Just last month, I marked my 25th year as a professional journalist, which I guess means my journalistic career is old enough to rent a car, no questions asked. Work in the news for that long, and you’ll occasionally find yourself surprised by things you published in the past. Like, I had all but forgotten that I had written this Time magazine cover story in 2008:

A couple things here. One, as the cover demonstrates, journalistic sensitivity was…less than ideal then, to say the least. And two, over a quarter-century occasionally covering obesity (both childhood and adult), that story only seemed to go in one direction: worse.

It wasn’t for lack of trying. We put calorie counts on menus, taxed soda (well, in some places), built workplace wellness programs, and funded a small library of diet research. We deplored food deserts and promoted farmers’ markets. We told people — again and again — to eat less and move more. But the lines just kept going up.

By the CDC’s measured survey, the share of US adults with obesity did not change meaningfully between 2013 and 2023. The age-adjusted obesity rate sat at 40.3 percent, while the age-adjusted severe obesity climbed from 7.7 percent to 9.7 percent over the same stretch.

While the question of weight in America is inextricably tied to body image and moralizing, those numbers had a deadly effect. One demographic model estimated that obesity was associated with roughly 18 percent of deaths among Black and white Americans ages 40 to 85 between 1986 and 2006. From diabetes to kidney failure, heart disease to sleep apnea, obesity is the delivery system for other diseases.

Which is what makes a Gallup report published in July so surprising. In Gallup’s self-reported height-and-weight series, the US adult obesity rate fell to 36.4 percent, down from a peak of 39.9 percent in 2022. Over roughly the same period, the share of adults who said they were currently taking a GLP-1 drug for weight loss rose from 3 percent in 2024 to 11 percent in 2026 — approximately 29 million people. While this only shows correlation, not causation, and Gallup’s self-reported measure should not be compared directly with the CDC’s measured rate, the timing is suggestive to say the least. 

And the weight might be the least interesting thing about these drugs. 

Semaglutide — the molecule sold as Ozempic and Wegovy — was first developed and approved as a treatment for type 2 diabetes, not obesity. It was only after earlier GLP-1 drugs and diabetes trials showed substantial effects on appetite and weight that researchers deliberately tested a higher dose for obesity, resulting in Wegovy in 2021. 

But as it turns out, the list of things that have been noticed happening on the side with GLP-1s has gotten so long it’s begun to eclipse the main event. The coverage of GLP-1s has barely kept up with this news, because weight loss is what made these drugs famous and what we continually obsess over. But it turns out, weight loss may not be what they’re best at.

Side effects may include…

Let’s start with sleep apnea, which, untreated, drives up blood pressure, strains the heart, and raises the risk of stroke. These are people whose breathing stops dozens of times an hour, all night, every night. Two year-long trials put 469 of them on tirzepatide — the drug sold as Mounjaro and Zepbound — and cut those interruptions by more than half. Roughly half the group finished the year with no apnea at all, or with so little left that they stopped being tired all day.

Then there are the kidneys. A major trial followed 3,533 people with type 2 diabetes and chronic kidney disease for a median of 3.4 years. Semaglutide reduced the relative risk of a composite of kidney failure, a sustained loss of at least half of kidney function, or death from kidney-related or cardiovascular causes by 24 percent; all-cause mortality was 20 percent lower.

And the liver: A trial, still underway, biopsied the livers of 800 people whose organs had grown fatty, inflamed and scarred and randomly assigned them to semaglutide or a placebo. After 72 weeks the inflammation had cleared in nearly 63 percent of those on the drug, with no worsening of the scarring, against 34 percent on placebo. 

And the knees: In 407 adults with obesity and moderate knee osteoarthritis, pain scores on the 0-100 WOMAC metric fell 41.7 points against 27.5 on placebo. 

And to top it off, a 17,604-person trial of participants who were overweight or obese but did not have diabetes found a 20 percent drop in major cardiovascular events.

These results may not be as grabby as cultural debates over “Ozempic face,” but they deserve far more attention.

