But 5 pounds would come off and then invariably reappear, said Bucklew, 75, a public transit retiree in Ocean View, Delaware. Nothing seemed to make much difference — until 2023, when her body mass index slightly exceeded 40, the threshold for severe obesity.

“There’s this new drug I’d like you to try, if your insurance will pay for it,” the nurse practitioner advised. She was talking about Ozempic.

Medicare covered it for treating Type 2 diabetes but not for weight loss, and it cost more than $1,000 a month out-of-pocket. But to Bucklew’s surprise, her Medicare Advantage plan covered it even though she wasn’t diabetic, charging just a $25 monthly copay.

Pizza, pasta, and red wine suddenly became unappealing. The drug “changed what I wanted to eat,” she said. As 25 pounds slid away over six months, she felt less tired and found herself walking and biking more.

Then her Medicare plan notified her that it would no longer cover the drug. Calls and letters from her health care team, arguing that Ozempic was necessary for her health, had no effect.

With coverage denied, Bucklew became part of an unsettlingly large group: older adults who begin taking GLP-1s and related drugs — highly effective for diabetes, obesity, and several other serious health problems — and then stop taking them within months.

That usually means regaining weight and losing the associated health benefits, including lower blood pressure, cholesterol, and A1c, a measure of blood sugar levels over time.

Widely portrayed as wonder drugs, semaglutide (Ozempic, Wegovy, Rybelsus), tirzepatide (Zepbound, Mounjaro), and related medications have transformed the treatment of diabetes and obesity.

The FDA has approved several GLP-1s for additional uses, too — including to treat and , and and strokes.

“They’re being studied for every purpose you can conceive of,” said Timothy Anderson, a health services researcher at the University of Pittsburgh and author of a recent JAMA Internal Medicine .

(Drug trials have found , however.)

People 65 and older represent prime targets for such medications. “The prevalence of obesity hovers around 40%” in older adults, as measured by body mass index, said John Batsis, a geriatrician and obesity specialist at the University of North Carolina School of Medicine.

The proportion of people with , too, to nearly 30% at age 65 and older. Yet a recent JAMA Cardiology study found that among Americans 65 and up with diabetes, about within a year.

Another study of 125,474 people with obesity or who are overweight found that almost 47% of those with Type 2 diabetes and nearly 65% of those without diabetes stopped taking GLP-1s within a year — a high rate, said Ezekiel Emanuel, a health services researcher at the University of Pennsylvania and senior author of the study.

Patients 65 and older were 20% to 30% the drugs and less likely to return to them.

What explains this pattern? As many as 20% of patients may experience . “Nausea, sometimes vomiting, bloating, diarrhea,” Anderson said, ticking off the most common side effects.

Linda Burghardt, a researcher in Great Neck, New York, started taking Wegovy because her doctor thought it might reduce arthritis pain in her knees and hips. “It was an experiment,” said Burghardt, 79, who couldn’t walk far and had stopped playing pickleball.

Within a month, she suffered several bouts of stomach upset that “went on for hours,” she said. “I was crying on the bathroom floor.” She stopped the drug.

Some patients find that medication-induced weight loss lessens rather than improves fitness, because another side effect is muscle loss. Several trials have reported that , but “lean mass” including muscle and bone.

Bill Colbert’s cherished hobby for 50 years, reenacting medieval combat, involves “putting on 90 pounds of steel-plate armor and fighting with broadswords.” A retired computer systems analyst in Churchill, Pennsylvania, he started on Mounjaro, successfully lowered his blood glucose, and lost 18 pounds in two months.

But “you could almost see the muscles melting away,” he recalled. Feeling too weak to fight well at age 78, he also discontinued the drug and now relies on other diabetes medications.

“During the aging process, we begin to lose muscle,” typically half a percent to 1% of muscle weight per year, said Zhenqi Liu, an endocrinologist at the University of Virginia who . “For people on these medications, the process is much more accelerated.”

Losing muscle can lead to frailty, falls, and fractures, so doctors advise GLP-1 users to exercise, including strength training, and to eat enough protein.

The high rate of GLP-1 discontinuation may also reflect shortages; from 2022 to 2024, these drugs temporarily became hard to find. Further, patients may not grasp that they will most likely need the medications indefinitely, even after they meet their blood glucose or weight goals.

Re-initiating treatment involves its own hazards, Batsis cautioned. “If weight goes up and down, up and down, metabolically it sets people up for functional decline down the road.”

Of course, in considering why patients discontinue, “a large part of it is money,” Emanuel said. “Expensive drugs, not necessarily covered” by insurers. Indeed, in of patients who discontinued semaglutide or tirzepatide, nearly half cited cost or insurance issues as the reason.

Some moderation in price has already occurred. The Biden administration capped out-of-pocket payments for all prescriptions that a Medicare beneficiary receives ($2,100 is the 2026 limit), and authorized annual price negotiations with manufacturers.

The Ozempic, Wegovy, and Rybelsus, though not until 2027. Medicare Part D drug plans will then pay $274, and since most beneficiaries pay 25% in coinsurance, their out-of-pocket monthly cost will sink to $68.50.

Perhaps even lower, if agreements announced in November between the Trump administration and drugmakers Eli Lilly and Novo Nordisk pan out.

The bigger question is whether Medicare will amend its original 2003 regulations, which prohibit Part D coverage for weight loss drugs. “An archaic policy,” said Stacie Dusetzina, a health policy researcher at the Vanderbilt University School of Medicine.

The Trump administration’s would expand Medicare eligibility for GLP-1s and related medications to include obesity, perhaps as early as spring. But key details remain unclear, Dusetzina said.

Medicare should cover anti-obesity drugs, many doctors argue. Americans still tend to think that “diabetes is a disease and obesity is a personal problem,” Emanuel said. “Wrong. Obesity is a disease, and it reduces life span and compromises health.”

But given the expense to insurers, Dusetzina warned, “if you expand the indications and extent of coverage, you’ll see premiums go up.”

For older patients, often underrepresented in clinical trials, questions about GLP-1s remain. Might a lower maintenance dose stabilize their weight? Can doses be spaced out? Could nutritional counseling and physical therapy offset muscle loss?

Bucklew, whose coverage was denied, would still like to resume Ozempic. But because of a recent sleep apnea diagnosis, she now qualifies for Zepbound with a $50 monthly copay.

She has seen no weight loss after three months. But as the dose increases, she said, “I’ll stay the course and give it a shot.”

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But in the past couple of years, she’s fallen from 600 pounds to 385, and her blood pressure and blood sugar levels are down, too. “I’m not as fatigued as I used to be, and I’ve been able to go back to church,” she said.

Hines, 46, credits her weight loss to Trulicity, part of a new class of expensive weight loss drugs known as GLP-1s, and her Medicaid coverage for it. “It’s a blessing,” she said.

In a state where the obesity rate ranks among the highest in the country, many health providers were thrilled when Mississippi Medicaid in 2023 began covering GLP-1s for people 12 and older. Only 13 states cover the drugs for Medicaid enrollees for obesity, and Mississippi’s Medicaid program typically has some of the sparsest benefits and strictest eligibility rules.

Hines is one of relatively few enrollees to have used the new Medicaid benefit, which weight loss doctors in the state say has been hindered by national drug shortages, the state’s prior authorization process for the drugs, and a lack of marketing. Just 2% of adults on Mississippi Medicaid who meet the weight-related criteria had been prescribed a GLP-1 as of December 2024, according to to the state’s Medicaid Drug Utilization Review Board.

“It’s a little sad to have so many people out there not benefiting,” said William Rosenblatt, a family doctor in Columbus who treats Hines. “These drugs get to the root cause of so many health conditions.”

