Why Do We Need GLP-1 Drugs like Ozempic Now?

Obesity keeps rising, and we now seem to need drugs to combat it. But why?
In recent years, medications like Ozempic and other GLP-1 agonists have surged in popularity—not just as diabetes treatments, but as tools for weight loss. Their rise reflects something deeper than a personal health choice: a public surrender to a food environment that has become too powerful to resist. We don’t suddenly have less willpower—we have a radically different world. This article explores how changes in food supply, culture, industry influence, and lifestyle patterns have collided to create an obesity epidemic that now seems to require pharmaceutical intervention just to keep up. When you step back and compare nations with vastly different obesity rates—like the U.S., Japan, France, and South Korea—the patterns become undeniable. The data tells a story of how we got here—and why drugs may feel like the only answer in a system designed to keep us overeating.

The Impact of Food Supply, Culture, and Industry on Obesity & Health Outcomes

Global Obesity Trends and Country Comparisons

Adult obesity rates vary widely by country – the U.S. has one of the highest prevalence (over 40% of adults obese) while Japan remains very low (under 10% obese). Worldwide, obesity has risen dramatically: more than one billion people are now classified as obese, reflecting a global epidemic. This surge is recent – 43% of adults were overweight in 2022, up from 25% in 1990. High-income Western countries tend to have the greatest obesity rates, whereas East Asian countries have maintained far lower levels.

• Stark Country Differences: Adult obesity affects ~42% of U.S. adults vs only 7–8% in Japan. Other Western nations fall in between (e.g. UK ~27%, Mexico ~32% obese) – still well above East Asia’s levels. These disparities highlight the role of environment and culture, not genetics alone.
• Rising Childhood Obesity: Childhood weight problems mirror adult trends. In the U.S., about 19% of children (ages 2–19) have obesity (nearly 1 in 5). By contrast, Japan has some of the lowest childhood obesity – only ~3% of children are obese. Youth obesity is an alarm bell, as overweight kids often become overweight adults with higher health risks.
• Trajectory Over Time: The prevalence of obesity has climbed steadily in most countries over the past few decades. In 1975, no country had an obesity rate above 15%; now dozens do. The global average adult obesity rate rose from approximately 8% in 1980 to ~13% by 2020, with especially sharp increases in North America and parts of the Middle East. This rapid change suggests environmental factors – especially diet and lifestyle – are driving the epidemic.

Food Supply and Diet Composition

Ultra-Processed Food Consumption: Highly processed, calorie-dense foods make up over half of adults’ diets in some countries (≈58% of calories in the U.S.), but under 15% in others (only ~10% in Italy). The quantity and quality of the food supply have shifted dramatically. In many nations, cheap calories are abundant: for example, the U.S. food system supplies ~3,900 kcal per person per day, far above an average adult’s needs. This overabundance, largely driven by industrialized production of refined grains, sugars, and oils, promotes overeating and weight gain.

• Calorie Availability: The U.S. and similar countries have the highest food energy availability. The U.S. food supply offers ~3,900 kcal/day per capita, versus only about 2,700 kcal/day in Japan. Such excess caloric supply (much of which is wasted or over-consumed) creates an environment where it’s easy to gain weight.
• Ultra-Processed Foods: Diets high in ultra-processed foods (pre-packaged snacks, fast foods, sugary drinks) correlate with higher obesity. In the U.S., an estimated 58% of daily calories come from ultra-processed products. By contrast, Italy (with its traditional Mediterranean diet) gets only ~10% of calories from ultra-processed foods. Countries like Canada (~50%) and Australia (~42%) fall in between. Populations sticking closer to minimally processed, whole foods have markedly lower obesity rates.
• Dietary Composition Shifts: Over past decades, global diets have shifted toward more refined carbohydrates, added sugars, and processed fats. For example, worldwide sugar consumption nearly tripled from 50 million tons in 1960 to ~150 million tons in 2020. Similarly, cheap vegetable oils have flooded food markets. These energy-dense ingredients raise total calorie intake without providing satiety, contributing to positive energy balance and weight gain. In essence, modern food supplies deliver more calories and poorer nutritional quality than ever before.

Food Culture and Dietary Habits

Cultural dietary patterns play a key role in obesity differences. Countries with deep-rooted traditional food cultures tend to have healthier outcomes. For example, Japan’s diet emphasizes fish, rice, vegetables, and fermented foods with modest portion sizes – factors linked to lower obesity and longer life expectancy. Similarly, Mediterranean cultures (Italy, Greece) historically prioritize fruits, vegetables, legumes, olive oil, and leisurely home-cooked meals. These patterns, rich in nutrients and fiber, help keep obesity rates relatively low (though they are rising as habits westernize). In contrast, a “Western” diet pattern – high in red meat, processed meats, sugary snacks, and sodas – prevails in the U.S. and parts of the UK/Australia, and is strongly associated with obesity and related diseases.

