Drug Story

Pain is probably the oldest problem in medicine. It’s the way our bodies tell us that something is wrong here.
But pain has long been considered a symptom. So when medicine can’t find what’s wrong, or when medicine can’t fix the pain, well, that’s usually the end of the story. And that’s left a lot of people with chronic pain suffering in silence.
In this episode, we learn why pain is one of the great mysteries of medicine - one of the most challenging conditions to diagnose, to measure, and to treat successfully.
We explore why the worthy effort to bring pain into the light inadvertently created what may be the most devastating social crisis (ahem, opioid epidemic) of the last century.
And we look at a new pain medicine - Journavx - which is not approved for chronic pain (yet) but has a lot of people hoping for a path to peace without addiction.
Sources for this episode
[1]  "Wrestling With Pain:" John J. Bonica, MD. Autobiography (1987) The International Symposium on Pain Analgesia: Dr. John J. Bonica recounts his life as a "wrestling match" against medical indifference to establish the multidisciplinary approach to pain therapy. 
[2] Oral History Interview with John J. Bonica (1993) John C. Liebeskind History of Pain Collection: John Bonica is widely regarded as the founding father of pain management.
[3] International Symposium on Pain (1974) Raven Press: Proceedings from the first major international meeting on pain research and management.
[4] Individual Differences in Pain: Understanding the Mosaic that Makes Pain Personal (2017) PAIN: Explains how biological, psychological, and social factors shape personal pain experiences.
[5] Chronic Pain: What Does It Mean? A Review on the Use of the Term Chronic Pain in Clinical Practice (2021) Journal of Pain Research: "Chronic pain" is a semantically inaccurate and potentially misleading clinical label because it overemphasizes duration while failing to account for biopsychosocial factors.
[6] Prevalence of Depression and Anxiety in Chronic Pain (2025) JAMA: Systematic review and meta-analysis showing high rates of depression and anxiety among adults with chronic pain.
[7]  Improving Outcomes of Analgesic Treatment: Is Education Enough? (1990) Annals of Internal Medicine: The persistent undertreatment of pain is rooted in a historical medical focus on physical lesions over subjective symptoms. 
[8]  Pain as the 5th Vital Sign Toolkit (2000) The Veterans Health Administration: A comprehensive guide developed by the Veterans Health Administration (VHA) to institutionalize a standardized, system-wide approach to managing patient discomfort.
[9] A Capsule History of Pain Management (2003) JAMA: Historical overview of approaches to managing pain, from ancient remedies to modern treatments.
[10] Bridging Old and New in Pain Medicine: An Historical Review (2023) Cureus: Historical review linking traditional pain remedies with modern medical practices.
[11] The Opioid Epidemic: It’s Time to Place Blame Where It Belongs (2017) The Journal of the Missouri State Medical Association: Dr. Ronald Hirsch argues that the opioid crisis was driven by a network of "co-conspirators" including pharmaceutical companies, medical oversight organizations, and government agencies.
[12] The 5th Vital Sign and America’s Painkiller Epidemic (2016) The University of Arizona Health Sciences: The institutionalization of pain management led to a surge in prescription drug abuse and overdose deaths. 
[13]  The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy (2008) The American Journal of Public Health: Oxycotin’s commercial success was driven by predatory marketing tactics, such as targeting high-volume prescribers and systematically understating the risk of addiction.
[14]  The fifth vital sign: A complex story of politics and patient care (2016) Cleveland Clinic Journal of Medicine: Aggressive marketing and institutional mandates minimized the perceived risks of addiction, leading to the current opioid epidemic.
[15] The Pain and Opioid Epidemics: Policy and Vital Signs (2016) JAMA Health Forum: The historical movement to treat pain as a fifth vital sign inadvertently fueled a massive increase in narcotic prescriptions.
[16] Addiction Rare in Patients Treated with Narcotics (1980) The New England Journal of Medicine: a 1980 letter to the editor of the New England Journal of Medicine covers the low incidence of narcotic addiction in medical settings.  