Already-scarce Medicaid coverage of the highly touted weight loss drugs could become more limited, with federal Medicaid funding cuts expected in the wake of the massive tax-and-spending bill President Donald Trump signed into law in July. The Congressional Budget Office estimated that the law would reduce Medicaid spending by about $911 billion over a decade.

“The law is going to create fairly intense pressure on states not to expand benefits,” said Michael Kolber, a partner in the health consulting firm Manatt. That may be especially true for these drugs, which often cost around $1,000 a month and could be used by a large percentage of Medicaid recipients, he said.

GLP-1s, which to treat Type 2 diabetes, have gained widespread attention as a way to lose weight and reduce obesity-related conditions and their long-term costs.

But states may remain reluctant to offer the expensive drugs for obesity, because Medicaid recipients frequently churn on and off the coverage as their income changes. And because the drugs’ health benefits may take years to materialize — such as averting a future heart attack — the long-term financial advantages could accrue to other insurers.

Even ahead of the federal cuts, which will largely take effect in 2027, states are already feeling the pinch. North Carolina’s Medicaid program of the drugs this month, citing their high cost.

Coverage for the weight loss drugs presents a dilemma for the Trump administration, which has identified as priorities attacking chronic health conditions and reducing federal spending. Health and Human Services Secretary Robert F. Kennedy Jr. has for the drugs and said more emphasis should be placed on eating better and exercising more.

In 2024, the Biden administration proposed that Medicare and Medicaid cover weight loss drugs to help tackle obesity as a public health crisis. In April, the Trump administration revoked the Biden-era proposal, saying the programs would not cover GLP-1 drugs for weight loss.

But in August, the Trump administration was considering a five-year pilot program for Medicare and Medicaid to cover the drugs after all. No details have been released. Asked for comment on the report, Centers for Medicare & Medicaid Services spokesman Alexx Pons told ºÚÁϳԹÏÍø News that all decisions go through a cost-benefit review.

Meanwhile, the Trump administration has included the GLP-1 drugs Ozempic, Wegovy, and Rybelsus on its list of 15 medicines that will be subject to price negotiations with pharmaceutical manufacturers under its Medicare Part D program, a system created during the Biden administration amid opposition from Republicans. The results of those negotiations are expected to be announced this fall.

Most private insurers don’t cover GLP-1s for weight loss, which can make the drugs unaffordable for those paying out of pocket.

to Mississippi’s Medicaid drug review board shows that, in the first 15 months the drugs were covered, only about 2,900 Medicaid enrollees age 12 or older started treatment. Nearly 90% of them were female, and many had high blood pressure and high cholesterol.

The analysis also found most enrollees using the drugs lived in the southern, central, or northern parts of Mississippi — not along the Mississippi Delta on the western side of the state, where obesity rates are highest, at nearly 50%.

About 40% of adults in Mississippi are obese, just one percentage point behind top-ranked West Virginia, according to federal data.

Mississippi Medicaid spokesman Matt Westerfield told ºÚÁϳԹÏÍø News that the state spent $12 million in the first 15 months, providing the weight loss drugs to 2,200 adult members. He said the state approved the new drugs on the logic that treating obesity would improve enrollees’ health and eventually could lead to cost savings by reducing diseases caused by obesity.

Westerfield said that while utilization has been below the state’s projections, such treatment decisions are up to patients and their doctors. He said the state has been “raising awareness” of the drugs among health care providers, but he declined to comment further.

Rosenblatt, who works for Baptist Medical Group, part of a large regional health system, said some doctors have less incentive to prescribe the medicine, because the state doesn’t pay them to counsel patients about necessary dietary changes when taking the new drugs.

He called the drugs “game changers,” adding that he has seen patients lose 50 pounds or more within a few months of starting the drugs and no longer need medications for diabetes or other conditions.

A published in 2021 found participants receiving GLP-1 drugs were more likely to show significant, sustained weight loss compared with those getting a placebo.

Other recent studies have shown the drugs help people with obesity lower their and reduce their odds of .

Mississippi is one of 10 states that have not expanded Medicaid eligibility under the 2010 Affordable Care Act to everyone with an income under 138% of federal poverty level, or $21,597 this year.

In Mississippi, Medicaid does not cover adults without dependent children. Parents qualify only if their income is below 22% of the federal poverty level, or $5,863 for a family of three this year.

The state’s prior authorization process requires doctors to document to the state that patients meet certain obesity levels and that a treatment plan is in place. Doctors must demonstrate that enrollees are losing weight every six months to renew their prescription.

At the Hattiesburg Clinic — a large, multi-specialty group with a location in Hattiesburg, Mississippi — Virginia Crawford, a physician who specializes in obesity, said she was surprised so few patients are getting the drugs. A year ago, there were shortages of the drugs that could have curtailed physicians prescribing them. And she said the state’s prior authorization requirements for the drug could discourage primary care doctors. Many common medications do not require progress reports or even prior authorization.

“We need to make patients more aware that this option is available for them,” she said.

Lauren Scott, 40, of Laurel, Mississippi, said that with the help of Medicaid coverage, she lost nearly 100 pounds taking Wegovy.

“It’s just been amazing,” she said of how the drug drastically cut her appetite. “I remember going to Outback with my husband, and we got the onion ring appetizer and 16-ounce ribeye and salad with extra ranch dressing. I had some onion rings and started on the salad and realized I could not eat any more of this.”

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Her request for coverage had been denied, the letter said, because she’d had a body mass index of less than 35 when she started Zepbound. The 25-year-old who lives in New York had been taking Zepbound without incident for months, so she was confused: Why was her BMI, which had been around 32 when she started, becoming an issue only now?

Wensley had no interest in quitting an effective drug. “Going right off like that, it’s easier said than done,” she said.

Her doctor fought to keep her on the GLP-1 agonist, the category that includes weight loss and Type 2 diabetes drugs Ozempic, Wegovy, Mounjaro, and Zepbound. But Wensley ultimately had to switch from Zepbound to Wegovy to meet her plan’s requirements. She said she doesn’t like Wegovy as much as her old medication, but she now feels lucky to be on any GLP-1.

Lots of research suggests such medications must be used indefinitely to maintain weight loss and related health benefits. But with list prices of , public and private payers are struggling to keep up with for GLP-1 weight loss drugs and in some cases are eliminating or restricting their coverage as a result.

North Carolina Medicaid plans to for weight loss on Oct. 1, just over a year after starting the coverage. Pennsylvania is planning to limit Medicaid coverage to beneficiaries at the highest risk of complications from obesity. And despite of a potential federal pilot program to extend coverage of GLP-1 obesity drugs under Medicaid and Medicare, all state Medicaid programs are likely to be under pressure due to in the budget reconciliation package recently signed into law by President Donald Trump.

Already, many GLP-1 users , — often due to side effects, high costs, or insurance issues. Now a growing number of researchers, payers, and providers are exploring deliberate “deprescription,” which aims to taper some patients off their medication after they have taken it for a certain amount of time or lost a certain amount of weight.

The U.K.’s National Institute for Health and Care Excellence, which creates guidance for the , on the use of some weight loss medications, such as Wegovy. And the concept was raised in a recent Institute for Clinical and Economic Review to obesity drugs.

, who directs the Center for Value-Based Insurance Design at the University of Michigan, that if some people using GLP-1s to lose weight were eventually transitioned off, more people could take advantage of them.

“If you’re going to spend $1 billion or $100 billion, you could either spend it on fewer people for a long period of time, or you can spend it on a lot more people for a shorter period of time,” he said.

Fendrick’s employer, the University of Michigan, indeed does that. Its prescription drug plan caps coverage of GLP-1 drugs if they’re used solely for weight loss.

