--:-- Noelle King: Welcome to Today Explained. I'm Noelle King with Emma Court. She's a reporter for Bloomberg, and her entire job is to cover the weight loss industry.
--:-- Emma Court: Thanks for having me on the show.
--:-- Noelle King: Let's take it through from the beginning. Jenny Craig, this company is named after a woman. Who is she and what is the evolution of this brand?
--:-- Emma Court: So there is a literal Jenny Craig and she founded the company with her husband back in 1983. Her full name is actually Genevieve Craig. She struggled to lose weight after having kids.
--:-- Noelle King: That's interesting. And what was her approach to weight loss?
--:-- Emma Court: She started this company first in Australia. She was an American, but it started in Australia. Then it expanded pretty soon after into the U.S.
--:-- Noelle King: And what was the main focus of Jenny Craig's weight loss program?
--:-- Emma Court: They have these physical brick-and-mortar locations, and that's where you could pick up your food, you could meet with a coach and talk about your weight loss, all that good stuff. Our menu plans are prepared especially for you, and you'll love our new food packaging, No Tins.
--:-- Noelle King: What's really interesting about these companies as they like evolve over time. So you see them kind of morphing as cultural trends shift or they, you know, die out, right?
--:-- Emma Court: So during the 90s, there was another weight loss drug craze called Fen-Fen. And they actually started prescribing Fen-Fen. And then very soon after, the drug was linked to like heart issues.
--:-- Noelle King: That became a big problem for Jenny Craig and the other diet companies that were getting into the fen-fen business now, had made a bit of a stumble here.
--:-- Emma Court: The stock ends up, like, towards the end of the, you know, 1990s, early 2000s, trading, like, at such a low value that the New York Stock Exchange delists it. It was later acquired by Nestle.
--:-- Noelle King: This was a time, like, even Weight Watchers at one point was owned by the Heinz Company that made ketchup.
--:-- Emma Court: So Nestle buys Jenny Craig. Like this is an era of like a lot of packaged food. This is like a big time for dieting and anxiety about weight.
--:-- Noelle King: You have Nutrisystem in the 70s. Flavorless diets used to force me to cheat and fail. But the new Nutrisystem Flavor Setpoint Weight Loss Program gives you all the flavor you need to succeed.
--:-- Emma Court: You have Jenny Craig in the 80s. You know, a couple decades later in the 2000s, the South Beach Diet comes out.
--:-- Noelle King: This place likes to stir things up. So let's compare whole grain. South Beach Diet Whole Grain Crunch has 19 grams of whole grain. Kellogg's Special K cereal has none.
--:-- Emma Court: Life is better on the beach. You know, I think Jenny Craig and Weight Watchers definitely had some of a worry and focus on like carbohydrates.
--:-- Noelle King: Like you did see early Weight Watchers, you know, you couldn't eat your bagels on that and pasta and things like that.
--:-- Emma Court: But, you know, really the main commonality was like eating less, right? So Jenny Craig has these like prepackaged meals.
--:-- Noelle King: If you follow their program and you eat only what they tell you to, you're eating a defined amount of calories.
--:-- Emma Court: The same thing for Weight Watchers, even though their program is like, not calories, but it's called the Point System.
--:-- Noelle King: All these programs ultimately have foods you can eat, foods you can't eat.
--:-- Emma Court: Wait till you try the lava cake. Lava cake? You know, with Jenny Craig, it's just you can eat the food we give you.
--:-- Noelle King: And if it's cake, you can eat it as long as it's our cake, right?
--:-- Emma Court: I feel incredible. And thanks to my personal coach, I always have the support that I need.
--:-- Noelle King: Okay, well, sign me up. How did Jenny Craig market herself?
--:-- Emma Court: Jenny Craig was very much typifying that like celebrity spokesmodel, right?