[17] Remove Pain as 5th Vital Sign, AMA Urged (2016) Medpage Today: Medical professionals at an American Medical Association met to advocate for the removal of pain as a "fifth vital sign".
[18] FDA Approves Novel Non-Opioid Treatment for Moderate to Severe Acute Pain (2025) US Food & Drug Administration: FDA announcement of approval for a new, non-opioid treatment for moderate to severe acute pain.
[19] F.D.A. Approves Drug to Treat Pain Without Opioid Effects (2025) The New York Times: The FDA approved a non-opioid painkiller developed by Vertex.
[20] What Is Journavx, the New Opioid-Free Painkiller from Vertex? (2025) Scientific American: Journavx functions by blocking sodium ion channels to stop pain signals before they reach the central nervous system, offering a mechanism entirely different from traditional treatments.
[21] Painkillers without the addiction? The new wave of non-opioid pain relief (2025) Guaridian:  The pharmaceutical industry is shifting toward developing non-opioid pain relief to address the devastating global addiction crisis.
[22] An SCN9A channelopathy causes congenital inability to experience pain (2006) Nature: Discovery that mutations in the SCN9A gene cause congenital inability to experience pain.
[23] Chronic Pain Is a Hidden Epidemic. It’s Time for a Revolution. (2025) The New York Times Magazine: Opinion piece calling for a revolution in how chronic pain is addressed in society.


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The idea of drug patents makes a lot of sense: The company that put the effort and resources into developing the medicine is the first to reap the benefits. That company gets a limited monopoly for 20 years, when it is the only company allowed to manufacture and sell that drug.
The deal is that after that patent expires, other companies can manufacture and sell the drug, too. The drug goes “generic.” Typically that means lower prices for patients - more people benefit. That’s how the system is supposed to work. 
But that system relies a lot on good faith - and many pharma companies have gotten very good at finding ways to extend that 20 years, making small tweaks to a drug to extend their monopoly for years.
Today, I hand Drug Story over to the excellent journalist Dan Weissmann, host of the NPR podcast An Arm and A Leg. In this episode of An Arm and a Leg, Dan talks with John Green - author of the new book, Everything is Tuberculosis. Green explains a very effective drug for TB was kept under patent protection for years, making it too expensive to treat millions of people with tuberculosis, leading to thousands of unnecessary deaths worldwide.


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It used to be that getting older meant slowing down. A little less pep, a little less zip, a little less zest. So it goes.
For men, this was partly about testosterone. After 40 or so, our bodies produce less and less testosterone, the hormone that helps give men energy and vigor and sex drive. Lower testosterone was just part of growing older.
But that was then! Nowadays, “Low T” is a bonafide medical condition - easily treated with a shot at your local neighborhood men’s health clinic.
Today, what used to be a secret sauce of bodybuilders or cheating athletes is now downright normal. Millions of men worldwide take testosterone therapy - and not just those over 40. Check out Reddit or TikTok...It is a WHOLE THING.
In this episode of Drug Story, we look at how TRT went mainstream, and how part of ordinary aging somehow became a disease.

Sources for this episode
[1] Male Hypogonadism (2024) STAT Pearls:Male hypogonadism is defined as inadequate testosterone production or impaired spermatogenesis, diagnosed via symptoms and low morning testosterone levels.
[2] Brown-Séquard: An improbable genius who transformed medicine (2011) The Journal of Clinical Investigation: Charles-Edouard Brown-Séquard, a pioneering 19th-century scientist who rose from a difficult childhood in Mauritius is said to be the founder of modern endocrinology and neurology.
[3] The life and legacy of Brown-Séquard (2017) Brain: Charles-Edouard Brown-Séquard’s insights helped show how nerves control blood vessels and laid the foundation for modern endocrinology by identifying internal secretions and early hormone therapy.
