to confront the culture that I'd ingested since I was a teenager. I grew up on Instagram, Tumblr, and Twitter at the peak of the body positivity movement. influencers and activists' attempts to raise eating disorder awareness and discourage body comparison were well-founded and well-meaning, and I took them to heart as a teen. Being overweight wouldn't make me a bad person or worth less than anyone else. But those influencers also never mentioned that it would mean I was more susceptible to illness and injury or less capable of physical activity than other people.

At the same time, the rise of GLP-1s has brought back the skinny culture that body positivity was created to resist. and I've learned that you can't put the self-awareness genie back in the bottle. Once I became aware of my weight, I became hyper-aware of it, perpetually conscious of my own imperfections. And in some ways, skinny culture is even worse now that people can use drugs to lose weight, because it now comes with the added moralizing dimension of how you become and stay skinny, not just whether you do.

It's hard to say what the ultimate solution to this problem even is, when the healthy weight conversation seems to constantly oscillate between the two extremes of you're healthy at any weight and you're only healthy at a very specific weight in a very specific way. But I think it probably requires walking a path between those extremes. Obsessing over being skinny and looking a certain way is unhealthy. And learning not to hang yourself worth on your physical appearance is vitally important for your mental and physical health. However, obesity is also unhealthy. And finding a solution, whether it's the diet plan that has worked for me or the GLP ones that have worked for others, is vitally important for your mental

and physical health. Oddly, I'm hopeful that the rise of GLP-1s with their extreme short-term effects will balance things out in the long run. I'm also hopeful that the attempts to stigmatize GLP-1s are just the last gasp of a moralizing weight-loss culture finally dying out, and that in its place, a culture that can stop thinking so much about food and weight will arise. That's it for my take. Thanks so much for listening. I'll pass it off to executive editor Isaac Saul for a staff dissent, and then Will will take it for the rest of the podcast. All right, thanks, Audrey. Isaac here with my dissent. So I agree with Audrey that GLP1 use is a great choice for some people

and will likely improve overall health throughout American society. Yet, I can't shake this concern. The GLP1s are just the latest rung on the ladder to a frictionless life. The AI chatbots do our thinking, the influencers summarize our news in one-minute videos, and GLP1s shed light on our weight. There's no need to read, think critically, research, or exercise anymore. Shoot, even the bikes are now electric and do our pedaling.

I have no idea if GLP1s will have some long-term unseen downside, but given how many parts of our lives they impact, I suspect they will. People's personalities are known to change, as well as other non-food-related habits. Heart rates also increase, and we don't yet fully understand any of this. I have a hard time finding GLP-1s encouraging in that larger context and am inherently skeptical of any so-called miracle drug.

But I mostly find myself worried about how few challenges people are overcoming on their own anymore. All right, that is it for my dissent. Back to Will. We'll be right back after this quick break. Now here's a note about the stories that we didn't cover this week. It was another week, and yes, another Pat news cycle. Now, our first three editions of the week were nearly set in stone coming out of the weekend, and those were the latest in the Middle East, Trump's press bans, and the Greenland Agreement, which we wrote about yesterday.

The range of timely issues available for today's edition was broader, including the Paramount Settlement, the Missouri redistricting court case, the ice shooting in Austin, and rising diesel prices. So why did we choose to discuss GLP once, a topic that's been in and out of the news for years now? Well, for one, the contours of the left-right debate on those newer topics that I mentioned before are still forming, and we thought that holding off on immediate coverage would allow for more comprehensive analysis as the dust settles. But in the bigger picture, we liked the idea of exploring a topic that spoke to broader cultural themes and that featured compelling disagreements within the left and the right. It's easy to fall into the habit of following the news cycle wherever it

goes, but we still want to discuss those evergreen issues that shape our everyday lives, even when they aren't dominating the headlines. And finally, here's our Have a Nice Day story. In 1964, President Lyndon B. Johnson declared a war on poverty and directed U.S. resources to tracking the nation's poverty rate. In 1967, the Census Bureau published its first ever poverty data. 59 years later this September, the Census Bureau announced that the U.S. poverty rate declined for a second straight year, coming to an all-time low of 10.2% in 2025. Additionally, the poverty rate for children fell to a historic low of 13.4% while median household income rose to a record high of $87,460.

Reuters has this story, and we'll drop the link to it in today's show notes. And that is it for today's edition. Like I mentioned a few moments ago, it's been a jam-packed week of news. So I hope that this weekend or whenever you're listening, you're able to disconnect a bit and recharge. Of course, we'll be back on Monday with our normal coverage. And don't forget to tune in tomorrow for a special Friday edition from executive editor, Isaac Saul. I'm going to keep it a secret for now. So make sure that you tune in tomorrow.

Until then, peace. Our executive editor and founder is me, Isaac Saul, and our executive producer is John Wall. Today's episode was edited and engineered by Dewey Thomas. Our editorial staff is led by managing editor Ari Weitzman with senior editor Will Kovac and associate editors Audrey Moorhead and Bailey Saul. Music for the podcast was produced by Diet 75. To learn more about Tangle and to sign up for a membership,

please visit our website at retangle.com.