• Home Cooking vs. Convenience: Americans today spend less time cooking than almost any other people – on average only ~30 minutes per day on food preparation. Many rely on ready-to-eat meals or fast food, whereas cultures like Italy or India traditionally dedicate more time to cooking fresh meals at home. More home cooking often means more whole ingredients and controlled portions; less cooking often means more packaged and restaurant foods, which tend to be higher in fat, sugar, and calories.
• Meal Patterns: In some cultures, meals are structured and communal. For instance, France and Spain have a strong tradition of a sit-down family lunch, and Japan’s schools serve balanced lunches to children nationwide. Regular meal patterns may discourage constant snacking. By contrast, in the U.S. and UK, meal times are more irregular and often rushed; “grazing” on snacks throughout the day is common. Skipping family meals and eating solo on-the-go can lead to higher calorie intake (and often less healthy choices).
• Cultural Attitudes to Eating: Attitudes toward food and fullness also differ. The Japanese practice “hara hachi bu,” a teaching to eat until only ~80% full, encourages moderation. Many Asian and Mediterranean cultures traditionally value balance and variety in the diet (e.g. a mix of vegetables, grains, proteins). In contrast, modern Western food culture has embraced “supersizing” and all-you-can-eat portions as bargains. Social norms in the West have shifted to accept larger body sizes and eating more frequently, whereas in other societies there may be social pressure to eat modestly and remain slim. These cultural norms influence everyday behaviors that add up over time.

Portion Sizes and Eating Behaviors

How people eat – portion sizes, snacking, and dining frequency – has changed alongside the obesity epidemic. Portion sizes in the U.S. have ballooned over the past 50 years. Restaurants and food manufacturers offer much larger servings than in the past, contributing to passive over-consumption. For example, the standard fast-food french fry portion is ~180% larger today than it was in the 1970s. Soda bottles that were once 6 ounces are now often 20 ounces or more. Larger portions encourage people to eat more calories often without realizing it.

• “Supersize” Culture: The trend of bigger portions is most pronounced in North America. Many U.S. chain restaurants serve meals that exceed an entire day’s recommended calories. Packaged snacks and drinks are sold in large sizes for value. By contrast, portions in Japan or France remain more modest – one reason why average calorie intake is lower. Simply put, bigger portions = more calories: studies show people eat 30–50% more from a large portion than a smaller one, unintentionally. This portion creep has been a significant contributor to obesity.
• Frequency of Eating Out: Americans also eat out very frequently, which often means calorie-rich meals. Over 50% of American adults report eating at restaurants or getting takeout three or more times per week, and more than one-third consume fast food at least twice a week. In contrast, only ~27% of UK adults eat out that often, and in many Asian countries frequent restaurant dining is less common (meals are more often home-cooked). Frequent dining out is linked to higher calorie intake and obesity, because restaurant meals tend to be larger and heavier in fats/sugar than home meals.
• Snacking Habits: Snacking has become a major source of calories in Western diets. In the U.S., snacks (between-meal items like chips, sweets, soft drinks) now account for about 24% of adults’ daily calories – effectively an extra “fourth meal” each day. Snack foods are typically high in salt, sugar, and fat. In cultures where snacking is less ingrained (for example, traditional meal patterns in East Asia or Africa), total calorie intake remains lower. The constant availability of snacks and encouragement to “graze” (through vending machines, convenience stores, advertisements) in the U.S. normalizes constant eating, contributing to excess caloric intake.

Food Industry Influence and Policy

The food and beverage industry wields immense influence on diets – from marketing that shapes consumer choices to lobbying that affects public policy. In the U.S., food companies spend roughly $14 billion per year on advertising, with over 80% of those ads pushing fast food, sugary drinks, candy, and other unhealthy products. This dwarfs the entire budget the U.S. government spends on nutrition education and chronic disease prevention (only ~$1 billion at the CDC). The result is an environment where people – including children – are bombarded with messages to consume high-calorie, nutrient-poor foods.