[4] The “Elixir of Life” (1889) J.G. Cupples Co: In a self-report, Charles-Édouard Brown-Séquard covers his controversial self-experiments where he injected animal testicle extracts in pursuit of rejuvenation.
[5] The effect produced on man by subcutaneous injections of a liquid obtained from the testicles of animal (1889) Lancet: In a 1889 Lancet article, Brown-Séquard describes his pioneering experiments with subcutaneous injections of animal testicular extracts to combat the physical and mental decline associated with aging.
[6] A Brief History of Testosterone (2001) Journal of Urology: Hormone therapy became widely used to treat age and disease-related hormone decline, before risks were fully understood.
[7] History of Testosterone and Therapeutic Potential (2020) Sexual Medicine Reviews: Testosterone was isolated in 1935 by the Organon group, with independent synthesis by Adolf Butenandt and Leopold Ruzicka.
[8] Adolf Butenandt—Nobel Prize for Chemistry (2012) Mayo Clinic Proceedings: Adolf Butenandt isolated key sex hormones, contributing to foundational methods for steroid chemistry and earning the 1939 Nobel Prize in Chemistry.
[9] Monkey business: reflections on testosterone (2012) BMJ: Testosterone is widely believed to drive masculinity, aggression, and performance, but strong evidence in humans is limited and inconsistent.
[10] The male hormone (1945) Harcourt, Brace and Company: The Male Hormone was an influential book that shaped public and medical perceptions of testosterone as central to masculinity and male health.
[11] Endocrines: The Use of Testosterone (1940) The New England Journal of Medicine: Dr. Joseph C. Aub’s NEJM article discusses testosterone as proven therapy for hypogonadism, with experimental applications for women and other conditions.
[12] History of Doping in Sport (2001) International Sports Studies: Testosterone and anabolic steroids became central substances in performance enhancement, prompting regulatory responses and anti-doping frameworks in international sport.
[13] New 'Breakfast of Champions': A Recipe for Victory or Disaster? (1988) The New York Times: Anabolic steroid use, including testosterone derivatives, was widespread in elite athletics despite known health risks and weak enforcement.
[14] FTC Sues Drug Companies for Unlawfully Conspiring to Delay the Sale of Generic AndroGel Until 2015 (2009) Federal Trade Commission: Pharmaceutical companies used patent litigation and settlement agreements to delay generic testosterone gel competition and maintain market exclusivity.
[15] Androgen deficiency in males (2010) Expert Review of Endocrinology & Metabolism: Clinical definitions of androgen deficiency rely on serum testosterone thresholds combined with symptoms, with variability across populations.
[16] The male menopause—does it exist? (2000) BMJ: Age-related testosterone decline occurs gradually and inconsistently and does not parallel the hormonal cessation observed in female menopause.
[17] Evolution of Guidelines for Testosterone Replacement Therapy (2019) Journal of Clinical Medicine: Article examines how definitions, diagnoses, treatments, and follow-up recommendations for testosterone replacement therapy have evolved across major societies (ISSAM, Endocrine Society, ISSM, AUA).
[18] The Hazards of Male Menopause (1997) Science: Medicalization of age-related testosterone decline outpaced clinical evidence, raising concerns about overtreatment and long-term risk.
[19] Selling That New-Man Feeling (2013) The New York Times: Direct-to-consumer advertising reframed testosterone therapy as a solution for fatigue, low mood, and diminished masculinity in aging men.
[20] Prevalence of hypogonadism in males aged at least 45 years: the HIM study (2008) The International Journal of Clinical Practice: A study established low measured testosterone levels prevalent among men over 45, particularly in those with obesity, diabetes, and chronic illness.
[21] Testosterone Aids Older Men's Brains, UCSF Study Says (2002) Science Daily: Testosterone supplementation was associated with short-term improvements in certain cognitive measures in older men.
