Myth: HOTs are just about aesthetics.

False. While aesthetics may be a key motivator for many HOT users, it is nowhere near the most important impact at a societal or economic level.

The aesthetics dimension is real, and people who lose substantial weight and gain muscle through HOTs will look different. They often feel more confident, engage more actively in their social and romantic lives, and buy new clothes. But framing HOTs as primarily aesthetic is like framing exercise as primarily aesthetic. Exercise improves appearance, yes, but the reasons we should want more people to exercise are overwhelmingly medical, economic, and social. The same is true for HOTs, and the case is even stronger.

Obesity is the root cause of type 2 diabetes, a large fraction of cardiovascular disease, several cancer diagnoses, most obstructive sleep apnea, and major pathways to osteoarthritis, cognitive decline, and late-life frailty. Treating obesity with HOTs is therefore simultaneously treating or preventing all of those downstream conditions. The financial stakes alone are enormous. Over $2.3 trillion of US healthcare spending annually is directed toward conditions driven by metabolic risk from obesity and poor diet.

The addiction dimension adds another non-aesthetic layer. GLP-1 drugs demonstrably reduce alcohol consumption, nicotine use, opioid cravings, and other addictive behaviors by modulating the reward circuitry that makes them hard to quit. A recent WashU Medicine study of over 600,000 patients found that GLP-1 use was associated with a 14% reduction in new substance use disorder diagnoses overall, and a 25% reduction in new opioid use disorder specifically. This has nothing to do with aesthetics.

The muscle-gain dimension is particularly important for older adults. Sarcopenia (age-related muscle loss) is one of the primary drivers of the frailty, falls, disability, and dependence that characterize the last years of many people's lives. The combination of fat loss and muscle gain from next-generation HOTs is, for a 65-year-old, not primarily an aesthetic intervention. It is a functional independence intervention. It is what keeps people off of mobility aids, out of nursing homes, and living independently for more years. It compresses the period of late-life morbidity. These are among the most important health outcomes that medicine can achieve.

HOTs improve how people look, but the reason they matter is overwhelmingly because they profoundly improve how people function, how long they remain healthy, and how large a burden they place on healthcare systems and public finances.

Explore the evidence...

• Clothing is, of course, partly about aesthetics, and the physical transformation driven by HOTs will have sweeping consequences for the fashion and apparel industry as tens of millions of people drop multiple clothing sizes. But the ripple effects extend far beyond how people look, reaching into textile demand, petrochemical supply chains, and even environmental pollution.
  • Explore the unexpected implications of mass body transformation for the fashion and apparel industry.

• HOTs have profound social implications that go far beyond how people look. A healthier, more physically capable, less addicted population means higher workforce participation, lower criminal justice costs, stronger families, and more resilient communities. 
  • Read about the social and cultural implications of the HOT disruption in our Rethinking Health report.

• Perhaps the most surprising non-aesthetic dimension of HOTs is their effect on addiction. By modulating the brain's dopamine reward pathways, GLP-1 drugs are showing remarkable results in reducing alcohol consumption, nicotine dependence, opioid use, and other compulsive behaviors. 
  • Read about how GLP-1s are cracking the biological code of addiction.
  • Explore the latest AI-powered research on GLP-1s and alcohol use.
  • Discover the full addiction implications of HOTs in our Rethinking Health report.

Witness the transformation

We are entering a new era of healthcare based on a categorically different kind of medicine whose purpose is not just to save us from illness, but to help us be the best version of ourselves.

The next generation of HOTs will trigger a multi-trillion-dollar global disruption, affecting dozens of industries across multiple sectors, driving a radical global improvement in health and wellness encompassing at least 1 billion people worldwide before 2040.

Optimizing well with advanced HOTs will soon become as important as eating well with nutritious foods. Nations, industries, and individuals that recognize this early and act decisively will be best positioned to capture the extraordinary benefits of this transformation.

Learn more about the HOT disruption and its implications for health, society, and the economy.

Disclaimer

The information provided in this FAQ is for general informational and educational purposes only and is not intended to constitute medical advice, diagnosis, or treatment. This content does not establish a doctor-patient relationship. The content regarding GLP-1 receptor agonists (or any other medical treatments) should not be used as a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or treatment options. Never disregard professional medical advice or delay in seeking it because of something you have read here. The authors and publishers of this FAQ and related report make no representation or warranty, express or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any information presented. Reliance on any information provided here is solely at your own risk.