Jamie Bennett, a spokesperson for Wegovy and Ozempic maker Novo Nordisk, declined to comment on the concept of deprescription, noting that its drugs are intended for chronic conditions. Rachel Sorvig, a spokesperson for Zepbound and Mounjaro manufacturer Eli Lilly, said in a statement that users should “talk to their health care provider about dosage and duration needs.”

Studies have shown that people typically regain within a year of , and that many people who quit ultimately go back on the drugs.

“There’s no standard of care or gold standard on how to wean right now,” said , an obesity and internal medicine doctor with UK HealthCare in Kentucky.

But the math shows why time-limited coverage is appealing to payers that struggle to pay for beneficiaries’ GLP-1 prescriptions, said , chief medical officer for the pharmacy benefit manager CVS Caremark.

And states are “between a rock and a hard place,” said Kody Kinsley, who until January led North Carolina’s Health and Human Services Department. “They’re going to have to look at every single thing and trim dollars everywhere they can.”

Pennsylvania was looking for cost-saving strategies even before the new federal tax-and-spending law, according to Brandon Cwalina, press secretary for the state’s Department of Human Services. Pennsylvania projects it will spend $1.3 billion on GLP-1 drugs this year.

Plans could see real savings, Fendrick said, if they covered GLP-1s for initial weight loss then moved people to cheaper options — such as more affordable drugs or behavioral health programs — to maintain it.

Plenty of companies are eager to sell insurers, employers, and individuals on behavioral alternatives. One is , its nutrition-focused weight management program as “a proven approach for deprescribing GLP-1s when clinically appropriate.” assessed 154 people with Type 2 diabetes who stopped using GLP-1 medications but continued following Virta’s program, concluding that their weight did not significantly increase after a year.

Researchers affiliated with a European weight management company also that slowly tapering off the medications may help maintain weight loss.

For employers and insurers, the “initial question” was whether to cover GLP-1s for obesity, said Virta CEO Sami Inkinen. “Now, basically, everyone’s coming to the middle and asking, ‘How do we responsibly cover these drugs?’”

Part of responsible coverage, Inkinen said, is providing other forms of support to patients who stop using GLP-1 medications, by choice or otherwise.

For some people, however, maintaining weight loss without a GLP-1 remains a challenge, even with other options available.

Lily, who lives in Michigan, lost almost 80 pounds in roughly 18 months on Wegovy. But she had to quit the drug when she turned 26 and left her parents’ insurance plan this year. The plan her employer offers stopped covering GLP-1s for weight loss right around the time she joined.

Lily, who asked to be identified by only her first name because she is not out to her family as transgender, has tried other medications since then, and previously tried lifestyle programs to control her weight. But she said nothing works as well for her as Wegovy.

She has regained 20 pounds since going off the drug at the beginning of the year and worries that number will continue to rise, potentially contributing to future health problems.

“Just give people the drugs,” she said. “It seems cheaper and safer in the long run.”

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Richards has heard Trump administration officials suggest that and cause autism and ADHD. That stance, she said, unfairly blames parents.

“There’s no evidence to support it,” said Richards, 44, a marketing director in Richmond, Virginia. “As a parent, it’s infuriating.”

In their zeal to “Make America Healthy Again,” Trump administration officials are making statements that some advocacy and medical groups say depict patients and the doctors who treat them as partly responsible for whatever ails them.

Health and Human Services Secretary Robert F. Kennedy Jr. and agency leaders have attributed a panoply of chronic diseases and other medical issues — such as autism, attention-deficit/hyperactivity disorder, depression, diabetes, and obesity — to consumers and their lifestyle choices, according to a review of 15 hours of recorded interviews, social media statements, and federal reports.

He said at a news conference on April 16 that and that rates are rising because of toxic substances in the environment, despite a lack of evidence there is any link.

“These are kids who will never pay taxes. They’ll never hold a job. They’ll never play baseball. They’ll never write a poem. They’ll never go out on a date,” he said. “Many of them will never use a toilet unassisted.”

The vast majority of people on the spectrum do not have those severe challenges.

The statements are more than rhetoric. These attitudes, ranging from judgments about individual behaviors to criticism of the chronically poor, are shaping policies that affect millions of people. The sentiments have been a factor behind decisions to cut Medicaid, keep federal insurance programs from covering anti-obesity drugs, and impose new barriers to covid vaccines for healthy people, say public health leaders and doctors. GOP lawmakers and federal health officials, they say, hold a reproachful stance toward chronic illnesses and the estimated 129 million people in the U.S. affected by them.

“This is at the heart of so much of our national problem with health,” said Robert Califf, who led the Food and Drug Administration during the Obama and Biden administrations. “It’s these two extreme views. It’s every health decision is up to the ‘rugged individual,’ versus the other extreme view that it’s all controlled by environment and social determinants of health. The truth is, it’s on a continuum.”

The Blame Game

Self-reliance is a common theme among adherents of MAHA, an informal movement for which Kennedy has fashioned himself the figurehead that promotes medical freedom, skepticism of vaccines, and a focus on nontraditional medicine to treat disease.

Taking medication to manage diabetes? FDA Commissioner Marty Makary suggested on in late May that it would be effective to “treat more diabetes with cooking classes” instead of “just throwing insulin at people.”

People with Type 1 diabetes must take insulin because their pancreases don’t produce it, according to the , which also notes that many with Type 2 diabetes “need to take diabetes medicines as well.”

Taking birth control pills? Casey Means, President Donald Trump’s nominee to be U.S. surgeon general, has said that’s a “disrespect of life” for short-term gain and efficiency.

“We are prescribing them like candy,” she said last year on “,” adding that birth control medications “are literally shutting down the hormones in the female body that create this cyclical, life-giving nature of women.”

Have a child on ADHD meds? , who is an adviser to Kennedy and is Casey Means’ brother, said on the same show that Adderall is prescribed as the standard of care when children get a little fidgety because they’re in sedentary environments with limited sunlight and eat too much ultraprocessed food.

As a society, he said, “we’re really committing mass child abuse in many ways, and we’re normalizing that and we’re not speaking out about that. And then we’re giving people stimulants developed by Nazi Germany.”

Calley Means was probably referring to Pervitin, a drug administered to Adolf Hitler’s forces in World War II. Adderall is a prescription drug containing amphetamine, a stimulant that’s as methamphetamine.

The Department of Health and Human Services didn’t respond to messages seeking comment from Means.

Some conservatives and MAHA adherents argue that people need to take more responsibility for their health. But comments that shift blame to patients and physicians risk perpetuating stigmas, fostering the spread of misinformation, and eroding trust in modern medicine, say medical groups, doctors, and patient advocacy groups.

The statements assume consumers and patients have control over improving their health and preventing chronic disease when the reality is more complex, according to some public health leaders. Lower-income people, they say, often lack access to grocery stores and healthy food, may juggle too many jobs to have time to cook from scratch, and may live in dangerous areas where it’s harder to get outside and exercise.

, surgeon general during the previous Trump administration, told ºÚÁϳԹÏÍø News that he worries efforts to promote health will be undone by “the return of vaccine-preventable diseases, increasing mistrust in the health care system, and the tearing down of social supports which are critical for making healthy choices.”

Tough Talk

The attitudes held by top Trump health officials have affected policy decisions, some doctors and public health leaders say.

Kennedy and other Trump administration health leaders have been especially outspoken, targeting issues they consider especially egregious in recent federal actions, research, or policy.

For example, the Biden administration proposed in November that would let Medicare cover weight loss medications such as Wegovy and Zepbound. But Kennedy and other political appointees at HHS and its agencies have criticized the drugs and the people who take them.

