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What happens when new weight-loss drugs like Ozempic transform a community? Bloomberg healthcare reporter Madison Muller went to Bowling Green, Kentucky to find out. That area has one of the highest concentrations of weight-loss drug prescriptions in the US.
On today’s Big Take podcast, we explore what that means for people who live there, how these drugs are reshaping the local economy, and what it could look like in other places when Ozempic comes to town.
Listen more: Are Cheaper Ozempic Knockoffs Safe?
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Here is a lightly edited transcript of the conversation:
David Gura: When you think about Ozempic and other similar drugs, it’s likely one group of people comes to mind.
NBC News: TikTok is all over it, and so are some celebrities.
GBH: Speculation surrounding celebrities who've slimmed down dramatically.
Good Morning America: Not everyone who needs them can get them and some who don't need them for medical use may be the problem.
Gura: Eli Lilly, the company behind two similar drugs, Zepbound and Mounjaro, even aired an ad during the Oscars… criticizing celebrities for contributing to shortages…
Eli Lilly: For the smaller dress or tux… For vanity. But that's not the point…
Gura: So, you might think that places like Hollywood or New York City would have the highest concentration of people on these drugs. Places packed with the rich and famous, influencers, people with money to spend on their appearance. That's exactly what Marie Ellis thought...
Marie Ellis: When I first got on TikTok and seen all this, I was like, ‘what is this? Is this for real or is this just for people in Hollywood?’
Gura: She’s an accountant in Bowling Green, Kentucky. And she says she struggled with weight her whole life… until she tried Mounjaro.
Ellis: So I've been on about a year and a half and I've lost 81 pounds.
Gura: And Marie isn’t the only one.
Ellis: My sister in law was doing the same thing. I mean, she was dropping six to ten pounds every time she weighed in. You can eat whatever you want to, I mean, My husband has not changed anything and lost 40 pounds.
Gura: Marie and her husband, and her sister in law are just a few of the people in her community who’ve taken these drugs. It turns out, the epicenter of the weight-loss shot boom wasn’t a wealthy, image-obsessed enclave like Hollywood or Manhattan’s Upper East Side… but right in Marie’s own backyard.
Today on the show, welcome to Ozempictown, USA.
We take a look at Bowling Green, Kentucky, the area with one of the highest concentrations of prescriptions for weight loss drugs in the United States. And unpack what it can tell us about how these drugs could transform communities across the country.
This is the Big Take, from Bloomberg News. I’m David Gura.
A decade ago, Bowling Green had farms on the outskirts of town. Today, it’s a city of 74,000 people, the third-largest in Kentucky.
It’s the birthplace of Duncan Hines, the namesake of those fudgy brownie mixes. One of the city’s biggest employers is the GM factory that churns out Corvettes. And according to the city’s official website, it has more restaurants per capita than anywhere else in the country.
Madison Muller: Driving down the main road into Bowling Green. There's like, a McDonald's, a Taco Bell, and then another McDonald's, and it's just like fast food place after fast food place.
Gura: Madison Muller is a healthcare reporter at Bloomberg with a focus on weight loss drugs. She visited Bowling Green twice to report this story.
Muller: In like, the month between the trips that I took to Bowling Green, there were more advertisements for the weight loss shots. There's like, fast food places, and then a sign for a weight loss shot on the other side of the road.
Gura: Madison’s been reporting on these drugs, known as GLP-1s, for over a year now. And she says Bowling Green is not the place she would have expected to find when she started crunching the numbers, to identify the location of “Ozempictown, USA.”
How did you go about pinpointing where the capital actually is?
Muller: So we got data from an analytics firm called Purple Lab and so we looked at different zip codes across the US to try to figure out which ones had a really high concentration of weight loss drug users and there were a few different hotspots, like there was one in Huntsville, Alabama and, and a couple of other places. Bowling Green was one of the highest.
We could also see that Kentucky as a state has the highest concentration of weight loss drug users. So we figured that that was a good place to look.