[22] Association Between Direct-to-Consumer Advertising and Testosterone Testing and Initiation in the United States, 2009–2013 (2017) JAMA: A study finds increased exposure to testosterone advertising correlated with higher rates of testosterone testing and treatment initiation.
[23] 2013 All-Star Large Pharma Marketing Team of the Year: AndroGel (2013) Medical Marketing and Media: AndroGel’s marketing strategy successfully expanded testosterone therapy into a high-revenue lifestyle pharmaceutical category.
[24] The marketing of testosterone treatments for age-related low testosterone or 'Low T' (2018) Current Opinion in Endocrinology & Diabetes and Obesity: Discusses how pharmaceutical companies promoted testosterone for off-label, age-related use without strong supporting evidence.
[25] “Manopause?! Aging, Insecurity and the $2 Billion Testosterone Industry” (2014) TIME: Highlights how clinics like Low T Centers exploit aging men’s fears and market testosterone as a cure-all for aging.
[26] “More Men Are Seeking Out Testosterone Tests. Are They Getting Duped?” (2022) The New York Times: Reports on rising interest in testosterone testing and treatment, often marketed through online platforms targeting fatigue and low sex drive.
[27] FDA Drug Safety Communication: FDA cautions about using testosterone products for low testosterone due to aging; requires labeling change to inform of possible increased risk of heart attack and stroke with use (2025) U.S. Food & Drug Administration: Testosterone products were required to update labeling to reflect increased risks of heart attack and stroke and to limit use to clinically verified hypogonadism.
[28] The Virility Paradox (2018) Simon & Schuster: Testosterone has a wide influence on human behavior, health, culture, and society, shaping traits from strength and drive to aggression and selfishness.
[29] The Testosterone Myth (2018) WIRED: Article explores the widespread but unfounded belief that testosterone can reverse aging and restore vitality.
[30] Effects of Testosterone Treatment in Older Men (2016) New England Journal of Medicine: In men 65 and older with low testosterone, raising levels of testosterone improved sexual desire and activity and had modest effects on mood and physical function, but did not improve vitality or walking distance.
[31] Promoting “Low T: A Medical Writer’s Perspective (2013) JAMA Internal Medicine: A former ghost writer for the Low T campaign reveals how they got their message out in "educational" materials and articles.



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Do you feel that?
That doubt and dread and worry?
That’s anxiety - and lucky for you, there’s a pill for that.
It’s called Xanax. And it works. Really well. And really fast.
Prescribed for panic attacks and anxiety, one dose of Xanax usually kicks in within 15 or 30 minutes. Just like that, a sense of calm sets in, and your concerns fall away. It’s not a high, more like the opposite. You feel relaxed, your brain stops racing. It does the trick.
Which is why Xanax is also super dangerous. Because of how well it works, and the way it works, Xanax is highly addictive. It brings such relief that one pill every once in a while turns into a little nibble every night. It tricks people into thinking that their concerns and worries can disappear with just one dose. Which is why Xanax is among the most counterfeited and abused drugs in the world right now.
Writing this episode, I started thinking that Xanax was a perfectly fine drug that is sometimes a problem. But as I dug in, I realized that Xanax, like all benzodiazepines, is a trickster. It promises to be an easy, even fun way to push our anxiety aside. But as much as it brings relief, it also brings consequences - which can turn deadly.
In this episode of Drug Story, we look at the idea of anxiety as a disease - a common human problem that can become, for some, a treatable condition. And we consider what “treatment” means, for good and for bad.
Sources for this episode
[1] Quitting Xanax: One Writer's Story (2024) Vogue Magazine: Martha McPhee details her seventeen-year dependence on Xanax, originally prescribed for panic attacks.
[2] Fear and fitness: An evolutionary analysis of anxiety disorders (1994) Ethology and Sociobiology: Anxiety evolved as a defense mechanism with subtypes adapted to specific threats; anxiety disorders arise from dysregulated defenses.
