Cathy O'D

We’re being told hospitals are “flooded” with GLP-1 complications and that we’re at the “tip of the iceberg.” I’ve been a bariatric surgeon long enough to remember these drugs when they were still in trials. I’ve prescribed them. I’ve monitored patients on them. And when the ER had a question about one of my patients on a GLP-1, they called me. I am not seeing a flood. What I see — every single shift — are the consequences of untreated obesity: heart failure, uncontrolled diabetes, infections, sleep apnea crises, fatty liver disease progressing quietly toward cirrhosis. That is the deluge. Yes, GLP-1 medications have side effects. We know what they are. We counsel patients about them. We stop the drug if needed. That’s called medicine. But the claim that a hidden catastrophe is overwhelming hospitals is not something you prove with adjectives. You prove it with data. And if such a signal were real, it would not remain invisible for long in a healthcare system that tracks admissions, billing codes, adverse events, and outcomes with relentless precision. Obesity is a chronic, relapsing disease with serious downstream consequences. Treating it is not cosmetic vanity, and it is not “forcibly stopping people from eating.” It is modifying disordered physiology — something we do every day with insulin, thyroid hormone, antihypertensives, and chemotherapy. The relevant comparison is not drug risk versus zero. It is drug risk versus the very real morbidity of leaving obesity untreated. If someone believes there is an iceberg, show the sonar. Until then, what I see in the emergency room is not a wave of GLP-1 disasters. I see the far more predictable damage of a disease we’ve under-treated for decades.