The story of the creation of the weight loss drugs involves a fair amount of serendipity and medical entrepreneurship. A case has been made that we would have had these drugs 25 years sooner if Pfizer had not abandoned the development of their version due to the dauntingly huge costs of drug development. Recall that the largest component of those huge costs are the mandated Phase 3 randomized double-blind clinical trials.
Almost everyone now views these drugs as a major medical advance. The question is: how big? According to the reviewer quoted below, Dr. Eric Topol speculates: very big indeed. He raises the possibility that to improve lifespan and healthspan eventually most of us will be on one of these drugs.
If so then the weight loss drugs will be even more compelling examples of the importance of regulating so as to allow entrepreneurs to take quick advantage of serendipity. How many lives were lost that could have been saved, how much suffering was experienced that could have been avoided, if over-regulation by the F.D.A. had not delayed the availability of these drugs by 25 years?
(p. A13) More than half of American adults suffer from at least one chronic illness—most commonly diabetes, heart disease, cancer or neurodegeneration. By age 65, 80% are afflicted with two or more conditions. Among those fortunate enough to reach 80, it’s rare to find anyone who has arrived unscathed. In 2008 a group of scientists at the Scripps Research Institute in San Diego set out to recruit 1,400 of these healthy souls—known as the Wellderly—to figure out how they managed it.
Led by the cardiologist Eric Topol, the researchers hoped to identify the genetic factors associated with healthy aging. To their surprise, they found little in the DNA that stood out. They did, however, notice several striking traits. Compared with their peers, the disease-free subjects were generally thinner, exercised more frequently and seemed “remarkably upbeat,” often with rich social lives. These observations encouraged the research team to think about longevity (years of life) and healthspan (years of health) more broadly. In “Super Agers” Dr. Topol shares the results of this intellectual exploration.
. . .
Expensive new weight-loss drugs like Ozempic and Zepbound, Dr. Topol writes, have “extraordinary potential to promote health span.” In addition to stanching appetite, these drugs also seem to rapidly reduce harmful inflammation—an effect that “precedes and is independent of weight loss.” In the future, the author believes it’s “conceivable that most people will be taking” such medications, . . .
For the full review see:
(Note: ellipses added.)
(Note: the online version of the review has the date May 6, 2025, and has the title “Bookshelf; ‘Super Agers’: Living the Good Life.”)
The book under review is:
Topol, Eric. Super Agers: An Evidence-Based Approach to Longevity. New York: Simon & Schuster, 2025.