GLP-1 receptor agonists: a wake-up call for the food system, not a silver bullet for obesity

New weight loss medications won’t solve obesity alone, but could they spark the regulatory shift our food environment desperately needs?

GLP-1 receptor agonists (GLP-1 RAs), marketed as Wegovy, Mounjaro and Ozempic, have been a lifeline for many people, and have been shown to lead to remarkable improvements in health outcomes for those taking them. But while they are currently dominating the weight loss conversation, their real significance could be their potential to drive long-overdue reform of our food environment.

These weight loss medications show huge promise for individuals, but they are far from being the solution to the obesity epidemic. At a time when 64% of adults are classified as overweight or obese, it is neither affordable nor desirable to medicate our way out of the crisis. Such medications come with a high price tag, and the NHS is currently limiting access to a tiny proportion of those who would benefit from them. 

They also are not a long-term fix. NICE guidance currently limits use of some of them to a maximum of 2 years, but evidence shows many people regain weight once they stop taking the medication. 

This has not dampened demand. Up to 2.5 million adults in the UK are estimated to be using these medications, with the vast majority spending hundreds of pounds a month to buy them privately (rather than by NHS prescription). Described by Wes Streeting as a ‘return to the days when health was determined by wealth’, this poses a real challenge for policymakers. Expanding access to everyone who would benefit from weight loss drugs is unaffordable – but not doing so is unequitable as it will deepen health inequalities and work against the government’s aim to halve the healthy life expectancy gap. While ensuring the NHS rollout is as fair as possible, policymakers need to retain focus on the population-level interventions that tackle the root cause of obesity – our food environment. 

A ‘moonshot’ moment – but not in the way we think

Even if GLP-1 RAs are unlikely to deliver the population-wide impact on obesity that we urgently need, they could still mark a turning point. Not because they will end the obesity crisis themselves, but because they are reshaping consumer behaviour in ways that create new incentives for the food industry.

Data from the US – where 12% of adults report having taken GLP-1 RAs – show strong signals that an economic imperative is encouraging food reformulation where voluntary government incentives have failed. 

A Cornell University study found that households with at least one GLP-1 RA user reduced their supermarket spend by up to 8.6% within 6 months – equivalent to billions of dollars in foregone sales. The steepest declines were in ultra-processed categories such as snacks, sweets and sugary drinks. By contrast, nutrient-dense products like yoghurt, fresh produce and nutrition bars were the least affected.

Manufacturers have already started to adapt to changing demand by producing nutrient-dense, low-calorie products. General Mills, Nestle and Conagra are among the food giants launching smaller-portion, high-protein products labelled as suitable for people on these medications.

Research by EY highlights a potential $12bn hit to the unhealthy snack food category as a result of these medications, and recommends food companies reformulate products to be healthier, while moving away from less healthy ranges.

For decades, governments have tried to encourage voluntary reformulation of this kind – with limited success. The salt reduction programme in the 2000s initially worked, but progress on sugar and calorie reduction has largely stalled. Now, for the first time, consumer health interests, food industry incentives and government goals are pulling in the same direction: towards a healthier food environment. 

It's not only food manufacturers who need to adapt. Walmart, a large US supermarket chain, has observed a ‘noticeable shift’ in shopping baskets that aligns with GLP-1 RA use (consumers are spending less overall but maintaining purchases of healthier staples). And restaurants are not immune: the Cornell study found an 8% fall in spending at fast food chains and coffee shops.

These shifts matter. We have seen how increasing GLP-1 RA use has had ripple effects across the entire food industry in the US. The UK will likely see similar trends. Retailers have already started to respond, with the Fat Duck the first restaurant to offer a specific menu catering for people taking weight-loss medications. Greggs is also now offering smaller, higher-protein portions to respond to the rise in GLP-1s. 

A unique opportunity for government

GLP-1 RAs may hold great promise for individuals, but they cannot substitute the population-level changes needed to reverse obesity. These interventions benefit everyone, especially those on lower incomes, and our research shows this approach commands more public support than many assume. Relying on medication alone risks treating the symptoms of an unhealthy food system while leaving its root causes untouched. 

For the first time since the obesity epidemic took hold, the interests of consumers, food companies and public health are aligning. Politicians should act now to formalise wider market shifts by introducing stronger regulation of the food environment – accelerating reformulation, reshaping promotions and taxing unhealthy products. This is important because, due to their price, GLP-1 RA uptake is likely to be higher among wealthier populations. Without government intervention, supermarkets and food manufacturers could increasingly target low-income groups when promoting high profit-margin unhealthy foods.

A good start could be the government’s recently announced ‘healthy food standard’, where retailers, including supermarkets, will have to find ways to make the average shopping basket of goods sold slightly healthier. At a time where retailers are already making these changes in response to customer demand and are therefore less likely to resist, the government has an opportunity to be more ambitious with these standards. 

GLP-1 RAs may prove to be a medical moonshot for some individuals, and a useful tool in an effective obesity strategy. But their real legacy could be as a catalyst for the systemic changes that will improve diets and health across the whole UK population. The government has a choice: seize the opportunity to transform prevention, or miss it once again.