Obesity is a worldwide severe disorder that can shorten life and bring on a variety of related illnesses, and how to deal with it is now big business.
Worldwide estimates are that around 880 million adults and 159 million children and adolescents are dealing with obesity in 2024. By 2035, 88% of overweight children and 79% of overweight adults will reside in low- and middle-income countries (LMICs), according to the World Obesity Federation. Further published analyses of national levels of obesity are troubling and indicate that more than 250 million adults and 7 million additional children and adolescents will be obese by 2050.
In addition to obesity, a growing number of people around the world are struggling with substance use disorders, tobacco use disorders, and alcohol use disorders. Everyone, from the person experiencing the disorder to their loved ones and the community at large, feels the effects of these conditions.
The co-existing disorder data indicate many patients are engaging in multiple substance use, which significantly raises the dangers linked to each substance individually. But there's also another factor: discrimination. Experiencing both obesity and discrimination can contribute to mental health problems, leading some to rely on substances for relief.
Consider, for a minute, who the primary targets are for advertising substances, such as alcohol and cigarettes. I suspect you will note that it is in communities with lower socioeconomic levels and higher rates of discrimination.
Medication to the Rescue?
Medications for alcohol use disorder, opioid use disorder, cocaine use disorder, and tobacco use disorder may not be as effective as we need. Recent findings suggest targeting GLP-1 receptors as a potential approach for developing new pharmaceutical therapies for many disorders besides obesity. How might they work?
The small intestine produces GLP-1 upon food consumption, and the brain also produces it and releases it as a neurotransmitter in several brain regions. Importantly, GLP-1 can cross the blood-brain barrier (the brain’s biological moat) and reach receptors in areas associated with the neurobiology of addiction.
These new GLP-1 drugs are assuredly affecting something that may drive obesity—junk food. Junk food may play a significant role in obesity, and the new medications meant to curb our taste for it are cutting into junk food profits. But the desire for junk food starts early, and many factors are associated with it.
Three reasons for junk food preferences may be present: lack of money leads to purchasing cheaper foods, one behavioral element, and one lifestyle element. The lifestyle element may have more to do with the demands of work and a lack of time for food preparation. But why do we crave junk food? Some experts believe it’s a learned response from infancy. We have an industrial palate.
The "industrial palate" is a taste preference for processed foods developed from early exposure in infancy and characterized by artificial ingredients. What's in baby foods, and do you recognize all the ingredients? Oddly, it echoes the expression, “Give me a child before the age of seven, and they are mine for life.”
Some people on GLP-1 medications have found that they no longer crave ultraprocessed foods. What is in these foods? They contain chemicals, such as artificial sweeteners, colors, bleaches, and modified starches, are not normally seen in a home kitchen.
Don’t you want bleach in your food anymore? (Side note: They bleach maraschino cherries before dyeing them red.) There may be several solutions for all of that, and it is problematic for industries built on keeping your palate leaning in their direction.
Food Choice and Obesity Medications
The GLP-1 medications may affect the reward center in our brains, but how do they specifically affect junk foods?
The main point is that the glucagon-like peptide-1 (GLP-1) system in the brain is very important for controlling how much food you eat and your weight. The study focuses on the differences between GLP-1 that comes from the gut and GLP-1 that comes from the brain, and how these differences affect the effects of drugs that bind to GLP-1 receptors and are used to treat obesity. It also shows that targeting the GLP-1 system in the brain could open up new ways to treat obesity.
There is a simpler way to state this interaction and the biology behind why these new drugs work. GLP-1 is secreted in the small intestine and aids in maintaining stable blood glucose levels, decreasing hunger, and delaying stomach emptying. As a possible treatment for addiction, GLP-1 receptor agonists have garnered interest via animal studies.
Preclinical research in mouse models has demonstrated that GLP-1 receptor agonists can reduce the rewarding and reinforcing effects of certain addictive substances, alcohol consumption, and seeking behaviors. We do not yet know how activation of GLP-1 receptors affects alcohol and drug effects, although it might have something to do with regulating the dopamine and stress systems, among other neurotransmitter systems.
Technology Enters the Mix
If our current economy demands workers have little time for shopping and food preparation, how might technological advances in food preparation affect the purchase of ultraprocessed food? Hot pots and countertop devices are gaining popularity with consumers and prices for them are coming down as their intended uses increase with advanced design.
In competing with food technology devices, corporations that are engaged in the production of fast or junk foods have research teams currently producing lines of weight-maintaining or weight-loss meals. These meals are designed to temper upward their attractiveness in a variety of ways, one of which is in the naming of the products. They are now being called products that are "weight conscious" or "high protein" or to be used in conjunction with weight reduction medication.
Consumers must decide whether fast food fits their lifestyle, despite potential health consequences and cost. The research on the GLP-1 receptors, however, offers promise in substance abuse disorders, and, therefore, in life-maintaining methods. The medication's will not be limited to obesity alone and will find a welcoming field in healthcare providers where addiction has proven to be difficult for many.