Photo by Jonathan Borba on Unsplash

Severe Obesity is on the Rise: America Needs to Wake Up

A reflection on growing rates of obesity and how Ozempic may be taking on a larger role

In a nation that spends more on healthcare than any other country in the world, the epidemic of severe obesity is an alarming development.

According to recent CDC data, the percentage of U.S. adults with severe obesity (defined as a BMI of 40 or higher) has more than doubled over the past two decades, and by 2030, nearly half of all U.S. adults will be obese. While general obesity is already widespread, severe obesity presents even greater risks — from type 2 diabetes and cardiovascular disease to increased risk of early death. It strains not only individuals and families but also our already overwhelmed healthcare system.

So why isn’t this being treated like the emergency it is?

A Crisis Beyond Vanity

This isn’t about aesthetics. This is about lifespan, quality of life, and economic sustainability. Children as young as 10 are being diagnosed with prediabetes: a condition where blood sugar levels are elevated above normal, but not yet high enough to be diagnosed as type 2 diabetes.

Even more, obesity-related complications now account for hundreds of billions in annual healthcare costs.

Severe obesity also intersects with mental health, income inequality, and food insecurity. Fast food is often cheaper and more accessible than fresh produce. Highly processed, addictive foods are aggressively marketed to low-income communities, while education about healthy eating remains minimal.

The Role of Policy and Prevention

America cannot “treat” its way out of this crisis with surgeries and medications alone. What’s needed is a multi-layered public health strategy, including:

• Nutritional education in schools, starting in elementary grades
• Tax incentives for grocery stores in food deserts
• Advertising limits on ultra-processed foods targeting children
• Public health campaigns that address both nutrition and exercise
• Employer incentives for wellness and prevention programs

Change starts with awareness. Advocate for healthier school lunches. Support local markets and urban farming. Push for transparency in food labeling. And most importantly, approach the topic with compassion, not blame — because obesity is influenced by biology, environment, and stress.

Ozempic

In recent years, medications like Ozempic (semaglutide) and its counterpart Wegovy have become household names in the fight against obesity. Originally developed to treat type 2 diabetes, these GLP-1 receptor agonists work by mimicking a hormone that regulates appetite and insulin. The result? Many patients experience significant weight loss — sometimes upwards of 15–20% of their body weight.

While these drugs represent a major breakthrough in obesity treatment, they’re not a silver bullet. They are expensive, often not covered by insurance for weight loss alone, and require long-term use to maintain results.

Once discontinued, many people experience rapid weight regain, suggesting these medications may need to be taken indefinitely, a key issue that argues in favor of sustained exercise and dieting.

Moreover, the Ozempic boom raises ethical questions:

• Are we medicalizing a public health problem without addressing its root causes — such as poor diet, lack of physical activity, and mental health?
• Are we relying too heavily on pharmaceuticals instead of investing in prevention?

Ozempic should be seen as one piece of a broader strategy, taken in conjunction with exercise and dieting, instead of a miracle substitute. These strategies may allow people to be able to use Ozempic for shorter periods of time and lower weight gain once they get off.

Severe obesity isn’t just a personal health issue — it’s a national crisis with deep social, economic, and medical consequences. While breakthroughs like Ozempic offer new hope, they are not replacements for long-term solutions. America needs to address the root causes: our food systems, our awareness, and our culture.