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Insulin should have belonged to the world; the researchers who discovered this monumental treatment for diabetes each sold their patents for $1 to the University of Toronto so insulin remained accessible to everyone who needed it, even splitting their Nobel Prize money. These scientists were in the game to change people’s lives, not count their spoils.
Who is in it for the money? Today, drug companies like Eli Lilly and Novo Nordisk have replaced older, animal-derived insulins with monopolies over newer, high-priced versions. Now, they’re raking in more profits than ever with the emergence of the latest diabetes treatment — Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound).
Big Pharma’s rush for profit has clouded any notice of dangerous medical red flags. In particular, doctors have increasingly noticed difficulty in reading PET-CT scans of GLP-1 users. These imaging tools usually look for signs of cancerous regions via patterns of radioactive molecule absorption. But for GLP-1 users, the absorption pattern is disrupted. However, while cancer rates rise in the United States, this issue goes unaddressed and unsolved, and misread scans cost time and lives.
Nor do we fully understand other possible short- and long-term effects of GLP-1 drugs’ popularity. The most common issues, often digestive — constipation, diarrhea, loss of appetite, nausea, vomiting — are brushed off. This leaves GLP-1 users vulnerable to social media grifters who manipulate trust to position themselves as commiserating friends and credible physicians.
Even as researchers are wary and consumers are anything but, people struggling with diabetes are often still unable to fill their prescription and some pharmacies have long waiting lists. Still, the FDA took semaglutide off their shortage list, revoking any federal assistance to fill that gap, heedless of shortage concerns — so much so that two pharmacy organizations are suing the FDA for the “reckless and arbitrary decision.”
People are desperate, turning to gray-market drugs not yet approved by the FDA, which have caused serious complications like overdosing, severe nausea, vomiting and dehydration. It’s clear this problem is one of demand, not supply, when new GLP-1 prescriptions have decreased by 10% for diabetes and more than doubled for weight loss from 2011 to 2023. Worse, a 2021 study in the JAMA Health Forum demonstrated “notable racial, ethnic, and socioeconomic inequities in GLP-1 RA use,” revealing “biases in health care delivery.”
After a health insurance change made his current Ozempic inaccessible, one GLP-1 user found a 10-month supply of tirzepatide in 10 vials of white powder. “He makes his own medicine by mixing it with sterile water and then injects himself,” Sydney Lupkin, NPR's pharmaceuticals correspondent said in an October episode of NPR’s All Things Considered. Third-party online companies saw an opportunity to extort people like Phil, putting them at extreme risk of contamination and counterfeit ingredients.
Scientists called it “serendipity” that this helped with weight loss. But inaccessibility and new research prove the opposite.
Your small intestine already makes the GLP-1 hormone and, when released, lowers blood sugar by signaling insulin release, blocking glucagon release and slowing digestion. These triggered signals transport sugar from the blood to cells for energy, prevent a rise in blood sugar, and lower the levels of sugar released from food, respectively. So, GLP-1 medication binds to the original GLP-1 hormone receptors and triggers this same cascade. It’s a natural system hijacked by mimics.
Now, however, we know that GLP-1 in your gut breaks down too quickly to affect appetite, so it’s the GLP-1 hormone and receptors in your brain that explain the effects on hunger and satiety.
Specifically, a 2012 Journal of Neuroscience study uncovered that GLP-1s could “deplete your dopamine response to any enjoyable activity,” Dr. Sera Lavelle, a clinical psychologist said. One April paper in Current Neuropharmacology even suggested that GLP-1 use in people genetically predisposed to low dopamine levels — a factor linked to ADHD — might increase risk of depression and suicidal ideation. Furthermore, of GLP-1 users surveyed, “59% reported at least one impact of the drug on their dating life” in a July survey by IU’s Kinsey Institute.
While researchers worry, celebrities shrink and people with diabetes struggle for healthcare, Eli Lilly and Novo Nordisk made deals with President Trump to cut prices of GLP-1s. However, the new TrumpRx website’s deals for customers paying themselves might not be less than insurance co-pays. Essentially, “the average consumer likely will not benefit from the Trump administration's deal,” Sydney Lupkin wrote for a Sept. 30 NPR story.
He’s also threatened drug companies to manufacture in the US with tariffs, but this is “largely leaving out the production of generic medicines, which account for 90 percent of Americans’ prescriptions,” Rebecca Robbins wrote in March for the New York Times.
Many people agree GLP-1s aren’t going anywhere, but let’s hold off heralding the drug as the impossible made possible or celebrating Trump and Robert F. Kennedy Jr.’s counterintuitive and failed attempt to make weight loss drugs cheaper while revoking access to food the nation does have an appetite for.
We need to approach the topic armed with greater attention to their psychological effects and practical access issues, not rose-colored glasses.
Odessa Lyon (she/her) is a senior studying biology and English, pursuing a minor in European studies.
CORRECTION: This story has been updated to include Sydney Lupkin's full name and title.