--:-- Noelle King: And I think you know many of us can remember the Kirstie Alley like TV commercials 1 Jenny Craig please
--:-- Emma Court: This is Kirstie Alley It's in regards to me being fat. You know what she'd say? Have you called Jenny? Hey, you're chubby too. Let's lose weight together.
--:-- Noelle King: Valerie Burnelli, she famously did a bunch of commercials, like, with Kirstie Alley, and they would kind of compete, you know, talking about how much weight they lost.
--:-- Emma Court: I've lost 30 pounds. Jenny was so easy for me to stick to. Valerie, this is my commercial. Yeah, but I'm still losing it.
--:-- Noelle King: You're losing it, all right.
--:-- Emma Court: For a period of time, Jason Alexander, a.k.a. George from Seinfeld, one of those rare male celebrity diet spokespeople.
--:-- Noelle King: Take a look, drink it in. I was fat, now I'm fat.
--:-- Emma Court: Then Mariah Carey was one of the celebrity spokespeople. It's a genuine thing. It's not like, oh, whatever.
--:-- Noelle King: You know, I honestly feel that way.
--:-- Emma Court: Mariah, was it? I didn't know that. Pretty crazy, right?
--:-- Noelle King: What was the peak moment for diet companies like Jenny Craig Nutrisystem Weight Watchers?
--:-- Emma Court: I think of sort of like peak diet years as being the 2000s going into the like early 2010s.
--:-- Noelle King: Like this is a very like thinness obsessed period of time, like even for our culture.
--:-- Emma Court: And, you know, you think of the low rise genes. you think of the crop tops, like celebrities were so, so thin back then.
--:-- Noelle King: Like if you look up photos, you might genuinely be shocked to see how thin some of these people were.
--:-- Emma Court: When asked by fashion industry website WWD if she has a motto, Kate replied, there's nothing tastes as good as skinny feels.
--:-- Noelle King: That's one of them. You know, Beyonce, I was doing like these insane juice cleanses with like lemon water and cayenne.
--:-- Emma Court: I heard you lost 20 pounds. I did.
--:-- Noelle King: We all want to know, what did you do? I did a fast master cleanser.
--:-- Emma Court: You know, things that I think now people would look back on and say, wow, that was, you know, we probably shouldn't be doing juice cleanses.
--:-- Noelle King: That doesn't seem very healthy.
--:-- Emma Court: And that style of jeans is like, you know, really difficult for everyone to be wearing.
--:-- Noelle King: When did cracks start to appear in the early 2000s model of everybody's got to be a size zero?
--:-- Emma Court: I think you could probably still argue that being thin is still fashionable.
--:-- Noelle King: But you do start to see this sort of toxic diet culture yielding to something else by the early 2010s.
--:-- Emma Court: Body positivity starts getting big. You see Dove doing these like kind of viral commercials about how, you know, women are beautiful and we need to stop hating ourselves.
--:-- Noelle King: We spend a lot of time as women analyzing and trying to fix the things that aren't quite right. And we should spend more time appreciating the things that we do like.
--:-- Emma Court: Girls, the show comes out and Lena Dunham is in it and people are up in arms about the fact that she wears a crop top and she's not a stick fin.
--:-- Noelle King: You've tried a lot to lose weight? No, I have not tried a lot to lose weight.
--:-- Emma Court: Because I decided that I was going to have some other concerns in my life, okay?
--:-- Noelle King: But we also see beauty ideals changing because there's different kinds of representation.
--:-- Emma Court: Ashley Graham is on the cover of, you know, the Sports Illustrated Swimsuit Edition. She's a plus-size model.
--:-- Noelle King: The myth is the bigger the bikini, the smaller looking the body. And the smaller the bikini, the better looking the body.
--:-- Emma Court: Just because you have curves, it doesn't mean you want a bigger suit. You just want something that, like, hugs everything in the right way.
--:-- Noelle King: So what we do is we're cheating everything, and we're rolling everything down and pulling everything down. The smaller the better.