“I think it’s very dark,” Calley Means , referring to the weight loss drugs. “I think it’s a stranglehold on the U.S. population, almost like solidifying this idea that there is a magic pill.”

He added: “Where is the urgency on saying ‘Hey parents, maybe we shouldn’t feed our kids toxic food?’”

Kennedy, too, has criticized the medications and people who use them, saying in October on that drugmakers “are counting on selling it to Americans because we’re so stupid and so addicted to drugs.”

In April, the Trump administration announced it would not finalize the Biden-era coverage rule.

“It’s impacting the kind of care and treatments patients will have,” said Andrea Love, a biomedical scientist and founder of ImmunoLogic, a science communication organization. “It sends the message that it’s your fault. It’s very much victim-blaming. It creates the idea that scientific progress is the devil, demonizes things that aren’t individually harming health, while avoiding addressing systemic issues that play a much larger role in health.”

Kennedy and HHS didn’t return messages seeking comment.

Data shows that the medications are effective. People who took the in clinical trials lost an average of 48 pounds, and 1 in 3 on that dose lost more than 58 pounds, or 25% of their body weight.

Kennedy and other agency leaders also oppose many covid-era health restrictions and rules. Some physicians and public health leaders note these officials downplayed covid risks while criticizing vaccines developed during the previous Trump administration.

Kennedy has said that people who died from covid actually fell victim to chronic diseases such as obesity, diabetes, or asthma.

“That’s really what killed them,” Kennedy said on “” in April. “These were people who were so sick they were basically hanging from a cliff, and covid came along and stamped on their fingers and dropped them off. But they were already living lives that were burdened by sickness.”

Covid was the underlying cause of death for more than in the U.S. from Aug. 1, 2021, to July 31, 2022, according to a 2023 report in JAMA Network, an open-access journal on biomedical sciences published by the American Medical Association.

Covid ranked first among deaths caused by infectious or respiratory diseases for youths under age 19, based on the report. Infants under a year old may be at higher risk of experiencing severe illness from covid compared with older children, , and risks are also higher for infants under 6 months and those with underlying medical conditions.

“ can help protect infants after birth,” according to the CDC.

But Kennedy announced in May that the federal government would no longer recommend covid vaccines for pregnant people and children who are healthy. Medical groups such as the American Academy of Pediatrics opposed this decision and filed a lawsuit. 

Kennedy also helped promote beliefs that many childless adults on Medicaid, the federal-state program for low-income people, don’t work and thereby drain resources from the program.

At a May hearing of the House Energy and Commerce Committee, Kennedy said the program was in jeopardy because of “all the able-bodied people who are not working [or] looking for jobs.”

It’s a view embraced by Republican lawmakers who portrayed adults enrolled in Medicaid as lazy or shirking work as they advanced a budget bill estimated to cut federal spending on the program by about $1 trillion over a decade, in part by imposing work requirements on many adult beneficiaries.

“Thirty-five-year-olds sitting at home playing video games, they’re going to now have to go get a job,” said House Majority Leader Steve Scalise of Louisiana.

The legislation, which Trump signed into law this month, will cause about 10 million more people to be without health insurance by 2034, .

Some health leaders who criticized the legislation say the statements inaccurately maligned Medicaid enrollees, who by law cannot hold high-paying jobs and remain in the program.

Nonetheless, nearly two-thirds of adults ages 19 to 64 covered by Medicaid in 2023 were working. For about 3 in 10, caregiving responsibilities, an illness or disability, or school attendance prevented them from working, , a health information nonprofit that includes ºÚÁϳԹÏÍø News.

“It’s using anti-welfare tropes for something that is basic health care, not a cash benefit,” said Anthony Wright, executive director at Families USA, which supports the Affordable Care Act and expanded health coverage. He summarized the Republican message: “We’re going to make it harder to get the help you need by imposing a bunch of paperwork, and if you don’t get it, it’s your fault.”

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The irony stung: When Dean was born, he was so weak and floppy he survived only with feeding tubes because he couldn’t suck or swallow. He was diagnosed as a baby with Prader-Willi syndrome — a rare disorder sparked by a genetic abnormality. He continued to be disinterested in food for years. But doctors warned that as Dean grew, his hunger would eventually become so uncontrollable he could gain dangerous amounts of weight and even eat until his stomach ruptured.

“It’s crazy,” said Foley Shenk, who lives in Richmond, Virginia. “All of a sudden, they flip.”

Prader-Willi syndrome affects up to 20,000 people in the U.S. The most striking symptom is its most life-threatening: an insatiable hunger known as hyperphagia that prompts caregivers to padlock cupboards and fridges, chain garbage cans, and install cameras. Until recently, the only treatment was growth hormone therapy to help patients stay leaner and grow taller, but it didn’t address appetite.

In March, the Food and Drug Administration , an extended-release version of the existing drug diazoxide choline, which eases the relentless hunger and may offer insights into the biology of extreme appetite and binge eating. This breakthrough for these patients comes as other drugs are revolutionizing how doctors treat obesity, which affects of American adults. GLP-1 agonist medications Ozempic, Wegovy, and others also are delivering dramatic results for millions.

But what’s becoming clear is that obesity isn’t one disease — it’s many, said , a senior obesity researcher at the National Institutes of Health, who co-authored some of the Vykat XR studies. Researchers are learning that obesity’s drivers can be environmental, familial, or genetic. “It only makes sense that it’s complex to treat,” Yanovski said.

Obesity medicine is likely heading the way of treatments for high blood pressure or diabetes, with three to five effective options for different types of patients. For example, up to 15% of patients in the GLP-1 trials didn’t respond to those drugs, and at least the medications didn’t significantly help Prader-Willi patients.

Yet, researchers say, efforts to understand how to treat obesity’s many causes and pathways are now in question as the Trump administration is dismantling the nation’s infrastructure for medical discovery.

While Health and Human Services Secretary Robert F. Kennedy Jr. promotes a “Make America Healthy Again” agenda centered on diet and lifestyle, is being slashed, including some grants that support the study of obesity. face cuts, FDA staffers are being laid off en masse, and rare disease researchers fear the ripple effects across all medical advances. Even with biotech partnerships — such as the work that led to Vykat XR — progress depends on NIH-funded labs and university researchers.

“That whole thing is likely to get disrupted now,” said , research director for the .

HHS spokesperson Andrew Nixon said in a statement that no NIH awards for Prader-Willi syndrome research have been cut. “We remain committed to supporting critical research into rare diseases and genetic conditions,” he said.

But Strong said that already some of the contacts at the FDA she’d spent nearly 15 years educating about the disorder have left the agency. She’s heard that some research groups are considering moving their labs to Europe.

Early progress in hunger and obesity research is transforming the life of Dean Shenk. During the trial for Vykat XR, his anxiety about food eased so much that his parents began leaving cupboards unlocked.

, a pediatric endocrinologist at the University of Florida who co-led the Vykat XR trials, treats around 600 Prader-Willi patients, including Dean. She said the impact she’s seen is life-changing. Since the drug trial started in 2018, some of her adult patients have begun living independently, getting into college, and starting jobs — milestones that once felt impossible. “It opens up their world in so many ways.”

Over 26 years in practice, she’s also seen just how severely the disease hurts patients. One patient ate a four-pound bag of dehydrated potato flakes; another ingested all 10 frozen pizzas from a Costco pack; some ate pet food. Others have climbed out of windows, dived into dumpsters, even died after being hit by a car while running away from home in search of food.

Low muscle tone, developmental delays, cognitive disabilities, and behavioral challenges are also common features of the disorder.

