The Current - Cheaper weight loss drugs “gamechanger” for Canadians

Episode Date: December 3, 2025

Generic GLP1-1s  are set to come to Canada next year — significantly lowering the price. What will this mean for people's lives and health?  With as many as ten per cent of Canadian adults on these drugs — we look at how consumer spending is changing.

I've been patiently yet anxiously dreading this moment. It is the end of Stranger Things. This is the show that started back in 2016. We get to watch these teenagers fighting supernatural forces. Now it's beginning its fifth and final season this week on Netflix. On Commotion, I talked to some of the smartest TV critics I know about all things, Stranger Things, and about how this show transformed the way that we watch television.

For this episode and more, you can find and follow Commotion with me, Alameen Abdul Mahmoud, on YouTube or wherever you get your podcasts. This is a CBC podcast. Hello, I'm Matt Galloway, and this is the current podcast. In the past 16 weeks, I've lost just under 25 pounds, which is great. And today I put on a pair of pants that I haven't worn in years. Two weeks ago, I was 214. Today, I am 208. That means we've officially hit 40 overall.

For a few years now, drugs have been changing. the game when it comes to weight loss for people with obesity, GLP-1 drugs like Ozempic, Manjaro, and Wagovi, have been, in their words, life-changing. This week, the World Health Organization issued the first guidelines on the use of weight loss drugs, saying that those drugs can play a key role in treatment, and the WHO has called for the cost of those drugs to drop so that more people can get them. In Canada, that may soon be the case, with generic versions of the popular weight loss drugs set to come here next year, and in a moment. We'll hear how these drugs are already changing consumer behavior and how that shift is

reshaping the economy. But first, I'm joined in studio by Dr. Sanjeev Sokolingham. He's the scientific director at Obesity Canada and the chief medical officer at Cam H, the Center for Addiction and Mental Health in Toronto. He's with me in our Toronto studio. Good morning. Good morning, man. What do you make of the WHO calling for broader access to these drugs? Well, first off, it's very validating. We've recognized obesity as a chronic disease for over a decade. However, we've been slow to really adopt that into guidelines. I would say Canada is ahead of the curve. Our guidelines have actually recommended GLP-1s

and behavioral interventions as part of treatment. And so this is a global recognition of the need for an integrated approach to obesity care. I was reading in advance of our conversation about the popularity of these drugs. OZEMPIC is the top-selling drug in this country. How many Canadians are on GLP-1 drugs? Well, we have North American data, so in Canada a little hard to get some of that data,

but I would say the data that we often quote is about one in eight people. This is as of last year. That's probably increased since the last year. And if you look at some of the private insurance data as well, it's somewhere around one in seven, one and eight Canadians. But that's really not the vast majority of Canadians who could probably benefit from these people. Yeah, I was reading somewhere close to 10%. of Canadians that's a huge number yes um who has these drugs in this country covered by the

healthcare system and who's paying out of pocket for them well i would say most people um are trying would have to pay out of pocket for this because as as you alluded to earlier the costs of these medications are quite high currently how much do they cost for people who don't know anywhere from 400 to 500 dollars give or take and 400 to 500 dollars per month yeah and you need to these drugs for life, essentially, right? And so the WHO recommendation say chronic disease, so you need to be on these long term as part of chronic disease management. And so are there any provinces or territories that cover the cost of these drugs? And no, none thus far. There's only one province that actually recognizes obesity as a chronic disease. So to get there to treatment would be

another leap and the cost is a huge barrier. And is that your sense? Part of this is around cost, but we'll talk about stigma in a moment, but part of this is around cost that means, as we always say, the pie is the pie and they've decided that the pie slices will go somewhere else rather than taking a piece of that for these drugs. Right. And remember, we're thinking about multiple chronic diseases and medications that people have to be on lifelong or for longer periods of time. And so these costs accumulate for provinces, which I understand. But I think we also have to think about the paradigm ship for obesity that what happens if we don't treat obesity early on, we might end up getting more chronic diseases. And there's actually data