--:-- Emma Court: And as, like, I think media also gets more decentralized, and people get more ownership of their own image and they can put things on Facebook and Instagram and now TikTok, you start seeing people saying there are many different kinds of bodies and we shouldn't just embrace one kind.
--:-- Noelle King: And that changes how we talk about dieting too because now the idea that you should be trying to lose weight is pretty fraught, right?
--:-- Emma Court: We have millions of girls and women devoting their brilliance to shrinking their waistlines instead of expanding their lives.
--:-- Noelle King: If we want a better world, we've got to kill diet culture.
--:-- Emma Court: People don't talk as openly about it as they used to. And in fact, like it's a little bit shameful to want to lose weight.
--:-- Noelle King: You know, I think people still do want to lose weight, but they don't want to admit it.
--:-- Emma Court: And that's an interesting moment for diet companies because they used to always be able to say, get thinner, and that was something people wanted.
--:-- Noelle King: And now you have to message differently.
--:-- Emma Court: Yeah, yeah. If Jenny Craig represented the old way of doing things, what's the company that represents this new way that you're talking about where it's like, it's less that you run around saying, oh, I haven't eaten a thing today. I'm trying to lose weight.
--:-- Noelle King: You're right. You can't say that anymore.
--:-- Emma Court: Which company is at the forefront here?
--:-- Emma Court: So the company that typifies this is Noom. Noom is this app.
--:-- Noelle King: They've become very popular in the last couple of years.
--:-- Emma Court: They basically pitch themselves as not a diet, they're a lifestyle change.
--:-- Noelle King: And they also kind of focus on a more psychological approach to eating.
--:-- Emma Court: Martha tried every way to get control of her weight, but Noom was different for her because it uses psychology to, wait, she'll say it better.
--:-- Noelle King: We can now kind of cook normal foods that we're all going to eat instead of whatever you're eating on these diets, you know?
--:-- Emma Court: Oh, we know, Martha. At the end of the day, like, all these programs are ultimately about eating less to lose weight.
--:-- Noelle King: So they're definitely leaning into this holistic wellness lifestyle approach, but they're also ultimately teaching you how to lose weight through the classic tenets of dieting, you know, eating less and moving more.
--:-- Emma Court: But Noom and all these other companies in the diet industry are now facing another sea change.
--:-- Noelle King: And it's these new weight loss drugs like Ozempic.
--:-- Emma Court: Coming up these new weight loss drugs like Ozempic and how they might revolutionize the weight loss industry
--:-- Noelle King: Support for Today Explained comes from Built Rewards.
--:-- Emma Court: These days, it seems like everybody has a rewards program. You swipe your card and you get one cent on the hundred dollars.
--:-- Noelle King: But with your rent, frequently, you just pay month after month. You never get anything from it other than that roof over your head.
--:-- Emma Court: Not anymore, says Built Rewards.
--:-- Noelle King: Built Rewards says it lets you earn points on your rent.
--:-- Emma Court: By paying rent through Built, they say you can earn flexible points that can be redeemed toward hundreds of hotels and airlines, perhaps a future rent payment, your next Lyft ride, and so much more.
--:-- Noelle King: Your home isn't just where you sleep. It's your community.
--:-- Emma Court: And Built wants you to go out and do things in the community.
--:-- Noelle King: You can eat at your favorite local restaurants, then earn more points.
--:-- Emma Court: You can get VIP treatment at certain fitness studios.
--:-- Noelle King: You can enjoy exclusive experiences just for Built members every month.
--:-- Emma Court: When you're ready to travel, they say Built points can be converted to miles or hotel points all around the world.
--:-- Noelle King: You can earn points on rent and around your neighborhood wherever you call home by joining Built.com slash Explained.
--:-- Emma Court: That's J-O-I-N-B-I-L-T dot com slash Explained.
--:-- Noelle King: Why shop at Burlington? Maybe it's the deals that are new each time you drop by.
