Fighting obesity: The uphill battle of America’s poor
For many low-income Americans, the fight against obesity and diabetes is a constant war, exacerbated by dependence on fast food and limited access to alternative medicines. The new system has the effect of losing weight.
Kim Jackson, a former delivery member, several years ago, was diagnosed with diabetes and was advised by his doctor to immediately change his diet and exercise regimen. Jackson took the traditional weight loss route: avoiding drugs and specialized treatments, cutting back on fried foods, sweets and fast food, and taking free educational classes at a city entertainment center in Atlanta, Georgia.
Last week, Jackson drove 50 minutes to the recreation center and learned her cancer weight loss class had been canceled. Unlike those with connections in the pharmaceutical industry, Jackson did not have access to newer injectable drugs such as Ozempic, Wegovy and Mounjaro – drugs commonly prescribed to diabetics and obese patients. because their side effects can help with weight loss.
Two of Jackson’s friends, one of whom weighed more than 158kg and was suffering from heart disease, were advised by doctors to consider taking these medications. But the problem is that low entry people like Jackson must be her uninsured and the other person’s insurance plan doesn’t cover diet pills.
In the United States, people of color, especially blacks, Latinos, and low-income people, are at higher risk of obesity and Type II diabetes. Recent studies have found these groups are less likely to prescribe new generation weight loss drugs.
The modern possibilities of Atlanta’s rich environment. In the affluent Buckhead area, weight-loss clinics are popping up to serve people willing to pay for GLP-1, the latest generation of weight-loss drugs. Educational centers are also adapting their programs to serve clients who use these medications. In contrast, residents of the low-income neighborhood in southwest Atlanta, where Jackson trained, said the weight-loss drug revolution was passing them by. Medicaid, the government insurance program for low-income people, does not cover these drugs, and few doctors are willing to prescribe them even when people know of their existence.
Trust is another barrier. People in the Black community often hear about weight loss pills through celebrity news. Oprah Winfrey has revealed that she is using these drugs and members of the Kardashian family are also rumored to have used them. But as Jackson wonders, “But how do we know we’re on the same drugs as them?”
Advertisements for these new generation weight loss drugs sound so simple, it seems like anyone can use them. “A week of injections to lose weight,” read an ad on a New York City subway. But in reality, using these drugs requires a major financial and time investment for which only a few people meet the above conditions.
Nationwide studies highlight inequities in access to next-generation weight-loss drugs. Serena Jingchuan Guo, an assistant professor at the University of Florida, found that in areas where GLP-1 use is booming—like New York and Silicon Valley—black people are prescribed these drugs just as often. Half of whites, by default, have higher rates of obesity and diabetes.
Another analysis by healthcare analytics firm Komodo Health found 65% of patients prescribed Ozempic, Mounjaro, Wegovy and Rybelsus between 2021 and 2022 were white. Antonio Lewis, an Atlanta City Council member who represents District 12, where there is a clear divide between rich and poor, noted that obesity in his district stems from unhealthy eating habits and the health care system. Take care of your poor health.
Lewis recalls his own struggles, gaining nearly 30kg working fast food during the day and snacking on chicken wings, beer and soft drinks at night. The weight gain affected his health, forcing him to work out hard to lose weight.
After 18 months of diligent walking, Lewis is back to a healthy weight, but he realizes that not everyone has the determination to take this weight loss measure. Some people may choose to lose weight with gastric bypass surgery, which is covered by insurance, but Lewis knows a relative who had the surgery faced complications and is now limited to just one meal a day. He believes that if low-income residents in District 12 could access these newer weight loss drugs at affordable prices, their lives would improve. In District 12, many residents face financial difficulties and find it difficult to buy healthy food, forcing them to rely on cheap, fast food and resulting in obesity.
The poorest residents in the 12th District rely on Medicaid, but coverage varies by state. Georgia is one of ten states that offer weight-loss drugs, but only for Saxenda, a first-generation diabetes drug that is less effective than Ozempic, Wegovy, Mounjaro and Zepbound.
Georgia also does not have health insurance under the Affordable Care Act, so many people cannot afford medical expenses.
“America needs to view medicine as a need, not a want,” Lewis argued. “If the federal government invested a portion of the COVID-19 vaccine budget in weight loss drugs, we could save lives.”
Ashley Keyes, head of the nonprofit Center for a Successful End to Childhood Obesity (CHOICES), used to weigh 180kg and was diagnosed with diabetes at age 16. She tried many diet and exercise programs various products, including Jenny Craig, WeightWatchers and Atkins, but it was only after gastric bypass surgery and lifestyle changes that she regained her health.
Keyes was excited about the drug GLP-1 but doubted he could afford the $1,000 monthly payment.
“As long as we worry about food, we cannot control obesity,” she said. “One cannot happen without the other.”
Keyes is also concerned about the long-term side effects of these drugs. “We may lose weight today, but what will happen in 12 or 13 years?” she asked, emphasizing the importance of building healthy living and eating habits.