Medicine’s happy accidents  

As GLP-1s — which in part came out of a hormone in Gila monster venom — demonstrate, medicine has long found some of its biggest wins in the margins of drugs ostensibly built to do something else entirely. 

Sildenafil, better known as Viagra, began life at Pfizer as a candidate treatment for the heart disease angina. It failed at that, and its now-famous use turned up in data as a side effect in what must have been a very interesting trial for its subjects. Minoxidil (Rogaine) was a blood pressure pill that turned out to help patients grow hair. Finasteride (Propecia) was approved for enlarged prostates before anyone thought to sell it for baldness — and then a trial of more than 18,000 men found it cut prostate cancer diagnoses by about 25 percent, a benefit that took 20 years of follow-up to fully vindicate. 

Perhaps the most famous example is aspirin, which spent most of a century as a painkiller before a doctor in California named Lawrence Craven noticed that the patients he’d given aspirin gum to after tonsillectomies bled more than they should. He guessed the aspirin thinned the blood, and started handing it out to middle-aged men, who were at higher risk of heart attacks. Craven died in 1957; the trial that ultimately proved that he was onto something — showing that aspirin in heart attack victims cut vascular deaths by a fifth — didn’t run until 1988. 

The strange morality of Ozempic

Viewed this way, GLP-1s can seem like miracle drugs — but even miracle drugs can’t cure everything.

There had been great hope that GLP-1 might reduce dementia rates, but when Ozempic maker Novo Nordisk ran a proper trial, it didn’t show evidence of slowing clinical progression of Alzheimer’s. Much the same happened with cancer. Observational data had hinted that GLP-1 users developed tumors less often, but when a Harvard team pooled 48 placebo-controlled trials covering 94,245 people, they found the drugs have little to no effect on the risk of thyroid, breast or kidney cancer, though evidence for other cancers was less certain, leading to FDA boxed warnings. One plus: In some early animal studies, high doses of GLP-1 drugs caused thyroid tumors in rodents, but further research largely hasn’t validated the fears that it could be more widespread, though uncertainty about some rare thyroid cancers remains.  

For many people, weight loss isn’t the end of what these drugs seem able to do. It’s where the benefits begin.

The bigger concerns largely remain the known ones, starting with muscle loss. Across 22 randomized trials, about 25 percent of the weight lost on these drugs turns out to be lean muscle mass. Some of that is simply unavoidable in any weight loss, but too much can mean a great deal, especially if you’re 75. 

And cost remains a barrier: In a 2025 KFF poll, 56 percent of adults who had ever used a GLP-1 said the drugs were difficult to afford; 27 percent said they had insurance but paid the full cost themselves. In a separate Cleveland Clinic chart review of 288 adults without diabetes who stopped injectable semaglutide or tirzepatide within a year, 47.6 percent stopped because of cost or insurance problems, compared with 14.6 percent because of side effects. (The money, at least, is improving. An oral GLP-1 drug was approved in April, and it starts at $149 a month for people paying cash, while Medicare trial pricing of $50 a month for some GLP-1s went live in July.)

A stickier obstacle is the one that can’t seem to be divorced from questions about weight: judgment. As my colleague Dylan Scott wrote recently, researchers at Rice University found that people rate a GLP-1 user more harshly than someone who never lost weight at all. That makes perfect sense when you consider how contentious weight is in America — and none at all when you think about just how many people have benefited from these drugs in so many different ways.

I sometimes wonder how we would view GLP-1s if they could do everything they’ve been shown to do, but somehow not change a person’s appearance. 

So much of the discourse around these drugs has been shaped by the fact that many of the earliest and most public and apparent users were already thin people, often celebrities, using them to get even thinner. But that framing has become increasingly difficult to square with reality. 

Two things can be true at once: American culture has a toxic relationship to weight, and millions of Americans can and are benefiting from these drugs. For many people, weight loss isn’t the end of what these drugs seem able to do. It’s where the benefits begin.

A version of this story originally appeared in the Good News newsletter. Sign up here!

