A Few Thoughts on Manhattan's World Cup Finale

The Big Weekend Show@BigWeekendShow

🚨 JUST IN: @TomiLahren @Johnny_Joey @LisaMarieBoothe & @bdomenech react to America successfully hosting the 2026 FIFA World Cup as Spain defeats Argentina. @LisaMarieBoothe: "I love the enthusiasm about what a great tournament this has been here in the United States."

Every shift I’ve worked in the emergency department, I’ve seen the downstream consequences of America’s obesity epidemic. I see the 52-year-old father having a massive heart attack, or the diabetic foot infection that ends in an amputation, or the stroke that steals someone’s ability to speak to their loved ones, or the dialysis patient whose life is scheduled around a machine three days a week. By the time obesity reaches my emergency department, it’s no longer about vanity; it’s about people’s lives permanently changing or even prematurely ending.

For decades, physicians had few effective tools beyond telling patients to eat less and exercise more, a prescription that is technically correct but woefully inadequate against a food environment engineered to maximize consumption.

GLP-1’s have flipped that entire conversation on its head. For millions of Americans living with obesity and diabetes, these drugs have been transformative. Patients who spent years cycling through diets and medications are finally losing meaningful weight, improving their blood sugar, lowering their cardiovascular risk, and reclaiming their health. But as remarkable as the clinical results around GLP-1s have been, people still tend to misunderstand how and why they work.

Most Americans think of GLP-1s as appetite suppressants. You get full after one slice of pizza instead of two, so you lose weight, but that’s only half of the story. GLP-1 receptors are found not only throughout the digestive tract, but also in many regions of the brain involved in appetite and reward; they block the ability of your brain to anticipate and perceive pleasure from food, among other things.

This is something wholly different than suppressing hunger. This is no longer about weight loss so much as it is something entirely more personal: motivation. That second slice of pizza may still taste good, but you just don’t want it now. That is not a drug acting solely on the gut. It is a drug acting on the mind.

The implications of this are gobsmacking and reach well beyond obesity. Early studies suggest similar effects on alcohol, gambling, and other compulsive behaviors. For the first time, medicine isn’t simply treating disease; it’s beginning to change the motivational systems that drive human behavior. And that possibility forces us to ask a much bigger question.

In the dystopian novel Brave New World, Aldous Huxley wrote of a society that sought to eliminate suffering through chemistry and genetic engineering. Citizens took a drug called soma, which didn’t cure disease so much as silence dissatisfaction itself. Huxley wasn’t really writing about pharmaceuticals, but asking what happens when chemistry replaces the cultivation of virtue and resilience to silence human pain and suffering.

For decades, that question lay in the realm of science fiction. Today, it no longer does. GLP-1s are obviously not soma. They don’t manufacture happiness, and for millions of Americans struggling with obesity and diabetes, they are genuinely life-changing medicines that reduce suffering and save lives. But Huxley understood something that neuroscience is only beginning to explain: that changing desire can actually change behavior.

For too long, our politics has framed obesity as a choice on one side and a disease on the other. The truth, as it often is, is more complicated. Those who argue that discipline, responsibility, and self-control matter are correct. But biology matters too. Anyone who has treated obesity understands that hunger and reward are not simply matters of willpower. If you’ve ever wanted to snack more or binge after an all-nighter, then you know biology can make good choices dramatically harder.

That is why we should resist both extremes. One extreme dismisses GLP-1s as another “miracle cure” sold by Big Pharma. The other imagines that a weekly injection can replace the hard work of building health. Both are false gods.

America’s chronic disease epidemic did not emerge because millions of people simultaneously lost their moral compass. It emerged because we’ve spent generations constructing a nutritional ecosystem that funnels the average American toward metabolic disease, and no injection can solve that problem on its own.

Disease begins with what we eat, how we sleep, how we move, and a food environment that has been, for decades, making processed calories cheaper, more addictive, and more accessible than real nutrition. The Make America Healthy Again (MAHA) movement is rightly focused on those upstream causes. GLP-1s should complement that mission, not compete with it.

Patients taking GLP-1s still need resistance training, adequate protein, better nutrition, better sleep, and sustainable lifestyle changes. Without those foundations, weight loss can come at the expense of strength, resilience, and long-term health. A GLP-1 can make healthier choices easier, but it can’t make them unnecessary.