--:-- Emma Court: Maybe it's the brand names you'll be shocked Burlington has in store.
--:-- Noelle King: Or maybe it's the quality of the items, the amazing selection, and the newest trends.
--:-- Emma Court: If you like to save but also like to stay in style, Burlington is your answer.
--:-- Noelle King: And the question you'll be asking yourself is, why go anywhere else?
--:-- Emma Court: Burlington. Deals. Brands. Wow.
--:-- Noelle King: It's Today Explained, Emma Court of Bloomberg.
--:-- Emma Court: So you said Ozempic and drugs like it are the next big sea change.
--:-- Noelle King: And at the moment, it does seem like more and more people are getting on this medication.
--:-- Emma Court: These are drugs that doctors are starting to recommend for weight management.
--:-- Noelle King: But there are certain clinical guidelines around it.
--:-- Emma Court: So doctors, I mean, can prescribe these drugs to anyone technically. They're allowed to.
--:-- Noelle King: They are using their medical judgment.
--:-- Emma Court: But really, the drugs are indicated specifically for people above a certain body mass index threshold.
--:-- Noelle King: So people who are on sort of the higher end of overweight and have a comorbidity like diabetes or something.
--:-- Emma Court: And then people who are considered obese by BMI standards.
--:-- Noelle King: How widely available are they?
--:-- Emma Court: Well, they're not widely available.
--:-- Noelle King: And there are kind of two big reasons.
--:-- Emma Court: The first is that they're incredibly expensive drugs and insurance typically doesn't cover them.
--:-- Noelle King: Ozempic costs, you know, about $900 or so a month if you're just paying cash, the list price.
--:-- Emma Court: Wagovi costs $1,350 a month.
--:-- Noelle King: You know, most people are not going to be able to pay these kinds of prices out of pocket, right?
--:-- Emma Court: And insurance coverage is an interesting aspect of this because, you know, typically when you have a medical condition, sure your insurance might give you a hard time about paying for it but typically people can persist and they can get those medications covered but weight loss has long been treated as sort of a superficial thing aesthetic condition not a medical condition so you tell someone you've got to starve yourself for the rest of your life and then if you're not able to do that they tend to take all the blame on themselves and it very rarely occurs to to the average patient perhaps the advice that I was given was just incorrect.
--:-- Noelle King: Maybe that doesn't work for 99.9% of people who are overweight or obese or morbidly obese.
--:-- Emma Court: And indeed, we find it doesn't.
--:-- Noelle King: Doctors are starting to change their tune on it, you know, more recently.
--:-- Emma Court: We have to think about obesity no different than hypertension, than high cholesterol, than diabetes.
--:-- Noelle King: But, you know, that sort of enabled insurance companies to not pay for these drugs.
--:-- Emma Court: There's even kind of the U.S. government through the Medicare program for the elderly doesn't pay for weight loss drugs.
--:-- Noelle King: And that sort of set a standard for private insurers to say we don't pay for them either.
--:-- Emma Court: Why don't they? What's the reasoning?
--:-- Noelle King: You know, they're saying these drugs are new.
--:-- Emma Court: They haven't been proven to keep weight off long term.
--:-- Noelle King: And kind of the crux of the matter really is they haven't been proven to reduce other expensive conditions that we pay for currently.
--:-- Emma Court: So if these drugs can prove that they make a dent in heart disease, that they bring down rates of stroke, they may be able to gain some more insurance coverage.
--:-- Noelle King: But, you know, it's going to be a high bar because insurance companies don't like to pay for things.
--:-- Emma Court: I think any of us who have had to deal with an insurance company as a consumer know that.
--:-- Noelle King: And I think they're really reluctant, especially in this case, to pay because so many people are eligible for these drugs.
--:-- Emma Court: The new drug, Wegovi, is approved for people who are either obese or overweight with at least one weight-related medical problem.