Dean attends a special education program, his mother said. He also has narcolepsy and cataplexy — a sudden loss of muscle control triggered by strong emotions. His once-regular meltdowns and skin-picking, which led to deep, infected lesions, were tied to anxiety over his obsessive, almost painful urge to eat.

In the trial, though, his hyperphagia was under control, according to Miller and Dean’s mother. His lean muscle mass quadrupled, his body fat went down, and his bone mineral density increased. Even the skin-picking stopped, Foley Shenk said.

Vykat XR is not a cure for the disease. Instead, it calms overactive neurons in the hypothalamus that release neuropeptide Y — one of the body’s strongest hunger signals. “In most people, if you stop secreting NPY, hunger goes away,” said Anish Bhatnagar, CEO of , which makes the medication, the company’s first drug. “In Prader-Willi, that off switch doesn’t exist. It’s literally your brain telling you, ‘You’re starving,’ as you eat.”

GLP-1 drugs, by contrast, mimic a gut hormone that helps people feel full by slowing digestion and signaling satiety to the brain.

Vykat XR’s possible side effects include high blood sugar, increased hair growth, and fluid retention or swelling, but those are trade-offs that many patients are willing to make to get some relief from the most devastating symptom of the condition.

Still, the drug’s average price of $466,200 a year is staggering even for rare-disease treatments. Soleno said in a statement it expects broad coverage from both private and public insurers and that the copayments will be “minimal.” Until more insurers start reimbursing the cost, the company is providing the drug free of charge to trial participants.

Soleno’s stock soared 40% after the FDA nod and has held fairly steady since, with the company valued at nearly as of early June.

While Vykat XR may be limited in whom it can help with appetite control, obesity researchers are hoping the research behind it may help them decode the complexity of hunger and identify other treatment options.

“Understanding how more targeted therapies work in rare genetic obesity helps us better understand the brain pathways behind appetite,” said , an internal medicine physician and the director of obesity medicine at the University of Oklahoma-Tulsa’s School of Community Medicine.

That future may already be taking shape. For Prader-Willi, two other notable phase 3 clinical trials are underway, led by Acadia Pharmaceuticals and Aardvark Therapeutics, each targeting different pathways. Meanwhile, hundreds of trials for general obesity are currently recruiting despite the uncertainties in U.S. medical research funding.

That brings more hope to patients like Dean. Nearly six years after starting treatment, the now-16-year-old is a calmer, happier kid, his mom said. He’s more social, has friends, and can focus better in school. With the impulse to overeat no longer dominating his every thought, he has space for other interests — Star Wars, American Ninja Warrior, and a healthy appreciation for avocados among them.

“Before the drug, it just felt like a dead end. My child was miserable,” Foley Shenk said. “Now, we have our son back.”

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“I’ve struggled with my weight for so long,” said Campbell, 40, a single mother of two. “I’m not opposed to trying anything.”

In early April, about four weeks after she’d started taking Wegovy, Campbell said she hadn’t experienced any side effects, such as nausea or bowel irritation. But she doesn’t use a scale at home, she said, so she didn’t know whether she’d lost any weight since her most recent medical appointment earlier this year, when she weighed 314 pounds. Still, she was confident about achieving weight loss.

“It’s going to work because I’m putting in the work. I’m changing my eating habits. I’m exercising,” said Campbell, a shipping manager at a Michaels store. “I’m not going to second-guess myself.”

Wegovy belongs to a pricey class of drugs called GLP-1s (short for glucagon-like peptide-1 agonists) that have upended the treatment of obesity in recent years, offering hope to patients who have tried and failed to lose weight in myriad other ways.

Campbell gained access to Wegovy through South Carolina Medicaid’s decision in late 2024 to cover these weight loss drugs. But the medications remain out of reach for millions of patients across the country who could benefit from them, because many public and private health insurers have deemed the drugs too expensive.

A by KFF, a health information nonprofit that includes ºÚÁϳԹÏÍø News, found only 13 states were covering GLP-1s for the treatment of obesity for Medicaid beneficiaries as of August. South Carolina became the 14th in November.

Liz Williams, one of the report’s authors and a senior policy manager for the Program on Medicaid and the Uninsured at KFF, said she was not aware of any other state Medicaid programs joining the list since then. Looking ahead, the remaining states may be reluctant to add a new, expensive drug benefit while they brace for potential federal cuts coming from Congress, she said.

“As the budget debate, federally, is developing, that may impact how states are thinking about this,” Williams said.

The federal government won’t be helping anytime soon, either. Medicare covers GLP-1s to treat diabetes and some other health conditions, including obstructive sleep apnea and cardiovascular disease, but not obesity. In early April, the Trump administration announced it will not finalize a rule proposed by the Biden administration that would have allowed an estimated 7.4 million people covered by Medicare and Medicaid to access GLP-1s for weight loss. Meanwhile, the FDA is poised to force less expensive, compounded versions of these drugs off the market.

And the barrier to entry remains high, even for Medicaid patients in those few states that have agreed to cover the drugs without a federal mandate.

Case in point: In South Carolina, where more than one-third of all adults, and nearly half of the African American population, qualify as obese, the state Medicaid agency estimates only 1,300 beneficiaries will meet the stringent prerequisites for GLP-1 coverage.

Under one of those requirements, Medicaid beneficiaries who wish to access these drugs to lose weight must attest to “increased exercise activity,” said Jeff Leieritz, a spokesperson for the South Carolina Department of Health and Human Services.

Campbell, who is insured by Medicaid, was granted coverage for Wegovy based on her body mass index. First, though, she was required to submit six months’ worth of documentation proving that she’d tried and failed to lose weight after receiving nutrition counseling and going on a 1,200-calorie-a day diet, said Kenneth Mitchell, one of Campbell’s doctors and the medical director for bariatric surgery and obesity medicine at Roper St. Francis Healthcare.

Campbell’s Wegovy prescription was approved for six months, Mitchell said. When that authorization expires, Campbell and her health care team will need to submit more documentation, including proof that she has lost at least 5% of her body weight and has kept up with nutrition counseling.

“It’s not just, ‘Send a prescription in and they cover it.’ It’s rather arduous,” Mitchell said. “Not a lot of folks are going to do this.”

Mitchell said South Carolina Medicaid’s decision to cover these drugs was met with excitement among those working in his medical specialty. But he wasn’t surprised that the state anticipates relatively few people will access this benefit annually, since the approval process is so rigorous and the cost high. “The problem is the medicines are so expensive,” Mitchell said.

Novo Nordisk, which manufactures Wegovy, announced in March that it was cutting the monthly price for the drug from $650 to $499 for cash-paying customers. The price that health insurance plans and beneficiaries pay for these drugs varies, but some GLP-1s cost more than $1,000 per patient per month, Mitchell said, and many people will need to take them for the rest of their lives to maintain weight loss.

“That is a tremendous price tag that someone has to foot the bill for,” Mitchell said.

That’s the reason California Gov. Gavin Newsom on May 14 proposed eliminating Medicaid coverage of GLP-1s for weight loss starting Jan. 1, to save an estimated a year by 2028.

And the North Carolina State Health Plan Board of Trustees voted last year to end coverage of GLP-1s for state employees, after then-North Carolina Treasurer Dale Folwell’s office estimated in 2023 that the drugs were projected to cost the State Health Plan $1 billion over the next six years. The decision came only a few months after a separate North Carolina agency announced it would start covering these drugs for Medicaid beneficiaries. North Carolina Medicaid has estimated it will spend $16 million a year on GLP-1s.

South Carolina Medicaid, which insures fewer than half the number of people enrolled in North Carolina Medicaid, anticipates spending less. Leieritz estimated GLP-1s and nutrition counseling offered to Medicaid beneficiaries in South Carolina will cost $10 million a year. State funding will cover $3.3 million of the expense; the remainder will be paid for by matching Medicaid funds from the federal government.

