{"id":35810,"date":"2025-08-26T14:46:14","date_gmt":"2025-08-26T18:46:14","guid":{"rendered":"https:\/\/www.thenewatlantis.com\/?post_type=article&p=35810"},"modified":"2025-09-29T16:14:08","modified_gmt":"2025-09-29T20:14:08","slug":"an-ozempic-in-every-lunch-box","status":"publish","type":"article","link":"https:\/\/www.thenewatlantis.com\/publications\/an-ozempic-in-every-lunch-box","title":{"rendered":"An Ozempic in Every Lunch Box"},"content":{"rendered":"\n

As a child, Marcy was chubby. Her mom was struggling with her weight, too, but she took drugs to keep it down. Fen-phen seemed to work, but it made her cranky, so Marcy was not a fan. When Marcy was fifteen, her mom took her to the doctor and got her on something similar. Marcy hated how jittery it made her feel, so she quit. After that she tried every diet on the books. She got results, but they were always temporary. This went on for decades.<\/p>\n\n\n\n

By the time Marcy started hearing about Ozempic, she was, to put it mildly, a skeptic. And not just of the drugs but of the whole scheme as she saw it: take the drugs or follow the diet, lose weight; go off the drugs or the diet, gain it all back.<\/p>\n\n\n\n

Marcy is now the co-owner of a plus-size clothing store in Los Angeles. She\u2019s come a long way in how she thinks about fatness. She eats well and is physically active, and her doctor has not flagged any problems like diabetes. And yet recently, when she was in charge of snack time at a children\u2019s theater, she snapped at an overweight little boy who told her he was \u201cstarving\u201d right after eating.<\/p>\n\n\n\n

\u201cGreat, you already had a snack,\u201d she said \u2014 and immediately regretted it. She wished that instead of assuming the kid was just going to overeat again, she had found him something that would satisfy his hunger.<\/p>\n\n\n\n

Marcy isn\u2019t the only person wondering how to help children who are overweight. In 2022, the FDA approved<\/a> semaglutide, the drug sold as Wegovy for weight loss, for use in children as young as age twelve. Wegovy and its related class of medications, including Mounjaro, Zepbound, and Ozempic, are far from the first weight loss drugs on the market, but they are touted as the most effective.<\/p>\n\n\n\n

Since then, President Trump has appointed Robert F. Kennedy, Jr. as the Secretary of the Department of Health and Human Services, and, informally, as leader of the Make America Healthy Again movement. MAHA claims that chronic diseases, including obesity, are best treated not with pharmaceuticals but through nutritious food.<\/p>\n\n\n\n

The stereotypical member of the MAHA movement is a tech skeptic: a \u201ccrunchy con\u201d mom who turns off her Wi-Fi at night to protect herself from electromagnetic radiation and drinks raw milk because she doesn\u2019t trust the FDA on the benefits of pasteurization. She washes her clothes with Castile soap (too many lab-generated synthetic chemicals in Tide) and was a regular at the local farmers\u2019 market before it was cool. She has bought into the idea of \u201corganic\u201d as not just a produce preference but a purer way of life.<\/p>\n\n\n\n

But Kennedy plans to do much more than nag Americans about eating their veggies; he wants to ensure that the latest health tech is drafted into his movement. His goal is that within four years every American has a wearable health device that tracks metrics such as blood glucose and daily step count. \u201cWe\u2019re about to launch one of the biggest advertising campaigns in HHS history to encourage Americans to use wearables,\u201d he said<\/a> in a Congressional hearing in June. \u201cWearables are a key to the MAHA agenda.\u201d<\/p>\n\n\n\n

It may be surprising at first that Kennedy is joining the techie side of America\u2019s booming wellness industry. But in fact he\u2019s not the only one: from Bryan Johnson\u2019s attempts to follow the algorithm to immortality to Kennedy advisor and Surgeon General nominee Casey Means\u2019s advocacy for clean eating and glucose monitoring to fix metabolic dysfunction, anti-establishment wellness gurus are increasingly pushing individualized health programs that present new technologies as magic bullets for Americans\u2019 health problems. So while MAHA tends to bill itself as the antithesis to Big Pharma, recent trends under Kennedy\u2019s HHS are turning the movement into pharma\u2019s biggest competitor in the game of selling high-tech biohacks that promise to reverse America\u2019s rising weight trends.<\/p>\n\n\n\n