Hasan Piker has for years now been both an asset and a liability for Democrats. The Twitch streamer has elevated base-energizing progressives, such as Darializa Avila Chevalier and Zohran Mamdani, in interviews and with endorsements. But he’s also stoked controversy with past anti-Israel commentary and generally caused headaches for establishment Democrats who would rather not see Hasan’s favored candidates get any more oxygen. 

Why? A familiar concept for these kinds of centrist Democrats: electability.

That concept has been on many left-leaning voters’ minds over the past few weeks, as primaries have put progressive candidates to the test — with very mixed results. Last week, Wisconsin gubernatorial candidate and democratic socialist Francesca Hong lost her primary to establishment favorite David Crowley. Not long before that, though, progressive Michigan Senate candidate Abdul El-Sayed won his primary against the more mainstream Democratic candidate, Rep. Haley Stevens — albeit by a much smaller margin than many polls predicted.

America, Actually host Astead Herndon caught up with Piker to talk about whether the recent primary results have refined his understanding of how prepared Americans are to vote for democratic socialists, what support for unabashedly progressive candidates tells us about the changing working class in America, and the “pundit brain” problem in the Democratic Party.

Below is an excerpt of Astead’s conversation with Piker, edited for length and clarity. There’s much more in the full show, so listen to America, Actually wherever you get your podcasts or watch it on Vox’s YouTube channel.

The last two weeks have produced mixed results for left-wing candidates: a big win in Michigan and a win this week in Minnesota for Peggy Flanagan, but a loss for Francesca Hong, which was a surprise in Wisconsin.

What have been your takeaways from the last set of results?

I think the ground game is phenomenal. There’s a lot of excitement on the platform. There’s a lot of excitement for the first time for “Change Candidates.” It’s still a good environment to be in if you are a socialist.

The establishment does have a lot of juice still, for sure. And when they can put together a similar strategy to what happened in 2020 against Bernie Sanders with Joe Biden, especially in a place like Wisconsin where Tony Evers is very clearly still a very popular governor, they were able to elevate David Crowley’s campaign, who actually had dropped out and consolidated support behind Sara Rodriguez initially. And he had to drop out because he was only performing at, like, 6 percent.

Yeah, the consolidation was swift, and it was complete. I mean, you’re comparing it to 2020, in which the establishment lined up behind Joe Biden and kind of nixed that Bernie Sanders campaign in the blink of an eye. I imagine you were surprised at the result.

I never underestimate my opponents, whether they be Republicans or whether they be establishment Democrats. You have to always operate as though you’re down 10 points. I don’t believe in the notion that we are going to win easy victories at the end of the day.

There are a lot of powerful interests at play here. There are a lot of people in positions of power that don’t wanna lose their seats. So they’re gonna fight like hell, so we have to also fight like hell. We have to fight extra hard, as a matter of fact, because we’re almost always outspent, right?

I got an alert right before we started talking from the New York Times that said, “A democratic socialist lost in Wisconsin, which shows the movement’s surging wave might crash before rippling out from big cities.” Is that wrong?

Oh, I love that. Look, people are gonna have their opinions. I’ll just say it like this.

Abdul El-Sayed’s one-point victory margin showed that the Democratic socialist-aligned movement or the progressive movement was in tatters. It was obviously a failure. And now, David Crowley’s less-than-one-point victory proves that the centrist bulwark is still here, and that the Democratic socialist movement is dying.

It kind of feels like it’s wish-casting for the most part, from a lot of people who maybe want to go back to the way things used to be. My assessment on this is definitely a little bit different. I think, at the end of the day, these are insurgencies, right? These are insurgent candidacies.

We’re talking about no name recognition for a state legislator that was entirely propped up by local Wisconsin DSA chapters. These people didn’t have a lot of money necessarily, and they were able to defy the odds, and they continued defying the odds all the way until the end.

The idea that the polls showed that Francesca was a clear frontrunner and was running away with this race is utterly irrelevant. Especially if you were to look at this with a broader perspective, like thinking about where Democratic Socialists of America have gotten to in the last two years.