to support that. So is your expectation that at some point in time, provinces and territories will have to figure out how to cover these? Because in the long run, money could be saved. Absolutely. We- The cost of obesity kind of increases and adds to the bill for health care down the line. Absolutely. We did a study just recently looking, estimating the cost for Canada. It's $27 billion for not treating obesity. $27 billion? Yes. And so could that be cut? Do you think if more, people have access to these drugs? So again, I want to be cautious that medications are one pillar of obesity treatment, and we need to make all pillars accessible. So yes, medications being more accessible be extremely helpful, but we also need behavioral and psychological interventions,

and we have metabolic and bariatric surgery for those who need it as well. The WHO spoke for the need for more affordable versions of these medications in Canada, not just access to the drugs, but make them cheaper for everybody. And then, as I said, in the introductory, that could soon be a reality in this country. Generic versions are set to be released here as early as next year. What would that mean practically do you think for the price? I mean, if you're talking about hundreds of dollars a month, what would that mean if the generics come in?

So again, maybe for listeners, just to clarify, generics are medications that are approved by Health Canada in terms of bioavailability. They're not compounding, so I want to make a clear distinction between the two. But generics becoming available could, it's estimated, reduce the cost by anywhere from 30, 70% of cost reduction. So you can imagine the affordability of this. I don't know where they will be priced in 2026. That's a big price cut, though.

And so what would that mean, again, as you understand it, for access to this? So I think for many Canadians, so one in three Canadians living with obesity, those who are having significant health in functional limitations, this could be a significant improvement in their overall comprehensive obesity treatment. I'll also say I do worry, though, about off-label use where people might be using it not for obesity treatment. I want to be clear, I think we're advocating physicians, organizations that are supporting people with obesity for obesity as a chronic disease and getting the treatments to the right people. What is that off-label use? I mean, again, there are people who use these drugs perhaps aren't living with obesity, but they want to lose a little bit of extra weight.

Is that what you're talking about? That's what I'm talking about. When we talk about obesity, we talk about the definition, excess fat tissue that's impairing someone's health and functioning, right? There are people who live in larger bodies or people who might want to lose a few pounds, and that is not obesity if it's not meeting that definition. And so those individuals might be trying to access these medications for aesthetic or cosmetic purposes, and that's not what we're advocating for.

What's your concern about that? Because we've spoken with people on this program who have said that you, using these drugs can be life-changing for them, that maybe they've been trying to lose a little bit of weight for any number of different reasons. They feel better, feel better when they see themselves because they're on those drugs. So what's your concern about that? I don't have concerns about that because if they are living with obesity, and again, we're moving away from body mass index, we're moving away from these more archaic parameters looking at health outcomes, but it includes quality of life. So if your mental health, your

mobility, your ability to participate in your family's lives, improves as a result of losing weight and addressing excess fat, then that is the definition of obesity and obesity treatment. That's the right person to get treatment to you. I think it's where we see the fad diet phenomenon being perpetuated by GLP with GLP ones. I think that's where I think we want to have a cautious distinction. How much stigma is there around taking these drugs now? I mean, given the fact that almost 10% of the population may or may not be on GOP-1s, what do we know about that in terms of a stigma?

Well, I think that's a great question. So if I were to say to you, Matt, that, you know, we have effective treatments that could be early interventions for people living with cancer. And I said to you, it costs too much, we're not going to give you that medication. And you're going to have to pay out of pocket, and most people wouldn't be able to afford it. that we would see an uprising, actually, of patients, families, health care providers. We don't have the same thing with obesity. Because of, I think, the stigma that there's an assumption that people have a lack of willpower and don't deserve this treatment and that we perpetuated, or that they just need

to eat better and exercise more and they haven't worked hard enough. That you need to do. Why am I dealing with this in society? You need to do it. Exactly. How do you change that? Well, I think one is to educate people on the science. You know, we know that obesity is a chronic disease.