In a country where 20 percent<\/a> of Americans under twenty and 40 percent<\/a> over that age are obese, and in an economy where treatment for chronic diseases related to obesity costs<\/a> hundreds of billions of dollars per year, finding and fighting the causes of obesity is one of the most important and high-stakes public policy debates of our time. The fact that for decades all attempts at reversing rising obesity levels have failed only makes the problem more pressing. And the fact that people are crossing the threshold for obesity ever earlier in their lives makes this one of those unavoidably anxious debates about posterity. Research suggests<\/a> that genetics and early habits determine weight to a degree that makes it difficult to ever mitigate with later lifestyle changes. Today\u2019s children are the first to grow up with both Wegovy and wearables, so they will be the final judges in the fight over which treatments actually work.<\/p>\n\n\n\n

Childhood Obesity Prevalence in the U.S., Ages 2\u201319 <\/strong><\/h6>\n\n\n
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Via the National Health and Nutrition Examination Survey at the CDC. The source uses a multiyear survey period for each figure. This chart plots the last year of each survey period.<\/cite><\/figcaption><\/figure><\/div>\n\n\n

The two camps in the debate are divided on the answer to an old question. Which is more responsible for the problem: genetics or upbringing? Nature or nurture? If you say nature<\/em>, then your solution is likely weight loss drugs. You believe that kids who are genetically predisposed to become obese will likely be and stay that way, and the new class of drugs could be a miracle in not just treatment but prevention. If you say nurture<\/em>, then you may look to the MAHA movement not only to fix the system that is making Americans addicted to unhealthy food but also, increasingly, to empower them with technology that allows them to make better choices.<\/p>\n\n\n\n

Though the chasm dividing these sides is vast, if you peer deep into it, at the bottom you may see common ground. Both are actually marked by forms of techno-optimism. Either drugs are going to save the kids \u2014 or \u201cbio-optimization\u201d and revolutionary organic farming practices will. Whatever the case, all we need is one weird trick to be healthy again.<\/p>\n\n\n

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\r\n\t\t\u2018We Want the Drugs Now\u2019\t<\/h5>\r\n<\/div><\/div>\n\n\n

If money could buy a solution to the problem of childhood obesity, it would be on display at the annual conference of the Obesity Medicine Association. This April, the conference took place at the expansive Gaylord National Resort in National Harbor, Maryland. National Harbor is all parking garages. The streets around the resort are filled with the kind of faceless franchises that exist in large part to kill the time of the tens of thousands of conference attendees spending down their company\u2019s expense accounts every year: Nando\u2019s, Ben & Jerry\u2019s, McCormick & Schmick\u2019s. The giant courtyard of the hotel has an entire indoor village with more ersatz establishments. A heavyset teenage girl, a middle-aged woman, and an older man, all positively glowing with health, smile down from a banner at least ten yards wide next to the registration desk. The banner\u2019s label blares, \u201cWegovy.\u201d There is no secret about who is backing this event.<\/p>\n\n\n\n

In the corridor leading to the meeting rooms, more pleasantly plump people gaze reassuringly at me from standing signs. One sign lists the \u201c5 Principles of Obesity<\/a>\u201d:<\/p>\n\n\n\n

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  1. It is undeniable that obesity is a complex, chronic disease.<\/li>\n\n\n\n
  2. Obesity is driven by powerful underlying biology, not by choice.<\/li>\n\n\n\n
  3. The many health effects of excess weight can start early.<\/li>\n\n\n\n
  4. Obesity is treatable.<\/li>\n\n\n\n
  5. Weight bias, stigma, and discrimination are harmful.<\/li>\n<\/ol>\n\n\n\n

    I note the polemical edge in that word \u201cundeniable.\u201d The question of how best to treat obesity is ostensibly under debate here, but the overall logic of the principles \u2014 if disease, then treatment \u2014 paired with the pharmaceutical advertising next to it seems to make the answer a foregone conclusion.<\/p>\n\n\n\n

    When I enter the first meeting room, I\u2019m struck by the sheer size of the audience for this message. Attendance gives medical professionals a Continuing Medical Education credit for certification in treating obesity in their practices, and they have come in droves with their Yeti water bottles and North Face sweaters. Many are primary care physicians, nurse practitioners, and the like who are responsible for advising patients on weight loss. Much of the information shared here will end up being used in doctor\u2019s offices across the country.<\/p>\n\n\n\n