[3] A history of anxiety: from Hippocrates to DSM (2022) Dialogues in Clinical Neuroscience: Traces the understanding and classification of anxiety from ancient Greek and Roman philosophy to the DSM, noting Greco-Roman recognition of anxiety as a medical condition and early cognitive-behavioral approaches.
[4] Should You Be Upset? Cicero on the Desirability of Emotion (2022) Antigone Journal: Examines Cicero’s views on whether suppressing or embracing emotions is desirable.
[5] Cicero and the state-trait theory of anxiety: Another case of delayed recognition (1983) American Psychologist: H.J. Eysenck argues Cicero anticipated the modern distinction between anxious temperament and temporary anxious states.
[6] The Effects of Stoic Training and Adaptive Working Memory Training on Emotional Vulnerability in High Worriers (2021) Cognitive Therapy and Research: Results from a study show that practicing Stoicism significantly reduces rumination and boosts self-efficacy.
[7] Seneca (2024) Stanford Encyclopedia of Philosophy: Lucius Annaeus Seneca was a Roman philosopher who shaped stoicism and contributed to the concept of mindfulness and use of the present to manage emotions. 
[8] The developmental origins of anxiety (2004) Nature: Early developmental mechanisms establish a predisposition to anxiety through the interplay of genetic and environmental factors. While anxiety is a biological adaptive response to danger it becomes pathological when interfering with normal life. 
[9] DSM-III and the transformation of American psychiatry: a history (1993) The American Journal of Psychiatry: American psychiatry transitioned from a biopsychosocial model to a research-based medical model following the publication of the Diagnostic and Statistical Model.
[10] The Feminine Mystique (1963) National Humanities Center: In her 1963 seminal writings, Betty Friedan wrote about a pervasive dissatisfaction and feeling of emptiness among American housewives.
[11] Barbiturates: A Blessing and a Menace (1947) Journal of the American Pharmaceutical Association: A 1947 journal article aptly describes the nature of barbiturates as both a blessing and menace describing their medical importance as sedatives and their ability to be misused. 
[12] Listening to the Past: History, Psychiatry, and Anxiety (2005) The Canadian Journal of Psychiatry: 19th–early 20th century treatments for anxiety included the use of bromides, alcohol, opiates, and later barbiturates for relief.
[13] How Was Anxiety Treated in the 1900s? (2023) Connect by ManagedMinds: Historically, anxiety has been treated by asylums, rest cures, early psychotherapy, and modern psychiatric medications like SSRIs.
[14] The history of benzodiazepines (2013) The Consultant Pharmacist: Leo Sternbach discovered one of the first benzodiazepines, Valium, in 1955.
[15] The Launch of Xanax (1989) Drug Information Journal: Upjohn Company ran a successful marketing strategy using targeted psychiatrist outreach and consistent messaging to establish Xanax’s market position.
[16] Listening to Xanax (2012) New York Magazine: This article explores “functional anxiety” in high-achieving urban professionals and Xanax’s role.
[17] The Great American Xanax Legacy (2018) VICE: Xanax has become a force in modern culture including hip-hop music where the brand drug is commonly name dropped and featured in songs. 
[18] The APA Task Force report on benzodiazepine dependence, toxicity, and abuse (1991) The American Journal of Psychiatry: Benzodiazepines are rarely abused alone but are often used alongside alcohol or opioids in substance abuse.
[19] F.D.A. Requires Stronger Warning Label for Xanax and Similar Drugs (2020) The New York Times: In 2020, the Food & Drug Administration added a warning label to all benzodiazepines cautioning against misuse and abuse of the drug.
[20] Balancing the Risks and Benefits of Benzodiazepines (2021) JAMA: Reviews benefits, risks, and strategies for rational prescribing following FDA labeling changes.
[21] FDA Drug Safety Communication  (2020) The U.S. Food & Drug Administration: FDA warning to highlight risks of abuse, addiction, dependence, and withdrawal for all benzodiazepines.