Gura: And what they found was that around four percent of residents in the Bowling Green area had a prescription for a weight-loss drug. That’s quadruple the rate in the Miami area, or Brooklyn, New York. And it’s a conservative estimate, since some people get off-brand versions of the drugs.
So what is it about this city that makes it so ripe for people to use these drugs?
Muller: Yeah, so one the obesity rates there are pretty high and people there also have the means in many cases to afford these drugs, which are quite expensive. They're like $1,000 a month.
A lot of big employers there were also covering the drugs, so those conditions sort of made it like the perfect place for these drugs to really take off.
And for most people, these drugs work pretty quickly, relatively speaking. And so they tell their, you know, cousin, they tell their friends, they tell their whoever. And then it just sort of spreads like wildfire.
Gura: Madison and her colleagues wanted to know what it’s like to live at the very center of America’s weight loss drug craze?
But the idea that they were at the heart of it all took some people by surprise.
Muller: We went to a place called Posh Salon, and it was funny seeing the women in the salon sort of laugh about Ozempic because they were like, ‘what are you talking about? Bowling Green's the capital of, you know, Ozempic in the US?’
But then they were all like, ‘actually, yeah, the more that we think about this, everyone we know is on these drugs,’ including Nikki Wilson, the, owner of this salon, who lost like 20 pounds, and then stopped taking it. But, her clients noticed her weight loss, asked her what she was doing.
Nikki Wilson: I mean, I don't care to talk about, like, everybody would ask me how I lost the weight and I would say ‘the shots.’ I wasn't like, ‘I'm working out. Doing a diet.’
Muller: She told them she was on one of the weight loss shots and says that a lot of her clients ended up going on the shots as well, as a result.
Wilson: Yeah, I have a lot of clients that do it too. So, one of my clients, she came in yesterday. She's lost 14 pounds.
Gura: Madison also visited a local doctor in Bowling Green, Dr. Suman Shekar. She’s been practicing family medicine there for the past decade.
Muller: And when she moved to Bowling Green, she was very struck by the number of people with obesity and the number of patients that she was seeing across the board, kids to elderly people and then the consequences of obesity. So like heart disease and other issues developing in pretty young people.
Suman Shekar: It is much easier to educate a 40 year old than like a 10 to 15 year old. We are seeing a lot of, like, hypertensive and obese patients in that age group.
Muller: And for a long time she didn't really have that many tools that were effective to help that besides diet and exercise and some of the older weight loss drugs that weren't as effective. And so she thinks it's a good thing that a lot of patients now are coming in and actually asking her about Ozempic because they're hearing about it on TV or on social media, and she's glad that people want to do something about their health.
Shekar: Almost 40 percent of our patients are obese. Once they're coming over and asking Ozempic, it means they’re thinking about all this. It's a good and positive thing, that they want to lose weight. They are inclined towards betterment of their health.
Gura: Like Candie Gray. She’s the executive director of a senior living home in Bowling Green.
Muller: She has a really sort of heartbreaking story because she lost many family members to heart disease and strokes.
Candie Gray: Within four weeks time, I had lost two brothers to massive heart attacks. Wow. And both of my parents had died of strokes. So, that was when, honestly, I took a good long look in the mirror, and said, ‘okay, I've got to do something different.’
Muller: That was sort of her turning point. That's why she decided to go on Ozempic.
Gura: What was her experience like on the drug?
Muller: Yeah, she lost a lot of weight. And she had a really good experience. No side effects. The compliments were rolling in.
Gray: They'd say, ‘honey, you've really lost the weight. What'd you do?’ I'd say, ‘Oh, I took them shots like everybody else.’ [laughs]
Muller: She was like, I have no shame in telling people that I used these weight loss drugs because, you know, she thinks that they should be destigmatized.
Gray: Obesity is a disease. Treating obesity, it's really no different.
Gura: How much did it change her eating and drinking habits broadly? And beyond that, maybe social habits as well?
Muller: Candie is a very social person and, and was telling us that Southern culture really revolves around eating.
Gray: If you think about it, how many of our social events, and I know you know this, they're all surrounded around food.