In a recent interview, Health and Human Services Secretary Robert F. Kennedy Jr. didn’t rule out the possibility that Medicare and Medicaid might cover GLP-1s for obesity treatment in the future as costs come down.

They’re “extraordinary drugs” and “we’re going to reduce the cost,” Kennedy told CBS News in early April. He said he would like GLP-1s to eventually be made available to Medicare and Medicaid patients who are seeking obesity treatment after they have tried other ways to lose weight. “That is the framework that we’re now debating.”

Meanwhile, public health experts have applauded South Carolina Medicaid’s decision to cover GLP-1s. Yet the new benefit won’t help the vast majority of the 1.5 million adults in South Carolina who are classified as obese, according to by the South Carolina Department of Public Health.

“We still have some work to do,” acknowledged Brannon Traxler, the public health department’s chief medical officer.

But the state’s new “Action Plan for Healthy Eating and Active Living,” written by a coalition of groups in South Carolina, including the Department of Public Health, makes no mention of GLP-1s or the role they might play in lowering obesity rates in the state.

The action plan, underwritten by a $1.5 million federal grant, isn’t meant to lay out an overarching approach for lowering obesity in South Carolina, Traxler said. Instead, it promotes physical activity in schools, nutrition, and the expansion of outdoor walking trails, among other strategies. A more comprehensive obesity plan might address the benefits of surgical intervention and GLP-1s, but those also carry risk, expense, and side effects, Traxler said.

“Certainly, I think, there is a need to bring it all together,” she said.

Campbell, for one, is taking the comprehensive approach. On top of injecting Wegovy once weekly, she said, she is prioritizing protein intake and moving her body. She also underwent weight loss surgery in late April.

“Weight loss is my biggest goal,” said Campbell, who expressed appreciation for Medicaid’s coverage of Wegovy. “It’s one more thing that’s going to help me get to my goal.”

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For years, the federal government has steered clear of regulating junk food, fast food, and ultra-processed food.

Now attitudes are changing. Some members of President-elect Donald Trump’s inner circle are gearing up to battle “Big Food,” or the companies that make most of the food and beverages consumed in the United States. Nominees for top health agencies are taking aim at ultra-processed foods that account for of the nation’s food supply. Based on recent statements, a variety of potential politically charged policy options to regulate ultra-processed food may land on the Trump team menu, including warning labels, changes to agribusiness subsidies, and limits on which products consumers can buy with government food aid.

The push to reform the American diet is being driven largely by conservatives who have taken up the cause that has long been a darling of the left. Trump supporters such as Robert F. Kennedy Jr., whose controversial nomination to lead the Department of Health and Human Services still faces Senate confirmation, are embracing a concept that champions natural foods and alternative medicine. It’s a movement they’ve dubbed “MAHA,” or Make America Healthy Again. Their interest has created momentum because their goals have fairly broad bipartisan support even amid a bitterly divided Congress in which lawmakers from both sides of the aisle focused on the issue last year.

It’s likely to be a pitched battle because the food industry wields immense political influence and has successfully thwarted previous efforts to regulate its products or marketing. The category of “food processing and sales companies,” which includes Tyson Foods and Nestle SA, tallied $26.7 million in spending on lobbying in 2024, . That’s up from almost $10 million in 1998.

“They have been absolutely instrumental and highly, highly successful at delaying any regulatory effectiveness in America,” said Laura Schmidt, a health policy professor at the University of California-San Francisco. “It really does feel like there needs to be a moment of reckoning here where people start asking the question, ‘Why do we have to live like this?’”

“” is a that means different things to different people and is used to describe items ranging from sodas to many frozen meals. These products often contain added fats, starches, and sugars, among other things. Researchers say consumption of ultra-processed foods is linked — in varying levels of intensity — to chronic conditions like diabetes, cancer, mental health problems, and early death.

Nutrition and health leaders are optimistic that a reckoning is already underway. Kennedy has pledged to remove processed foods from school lunches, restrict certain food additives such as dyes in cereal, and shift federal agricultural subsidies away from commodity crops widely used in ultra-processed foods.

The intensifying focus in Washington has triggered a new level of interest on the legal front as lawyers explore cases to take on major foodmakers for selling products they say result in chronic disease.

Bryce Martinez, now 18, filed a lawsuit in December against almost a dozen foodmakers such as Kraft Heinz, The Coca-Cola Co., and Nestle USA. He developed diabetes and non-alcoholic fatty liver disease by age 16, and is seeking to hold them accountable for his illnesses. According to the suit, filed in the Philadelphia Court of Common Pleas, the companies knew or should have known ultra-processed foods were harmful and addictive.

The lawsuit noted that Martinez grew up eating heavily advertised, brand-name foods that are staples of the American diet — sugary soft drinks, Cheerios and Lucky Charms, Skittles and Snickers, frozen and packaged dinners, just to name a few.

Nestle, Coca-Cola, and Kraft Heinz didn’t return emails seeking comment for this article. The Consumer Brands Association, a trade association for makers of consumer packaged goods, disputed the allegations.

“Attempting to classify foods as unhealthy simply because they are processed, or demonizing food by ignoring its full nutrient content, misleads consumers and exacerbates health disparities,” said Sarah Gallo, senior vice president of product policy, in a statement.

Other law firms are on the hunt for children or adults who believe they were harmed by consuming ultra-processed foods, increasing the likelihood of lawsuits.

One says on its website that “we are actively investigating ultra processed food (UPF) cases.” Trial attorneys in Texas also are looking into possible legal action against the federal regulators they say have failed to police ultra-processed foods.

“If you or your child have suffered health problems that your doctor has linked directly to the consumption of ultra-processed foods, we want to hear your story,” they say on their website.

Meanwhile, the FDA on Jan. 14 announced it is proposing to require to appear on most packaged foods to make information about a food’s saturated fat, sodium, and added sugar content easily visible to consumers.

And on Capitol Hill, Sens. Bernie Sanders (I-Vt.), Ron Johnson (R-Wis.), and Cory Booker (D-N.J.) are sounding the alarm over ultra-processed food. Sanders that could lead to a federal ban on junk food advertising to children, a national education campaign, and labels on ultra-processed foods that say the products aren’t recommended for children. Booker cosigned the legislation along with Sens. Peter Welch (D-Vt.) and John Hickenlooper (D-Colo.).

The Senate Committee on Health, Education, Labor and Pensions held a examining links between ultra-processed food and chronic disease during which FDA Commissioner Robert Califf called for more funding for research.

Food companies have tapped into “the same neural circuits that are involved in opioid addiction,” Califf said at the hearing.

Sanders, who presided over the hearing, said there’s “growing evidence” that “these foods are deliberately designed to be addictive,” and he asserted that ultra-processed foods have driven epidemics of diabetes and obesity, and hundreds of billions of dollars in medical expenses.

Research on food and addiction “has accumulated to the point where it’s reached a critical mass,” said Kelly Brownell, an emeritus professor at Stanford who is one of the editors of on the subject.

Attacks from three sides — lawyers, Congress, and the incoming Trump administration, all seemingly interested in taking up the fight — could lead to enough pressure to challenge Big Food and possibly spur better health outcomes in the U.S., which has the among high-income countries.

“Maybe getting rid of highly processed foods in some things could actually flip the switch pretty quickly in changing the percentage of the American public that are obese,” said Robert Redfield, a virologist who led the Centers for Disease Control and Prevention during the previous Trump administration, in remarks at hosted by the Heritage Foundation, a conservative think tank.

