Gary Taubes on choosing diet over GLP-1 drugs like Ozempic

He seems a little defensive on this piece, but I agree with him in part. He argues that a keto diet like he advocates will tend to have the same results as these drugs for weight loss, but then he also says that while GLP-1 drugs may help with chronic diseases, we don’t know that a keto diet wouldn’t make you even more healthy.

At home we call this the Elon vs. RFK Jr. debate. Elon famously tweeted, “Nothing would do more to improve the health, lifespan and quality of life for Americans than making GLP inhibitors super low cost to the public. Nothing else is even close.” RFK by contrast has said that "If we just gave good food, three meals a day, to every man, woman and child in our country, we could solve the obesity and diabetes epidemic overnight [without drugs].” In my view they’re both right.

As I understand it from friends who’ve taken them, these drugs work for weight loss because they suppress your hunger and cravings for food. So you eat fewer calories. Taubes will hate me saying it, but that’s also why a keto diet works. If you don’t have the facility to eat fewer calories than you expend, whether through a keto diet or just a well-regulated balanced diet, then a drug will certainly bail you out—and that will be a great thing for millions. But this has two big caveats.

First, if you eat fewer calories because, thanks to the drug, you’re less hungry, but the calories you do eat are donuts and pizza, then I imagine you’ll still get diabetes and heart diseases and other chronic diseases. I really hope people on these drugs realize that if they want to be healthy and not just thin then diet, exercise, and sleep still matter. What I would hate to see, but what would be so American, is a pill that just lets us avoid the most obvious aesthetic consequences of shitty diet and exercise.

Second, and related, is that if everyone is on Ozempic, then there goes a big reason to clean up our horrendous food system. And our food is screwed up in part because of government interventions in the incentives in food markets. Government subsidized corn and sugar make us obese because they’re so cheap they’re in everything, but not to worry because government subsidized drugs will make you thin.