--:-- Noelle King: More than 100 million American adults could be eligible.
--:-- Emma Court: Almost three in four American adults are considered to be overweight or obese.
--:-- Noelle King: So many of those people are going to be eligible for medication just based on the medical guidelines and the label that the FDA approved.
--:-- Emma Court: Is the fact that so many people are eligible for these drugs, is that why we keep reading that there is a shortage of them?
--:-- Noelle King: I think there's been a lot of hype around these medications.
--:-- Emma Court: And it's because, you know, it's not just eligible people trying to take them, too.
--:-- Noelle King: We know, you know, at least anecdotally, that there are thinner folks who are trying to use these medications as well.
--:-- Emma Court: You know, people like the celebrity set.
--:-- Noelle King: I knew I had to lose at least 10 pounds for it to even go up on me. So I would say it's just sheer demand.
--:-- Emma Court: Honestly, it's not just eligibility. There's a lot of people excited about medications that will help them lose weight.
--:-- Noelle King: And, you know, the word is spreading on places like TikTok.
--:-- Emma Court: So many people were asking me, like, oh, my God, how did you get it? Like, how much was it and stuff like that?
--:-- Noelle King: So that's the second piece of the access picture, right?
--:-- Emma Court: Number one is cost Number two is there have been these shortages and it kind of looking like the shortages are going to be a problem longer term
--:-- Noelle King: There another side effect to its soaring popularity shortages
--:-- Emma Court: And now diabetics are calling out people just using it to drop a few pounds
--:-- Noelle King: Novo Nordisk is now saying again that they're having issues meeting demand for Wagovi.
--:-- Emma Court: So they reduced the supply of like starter doses for the drug.
--:-- Noelle King: Some more people can't get on it.
--:-- Emma Court: And they also said that they're going to slow down the global launch.
--:-- Noelle King: So, you know, the U.S. is actually sort of unique in that not every country in the world has even access to Wagovi right now.
--:-- Emma Court: And it's looking like even places like the UK, where the drug was expected to launch soon, you know, might not have it for some time because they just can't keep up with the demand.
--:-- Noelle King: I've seen in the debate around these drugs, pro and con, I've seen people describe them as miracle drugs.
--:-- Emma Court: Assuming that manufacturers can meet demand, do you think we might be looking at the end of the traditional diet Jenny Craig Weight Watchers, Atkins diet industry?
--:-- Noelle King: Like, are these game-changing as they appear on the surface to be?
--:-- Emma Court: These drugs are definitely a big deal. They're changing the paradigm of what is offered as a solution for weight loss.
--:-- Noelle King: You know, if you're in the diet business, that's a really scary prospect for you, right?
--:-- Emma Court: I think diet companies are having to reckon with the fact that this does change their business model.
--:-- Noelle King: WW International, formerly known as Weight Watchers, announced it is buying the company's Sequence for $100 million.
--:-- Emma Court: The subscription service helps overweight customers access groundbreaking new medications like Ozempic for diabetes.
--:-- Noelle King: Are these drugs going to mean the end of weight troubles?
--:-- Emma Court: I don't think so.
--:-- Noelle King: For one, they don't work for everyone.
--:-- Emma Court: They're very expensive.
--:-- Noelle King: And there are questions about how they work in the long term.
--:-- Emma Court: There are side effects.
--:-- Noelle King: And one of the issues is there's really no rhyme or reason to the side effects.
--:-- Emma Court: We don't really have a good understanding of what they are in people who are not diabetic because that's what it was tested in.
--:-- Noelle King: So we understand those to a certain extent, but for people who are taking it for weight loss, we're not quite sure.
--:-- Emma Court: Even though these have been studied for some time, there are lingering questions about safety.
--:-- Noelle King: Some people can have serious problems, well, rare, like serious issues on these drugs.
--:-- Emma Court: So yes, this is a reckoning for diet companies.