    At the first session of the morning, Dr. Harold Bays, the president of a medical research institute in Louisville, Kentucky, discloses that he has consulted or contracted research for Eli Lilly (the maker of Mounjaro and Zepbound) and Novo Nordisk (Ozempic and Wegovy), along with Amgen, Pfizer, and a whole alphabet\u2019s worth of others. Previous weight loss medications have had such bad side effects that they\u2019ve been taken off the market, he says, but this new class of drugs, called GLP-1 agonists for the human satiety hormone they mimic, is a game-changer. They\u2019re both more effective and less taxing on patients\u2019 bodies than previous treatments.<\/p>\n\n\n\n

    Bays is optimistic about not just the current medications but the overall new approach to treating obesity. Other metabolic diseases, such as hypertension and diabetes, also once resisted being treated with medication. Now, medication is a standard part of what he calls \u201ccomprehensive\u201d care for those conditions: lifestyle changes and dieting along with drugs. Before too long, he says, the same package will gain social acceptance as the standard of care for obese patients young and old.<\/p>\n\n\n\n

    GLP-1 agonists are the first in a wave of drugs that are increasingly capable of being personalized to do more than one thing: reduce appetite and fight nausea, for example, or preserve muscle tone during rapid weight loss. Bays fires off a barrage of these drugs: dual agonists, tri-agonists, muscle-acting agents. Trials are ongoing and long-term effects are unknown, but \u201cwe want the drugs now,\u201d he says, because the results are so life-changing for patients. So he advises doctors to keep up with the news about the latest approvals and add them to the suite of medications they prescribe.<\/p>\n\n\n\n

    Despite all the talk of lifestyle modifications that should accompany weight loss drugs, doctors are often better informed about the drugs than the new lifestyles they are supposed to support. \u201cA lot of physicians do not feel adequately trained to talk to their patients about nutrition,\u201d says Dr. Nate Wood, a chef and the director of culinary medicine at Yale, in the second session I attend. In 1985, the National Academy of Sciences issued a report that recommended twenty-five hours of nutrition education for medical students, he says. Today, they get about eleven.<\/p>\n\n\n\n

    Wood offers some common-sense guidelines for patients both on and off weight loss drugs: focus on hitting protein targets, but don\u2019t forget about that sleeper nutrient, fiber. Ninety-five percent of Americans aren\u2019t eating enough fiber, he says, and patients on GLP-1 drugs are at risk of constipation because the drugs slow down their digestive systems. Most importantly, make sure patients are eating enough. He tells the story of one patient who gave a glowing review of her progress to one of Wood\u2019s colleagues: \u201c\u2018It is great,\u2019 she said. \u2018I\u2019m not hungry all day. Yesterday, all I had was a small bag of popcorn.\u2019 And you\u2019re like, oh, gosh, that\u2019s concerning.\u201d The audience laughed sympathetically.<\/p>\n\n\n\n

    He advised setting a target of at least 1,200 calories a day to keep patients from dropping weight too fast and missing out on vital micronutrients. Suddenly it sounded like the drug was the disease and the food was the prescribed medication: doctors should watch dosage, symptoms, and the overall sustainability of the regimen. A treatment prescribed in large part to fix problems with food intake has actually created new problems with food intake.<\/p>\n\n\n\n

    And while it\u2019s clear that Wood treats mostly adults, the stakes for children\u2019s eating patterns when they\u2019re taking GLP-1 drugs seem even higher. Children\u2019s diets, more than those of adults, are made up of a majority of ultra-processed, low-fiber foods \u2014 some studies estimate up to two-thirds<\/a> of what they eat. What happens if a child starts taking the drug and is now eating less, but not necessarily better? That could mean even fewer of the nutrients needed to sustain healthy growth, puberty, fertility, and so on. There are no long-term studies to either prove or disprove this, but sometimes the most sobering answer to hear from a doctor is \u201cI don\u2019t know.\u201d And that\u2019s often the answer when the question is \u201cWhat about the kids?\u201d<\/p>\n\n\n

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    \r\n\t\t\u2018Baked Into Our DNA\u2019\t<\/h5>\r\n<\/div><\/div>\n\n\n

