When Mary Johnson, 58, first injected herself with semaglutide in early 2023, she was desperate. Diagnosed with type 2 diabetes and battling obesity for most of her adult life, she’d tried everything—from calorie counting to keto. “I felt like my body was working against me,” she said. Within six months, she had lost 35 pounds. Her blood sugar normalized. Her energy returned. “It changed my life.”
Mary is not alone. According to the latest polling data from KFF, roughly 12% of American adults—an estimated 31 million people—have used a GLP-1 receptor agonist like Ozempic, Wegovy, or Mounjaro. About 6% (15 million)are currently on them. What was once a treatment for diabetes has rapidly evolved into one of the most disruptive forces in modern medicine—and American society.
A Drug for the Times
GLP-1 (glucagon-like peptide-1) drugs, originally approved to regulate blood sugar in diabetics, have emerged as powerful appetite suppressants that lead to sustained weight loss. Clinical trials have shown average weight reductions of 15–20% over the course of a year, far surpassing older obesity medications.
Demand is soaring. U.S. spending on GLP-1s skyrocketed to $71.7 billion in 2023, a fivefold increase since 2018, according to IQVIA. The drugs now dominate pharmaceutical budgets, driving double-digit growth across retail and specialty drug spending.
“GLP-1s are not just a class of drugs—they’re a cultural shift,” said Dr. Anne Wu, an endocrinologist at the Mayo Clinic. “We are entering an era where obesity and metabolic disease are treatable with unprecedented efficacy.”
Who Is Taking GLP-1s—and Why?
The demographic landscape of GLP-1 use is as varied as America itself.
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Chronic Disease: 61% of GLP-1 users take them for diabetes, heart disease, or high blood pressure.
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Weight Loss Only: 38% use them exclusively to lose weight, many with a BMI over 30 but no formal diagnosis of obesity-related illness.
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Age and Race: Usage peaks among those aged 50–64, with 19% having used GLP-1s. Notably, Black Americans report higher use (18%) than White Americans (10%), reflecting broader disparities in chronic disease rates.
“These drugs have become the great equalizer for people who have battled obesity and its stigma for decades,” said Dr. Raymond Torres, a public health expert at Columbia University. “But they’re also deepening divides—because not everyone can afford them.”
The Cost Barrier
A one-month supply of semaglutide or tirzepatide can range from $936 to $1,349 without insurance. Even with coverage, 54% of users report difficulty affording their prescriptions. And coverage itself is far from guaranteed.
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Private insurance: 24% of patients report full coverage, while 57% have only partial benefits.
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Medicare: GLP-1s are not covered for weight loss alone. As a result, only 1% of seniors are using them solely for obesity.
Insurance denials have become so common that patients are turning to overseas pharmacies, black-market alternatives, or unregulated compounding clinics. “It’s an absolutely insane maze,” said Emily Garner, who runs a GLP-1 support group in California. “Some people get access in weeks, others are fighting their insurer for months.”
The Societal Ripple Effect
Beyond personal health, GLP-1s are reshaping industries.
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Food and Beverage: Analysts report reduced consumer spending on high-calorie snacks and fast food among users, prompting concern across processed food conglomerates.
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Fitness and Wellness: While gyms once marketed themselves as weight-loss centers, many are pivoting to strength training and “metabolic support” for GLP-1 users.
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Employment and Productivity: Anecdotal reports suggest improved workplace engagement, reduced sick days, and increased self-confidence among long-term users.
But there’s a darker undercurrent.
“The conversation around these drugs is rapidly shifting from medical innovation to body image obsession,” said Dr. Rachel Lin, a psychologist specializing in disordered eating. “We’re seeing people with healthy weights seeking prescriptions purely for cosmetic reasons, sometimes even forging diagnoses.”
What’s Next?
With more than 100 million Americans living with obesity or type 2 diabetes, the market for GLP-1s remains vast and underpenetrated. Analysts expect U.S. users to surpass 20 million by 2026, particularly if the FDA approves more indications for cardiovascular health and addiction treatment, both currently under study.
Yet the question looms: How sustainable is this?
Some policymakers are calling for Medicare expansion to cover weight loss uses. Others warn of spiraling costs if the government takes on tens of billions annually in GLP-1 coverage.
And then there are the human questions—of identity, stigma, self-control, and what it means to take a drug to alter one’s body so profoundly.
Mary Johnson has now been off semaglutide for two months. She’s gained back a few pounds, but not many. “I’m not the same person I was before,” she says. “But I’m also not sure who I am now. This drug gave me a second chance. The rest,” she pauses, “is up to me.”