--:-- Noelle King: A big part of the diet company business model is people lose weight, but they can't keep it up.
--:-- Emma Court: And then they regain weight, but then they rejoin the program and they pay them again and they lose weight again.
--:-- Noelle King: And then they can't keep it up.
--:-- Emma Court: And then, I mean, if you look at a company like Weight Watchers or Jenny Craig, there are people who cycle in and out of one program or another for their entire lives.
--:-- Noelle King: This is a customer that is not having their needs met long term.
--:-- Emma Court: And that's why this is a booming business.
--:-- Noelle King: But these medications are creating a new place for them to go, right?
--:-- Emma Court: They can go to their doctor. They can go to a telemedicine company that will prescribe these.
--:-- Noelle King: And a lot of people are interested.
--:-- Emma Court: You mentioned some of the drawbacks, which are unknowns.
--:-- Noelle King: Some of the drawbacks are very well known. They just don't work for everyone.
--:-- Emma Court: Are there other critiques of these drugs, whether medical or maybe even cultural?
--:-- Noelle King: You know, I think there's still a crowd that says people don't need medication to lose weight.
--:-- Emma Court: They can lose weight with lifestyle.
--:-- Noelle King: The evidence is pretty clear on this regard that like most people aren't able to lose weight long-term with diet and lifestyle changes.
--:-- Emma Court: And the best explanation for that, by the way, that I've heard is sort of our environment is so food rich.
--:-- Noelle King: It's so like overflowing with calories that diet programs just say, you got to rise above it, right?
--:-- Emma Court: Like you have to separate yourself from this environment that we're all living in that's rich with food.
--:-- Noelle King: And you have to rise above it and bring your blueberries in a container to work and pack a salad and tell your co-workers you can't join them for margaritas or get a skinny margarita or whatever the case may be.
--:-- Emma Court: All right, if we take all of this as a piece, so you've got the companies like Jenny Craig and Weight Watchers that are selling you stuff.
--:-- Noelle King: You've got the meal plan companies that are selling you stuff.
--:-- Emma Court: You've got a diet like Atkins where they don't really need to be selling you anything.
--:-- Noelle King: It's just you're the one going out and buying the protein and not the carbs.
--:-- Emma Court: And then you have, as time evolves, you have things like Ozempic, Wagovi.
--:-- Noelle King: Where do you think this industry, this really varied and diverse and evolving industry is going?
--:-- Emma Court: I think we're going to start seeing more of a meld of the medication and the lifestyle approaches, or at least businesses will be selling that.
--:-- Noelle King: We can offer you help with the lifestyle piece of this.
--:-- Emma Court: You know, the drugs don't work entirely on their own.
--:-- Noelle King: You still need to make these lifestyle changes.
--:-- Emma Court: You still want to make sure you're strong and healthy and live a long life.
--:-- Noelle King: And we know that weight loss is not the entire story when it comes to health.
--:-- Emma Court: So I think like that's where this business is going.
--:-- Noelle King: It'll be interesting to see, you know, how that stays in the picture, because I know like one of the things that gets people really excited about these medications is not like, I'll get on a drug so I can have a healthier lifestyle, right?
--:-- Emma Court: They're like, great, I want to get on these drugs so I can lose a bunch of weight.
--:-- Noelle King: And lifestyle is not at the forefront of people's minds.
--:-- Emma Court: And I think it's going to be a really interesting tension moving forward, especially depending on what these studies find about disease and whether these drugs reduce the burden of obesity-related diseases.
--:-- Noelle King: That was Bloomberg's Emma Court. Today's episode was produced by Miles Bryan and Siona Petros.
--:-- Emma Court: It was edited by Matthew Collette and fact-checked by Laura Buller.
--:-- Noelle King: It was engineered by Patrick Boyd.
--:-- Emma Court: I'm Noelle King.
--:-- Noelle King: It's Today Explained. Thank you.