[22] A Review of Alprazolam Use, Misuse, and Withdrawal (2018) Journal of Addiction Medicine: There is high misuse liability of alprazolam and more severe withdrawal compared to other benzodiazepines.
[23] Alprazolam: Good for Some, Not Good for All! (2023) Journal of Clinical Psychopharmacology: Alprazolam poses high risk for addiction and difficult withdrawal given its pharmacological properties. 
[24] Benzodiazepine use, abuse, and dependence (2005) The Journal of Clinical Psychology: While there are few addiction cases from prescribed use of benzodiazepines, pharmacologic dependence can occur with long-term therapy.
[25] Benzodiazepine Tapering American Society of Addiction Medicine: Clinical guidelines recommend gradual tapering when discontinuing benzodiazepines.


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For decades, obesity was treated as a matter of self-control and free will: If you were fat, it was your own fault.
You could try a diet - but the diet companies were also in on the fix: For years, Weight Watchers was owned by Heinz food … and Jenny Craig was owned by Nestle. 
But it was still up to you. You made your choices, and you had to live with them. And so the obesity rate in the US soared from around 15% of the population in 1970 to more than 40% today. Clearly something is going on other than free will and personal choices.
In this episode of Drug Story, we explore the origins of the obesity epidemic: the Green Revolution in agriculture, which saved a billion lives, but also made grain cheap cheap cheap. And we look at what happened when the tobacco companies decided to diversify into the food business (surprise: food became a lot more addictive, and a lot less healthy). 
And we re-consider the whole idea of personal freedom and free will.
This episode's drug is Ozempic, and the whole class of GLP-1s that have up-ended our presumptions around obesity. These drugs have transformed millions of lives - they are surely one of the most impactful medical discoveries of the century. 
Unfortunately, these drugs have not dispelled the stigma around obesity. They’ve just shifted it a bit. If you think taking a GLP-1 is “cheating,” you’re still stuck in the old blame game.

Sources for this episode
[1] KFF Health Tracking Poll May 2024: The Public’s Use and Views of GLP-1 Drugs (2024) KFF: KFF poll showing awareness, perceptions, and use of Ozempic, Wegovy, and similar medications in the U.S.
[2] Norman Borlaug Man Of The Year 1969 (2011) The International Maize and Wheat Improvement Center: Norman Borlaug introducing himself as a man who grew up during the Great Depression and was raised on a farm in Iowa. 
[3] Norman Borlaug and the Green Revolution (2017) 20th Century Time Machine: Norman Borlaug created a high-yield wheat strain that transformed the agricultural industry and saved an estimated one billion lives. Considered the father of the Green Revolution, he was awarded the Nobel Peace Prize in 1970.
[4] Chapter 1 | The Man Who Tried to Feed the World (2020) American Experience PBS: Norman Borlaug, inspired by his own upbringing in struggling Iowa, helped the world avoid famine and hunger through revolutionizing wheat production.
[5] Food Timeline FAQs: historic food prices (2024) Food Timeline: In addition to increasing the supply of food globally, the Green Revolution also made food much more affordable.
[6] What Is the Evidence for “Food Addiction?” A Systematic Review (2018) Nutrients: A systematic review of 52 studies concludes that food addiction is a valid diagnostic construct that is more similar to substance use disorder than behavioral addiction, especially among processed foods with added sweeteners and fats.
[7] The Origins of the Obesity Epidemic in the USA–Lessons for Today (2022) Nutrients: The origins of obesity can be traced back to the introduction of ultra-processed food in the American diet. 
[8] US obesity rates have tripled over the last 60 years (2025) USA Facts: American rates of obesity have tripled since the 1960s, with over 40% of Americans having obesity.
[9] Daily supply of calories per person (2025) Our World in Data: From 1970 to 2020, Americans increased their daily calorie intake from about 3,000 to over 3,800 calories.