• Aggressive Marketing: Big Food and Big Soda target consumers relentlessly. An American child might see dozens of ads for junk food in a single day on TV and social media. These ads are designed to create cravings and brand loyalty from an early age. Research confirms that such marketing drives higher preferences for sugary and high-fat foods, contributing to poor diets. Industry marketing often disproportionately targets minority and low-income communities with cheaper unhealthy products, exacerbating health disparities.
• Lobbying and Policy Shaping: The processed food industry has a track record of influencing nutrition policy in many countries. For example, in Mexico, soda and snack companies have had close relationships with policymakers – Coca-Cola even had a former executive become President of Mexico in the 2000s. This influence has historically hindered strong anti-obesity measures, though Mexico did implement a soda tax in 2014. In China and India, industry-backed organizations have steered governments to emphasize exercise over dietary regulation in tackling obesity. And across Latin America, big food companies have lobbied against front-of-package warning labels on junk food. Such “junk food politics” mean that public health often loses out to corporate interests.
• Regulatory Responses: Some governments are pushing back. Several countries (the UK, Chile, Mexico, etc.) have introduced taxes on sugary drinks or restrictions on marketing to kids. But strong policies face industry pushback. The former WHO director Dr. Margaret Chan noted that failure to reduce obesity globally is “not due to individual willpower, but to the absence of political will to take on the power of major food corporations.”. In other words, curbing obesity will require governments to enact bold policies despite industry pressure – such as regulating food advertising, improving school meals, and subsidizing healthy foods.

Health Outcomes and Impacts

Obesity carries serious consequences for health. Excess body fat increases the risk of many of the leading causes of death – including heart disease, stroke, type 2 diabetes, certain cancers, and even mental health disorders. The rise in obesity is linked to a rise in these non-communicable diseases worldwide. Diets high in ultra-processed, high-sugar, and high-fat foods in particular are associated with worse health outcomes. Large-scale reviews have found that people with the highest ultra-processed food intake have significantly elevated health risks: for example, a ~50% higher risk of death from cardiovascular disease, and about a 21% higher risk of all-cause mortality compared to those with low intake. Reducing obesity is not just about weight – it is fundamentally about improving health and longevity.

• Chronic Disease Burden: Obesity greatly increases the likelihood of developing type 2 diabetes – a prime example of diet’s impact. Countries with the highest obesity rates now also have among the highest diabetes rates. In Mexico, approximately 14% of adults have diabetes (one of the highest rates globally), whereas in Japan – with low obesity – only about 6–7% of adults have diabetes. Likewise, obesity fuels higher rates of hypertension, heart disease, fatty liver disease, and orthopedic problems. These conditions emerge earlier in life now as younger generations experience obesity from childhood.
• Life Expectancy and Quality of Life: Populations with lower obesity enjoy longer average lifespans. Japan, with the lowest obesity among industrialized nations, also has the longest life expectancy (~84 years) – a connection attributed in part to its healthy diet and weight profile. In contrast, U.S. life expectancy (around 76–77 years) lags behind most peer countries, and researchers estimate that obesity has shaved about 1.5 years off U.S. life expectancy at age 50. Beyond longevity, obesity diminishes quality of life by causing joint pain, sleep apnea, and mobility limitations, and it increases healthcare costs substantially.
• Healthcare and Economic Impact: The medical costs of obesity-related diseases are enormous – running into hundreds of billions of dollars in the U.S. for treating diabetes, heart conditions, and cancers linked to high BMI. Indirect costs (lost productivity, disability) add further burden. Even countries like Japan, despite low obesity, spend ~1% of GDP on obesity-related issues. In higher-obesity countries, the economic toll is higher (estimated >2–3% of GDP in the U.S. and Middle East nations). Thus, improving diet and weight outcomes is not only a health imperative but an economic one for societies.

Conclusion: Food Environment Shapes Health

In summary, data across countries demonstrate that the food environment and culture strongly dictate obesity outcomes. Nations where traditional, minimally processed diets and moderate eating habits persist (paired with lower influence of junk-food industries) show far lower obesity and better health. On the other hand, countries that have embraced an industrial food supply – with plentiful cheap calories, aggressive marketing of fast/processed foods, larger portions, and snacking culture – are grappling with high obesity and rising chronic disease. The evidence suggests that tackling obesity will require shifting food supply and culture: making whole foods more accessible, reining in ultra-processed food marketing, and perhaps drawing lessons from cultures that have maintained healthier eating patterns. Ultimately, letting the data speak, we see that when people eat like those in the U.S. (or similar environments), they tend to grow heavier and sicker, whereas eating in line with traditional patterns (as in Japan or the Mediterranean) leads to leaner bodies and longer, healthier lives. The challenge ahead is translating these insights into effective public health actions.

Sources: The statistics and findings above are drawn from global health data and research, including the World Obesity Federation, WHO, CDC, peer-reviewed studies, and reports cited throughout, among others. See sources below for further exploration.

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