    On the second day of the conference, I have no child care. So I strap my newborn to my chest and toss some crayons in my three-year-old\u2019s backpack and show up to Dr. Claudia Fox\u2019s session on \u201cEmpowering Comprehensive Obesity Care from Youth to Adulthood\u201d with two daughters in tow.<\/p>\n\n\n\n

    Fox is an associate professor in the University of Minnesota\u2019s department of pediatrics and the co-director of its Center for Pediatric Obesity Medicine. She paints a grim picture of childhood obesity treatment. In the past, she says, doctors followed a \u201cwait and see\u201d approach, monitoring children whose weight was high for their age and waiting to see whether it would resolve after puberty, when girls especially gain weight as their bodies prepare for childbearing. What they saw, though, was that \u201cobesity in adolescents almost universally persists to adulthood.\u201d In fact, the problem was evident even before puberty: \u201cNinety percent of three-year-olds with obesity will continue to have overweight or obesity in adolescence.\u201d<\/p>\n\n\n\n

    According to Fox, doctors have been fooling themselves into thinking that obesity is more about nurture than nature: \u201cObesity is essentially baked into our DNA really, really early on.\u201d And this has led to the lie that \u201clifestyle modification\u201d can work for children, and has also fueled the shame that comes with children\u2019s failure to lose weight: \u201cI very deliberately say, when I\u2019m seeing a new family, this is not your fault. This is not a willpower problem. This isn\u2019t a parenting problem. This is a biological condition that\u2019s primarily determined by our genetics.\u201d<\/p>\n\n\n\n

    What to do, then? The American Academy of Pediatrics recommends that in addition to \u201clifestyle therapy,\u201d \u201cpediatric health care providers should offer obesity medications to children who are age twelve and older,\u201d she says. \u201cNotice that word \u2018should,\u2019\u201d she adds. \u201cThey didn\u2019t say you \u2018may,\u2019 or that you \u2018could\u2019 do it. No, you shoul<\/em>d<\/em> do it.\u201d<\/p>\n\n\n\n

    Fox says she\u2019s aggressive about prescribing medication because she cares about curing kids. Think about cancer. \u201cWe would never be satisfied with just the stability of their leukemia,\u201d she says. \u201cWe want them to be cured. We want resolution of their disease.\u201d<\/p>\n\n\n\n

    \u201cWhat is our goal for treatment?\u201d she asks. \u201cI think it\u2019s still hard to say. With regards to treatment, our foundation, at least at this point, is lifestyle modification therapy.\u201d But therapy is hard: research suggests<\/a> that it takes at least twenty-six hours of lifestyle therapy \u2014 think food logs and tracking cardio \u2014 over the course of two months to a year to achieve significant weight loss. Vanishingly few patients manage this, or even have the potential to, given how little insurance will usually cover for nutrition therapy. That\u2019s why \u201cearly intervention with the most intensive therapy available\u201d \u2014 meaning GLP-1 drugs like Wegovy \u2014 \u201cis really critical,\u201d she says.<\/p>\n\n\n

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    \r\n\t\tNot for Children\t<\/h5>\r\n<\/div><\/div>\n\n\n

    I listen in mounting dismay and then trundle my daughters out the door in search of a snack. We\u2019re the lucky ones, too: my three-year-old\u2019s favorite food is pizza, but her dad makes it for her from scratch. Her mom works from home and spends a significant amount of time persuading her to try spinach, cherry tomatoes, lychee, and tofu. And neither of her parents is overweight. Simply because of these early advantages, she\u2019ll likely never face the problems that, according to Fox, many of her patients will struggle with all their lives.<\/p>\n\n\n\n

    The speakers at the OMA conference don\u2019t misdiagnose the many challenges of obesity and the pressing concerns that arise as it presents itself earlier in people\u2019s lives. Many of them are just surprisingly certain about its solution, given the dubious track record of past weight loss drugs in reversing rising levels of obesity. The exhibition hall reveals one source of that confidence: Novo Nordisk itself is here, and Eli Lilly, along with innumerable coattail-riders competing to sell their supplements in the attendees\u2019 health care practices. And to do that they\u2019ve brought bribes: boxes overflowing with sample shakes and probiotic drinks, free tote bags, and (deliciously) lollipops at vendor stalls selling healthy solutions for patients on weight loss drugs.<\/p>\n\n\n\n