Claims that Big Food knowingly manufactured and sold addictive and harmful products resemble the claims leveled against Big Tobacco before the landmark was reached in 1998.

“These companies allegedly use the tobacco industry’s playbook to target children, especially Black and Hispanic children, with integrated marketing tie-ins with cartoons, toys, and games, along with social media advertising,” , one of the lawyers at Morgan & Morgan representing Martinez, told ºÚÁϳԹÏÍø News.

The 148-page Martinez lawsuit against foodmakers draws from documents made public in litigation against tobacco companies that owned some of the biggest brands in the food industry.

Similar allegations were made against opioid manufacturers, distributors, and retailers before they agreed to pay tens of billions of dollars in a 2021 settlement with states.

The FDA ultimately put restrictions on the labeling and marketing of tobacco, and the opioid epidemic led to legislation that increased access to lifesaving medications to treat addiction.

But the Trump administration’s zeal in taking on Big Food may face unique challenges.

The ability of the FDA to impose regulation is hampered in part by funding. While the agency’s drug division collects industry user fees, its division of food relies on a more limited budget determined by Congress.

Change can take time because the agency moves at what some critics call a glacial pace. Last year, the FDA allowing brominated vegetable oil in food products. The agency determined in 1970 that the additive was not generally recognized as safe.

Efforts to curtail the marketing of ultra-processed food could spur lawsuits alleging that any restrictions violate commercial speech protected by the First Amendment. And Kennedy — if he is confirmed as HHS secretary — may struggle to get support from a Republican-led Congress that champions less federal regulation and a president-elect who during his previous term .

“The question is, will RFK be able to make a difference?” said David L. Katz, a doctor who founded True Health Initiative, a nonprofit group that combats public health misinformation. “No prior administration has done much in this space, and RFK is linked to a particularly anti-regulatory administration.”

Meanwhile, the is recognized as among the most obese in the world and has the highest rate of people with multiple chronic conditions among high-income countries.

“There is a big grassroots effort out there because of how sick we are,” said , who served as deputy undersecretary for food safety at the Department of Agriculture from 2009 to 2011. “A big part of it is people shouldn’t be this sick this young in their lives. You’re lucky if you get to 18 without a chronic disease. It’s remarkable.”

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Durante años, el gobierno federal ha evitado regular la comida chatarra, la comida rápida y los alimentos ultraprocesados.

Ahora, las actitudes están cambiando. Algunos miembros del círculo íntimo del presidente Donald Trump se están preparando para luchar contra las “grandes empresas alimentarias”, es decir, las compañías que producen la mayor parte de los alimentos y bebidas que se consumen en el paía.

Los candidatos a las principales agencias de salud están apuntando a los alimentos ultraprocesados, que representan del suministro de alimentos de Estados Unidos.

Según declaraciones recientes, una variedad de posibles opciones de normas con carga política para regular los alimentos ultraprocesados ​​pueden llegar al menú del equipo de Trump, incluidas las etiquetas de advertencia, los cambios en los subsidios a la agroindustria y los límites a los productos que los consumidores pueden comprar con la ayuda alimentaria del gobierno.

El impulso para reformar la dieta estadounidense está siendo impulsado en gran medida por los conservadores que han asumido la causa que durante mucho tiempo ha sido la favorita de la izquierda.

Los partidarios de Trump, como Robert F. Kennedy Jr., cuya controversial nominación para dirigir el Departamento de Salud y Servicios Humanos aún enfrenta la confirmación del Senado, están adoptando un concepto que defiende los alimentos naturales y la medicina alternativa.

Es un movimiento que han denominado “MAHA”, o Make America Healthy Again (Hagamos a América saludable de nuevo). Su interés ha cobrado impulso porque sus objetivos tienen un apoyo bipartidista bastante amplio, incluso en medio de un Congreso amargamente dividido en el que los legisladores de ambos partidos se centraron en el tema el año pasado.

Es probable que sea una batalla campal porque la industria alimentaria ejerce una inmensa influencia política y ha frustrado con éxito los esfuerzos anteriores por regular sus productos o su comercialización. La categoría de “empresas de procesamiento y venta de alimentos”, que incluye a Tyson Foods y Nestlé SA, registró un gasto de $26,7 millones en actividades de lobby en 2024, . En 1998 fueron $10 millones.

“Han sido absolutamente instrumentales y muy, muy exitosos en retrasar cualquier efectividad en la regulación en Estados Unidos”, dijo Laura Schmidt, profesora de política de salud en la Universidad de California-San Francisco. “Realmente parece que debe haber un momento de ajuste de cuentas aquí donde la gente comience a preguntarse, ‘¿Por qué tenemos que vivir así?’”

es que significa cosas diferentes para distintas personas y se utiliza para describir artículos que van desde refrescos hasta muchas comidas congeladas. Estos productos a menudo contienen grasas, almidones y azúcares agregados, entre otras cosas. Los investigadores dicen que el consumo de alimentos ultraprocesados ​​está vinculado, en diferentes niveles de intensidad, a enfermedades crónicas como diabetes, cáncer, problemas de salud mental y muerte prematura.

Los líderes en nutrición y salud son optimistas de que ya se está llevando a cabo un ajuste de cuentas. Kennedy se ha comprometido a eliminar los alimentos procesados ​​de los almuerzos escolares, restringir ciertos aditivos alimentarios como los colorantes en los cereales y redireccionar los subsidios agrícolas federales de los cultivos básicos ampliamente utilizados en los alimentos ultraprocesados.

La intensificación de la atención en Washington ha desencadenado un nuevo nivel de interés en el frente legal, ya que los abogados exploran casos para enfrentarse a los principales fabricantes de alimentos por vender productos que, según ellos, provocan enfermedades crónicas.

Bryce Martínez, que ahora tiene 18 años, presentó una demanda en diciembre contra casi una docena de fabricantes de alimentos como Kraft Heinz, The Coca-Cola Co. y Nestlé USA. Desarrolló diabetes y enfermedad del hígado graso no alcohólico a los 16 años, y está tratando de hacerlos responsables de sus enfermedades.

Según la demanda, presentada en el Tribunal de Causas Comunes de Philadelphia, las empresas sabían o deberían haber sabido que los alimentos ultraprocesados ​​eran dañinos y adictivos. La demanda señalaba que Martínez creció comiendo alimentos de marca muy publicitados que son básicos en la dieta estadounidense: refrescos azucarados, Cheerios y Lucky Charms, Skittles y Snickers, comidas congeladas y envasadas, por nombrar solo algunos.

Nestlé, Coca-Cola y Kraft Heinz no respondieron a los correos electrónicos en los que se solicitaban comentarios para este artículo. La Consumer Brands Association, una asociación comercial para fabricantes de bienes de consumo envasados, cuestionó las acusaciones.

“Intentar clasificar los alimentos como poco saludables simplemente porque están procesados, o demonizar los alimentos ignorando su contenido nutricional completo, engaña a los consumidores y exacerba las disparidades en materia de salud”, dijo Sarah Gallo, vicepresidenta sénior de política de productos, en una declaración.

Otros bufetes de abogados están a la caza de niños o adultos que creen que fueron perjudicados por consumir alimentos ultraprocesados, lo que aumenta la probabilidad de demandas.

Un grupo de especializado en lesiones personales dice en su sitio web: “estamos investigando activamente casos de alimentos ultraprocesados ​​(UPF)”. Y abogados litigantes de Texas también están estudiando la posibilidad de emprender acciones legales contra los reguladores federales que, según ellos, no han controlado los alimentos ultraprocesados.

“Si usted o su hijo han sufrido problemas de salud que su médico ha vinculado directamente con el consumo de alimentos ultraprocesados, Queremos escuchar su historia”, dicen en su sitio web.

