GLP-1 Agonists and Obesity: A Public Health Perspective

Sadiqa Sheikh is completing her Masters of Public Health at McMaster University

Scroll through social media, flip through celebrity headlines, or sit through a commercial break; Ozempic is everywhere. Beyond the headlines and celebrity endorsements, the rapid rise of glucagon-like peptide-1 (GLP-1) receptor agonists for weight-loss presents both opportunities and challenges for public health.

What Are GLP-1 Receptor Agonists? 

GLP-1 receptor agonists are a class of medications that are used to treat type 2 diabetes and obesity. It works by stimulating glucose-dependent insulin release, suppressing glucagon, slowing stomach emptying, and reducing appetite (Kim & Jung, 2021). Common examples of GLP-1 medications include semaglutide (Ozempic/Wegovy/Rybelsus), liraglutide (Saxenda/Victoza), and tirzepatide (Mounjaro) (Abdelrahman et al., 2025). 

The Rise of GLP-1 Agonists

Ozempic rose to fame with the help of social media, celebrity endorsement, pop culture, and advertising, turning it into a global phenomenon (Muhammad & Cheema, 2025). It arrived at a time of intense social focus on weight, appearance, and 'biohacking,' fitting neatly into existing wellness and optimization cultures. TikTok and other platforms saw an explosion of #Ozempic and related hashtags, from 2 million views in 2021 to more than 1.2 billion in 2023 (Sundar & Singhal, 2025). In the first nine months of 2025, pharmaceutical company Novo Nordisk spent nearly $500 million on U.S. advertising for its GLP-1 drugs (Harshita & Wingrove, 2026). While Canada enforces stricter direct-to-consumer drug advertising regulations, “ask your doctor if Ozempic is right for you” ads have made GLP-1 marketing nearly inescapable. 

As of early 2026, an estimated 3 million Canadian adults are currently taking GLP-1 receptor agonists to manage Type 2 diabetes and/or weight loss, making Canada the second-largest user of GLP-1’s in the world (Ireland, 2026).

Opportunities

GLP-1 receptor agonists present a meaningful opportunity in obesity care. About ⅓ of Canadian adults now live with obesity, and this number only continues to rise (Chen et al., 2025). Obesity substantially increases risk of type 2 diabetes, cardiovascular disease, respiratory disease, osteoarthritis, and related disability (Chen et al., 2025). It is closely linked to reduced quality of life, affecting both physical and mental health, limiting daily functioning, and impairing overall psychological well-being (Okolo et al., 2024). Additionally, the crisis is associated with over $27 billion in economic costs in Canada, including healthcare, productivity losses, and premature death (Chen et al., 2025). 

These medications can support significant weight loss and improvements in obesity-related conditions, potentially reducing the population burden of chronic disease (Celletti et al., 2025). When used appropriately, they may enhance quality of life, decrease healthcare utilization, and complement existing prevention strategies. Their growing acceptance also signals a shift toward recognizing obesity as a chronic, treatable condition rather than an issue of individual behavior.
Implications and Recommendations
While GLP-1-based therapies offer benefits, they also bring complex challenges and responsibilities for public health. The following actions position public health as a leader in shaping healthier, fairer systems.

1. Addressing industry influence and the commercial determinants of health

Novo Nordisk and other pharmaceutical companies hold significant control over shaping research priorities, policies, pricing, and access. Their strategies, including high drug prices, patent protections, and marketing, can lead to drug shortages, limited access, health system strain, and altered public perception of health. These strategies constitute a “corporate playbook” that amplifies market share and profit while also creating health‑impact externalities (Lacy-Nichols et al., 2022). Public health should play an active role in responding and monitoring these dynamics; for example, engaging in policy reform and advocacy around drug pricing, regulation and access. 

2. Strengthening Evidence and Surveillance 

The long-term effectiveness of GLP-1 drugs in everyday use is still uncertain, including whether weight loss is sustained and what happens after stopping treatment (Chao et al., 2026). Expanding independent, long-term research is important to understand the sustained benefits and potential risks of GLP-1-based therapies. Public health should also strengthen surveillance to track obesity trends, GLP-1 use, access, outcomes, and inequities, so that policy responses are timely, evidence-based, and equitable (Chao et al., 2026).

3. Countering Misinformation

Widespread misinformation about GLP-1 weight-loss drugs has become a major public health issue. This misinformation poses serious health risks and increases misuse (Muhammad & Cheema, 2025). Public health can help address this through knowledge translation and health education initiatives. For example, campaigns and public messaging can provide clear, evidence-based information about GLP-1 drugs, debunk myths such as misleading “doctor-approved” claims, and counter false information about unregulated products.

Conclusion 

GLP-1-based therapies represent a meaningful clinical advancement; however, they are not a standalone solution. Addressing obesity requires a comprehensive public health approach that combines medical treatment with upstream interventions. This includes improving access to affordable, nutritious foods, investing in health education, and designing environments that support physical activity (Cantor, 2024). Without addressing the social and structural determinants that shape health, lasting progress will remain difficult to achieve.

References
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Harshita, & Wingrove, P. (2026, January 28). Novo’s Wegovy and Ozempic US advertising spend doubles rival Eli Lilly, data shows. Reuters.  https://www.reuters.com/business/media-telecom/novos-wegovy-ozempic-us-advertising-spend-doubles-rival-eli-lilly-data-shows-2026-01-28/

Ireland, N. (2026, March 4). 3 million Canadians use GLP-1 drugs. Survey says that's changing their appetites — and habits. CBC. https://www.cbc.ca/news/health/canadians-glp1-ozempic-mounjaro-9.7114197

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Lacy-Nichols, J., Marten, R., Crosbie, E., & Moodie, R. (2022). The public health playbook: ideas for challenging the corporate playbook. The Lancet Global Health, 10(7), e1067–e1072. https://doi.org/10.1016/s2214-109x(22)00185-1

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Okolo, D., Akpanumo, B., Okeke, C. H., Aniekwe, C. E., Ezenekwe, E. B., Okobi, O. E., Olaniyi, M., & Aboyeji, A. (2024). The Influence of Obesity on Quality of Life: A Systematic review. Journal of Advances in Medicine and Medical Research, 36(11), 267–279. https://doi.org/10.9734/jammr/2024/v36i115637