This year, the incredible potential of obesity medicines like Novo Nordisk’s Ozempic and Wegovy and Eli Lilly’s Zepbound started to come into view. The drugs work so well for so many that it’s starting to look like they could change the literal and metaphorical shape of society – starting with our waistlines and extending to our overall health and our habits around food and alcohol.

And yet, the way we talk about these drugs remains stuck in frustrating binaries. The drugs are either a panacea or an overpriced Band-Aid; they will either solve one of the biggest problems in healthcare or burden the system with hundreds of billions of dollars in unjustified cost. The extremes keep us from honestly addressing some fundamental questions about these drugs. Most pressingly: What role should they play in addressing a sicker, fatter society?