Mientras tanto, el 14 de enero la Administración de Drogas y Alimentos (FDA)  anunció que propone exigir que aparezca del paquete en la mayoría de los alimentos envasados ​​para que la información sobre el contenido de grasas saturadas, sodio y azúcar agregado de un alimento sea fácilmente visible para los consumidores.

Y en el Capitolio, los senadores Bernie Sanders (independiente de Vermont), Ron Johnson (Republicano de Wisconsin) y Cory Booker (demócrata de New Jersey) están haciendo sonar la alarma sobre los alimentos ultraprocesados.

En 2024, Sanders que podría conducir a una prohibición federal de la publicidad de comida chatarra dirigida a niños, una campaña nacional de educación y etiquetas en alimentos ultraprocesados ​​que digan que los productos no están recomendados para pequeños. Booker firmó la legislación junto con los senadores Peter Welch (demócrata de Vermont) y John Hickenlooper (demócrata de Colorado).

En diciembre, el Comité de Salud, Educación, Trabajo y Pensiones del Senado tuvo para examinar los vínculos entre los alimentos ultraprocesados ​​y las enfermedades crónicas, durante la cual el comisionado de la FDA, Robert Califf, pidió más fondos para la investigación.

Las empresas alimentarias han aprovechado “los mismos circuitos neuronales que intervienen en la adicción a los opioides”, dijo Califf en la audiencia.

Sanders, que presidió la audiencia, dijo que hay “evidencia creciente” de que “estos alimentos están diseñados deliberadamente para ser adictivos”, y afirmó que los alimentos ultraprocesados ​​han impulsado epidemias de diabetes y obesidad, y cientos de miles de millones de dólares en gastos médicos.

La investigación sobre los alimentos y la adicción “se ha acumulado hasta el punto de haber alcanzado una masa crítica”, dijo Kelly Brownell, profesora emérita de Stanford y una de las editoras de un sobre el tema.

Los ataques de tres bandos —abogados, el Congreso y la administración Trump, todos aparentemente interesados ​​en presentar batalla— podrían generar suficiente presión para desafiar a las grandes empresas alimentarias y posiblemente impulsar mejores resultados de salud en Estados Unidos, que tiene la entre los países de altos ingresos.

“Tal vez deshacerse de los alimentos altamente procesados ​​en algunas cosas podría realmente cambiar rápidamente el porcentaje de la población estadounidense que es obesa”, dijo el virólogo Robert Redfield, que dirigió los Centros para el Control y Prevención de Enfermedades (CDC) durante la administración Trump anterior, en comentarios en un evento en diciembre organizado por , un grupo de expertos conservador.

Las acusaciones de que las grandes empresas alimentarias fabricaron y vendieron a sabiendas productos adictivos y nocivos se parecen a las acusaciones formuladas contra las grandes tabacaleras antes de que se alcanzara el de $206.000 millones, en 1998.

“Supuestamente, estas empresas utilizan el manual de estrategias de la industria tabacalera para dirigirse a los niños, especialmente a los niños negros e hispanos, con vínculos de marketing integrados con dibujos animados, juguetes y juegos, junto con publicidad en las redes sociales”, dijo a ºÚÁϳԹÏÍø News , uno de los abogados de Morgan & Morgan que representa a Martínez.

La demanda de Martínez contra los fabricantes de alimentos, de 148 páginas, se basa en documentos que se hicieron públicos en un litigio contra las empresas tabacaleras que eran dueñas de algunas de las marcas más importantes de la industria alimentaria.

Se hicieron acusaciones similares contra los fabricantes, distribuidores y minoristas de opioides antes de que aceptaran pagar decenas de miles de millones de dólares en un acuerdo de 2021 con los estados.

La FDA finalmente impuso restricciones al etiquetado y la comercialización del tabaco, y la epidemia de opioides condujo a una legislación que aumentó el acceso a medicamentos que salvan vidas para tratar la adicción.

Pero el celo de la administración Trump al enfrentarse a las grandes empresas alimentarias puede enfrentar desafíos únicos.

La capacidad de la FDA para imponer regulaciones se ve obstaculizada en parte por la financiación. Mientras que la división de medicamentos de la agencia recauda tasas de usuario de la industria, su división de alimentos depende de un presupuesto más limitado determinado por el Congreso.

El cambio puede llevar tiempo porque la agencia avanza, según algunos críticos, a ritmo de tortuga. El año pasado, la FDA que permitía el aceite vegetal bromado en productos alimenticios. La agencia determinó en 1970 que el aditivo no era generalmente reconocido como seguro.

Los esfuerzos para limitar la comercialización de alimentos ultraprocesados ​​podrían impulsar demandas que aleguen que cualquier restricción viola la libertad de expresión comercial protegida por la Primera Enmienda. Y Kennedy —si es confirmado como secretario del Departamento de Salud y Servicios Sociales (HHS)—  puede tener dificultades para obtener el apoyo de un Congreso liderado por  republicanos, que defiende una menor regulación federal, y de un presidente que durante su mandato anterior .

“La pregunta es: ¿podrá RFK marcar una diferencia?”, dijo David L. Katz, médico fundador de True Health Initiative, un grupo sin fines de lucro que combate la desinformación sobre salud pública. “Ninguna administración anterior ha hecho mucho en este ámbito, y RFK está vinculado a una administración particularmente antirregulatoria”.

Mientras tanto, la población estadounidense es reconocida como y tiene la tasa más alta de personas con múltiples enfermedades crónicas entre los países de altos ingresos.

“Hay un gran esfuerzo de base debido a lo enfermos que estamos”, dijo , quien se desempeñó como subsecretario adjunto para la seguridad alimentaria en el Departamento de ASgricultura entre 2009 y 2011.

“En gran parte, esto se debe a que la gente no debería estar tan enferma tan temprano en la vida. Tienes suerte si llegas a los 18 años sin una enfermedad crónica. Es extraordinario”, observó.

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• Read Allen’s “Scientists Fear What’s Next for Public Health if RFK Jr. Is Allowed To ‘Go Wild’”

ºÚÁϳԹÏÍø News contributor Andy Miller discussed U.S. obesity rates on WUGA’s “The Georgia Health Report” on Nov. 29.

ºÚÁϳԹÏÍø News senior correspondent Julie Appleby discussed how Wisconsinites can get health insurance from the federal marketplace on Wisconsin Public Radio’s “Wisconsin Today” on Nov. 15.

• Read Appleby’s “What’s New and What To Watch For in the Upcoming ACA Open Enrollment Period”

ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

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This story can be republished for free (details).

ºÚÁϳԹÏÍø News chief Washington correspondent Julie Rovner discussed obesity on WAMU and NPR’s “1A” on Oct. 9.

ºÚÁϳԹÏÍø News senior correspondent Arthur Allen discussed pulse oximeter bias on KCBS Radio on Oct. 7.

• Read Allen’s “FDA’s Promised Guidance on Pulse Oximeters Unlikely To End Decades of Racial Bias”

ºÚÁϳԹÏÍø News contributor Andy Miller discussed the impact of climate change on human health and a potential new hospital in Atlanta for WUGA’s “The Georgia Health Report” on Oct. 4 and Sept. 27, respectively. He also spoke on a panel about climate and public health aired on Atlanta Video Network on Sept. 30.

ºÚÁϳԹÏÍø News correspondent Daniel Chang discussed vaccine misinformation in Florida on Radio Bilingüe’s “Línea Abierta” on Oct. 2.

• Read “Florida’s New Covid Booster Guidance Is Straight-Up Misinformation,” which Chang co-authored with Arthur Allen and Sam Whitehead

ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

USE OUR CONTENT

This story can be republished for free (details).