I mean, I remember how I felt in 2024, in the aftermath of the DNC, about where the American socialist movement was as opposed to where it is now. We are clearly a force to be reckoned with, and that’s precisely the reason why a lot of people are paying close attention to what’s going on.

And I’ll say it like this. The fact that the Hong campaign did not have any major progressive national endorsements, and that I was like their top surrogate.

There was no Bernie Sanders endorsement, there was no AOC endorsement. That did make the Hong campaign unique on that front.

I think there were a couple other races that I was also involved in where my candidates lost, right? 

I mean, Saikat Chakrabarti was another great example of this as well. It wasn’t a statewide race, and obviously, there’s always clear local differences that play a formative role in how these races turn out.

But we’ve looked back at this data. There are a couple different endorsement trackers out there, and they’ll put my endorsement up there, and they’ll put, like, AOC and Bernie Sanders. And it’s very clear that the best likelihood of success usually comes from a consolidation of national progressive forces, whether it be outside expenditures coming from Justice Democrats or things like that. And with the Francesca Hong campaign, I think it’s a testament to their success. It’s a testament to how popular the platform is in general.

And one thing I will have to stress here is the salience of the electability narrative. I think that’s still a real motivator for a lot of people.

Yeah, I hear that. Both El-Sayed’s campaign and Hong’s campaign did better among middle-class voters — I should say, than the data would tell us, among working-class voters. Considering how central working-class and bottom-up issues are to the DSA message, why has it not produced results that actually get it more working-class votes? Because that does seem to be something we’ve learned over the last three, four weeks.

I think that we have to dramatically reconstruct how we understand what it means to be working-class in this country. I think a lot of people will disagree with what I’m about to say here, but we have to do away with this fantastical notion that the working-class is one specific thing.

I think for the longest time, people have thought about this hardhat-wearing coal miner as the true working class, oftentimes White as well. And the working class is unbelievably diverse in this country, and it’s also a lot more college-educated than people actually give it credit for.

I think partially this is because if you look back to the ’90s as opposed to right now, yes, if you had a college education, you were upwardly mobile. You were probably a professional managerial class individual that was going to be able to retire at a reasonable age. You were doing fairly well. It was a guarantee for getting a good job, right? 

That’s not the case in America any longer. There are a lot more people who have a college degree who are downwardly mobile, who are having a very tough time in the current job market, who do not own a home, and it’s seemingly less likely than before that they will ever be able to own a home.

And that is the actual working class. It’s much broader, right? So we’ve seen in Zohran’s race and in Abdul’s race, there’s this massive group of working-class folks that constantly get cast aside as not being a true representation of the American working class, when I think like, No, that is the true representation.

This story appeared in Today, Explained, a daily newsletter that helps you understand the most compelling news and stories of the day. Subscribe here.

The 2026 wildfire season on the West Coast is shaping up to be an especially bad one: In Oregon, more than 2 million acres have already burned, breaking a record set just a few years ago, in 2024. In neighboring Washington state, suburbs around the city of Spokane recently burned in an increasingly common example of fires reaching urban and suburban areas (as my colleague Caitlin Dewey covered recently). And the consequences are spreading far beyond where the fires are burning, with hazardous smoke from the Pacific Northwest drifting as far away as New England. 

Much of this is a story about climate change, as increasingly dry, hot summers provide ample fuel for fires. But the crisis is also being made worse by the Trump administration: Staff cuts to the US Forest Service have left the agency stretched thin and unable to respond as effectively to fires, while a planned reorganization is also set to shutter Forest Service labs researching and tracking wildfires. EPA research into wildfires and wildfire smoke has also been slashed. 

All of this — plus a Trump administration shift away from letting some fires burn themselves out, which has further increased the workload on wildland firefighters — has also resulted in a more dangerous fire season for firefighters; Reuters reported this week that firefighters are “being overrun by wildfires at the highest rate in two decades” — with months still to go until the end of the season.

