A few years ago, I interviewed a Black teen as part of a study on the health of Gen Z. What this ninth-grader from an inner-city community was most passionate about surprised me.“In eighth grade, lunch used to be something tasty; I could eat it,” she told me. “Here we go now: 65% reduced fat. Barely any seasoning. I’m like, ‘What is this crap?’”She was talking about the healthy meals program being rolled out in California K-12 schools like hers as part of the Obama administration’s effort to tame the nation’s childhood obesity epidemic.I suggested to her that the government’s lunch initiative — which to be fair was also deeply disliked by a number of adults, namely Republicans in Congress — might help teens she knew lose weight or stave off diabetes. She wasn’t having it. “When they get home,” she said of her peers, “they’re going to eat a thousand bags of hot Cheetos.”Roughly 30% of Los Angeles Unified School District students are overweight or obese, uncannily mirroring the rate among Los Angeles County adults. Black and Latino individuals are disproportionately represented in each group, making the city ground zero for this persistent, racialized epidemic. And by 2030, a staggering 41.5% of California adults, a good portion of whom will be Black and Latino members of Gen Z, are expected to be obese.In America, obesity rates are consistently higher among racial minorities relative to white populations. The same pattern exists for type 2 diabetes, with nonwhite individuals having a higher burden of the complex disease. Disproportionately lower levels of access to healthy, affordable foods and limited access to infrastructure and amenities that promote physical activity serve as the primary culprits. The downstream effects, a lower quality of life and a higher likelihood of premature death, are grave.GLP-1s, the seemingly magic drugs capable of dramatically reducing diabetes and obesity-related issues, seem to be an obvious — or at least the most efficient — solution to this preventable public health crisis. But studies consistently show that, despite their elevated need, racial minorities receive significantly fewer prescriptions for GLP-1s. And it’s not necessarily from a lack of trying on the part of Big Pharma, an industry eager to expand its customer base. In fact, in the last few years, Big Pharma and its allies have worked hard to bring minority customers into the GLP-1 fold.In 2021, Novo Nordisk, the maker of Ozempic and Wegovy, sponsored a panel on obesity at a conference held by the powerful Congressional Black Caucus. Last year, the mammoth pharmaceutical company organized a similar panel for the influential National Assn. of Hispanic Nurses.Oprah Winfrey, whose battles with weight loss are well-documented, hosted a highly publicized ABC special on GLP-1s in 2024. The billionaire media personality formerly served as a board member and spokesperson for Weight Watchers, which now offers a subscription-based program providing customers with access to various GLP-1s. Winfrey later discussed in an interview the profound ways the drugs helped her quiet the “food noise” around her. And in 2025, telehealth company Ro, which has its own GLP-1 distribution service, unveiled a partnership with tennis megastar Serena Williams, who used GLP-1s to manage her postpartum weight gain.A host of well-known Black and Latino social media influencers have also served as boosters for GLP-1s (and, by extension, Big Pharma’s outreach efforts).The lower adoption of GLP-1s by racial minorities has been, ironically, largely of Big Pharma’s making. Racial minorities frequently aren’t included in the formative clinical trial testing phase in which drugs are optimized to prospective patients’ biological and cultural nuances. The dearth of participation is both a function of researchers’ historically soft interest in including minorities in studies and minorities’ own distrust and fears about participating.Despite awareness of these participation gaps, which go back decades, there have been only marginal improvements in minorities’ representation in clinical studies, including those for GLP-1s. A review of clinical trials conducted with GLP-1s found that Black and Latino people were significantly underrepresented relative to white people.There’s also the stingy issue of price. Totaling an average of nearly $7,000 annually, the costs of GLP-1s are simply untenable for the many racial minorities who lack the income or premium insurance needed to cover the expenses. Indeed, a number of private and public insurers are still only marginally covering the costs of GLP-1s, if at all.Medicaid coverage for GLP-1s is currently optional for states. Only 13 currently cover GLP-1s for obesity treatment , and that largely doesn’t include states with large racial minority populations dealing with obesity like Florida and Texas. Despite outcry, Medi-Cal severed coverage of GLP-1s for weight loss earlier this year as part of a broader budget-trimming effort in California. GLP-1 coverage through Medicare, which historically has been hostile to covering weight loss drugs, is even more limited. However, the Centers for Medicare & Medicaid Services, which administers Medicare, began a pilot program in July to provide coverage to some Medicare beneficiaries. This program may provide a path for lowering GLP-1s’ steep financial burden for low-income minorities, but even if it’s successful, other barriers exist to racially equitable uptake.For one, despite their mainstreaming, GLP-1s still haven’t entirely shed their image as an amenity for white elites and at odds with the body positivity movement. Years of social conditioning around the white female beauty standard — one exalting thinness — may push some racial minorities to outright reject GLP-1s and the bodily gentrification the drugs seem to facilitate. Relatedly, some believe GLP-1s are a shameful shortcut, misaligned with the grit we traditionally associate with “real” fitness. Incidentally, though, a 2024 Pew poll found that 70% of Black people and 68% of white people feel that willpower alone is usually not enough to lose weight and keep it off.I asked that Black teen a few years ago what a potential answer to the obesity epidemic could be, and she was clear: “If you’re going to have somebody eat healthy, pair it with exercising. Or it ain’t doing nothing.”GLP-1s’ success largely upends such conventional wisdom. That these drugs can be an all-in-one solution is becoming increasingly obvious, even to naysayers. Whether we should allow them to be is a very different — and very racialized — question.Jerel Ezell is a sociologist and assistant professor at the University of Chicago Medical Center.