It's a brain disease as well, which is, you know, interesting for me as a psychiatrist and an obesity medicine specialist. But and also that many of the patients I see in my clinic have tried three, four, ten interventions, but have not been given scientifically based interventions. So, again, behavioral interventions, medications that could work as they can. can access it. Or some people I may even see who have undergone metabolic and bariatric surgery. Do we know, I mean, again, there is this tidal wave of excitement around the potential of these drugs, but this is all new. Do we know the long-term impacts of taking these drugs? You have to take them for life. Yeah. So, again, I think most people will have to take them longer term. It could be for life. We do know, again, these medications were used for diabetes, introduced in

diabetes. So we do have data from diabetes, so about, you know, 15 years of data. We also have the first wave of these treatments in about a decade ago. And so we are seeing some of the longer term studies, but you're absolutely right. We still need to monitor and look at the long-term effects for individuals, but also, you know, societal effects as well that we need to really focus on. Just before I let you go, the American Medical Association says that these medications represent a tipping point in how we treat obesity. You're nodding your head. You agree? I agree. I think the health benefits and you are seeing increasing indications now beyond weight loss for cholesterol, preventing recurrent heart attacks. Addiction? Addiction. Data is still to be

determined, but some promising early results. So I think there is an opportunity here to really address obesity in a comprehensive way. And more importantly, maybe that we can intervene early enough that we could prevent these downstream health effects in our various domains. Early days, we'll follow this along. Sanjeev, thank you very much. Thank you for having me.

Dr. Sanjeev Sokolingham is the scientific director at Obesity Canada and the chief medical officer at the Center for Addiction and Mental Health in Toronto. Welcome to the Little Fair. In the late 90s, a groundbreaking all-female music festival emerged led by Canadian artist Sarah McLaughlin. motor said, you can't put two women on the same bill. People won't come. And it put a huge fire under my butt to prove them wrong. Representation for women in rock music wasn't there. And

worse, you're being pitted against each other. Lilith became a free train. Catch the documentary that chronicles a pivotal moment in music culture. Watch Lilith Fair, building a mystery for free on CBC Gem. GLP1 weight loss drugs aren't just impacting people's physical health. They're also changing how people are spending their money and living their lives. Paul Linewand is a principal with PWCUS's strategy consulting group. He has studied how weight loss drugs are influencing consumer behavior. Paul, good morning to you. Good morning, Matt. Great to be with him. Great to have you here. You wrote in a recent report, GLP-1s may be catalyzing a behavioral and economic shift that is on par with major technological breakthroughs. You compared it in some ways to an iPhone and

other technological breakthroughs. What do you mean? Well, we're really quite impressed, in fact, at the nature of how this demand has surged over the last several years. Ali Furman and I, my colleague, wrote this article on HBR, which was called The Appetite Economy, because consumers are not just changing how they buy food. They're really rethinking their basic daily lives. And I think you mentioned it earlier in the show, just around how people see themselves for the first time, how they're finally able to really address something that's been an issue for many, many years. And as such, it's not just that they're buying less food. We see that in a study we did, maybe six to eight percent grocery purchases decline, alcohol purchases decline, increases of

some types of restaurants and decreases in others, retail purchases around a apparel, not just because your size is changing, but because you may be doing different things with your lives, and you may need different outfits. And so the effects of this are really profound. And yes, for sure, as we look at comparing this against other big breakthrough products and innovations, this is really at the top of the list. Let's talk about some of those specific shifts, and you've hinted at them. I mean, in the food world, you think of grocery stores. One of the things that we've heard from people is that taking these drugs kind of eliminates or turns down what they call the food noise in their head. And they don't feel like spending money on the same kinds of things or eating the same kinds of things.

What does that mean in terms of, say, the grocery business? Yeah, for sure. And this isn't just a purchase decision change. It's a physiological change. Right. And so therefore, people are thinking differently about impulse purchases. That could be food at the supermarket. It could be the categories that I'm interested.

It could be, as I'm spending my day, places that I'm not going to get food from anymore. Maybe I was stopping, you know, for a quick snack. And so the changes are pretty profound. But the other interesting thing is we're just learning how these changes are being reflected by category. And there is no one-size-fits-all answer. It's not that everybody in this class of drugs is somehow spending less money on chocolate. because we're all different, and we all had different preferences before being part of this trend. We have different preferences after, and companies are now just beginning to understand how some of their consumers are changing what they buy.