Go a little deeper

As if the above weren’t enough to worry about, lawmakers are also raising a brand-new fire season concern: prediction markets. Specifically, the possibility that bettors could turn to arson in order to manipulate prediction markets — and earn themselves some money. 

Polymarket, on its international platform, has offered users the chance to bet on everything from when and where a fire might spread to when it could be contained or extinguished, which resulted in more than $1 million in bets on major fires in California last year. High Country News reported in June that a new prediction market, called Wyldfyre, had launched specifically for betting on wildfires.

Legislators like Sen. Jeff Merkley (D-OR) have pointed out that, unlike most other natural disasters, fires are easily started or spread by humans, creating a real risk that people could attempt to manipulate markets. 

“Offering bets on destructive wildfires threatens to minimize communities’ suffering all so the rich and powerful can profit,” Merkley and eight other Democratic senators wrote in a letter to the head of the Commodity Futures Trading Commission last week. “There’s also the heightened risk—according to state and local fire officials—that individuals could be tempted to commit arson in order to make sure their bets are successful. By offering contracts on fires, prediction market sites run the risk of encouraging people to influence fires that have already started, creating additional concerns around public safety and insider trading.

One link for later

➨ Build (your attention span) back better. Beset as we are by short-form video and tweets, it can often feel like our attention spans are slipping unavoidably away. The good news, it turns out, is that decline doesn’t have to be permanent — there are ways to rebuild attention, including by simply letting your brain rest more.

Before you go…

• Did you know…that feral pigs are a serious problem for parts of rural America? After a tweet about “30 to 50 feral hogs” went viral in August 2019, my former colleague Dylan Matthews embarked on a serious consideration of how the pigs impact the US — and how we impact them in turn. It’s still one of my favorite articles on the Vox site. 
• Today’s trivia: Which US president responded to inflation by ordering wage and price freezes? (You can find this and other brain puzzles in Vox’s daily crossword. Look for the answer in Monday’s edition.)
• Yesterday’s trivia: Yesterday, we asked you for the first woman to perform hip-hop at the White House. That was MC Lyte, who performed at the Obama White House in 2014.

This story appeared in The Logoff, a daily newsletter that helps you stay informed about the Trump administration without letting political news take over your life. Subscribe here.

Welcome to The Logoff: Remember President Donald Trump’s first-term border wall? It’s still being built — through a pristine Texas national park.

What’s happening? The Trump administration is preparing to build hundreds of miles of roads through Big Bend National Park in southwest Texas as part of its latest border security project, despite a bipartisan outcry over damage to the beloved park. 

Starting last week, bulldozers and heavy machinery began to clear land for the construction of about 200 miles of patrol road, new border barriers, and electronic surveillance measures to cover the park’s 118 miles of shared border with Mexico. The construction is proceeding after the administration overrode environmental laws intended to protect places like Big Bend earlier this year.

What does a border wall look like in 2026? In this case, “wall” is a bit of a misnomer. Despite Trump’s fixation with an actual, physical wall circa 2016, the Trump administration’s current project isn’t always 30 feet high and topped with concertina wire.

Instead, the Big Bend project is part of what the administration has described as a “smart wall,” which will combine stretches of traditional wall elsewhere along the US-Mexico border with patrol roads and vehicle barriers like those planned for the park, all blanketed with surveillance. 

It’s a small retreat from the administration’s original plan for a border wall through Big Bend, which sparked outrage earlier this year. Still, the administration intends to build about 700 additional miles of “primary” wall, spanning all four border states. The whole project is slated to cost around $47 billion. 

Why Big Bend? It’s hard to say. As the New York Times reported earlier this year, the park has long been considered low-priority given its remote location and inhospitable weather. Only about 1 percent of those apprehended for crossing the US-Mexico border have been detained in Big Bend.

And with that, it’s time to log off…

Hi readers, happy Friday! Before we log off today, here’s a story from my colleague Allie Volpe about how to bring some playfulness back into your life and why we’d all stand to benefit from it. You can read it here with a gift link. 

Have a good weekend, and we’ll see you back here on Monday!