Muller: And so that was something that was difficult to navigate at first. But she didn't want to give up her social life. She has kids. She has friends, you know, her and her husband go out to Friday night dinners with their friends. That's something that she wasn't willing to give up. So she just figured out how to tailor her experience to the weight loss drugs.
Gray: Do we still do our every Friday night dinners with our friends? Absolutely if we can. Am I eating half of what I used to eat before? Yes.
Gura: But if eating half of what they used to is good for their health... for businesses in Bowling Green, there could be some undesired side effects.
Muller: One of the main things we were really interested in figuring out in Bowling Green is, are these drugs changing the economy?
Gura: Coming up: the surprising ways that Ozempictown, USA’s economy has been transformed by these drugs.
Muller: We keep hearing from analysts and from different companies that these drugs are going to change everything. And the CEO of Novo Nordisk, told us that he's getting calls from scared food CEOs who are like asking him about the drugs that his company is making.
Gura: Given these dire warnings, Bloomberg health reporter Madison Muller told me, she’d expected to see restaurants going out of business, and empty gyms, in Bowling Green, Kentucky.
Muller: But the gym's doing fine. The restaurants were all bustling. What you do see is this kind of side economy developing.
Gura: “A side economy.” Take for example – the local GNC, a place where you can buy vitamins and supplements.
Muller: They have all of these supplements right at the front of the store for people that have side effects from the drugs. And the GNC's general manager, told me that like all of those supplements are extremely popular. She has people coming in all the time asking about them.
Gura: And then there are new businesses:
Muller: There's a lot of medical spas that have been popping up in the last couple of years to offer these shots and to offer compounded versions that are cheaper. So it's like this side economy is sort of developing around Ozempic. And if anything, it's actually like boosting some of the businesses there.
Gura: Candie Gray, who went on Ozempic after losing several family members to obesity-related health problems… she turned to one of these new alternatives. A telehealth company offering a copycat drug.
Gray: The first six months, I took branded Ozempic. And then I no longer qualified for my insurance to pay for it.
Gura: She says that off-brand version costs her about $250 a month. And that’s a pretty common occurrence in Bowling Green, says Madison.
Muller: There's a lot of people that went on these drugs and even in the course of the couple of months that we were going to Bowling Green and talking to people there their insurance stopped covering it.
MedCenter Health, where Dr. Shekar works, that health center was paying for the drugs for employees but stopped in January, and they're one of the largest employers in Bowling Green.
So, this is something that's happening across the US, but we're seeing it really acutely in Bowling Green where there is such a high concentration of people on these drugs, and the lack of availability and accessibility is making people seek out alternatives from other places.
Gura: The four percent of Bowling Green area residents with these drug prescriptions… that doesn’t account for all those knockoffs and compounded versions that people get through medical spas or telehealth services. As Madison told us in an episode last month, those versions aren’t as regulated as the brand name medications. But they can often be a lot cheaper – and easier to get.
Muller: The problem with that is that there is variability in how good the medications are, how safe they are. Some of them are fine. Some of them are not.
Gura: Madison, what's the takeaway as you see it? What would the consequences be if more towns, more cities, became like Bowling Green?
Muller: The takeaway from this story is that it's not just Bowling Green, like we zoomed in on Bowling Green to sort of show what's happening there, but just covering this beat for the last, you know, year plus, there's so many themes that I'm, we were seeing and hearing in Bowling Green that I have heard from patients all over the US and likely are playing out in other cities across the US.
Gura: And Madison says those voices from Bowling Green offer a window into what we may hear more of — the good… and the bad. From side effects....
Pat Stiff: My wife's frustrated because at night she wants to have dinner together. Now it's like, I feel sick.
Gura: To access and affordability…
Brittany Feltner: I called every pharmacy in Bowling Green. I could not find it anywhere. Nowhere.
Gura: To the way these drugs can transform what’s possible, for people like Candie Gray.
Gray: For the first time last year, I went to Colorado and was able to hike seven miles. I got to see spots and do things that I never would have probably been able to do before.
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