    I let my three-year-old try a granola bar formulated for GLP-1 drug patients and then feel weird about it, less because I think it\u2019s bad for her than because it looks like the kind of failing diet product I often see on grocery store clearance racks: highly processed, covered in questionable marketing claims, and likely to taste kind of gross.<\/p>\n\n\n\n

    After a presentation on \u201ccomplex\u201d GLP-1 treatment cases, I\u2019m approached by a thirty-something woman in a bright pink pantsuit and kitten heels and a lanyard whose rainbow of ribbons displays a long association with the Obesity Medicine Association. No, she doesn\u2019t do media anymore, she says, but she gives me her number and implores me to allow her to connect me with her babysitter. She adds as we part for the morning break that she hopes I\u2019ll report fairly and acknowledge that obesity is, indeed, a disease \u2014 in case I\u2019d missed the party line.<\/p>\n\n\n\n

    Even if that\u2019s true, Ozempic may be less of a revolution than its promoters say it is. Who can afford it, in literal dollars or in years spent on the drug, possibly to end up right where one started if one ever quits? After all, an Oxford University analysis of eleven studies found<\/a> that patients who stop taking GLP-1 drugs typically regain the weight within a year.<\/p>\n\n\n\n

    The fact that there\u2019s not yet long-term data on the effects of these drugs for weight loss offers hope for the children starting to take them now. But it also means there\u2019s no reason to assume they will work. Adolescents have ahead of them a whole life of navigating temptations, social pressures, genetic predispositions, economic obstacles, and all the other challenges that come with having to take care of one\u2019s body in the long run. It\u2019s how they manage those pressures that will determine much of the results of the Ozempic experiment.<\/p>\n\n\n\n

    Not long later, as I leave the lunch buffet, I\u2019m approached by an employee from the resort. I\u2019m holding two plates of chicken salad and two glasses of water and pushing a stroller with my hip while directing my older daughter to a table.<\/p>\n\n\n\n

    You need to leave, the woman says. Don\u2019t you know that this event is not for children?<\/p>\n\n\n

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    \r\n\t\t\u2018The Era of Bio-Observability\u2019\t<\/h5>\r\n<\/div><\/div>\n\n\n

    If you\u2019re the kind of person who generally avoids medical conferences and big-box hospitals, you might find yourself attracted to an approach to obesity that, on its face, is the very opposite from that advocated by the Obesity Medicine Association.<\/p>\n\n\n\n

    The story Casey Means tells about her life is that of a fat kid gone right. As we read in her book Good Energy<\/em>, she was born with a predisposition for weight problems because of her mother\u2019s undiagnosed gestational diabetes and related health conditions, then packed on pounds during puberty. According to the \u201cnature\u201d narrative, she was destined to be overweight her whole life. But instead of further abusing her body with dieting or disordered eating, she turned herself into a health nut: she studied nutrition, taught herself to cook, joined a gym, and worked it all off. This knowledge turned out to be more useful than the curriculum at Stanford Medical School, where she became disillusioned with the health care system\u2019s specialist, drugs-forward approach to treatment of disease.<\/p>\n\n\n

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    Courtesy Casey Means via caseymeans.com<\/figcaption><\/figure><\/div>\n\n\n

    She came to see an increasing number of ailments in her patients as not just related to but rooted in bad eating habits. Those habits were based on people\u2019s ignorance about how they should fuel their bodies \u2014 and since each body is different, each person needs an individualized health plan, not a one-size-fits-most prescription. She found herself coming around to the \u201cnurture\u201d model regarding chronic diseases and obesity: our habits determine our health far more than our genes do.<\/p>\n\n\n\n

    She dropped out of her surgical residency program and co-founded a health company named Levels, which sells continuous glucose monitors (CGMs) and offers an app that tracks people\u2019s blood sugar and thus helps them optimize their eating, exercise, and sleep. Last year, she published Good Energy: The Surprising Connection Between Metabolism and Limitless Health<\/em>, which argues that malfunctioning mitochondria (the powerhouse of the cell, as you no doubt remember from middle school) are the cause of the majority of chronic diseases, including those related to obesity. The solution? Bio-optimization: eating organic and gluten-free to avoid toxins, strategically planning meals and sleep to minimize stress, and tracking it all with a CGM.<\/p>\n\n\n\n