[10] US tobacco companies selectively disseminated hyper-palatable foods into the US food system: Empirical evidence and current implications (2024) Addiction: In a study reviewing industry documents and U.S. Department of Agriculture data from 1988 to 2002, food produced U.S. Tobacco companies that owned food companies were 80% more likely to be high in carbs and sodium than other foods.
[11] Many of today’s unhealthy foods were brought to you by Big Tobacco (2023) University of Michigan Department of Psychology: Research shows how major tobacco companies exerted their influence on the American diet by applying their expertise in chemical dependency to the food industry.
[12] Ultra-processed Food Consumption in Youth and Adults: United States, August 2021–August 2023 (2025) CDC: According to the CDC, ultra-processed foods are hyperpalatable, high in sodium, and low in fiber, like sandwiches, sweet bakery products, and sweetened beverages.
[13] Highly processed foods can be considered addictive substances based on established scientific criteria (2022) Addiction: Using the same scientific criteria the U.S. Surgeon General employed in 1988 to identify tobacco as addictive, this analysis suggests that highly processed foods, rich in refined carbs and added fats, should be considered addictive.
[14] Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake (2019) Cell Metabolism: In a randomized control trial, researchers discovered that participants on an ultra-processed diet voluntarily consumed about 500 extra calories per day. The study concludes that people gain weight on ultra-processed diets and lose weight on unprocessed ones.
[15] Cereal, pasta, and other food companies blast the FDA for a too-strict definition of ‘healthy’ (2023) STAT: The FDA has posed new rules on what can be considered “healthy” for a food product, limiting added sugar, sodium, and saturated fats. Industry giants argue that these rules are overly restrictive and food will be less palatable to consumers if less sugar and salt is in food.
[16] Adult obesity rates rise in 6 states, exceed 35% in 7 (2018) American Medical Association: The American Medical Association reports that adult obesity rates in the United States have reached historic highs, now affecting nearly 40 percent of the population.
[17] Recognition of Obesity as a Disease H-440.842 (2023) American Medical Association: The American Medical Association recognized obesity as a disease in 2013.
[18] Obesity as a Disease: Has the AMA resolution had an impact on how physicians view obesity? (2016) Surgery for Obesity and Related Diseases: Even after obesity was classified as a disease in 2013, many providers remained unaware of the resolution or held conflicting views on its validity, and debated whether obesity is a primary pathology or merely a behavioral risk factor.
[19] The Story of GLP-1: Episode 4 - "The next really good idea". (2022) Novo Nordisk Foundation: Novo Nordisk executives convinced their CEO that obesity should be treated as a medical challenge rather than a cosmetic issue. 

[20] What the Scientists Who Pioneered Weight-Loss Drugs Want You to Know (2023) WIRED: Interview with Jens Holst and Joel Habener, pioneers of GLP-1 research and early development of this drug class.
[21] We Know Where New Weight Loss Drugs Came From, but Not Why They Work (2023) The New York Times: This article discusses unknowns in GLP-1 mechanism of action, their effects on brain hormone levels, and the reframing of obesity as a biological rather than moral condition.
[22] The Ozempic Era Could Shift Blame for Obesity From Individuals to Commercial Food Systems (2025) Issues in Science and Technology: Given GLP-1’s mechanism of action, which targets biological pathways in the brain, obesity can be understood as a consequence of ultra-processed foods and an industrialized food system rather than a failure of individual willpower; the authors draw parallels to the alcohol and tobacco industries.
[23] Jim Gaffigan's Laughs Through His Weight-Loss Journey | Hulu (2025) Hulu: Jim Gaffigan addresses the stigma of using weight-loss drugs, highlighting how critics accuse him of "cheating" while he views the medication as a necessary tool for a "guy trying to not die".
[24] PEP Stock | PepsiCo Inc. Q1 2025 Earnings Call (2025) AlphaStreet: In a 2025 earnings call, the CEO of PepsiCo reports on the need to manage and adapt to recent health trends, including the rise and adoption of GLP-1s, which have resulted in customers eating smaller portions.



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