The rise of Ozempic and similar weight loss drugs like Mounjaro has captured widespread attention, prompting investigations into their efficacy, cost, and potential impact. Among these explorations is the Wall Street Journal's podcast, "Trillion Dollar Shot" (TDS), which delves into the business story behind these blockbuster drugs. While the podcast aims to provide an objective perspective, its approach, particularly its focus on one of its narrators, Bradley Olson, and its handling of potential downsides, warrants a closer examination.
A Promising Start: Unveiling the History and Mechanism
The first episode of TDS stands out as the most informative, offering valuable insights into the history of these drugs and how they are believed to function. This initial exploration sets the stage for a deeper understanding of the science behind Ozempic and similar medications.
The Price of Progress: Cost and Coverage Concerns
Episode 2 brings up the significant costs associated with these drugs, which are administered via injection and can cost around $1000 a month. The podcast notes that insurance companies often do not cover them for weight loss purposes. While acknowledging the financial burden, the podcast seems sympathetic to the pharmaceutical companies' research and development justification for the high price tag, leaving the question of who should bear the financial responsibility unanswered. It's suggested that government or insurers might need to step in, but the podcast acknowledges the potential financial strain on insurers if they were to cover everyone seeking these popular drugs.
Anecdotes and Tangents: Losing Focus on Information
As the series progresses, the focus shifts away from concrete information and veers into anecdotal territory. Episode 3, in particular, dedicates a significant portion of its runtime to the personal experiences of Brad Olson, one of the narrators. While Brad seems like a relatable individual, his anecdotes don't contribute significantly to the overall understanding of the drugs.
The episode also explores the body positivity movement and the potential for targeting the food industry as alternative approaches to addressing weight issues. While these are valid topics for discussion, their inclusion feels somewhat tangential and detracts from the central focus on Ozempic and related drugs. The podcast questions whether the endgame of targeting the food industry would involve compelling companies to produce less palatable food. It also raises concerns about the government dictating dietary choices. The author expresses a willingness to take responsibility for their own food choices, acknowledging that they are not always the healthiest.
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Missing the Mark: A Lack of In-Depth Discussion on Side Effects
One of the most significant shortcomings of the series is its failure to thoroughly investigate the potential side effects associated with these drugs. While the narrators briefly mention that there are no long-term outcome trials, the podcast doesn't give this point enough attention. Reports suggest that nausea and other unpleasant side effects are relatively common, potentially contributing to weight loss by suppressing appetite and diminishing the enjoyment of food.
Serious abdominal pain and nausea are reported to affect at least 10% of patients, leading to discontinuation of the drug. Lawsuits have also been filed, alleging that the drug can cause stomach paralysis, a severe condition with potentially long-lasting consequences. The podcast also neglects to mention other serious side effects, such as pancreatitis, kidney failure, and potential thyroid tumors. The lack of a deep dive into these negative aspects leaves a significant gap in the overall assessment of the drugs.
Snake Oil Speculation: Overblown Claims and Miraculous Cures
In episode 4, the podcast takes a turn towards speculative territory, suggesting that these drugs could potentially cure a wide range of ailments, from alcohol addiction to Alzheimer's Disease. This shift into "snake oil" territory raises concerns about the podcast's objectivity and potential influence from the drug companies themselves. The narrators draw a parallel between these drugs and the 1990s release of Prozac, seemingly unaware that Prozac's effectiveness in treating mild to moderate depression has been questioned, particularly in light of its potential side effects, including an elevated risk of suicide in young people.
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