    \u201cWe are entering the era of bio-observability: more readily available blood tests and real-time sensors filtered through AI analysis to give us a highly personalized understanding of our bodies and a personalized plan to meet each body\u2019s needs with daily choices,\u201d she writes.<\/p>\n\n\n\n

    It\u2019s easy to see how this pitch is attractive to individualistic Americans, especially those who are already skeptical of the medical establishment. \u201cYou should no<\/em>t<\/em> <\/em>blindly trust your doctor and you should no<\/em>t<\/em> <\/em>blindly trust me,\u201d Means writes. \u201cYou should trust your own body.\u201d<\/p>\n\n\n\n

    The book was a No. 1 New York Time<\/em>s<\/em> bestseller. It popped up in chiropractic offices and other alternative health practices around the country. Means and her brother, Calley Means, became top advisors to Robert F. Kennedy, Jr. and his Make America Healthy Again movement. And in May of this year, Means was nominated to be Surgeon General of the United States.<\/p>\n\n\n

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    Levels, co-founded by Casey Means, offers a continuous glucose monitor together with an app to track blood sugar and metabolic health.
    Courtesy Levels.com<\/cite><\/figcaption><\/figure><\/div>\n\n\n

    These are no longer the mere musings of an Instagram influencer and alt-health entrepreneur: the idea that \u201cfood is our most potent weapon against chronic disease<\/a>\u201d and that tech will help heal us is a serious competitor to the Wegovy weight loss model. In fact, this techno-optimist narrative is much bigger than Means \u2014 and much less mad than the prospect of going to bed at eight thirty and injecting one\u2019s children\u2019s blood to live forever, \u00e0 la<\/em> Bryan Johnson. The wellness industry \u2014 health products and regimens sold outside the typical health care pipeline \u2014 is larger than the pharmaceutical industry: an estimated $6.3 trillion<\/a> per year compared to $1.6 trillion<\/a>. It\u2019s expected to reach $9 trillion in the next three years. Social media\u2013mediated wellness and app-based health make up the water the next generation of health-seekers will swim in.<\/p>\n\n\n

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    \r\n\t\tThere\u2019s an App, or a Drug, for That\t<\/h5>\r\n<\/div><\/div>\n\n\n

    Much of what Casey Means proposes to do to fix our food system makes sense, especially for addressing the problems many Americans see affecting children\u2019s diets. Her ideas: remove ultra-processed foods from school meal programs, ban food dyes that have been linked to behavioral problems, and redistribute Farm Bill subsidies from corn, soy, and tobacco to support fruits and vegetables, ideally organic.<\/p>\n\n\n\n

    Many critics have focused on her anti-pharma positions and speculated about the implications for vaccines and drugs like GLP-1 agonists. But beneath the crunchy-conservative advice about how to get kids to eat organic lies a techno-optimism strikingly like that of the pediatrician prescribing semaglutide to sixth-graders. \u201cWhat if we treated humans like rockets, equipping them with sensors before <\/em>systems fail, to understand where dysfunction is arising so we can address it?\u201d Means writes in Good Energy<\/em>. The metaphor is borrowed from Josh Clemente, her co-founder at Levels, who is an alumnus of SpaceX. Reducing food to its component parts, and eating habits to an \u201cindividualized\u201d health plan, makes it easy to turn the human body into a machine.<\/p>\n\n\n\n

    Yet Means sees her solutions for chronic disease as not mechanistic but spiritual, in contrast to those of the soulless medical establishment. \u201cEverything is connected,\u201d she writes in her book. And the \u201cspiritual crisis\u201d of America\u2019s chronic disease epidemic is \u201can assault on the miraculous flow of cosmic energy from the sun, through the soil and plants, through bacteria in my gut, through my cells\u2019 mitochondria to create the energy that sparks my consciousness.\u201d<\/p>\n\n\n\n

    This is why individualized tech is so much more promising for her than the old wait-and-drug medical model, which waits until people get fat and sick and then charges them to treat their symptoms. \u201cWe have the potential to live the longest, healthiest lives in human history, but this will require optimization,\u201d she writes.<\/p>\n\n\n\n

    And it has to start young. The \u201cnatural\u201d alternative to the medical establishment\u2019s drug-first model turns out to draw on the same assumptions as not just Wegovy but the failed weight loss cures that came before it: your body is a problem, and there\u2019s a product that can solve it if you start early enough and work at it hard enough. Bringing parenting into the equation shows how this pitch can be less freeing than it seems. After all, the earlier you optimize, the better off you and your children will be. Mothers should start optimizing their children in utero, since everything Mom eats also feeds baby.<\/p>\n\n\n\n

