‘Game-changer’ GLP-1s could fix America’s obesity crisis—but 2 inequalities stand in the way

For roughly 40% of American adults living with obesity, the medical playbook has barely changed in decades: Eat less, move more, and if that fails, wait until the disease progresses far enough to justify surgery.

GLP-1 drugs like Ozempic, Wegovy, and Zepbound have broken that script—but according to Robin Wenzel , head of Wells Fargo Industry Insights, the drugs are exposing a harder problem than obesity itself: who can afford to wait for them to work.

“It’s a game-changer,” Wenzel told Fortune , describing how GLP-1s have shifted obesity treatment “upstream”—from late-stage interventions like gastric bypass and orthopedic surgery toward proactive weight management that can head off disease before it starts.

“That’s what we’re seeing, how this filters through the economics within healthcare.” The numbers back her up.

A 2026 JAMA Surgery analysis found as GLP-1 use rose more than 140% between 2022 and 2024, bariatric surgery volumes fell 34.1% over the same stretch—a direct substitution effect, according to a Wells Fargo Industry Insights report co-authored by Wenzel and John Teasley, a market executive in the bank’s healthcare commercial banking group.

Cardiovascular outcomes may be an even bigger story: The SELECT trial found semaglutide reduced major adverse cardiovascular events by 20% in overweight or obese adults without diabetes—a result Wenzel called “an eye-opener” given cardiology’s status as one of the most lucrative lines of business within healthcare.

Obesity therapies now account for roughly 25% of pharma’s forecast late-stage drug pipeline value, up from just 1% in 2022, surpassing oncology for the first time in 16 years of tracking by Deloitte.

Emerging research is also linking GLP-1s to reduced substance abuse, including alcohol use disorder.

A Washington University School of Medicine study published in The BMJ in March found GLP-1 use was associated with an 18% lower risk of alcohol use disorder and similar reductions across other major addiction categories, adding to a growing body of clinical evidence the drugs’ effects extend well beyond weight loss.

A disease, not a failure of willpower Central to Wenzel’s framing is a reset of how obesity itself should be understood.

“It’s a very complex disease, a recognized medical disease,” she said, pushing back on the historical medical framing that treated obesity primarily as a matter of “reshaping reasonable habits” through diet and exercise.

“The hope, and what we’ve seen with GLP-1s, is it’s finally giving people a path to truly address it and prevent it in many cases.” That reframing has real economic backing.

Federal health agencies now recognize obesity as a chronic disease shaped by genetics, environment, and food systems as much as individual behavior.