FYI: US obesity rates are falling for the first time ever. Here's the data.

So, Earlier we covered Novo Nordisk's near-death experience. Now we run the numbers on the market they helped create.

And one stat that should be front-page news: US obesity rates are dropping for the first time in recorded history, and the decline tracks directly with GLP-1 uptake.

This is Off Label, Not Medical Advice.

Let's go.

The Evening Read: US obesity rates just fell for the first time in recorded history. Here's the data nobody's running.

For four decades, US obesity rates only moved in one direction: up. Every year, higher. Every demographic, worse. Every public health intervention, nothing.

Gallup just published the first measured reversal.

The third number is the buried story. The fourth number is the scandal nobody's naming.

Let's run through all of it.

How many Americans are actually on a GLP-1 right now? KFF's November 2025 Health Tracking Poll, cross-referenced against Gallup and RAND, gives us the clearest picture:

Overall usage:

By gender:

By age:

By condition:

The fastest-growing demographic is adults 40-64 using GLP-1s for weight management, not diabetes. That's the demographic shift driving everything.

For almost three years, Ozempic was shorthand for this entire category. Novo Nordisk created the market, took it public, and was Europe's most valuable company.

Then Lilly showed up with a better molecule.

Tirzepatide is now the most prescribed anti-diabetic medication in America (Truveta, June 2025). It is also the most prescribed anti-obesity medication. Lilly quietly became the #1 GLP-1 company by every meaningful US metric.

Some data points:

Why? Head-to-head clinical trials showed Zepbound delivering 47% more relative weight loss than Wegovy. About 21% total body weight reduction versus about 15%. Doctors noticed. Patients noticed. The switch was quiet but total.

Projected 2026 global revenue:

Tirzepatide combined ($45.5B) vs semaglutide combined ($34.8B). Lilly wins by about $10 billion.

This is the number that should be on every front page and isn't.

US obesity rates are declining.

For the first time in the era of reliable obesity tracking, Gallup's Q3 2025 data shows measurable drops across nearly every demographic:

The drop correlates almost exactly with GLP-1 uptake. The demographics using the drugs the most are the demographics with the biggest obesity rate declines. The demographics using the drugs the least (young adults, seniors without Medicare coverage) saw minimal change.

Caveat: Gallup data can move on sampling shifts. The 2026 and 2027 numbers will confirm whether this is a durable trend or a one-year signal. But if it holds, we are watching something that has not happened in modern American public health. The obesity curve is bending.

Here is the sleeper statistic.

Only 49% of first-time anti-obesity GLP-1 prescriptions get filled within 60 days.

That's the Truveta June 2025 finding. Compare to 72.9% of anti-diabetic GLP-1 prescriptions, which do get filled at normal rates. The 23-point gap is almost entirely about insurance and cost.

What this means in practice: for every person who shows up in the "12% of Americans on GLP-1s" statistic, there is roughly one other person whose doctor has written the prescription, who has decided to start the drug, and who then hit a wall at the pharmacy counter. Insurance denial, too-high cash price, prior authorization delay, formulary exclusion.

Half of everyone who wants to start a weight-loss GLP-1 doesn't actually start it.

This is the real access crisis. The "everyone's on Ozempic" narrative is misleading in both directions. It's huge (12% is massive for any single drug class). It's also smaller than it could be, because half of the addressable market is being blocked at the point of sale.

Three data points that matter for decision-making:

3.4 million Medicare beneficiaries become eligible for Wegovy and Zepbound coverage at a flat $50/month copay. This unlocks the 65+ demographic that has been suppressed by Medicare's traditional GLP-1 exclusion for weight loss. Expect Q3 2026 data to show a meaningful bump in older-adult usage.

Wegovy dropped from $1,349 to $349 cash. Zepbound dropped to $349 starting dose via LillyDirect. Novo just announced Wegovy list price cut to $675 effective January 2027. These aren't marketing promotions. They are structural federal-negotiated price resets through TrumpRx and Medicare MFP.

US men and women have similar obesity rates, but men are using GLP-1s at about half the rate women are. This is a cultural and marketing gap, not a medical one. A large underserved population of men with equal clinical indication is not accessing these drugs.

Text your doctor this: "I've read that about half of first-time anti-obesity GLP-1 prescriptions don't actually get filled because of insurance and cost barriers. Can you help me check my specific insurance coverage and any manufacturer savings programs before you write the prescription, so I don't end up in that 51%?"

This is the conversation that prevents the denied fill. Proactive coverage check before the prescription is written. Your time, your pharmacy's time, your insurances' paperwork.

The Lilly vs Novo race is the Ford vs GM of modern pharma. Weekly IQVIA prescription data releases move stock prices. Analyst reports run on quarterly prescription trends. Every data point is tracked by healthcare investors the way tech investors track App Store rankings.

Tirzepatide has become a verb in clinical vernacular. Patients say "I'm on tirzepatide" without distinguishing whether they're on Mounjaro or Zepbound. The molecule is the brand. This is rare in pharma and signals a matured category.

The obesity rate decline is the biggest underreported public health story of the decade. If this trend continues, US cardiovascular disease rates, type 2 diabetes incidence, orthopedic surgery volumes, and healthcare cost projections all shift. This is a population-level health intervention working in real time, and we're barely naming it.

The food industry is quietly adjusting. Smaller portion sizes, protein-forward product lines, Nestle's Vital Pursuit. PepsiCo restructuring snack portfolios around lower calorie consumption. Costco changing bulk packaging. The grocery store response is happening in real time.

Watch this: Eli Lilly stock (LLY). Lilly is now the number one GLP-1 company by every meaningful US metric. If obesity rates keep dropping and Zepbound's share keeps growing, LLY becomes the defining pharma stock of the decade. Next data points to watch: Q2 2026 IQVIA weekly prescription counts, July 1 2026 Medicare Bridge launch (3.4M new potentially eligible users), and Lilly's orforglipron pill head-to-head data against the Wegovy pill.

Tomorrow: the weird ways GLP-1s are reshaping everything outside the pharmacy. Dating apps, airline seat sizes, Thanksgiving dinner, divorce rates, grocery store aisles, fashion week. The culture shift nobody saw coming, and the one industry that might not survive it.

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— Off Label

This is Off Label, Not Medical Advice. Content is for informational purposes only. Always consult a qualified healthcare provider before making medical decisions. Numbers and projections cited may change as new data is published.