Beyond food, again, you hinted at fashion. Tell me a little bit more about how people's self-perception or the way that they think about themselves translates to how and where they spend their money. Yeah, I mean, in a study we did just about a year ago, and we've been looking at this now for several years, body image, right? Your image of self, it's the first time people really reflect a material change in that. And so, therefore, how I might think about where I want to go eat, right? Am I comfortable going out to dinner? Am I going to see friends? Well, I spend my vacations in a different way. Will I go on vacation?

What kind of job I might be interested in having? Am I thinking about dating in a different way? These effects are so profound, and so then when you get to things like, yes, apparel shopping, accessory shopping, all of these things are seeing that impact, and we're really encouraging organizations to get to know their consumers in a meaningful way. What is happening to them? Even if the changes are small at this point, mentioned the 10% we've seen up to 14% of U.S. households. But the really amazing thing here is the unpenetrated demand, right? The individuals that are saying, I would love like to be part of this if some barriers could be reduced. And if you could imagine a future where perhaps, you know, there's a once a year injection. Some people are estimated that we could have a majority of individuals on this class of drugs. And so the changes at the purchase cycle then would grow exponentially. We've talked before on this program about the airline industry. This one industry that people are paying very close attention to when it comes to the impact of these

drugs. What are you already saying? For sure. I mean, there's definitely a lot of discussion about people changing their travel habits. And so are people going to be traveling more? Are they going to be going to different destinations? And so I think the airlines are definitely paying attention. It has impacts on travel in other ways, you know, that have to be better understood. I think there's even hospitality, hotels, vacation, cruises, all of these organizations are starting to notice changes. And I think one of the dangers, right, now is to see changes reflected amongst all of the other variables that are affecting what's happening with purchases. So if you see your purchases are down in a category, you could say,

well, it's the economy. Maybe people are concerned about buying, but it could be that GLP-1s are having an effect within that. And we have to understand those changes in order to better respond to them. The way that you articulated that in the report is you said, these aren't just side effects, the changes that we're talking about. There's signals that identity does. desire and consumption are being fundamentally renegotiated. What does that mean? I mean, that's a psychological shift in some ways, right? Absolutely. Again, the basic nature of the psychology here of what do I want to be doing, where are my impulses, how do I want to spend my time, what am I going to be doing with my life? People are evaluating really big questions. And, you know,

in the consumer segment in general, we take a lot for granted, right? We sort of assume people's habits are really stuck. They're not changing very fast. It can take decades to see something. Well, here, we're seeing not only the purchase cycle changes very quickly, but we're seeing the underlying behaviors of human beings change very quickly. So if you look at, if you, if you look at strip malls, is the impact of that going to be that in the strip mall there will be fewer fast food restaurants and more gyms, for example? Well, exercise is really interesting, actually. And yes, we're definitely seeing this change in where people are eating. definitely a decrease in some of those, I would say, quick meals and an increase in some of the

restaurant experiences, which makes a lot of sense given our earlier discussion. But I think the broader change here is really what type of retail environment are people going to be interested in? How can we best serve these consumers? And there's new opportunities, right? Because these consumers are living their lives differently. And exercise is a great example. We might see some people that we're exercising a lot in order to lose weight. And some of those people may be exercising less. And then there's other parts of, you know, there's other consumers that are saying, look, I can now exercise, right?

I've actually reduced weight. I want to be more active and they're engaging in exercise. And so again, this understanding that it's not a one size fits all, that we've got to figure out what's happening with consumer behavior can lead to all kinds of opportunities. I have to let you go. But is your sense that businesses understand that this shift has happened? now? I mean, again, the point that you make in this report is that this is already affecting

businesses. For sure that executives see the impact, and I think everybody is impressed with the demand. However, if it's not affecting you directly right today or you can't see the effect, there may be a little bit of an inhibition to really understand it at the next level. Again, we've gotten used to sort of assuming that most of our demand is stable. I think companies really have to use this opportunity to say, let's go figure out. out what's happening to our consumers because their lives are changing, even if we can't see massive impact yet from this class of drugs. Paul, thank you very much for this. It's fascinating. Thank you. Paul Linewand is a principal with PWCUS's strategy consulting group. He's an adjunct

professor of strategy at Northwestern University. You've been listening to the current podcast. My name's Matt Galloway. Thanks for listening. I'll talk to you soon. For more CBC podcasts, go to cBC.ca slash