Fixing the food environment: beyond weight-loss drugs

The growing use of glucagon-like peptide-1 (GLP-1) receptor agonists and dual GIP/GLP-1 agonists has intensified debate over the role of pharmacotherapy in addressing obesity. While these drugs can support short-term weight loss, access remains limited, costly and unequal across health systems. Weight regain after cessation and recent price increases, such as for tirzepatide in the United Kingdom, underscore the fragility and inequity of drug-focused approaches. Reliance on medication risks diverts attention from structural drivers of obesity, including the widespread availability, marketing and placement of ultra-processed and high-fat, salt or sugar products and limited access to healthy, minimally processed foods. Population-level action, including mandatory reformulation, marketing restrictions, improved affordability and expanded access to nutritious foods, is essential. Medications may support individuals, but only comprehensive food-system reform can sustainably reduce obesity and diet-related disease.