For roughly 40% of American adults living with obesity, the medical playbook has barely changed in decades: Eat less, move more, and if that fails, wait until the disease progresses far enough to justify surgery. GLP-1 drugs like Ozempic, Wegovy, and Zepbound have broken that script—but according to Robin Wenzel, head of Wells Fargo Industry Insights, the drugs are exposing a harder problem than obesity itself: who can afford to wait for them to work.
“It’s a game-changer,” Wenzel told Fortune, describing how GLP-1s have shifted obesity treatment “upstream”—from late-stage interventions like gastric bypass and orthopedic surgery toward proactive weight management that can head off disease before it starts. “That’s what we’re seeing, how this filters through the economics within healthcare.”
The numbers back her up. A 2026 JAMA Surgery analysis found as GLP-1 use rose more than 140% between 2022 and 2024, bariatric surgery volumes fell 34.1% over the same stretch—a direct substitution effect, according to a Wells Fargo Industry Insights report co-authored by Wenzel and John Teasley, a market executive in the bank’s healthcare commercial banking group.
Cardiovascular outcomes may be an even bigger story: The SELECT trial found semaglutide reduced major adverse cardiovascular events by 20% in overweight or obese adults without diabetes—a result Wenzel called “an eye-opener” given cardiology’s status as one of the most lucrative lines of business within healthcare. Obesity therapies now account for roughly 25% of pharma’s forecast late-stage drug pipeline value, up from just 1% in 2022, surpassing oncology for the first time in 16 years of tracking by Deloitte.
