There are many advantages to traveling besides the obvious ones. Among them is that I get to listen to morning TV news while I’m getting ready. For some reason, we don’t do that at home because after getting ready in the morning, we are in the habit of sitting in the living room across from one another, Kim on her games and me on my iPad writing my stories. So, this morning in addition to the full array of UN week news of competing autocrats justifying themselves to the court of world opinion (it’s Netanyahu’s day today…good luck either way that Bebe), I watched an interesting fluff piece.
It seems the fast food industry, the bain of many of us weaker soul’s existence, has conceded defeat to the power of the GLP-1 trend. This is the same industry who wanted to super-size us and offer us breakfast sandwiches wrapped in pancakes and syrup. Now they want to figure out how to help us either our weight loss goals without losing our business. Fast food’s push toward healthier fare is not entirely new and has come in waves, usually in response to public pressure, and has repeatedly run into the fact that customers say they want healthy options but mostly buy burgers and fries. The first experiments happened in the 1970’s. Wendy’s added a salad bar in 1979, and McDonald’s introduced prepackaged salads in 1987. Health activist Phil Sokolof ran full-page ads attacking fat and cholesterol in fast food, and in 1990 McDonald’s switched its fries from beef tallow to vegetable oil. Then in the 1990s the low-fat trend became prevalent and let’s face it…fast food is all about fat, salt and sugar, none of which work all that well with a healthy diet…at least not in the proportions Americans tend to [refer. McDonald’s launched the McLean Deluxe (1991), a 91% fat-free burger that used seaweed-derived carrageenan to hold moisture; it sold poorly and was dropped in 1996. KFC’s skinless Lite ‘n Crispy chicken and Taco Bell’s Border Lights met similar fates. The 2000s brought lawsuits, documentaries, and regulation. Subway built its “Eat Fresh” brand around Jared Fogle’s weight-loss story (right up until his conviction for distributing child pornography). Obesity lawsuits against McDonald’s (2002) and the film Super Size Me (2004) pushed McDonald’s to drop Super Size portions, launch premium salads, and add apple slices to Happy Meals. New York City banned artificial trans fats (2006) and required calorie counts on menus (2008), and chains reformulated their frying oils. And in the 2010s, labeling and “clean” ingredients came into play. The Affordable Care Act made calorie labeling national for large chains, taking effect in 2018. Fast-casual chains like Chipotle and Sweetgreen drew health-conscious customers, and legacy chains responded by shrinking kids’ portions, removing artificial preservatives, and adding plant-based options like the Impossible Whopper (2019). During the pandemic, many chains cut salads to simplify menus, a sign of how little they sold. The newer health pitch is less about low fat and more about protein, smaller portions, and meals marketed to people on GLP-1 weight-loss drugs.
When I started on Zepbound a year ago, I went on LilyDirect to get my weekly fix for $500/mo. which was a good deal relative to regular retail pricing. I came up with a quick justification for the expense by saying that $500/30=$16.67 which is approximately the cost of one fast food meal per day that I should be able to eliminate with the GLP-1. As a regular fast food customer in the past, that logic actually holds up for me since I really have stopped frequenting fast food at all and certainly haven’t had one lunch there for the past year. The closest I come is an occasional Chipotle bowl, which Zepbound does not allow me to finish anyway.
The research shows that GLP-1 drugs (Ozempic, Wegovy, Zepbound) are changing what people order at fast-food chains more than whether they go. The irony, after the Subway story, is that the industry now sells itself as diet-friendly because the drugs, not the sandwiches, are driving weight loss. About 1 in 8 U.S. adults currently take a GLP-1 medication (and those numbers are rising rapidly), and in a National Restaurant Association survey another 29% of non-users said they’d consider one if it were cheaper and easier to get. By 2025 the U.S. obesity rate fell for the first time in a decade. My Alma Mater, Cornell, did research on 150,000 households and found that GLP-1 users cut grocery spending 5.3% within six months. Fast food fell 8.0%, and savory snacks were hit hardest at 10.1%. Fast food restaurant visit frequency isn’t the main problem. Users still eat out about as often, but they order fewer sides and appetizers, and those categories are showing real sales declines. JPMorgan estimates GLP-1s could cost the food and beverage industry $30–55 billion in annual revenue by 2030. How chains are responding is interesting and was the subject of this morning’s TV news story. McDonald’s CEO Chris Kempczinski has acknowledged the impact. He says these customers lean toward protein, skip large portions, and add fewer snacks and sugary drinks. Subway, Chipotle and Shake Shack have all launched high-protein items, and Kempczinski predicted fiber would be the big trend for 2026.
The wild card here is that about 34% of GLP-1 users stop the drugs, and afterward their candy and chocolate purchases rise 11.4% above where they were before starting. That suggests the drugs suppress appetite without building lasting habits, which is why I have always assumed that I would be staying on Zepbound for the rest of my life. I have still failed to convince Medicare and my supplemental insurance provider that I should qualify for the $50/mo Bridge Program, but I have not completely given up on that. I saw an ad on TV for it, so I figure I will eventually prevail, but they sure do make it difficult. I view that as only a money issue, not an issue of whether I will continue to medication.
GLP-1s have gone from diabetes drugs to treatments for a growing list of conditions and that is causing physicians to prescribe it quite broadly and regularly to people who are not obvious users. The line between what’s formally approved and what’s still being studied matters. FDA-approved uses are for type 2 diabetes, which was the original use case that spawned Ozempic, Mounjaro, Trulicity, Rybelsus, and Victoza. Obesity and overweight needs were the second use and that was addressed best by Wegovy, Zepbound, and Saxenda. These were all set up as weekly injections, but there are now pill options too. Oral semaglutide was cleared for obesity in December 2025, and Lilly’s oral orforglipron (Foundayo) was approved for weight management in April 2026. Heart attack, stroke and cardiovascular death risk has also been shown to benefit and semaglutide was approved in March 2024 to lower these in adults with heart disease and excess weight. Obstructive sleep apnea is addressed by tirzepatide (Zepbound), which became the first drug approved for moderate to severe sleep apnea in adults with obesity. And then there are the derivative uses like chronic kidney disease in type 2 diabetes, which Ozempicis in trials for as well as fatty liver disease with liver scarring (MASH), which Wegovy received accelerated approval for in 2025. In addition, there is study underway on a long list of other benefits like avoiding heart failure with preserved ejection fraction in obese patients, peripheral artery disease, knee osteoarthritis pain, alcohol use disorder and other addictions (a Danish trial of 108 adults tested whether weekly semaglutide reduces heavy drinking), Type 1 diabetes, as an add-on to insulin, psoriasis, psoriatic arthritis, ulcerative colitis and Crohn’s disease, when combined with immune drugs, and even high blood pressure, Parkinson’s, PCOS and infertility.
My point is simple…nothing is more American than fast food and now nothing is more American than using a GLP-1 to defeat fast food.