    It\u2019s hard to give up the idea that weight loss is a matter of personal responsibility: of finding the right hack to fix it, with a drug or a gadget or with pure grit. And it\u2019s easy, when one tries to give up that idea, to fill the void with a dream that ultimately follows from the same assumptions. Means\u2019s story, then, is not that of a fat kid who found the true fitness gospel. Or if it is, it\u2019s the same old story: she is one of the few lucky people who found salvation through weight loss and now has the difficult task of trying to share it. But solutions tend naturally toward the one-size-fits-all, while crises tend, unfortunately, toward complexity.<\/p>\n\n\n\n

    The danger of techno-optimist solutions is that they treat the same thorny problem \u2014 stubbornly rising weight at younger and younger ages \u2014 with the same old solution: now there\u2019s a drug, or an app, for that. The problem is not that these solutions are bad, or bound to fail. It\u2019s that they\u2019re utopian. What they are both selling is the idea of a simple fix for all the problems with food and health that contribute to obesity. This is a recipe for disappointment.<\/p>\n\n\n

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    \r\n\t\t\u2018It Might Not Be Enough\u2019\t<\/h5>\r\n<\/div><\/div>\n\n\n

    Many patients come to Dr. Siham Accacha looking for the simple fix they\u2019ve seen in all the ads recently: they want to be prescribed a GLP-1 drug. Like the doctors at the conference, Accacha, a pediatric endocrinologist at Cohen Children\u2019s Medical Center in New York, is willing to prescribe it. \u201cI try to present it to them as a help, as an extra motivation,\u201d she says.<\/p>\n\n\n\n

    But she warns them that a lifetime on medication, despite what the Ozempic ads suggest, is likely not realistic or desirable. \u201cThey have the opportunity,\u201d she says, \u201cto actually go to the next step, to lose weight, but also to learn how to eat healthier because it decreases their appetite significantly.\u201d<\/p>\n\n\n\n

    Accacha tells me that her experiences with patients show that the causes of obesity are not as simple as nature or nurture alone but stem from something like culture: the framework of habits that exist outside an individual or family and guide people about what eating and living are good for in a larger sense.<\/p>\n\n\n\n

    A major part of the problem is the conflation of junk food and childhood: \u201cThere is this belief that the kids are kids and they should live like kids, and eating bad food is, you know, it\u2019s fun,\u201d she says.<\/p>\n\n\n\n

    Accacha argues that teaching people how to eat still offers the best shot at beating obesity before it starts. But that education has to begin earlier. \u201cWe don\u2019t wait until we are adults to learn mathematics. You start young. And if that is ingrained in your brain and you learn how to eat healthy and you learn that you have to exercise, it becomes part of your life, so then it\u2019s less effort as an adult to have to deal with this problem.\u201d<\/p>\n\n\n\n

    \u201cAnd it might not be enough,\u201d she adds. \u201cI don\u2019t know. I don\u2019t pretend to have all the answers.\u201d<\/p>\n\n\n\n

    That\u2019s because there is no single answer. Both the medical model and the food-as-medicine alternative isolate one aspect of the problem of childhood obesity and call it the root of the disease. But in reality roots form in networks: genetics, eating habits, the quality of the food system, bad information, poverty, ignorance, unrealistic goals, and good old-fashioned despair.<\/p>\n\n\n\n

    As Marcy sees it, the deck is stacked against her. According to the \u201cnature\u201d crowd, she was destined to be fat and so weight loss drugs should be her greatest hope. According to the \u201cnurture\u201d camp, the responsibility for every pound of her weight, and eventually that of her children, now lies squarely on her.<\/p>\n\n\n\n

    \u201cI\u2019m not healed enough to train up a little person on how to eat and how to fuel their body and how to feel healthy and whole in it,\u201d she says. \u201cI\u2019m child-free by choice.\u201d<\/p>\n\n\n\n

    Techno-optimism, when it fails, devolves into pessimism. Quests for impossible ideals like that of perfect health have a way of being abandoned. This is all the worse for those who come after us, who deserve that their lot be not perfect, just better.<\/p>\n\n\n

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