Reacción a "Medicines for obesity control are associated with a healthier shopping basket"

The study recently published in JAMA Network Open, which analyses changes in food purchasing patterns after starting treatment with GLP-1 receptor agonists, is a high-quality methodological work with an innovative approach. It uses objective purchasing data from supermarket receipts, linked to drug prescription records in a well-characterised population cohort, which reduces one of the major problems commonly encountered in nutrition: reliance on self-reporting. From the point of view of novelty, this study stands out precisely because it analyses purchasing behaviour, an indirect but highly relevant marker of actual eating behaviour. Until now, most research has focused on changes in intake or stated preferences; having objective large-scale consumption data represents an interesting advance and opens the door to new lines of research.

That said, as with observational studies, it is important to interpret the results with caution, as the design itself does not allow a direct causal relationship to be established between the start of treatment with GLP-1 analogues (aGLP-1) and the change in food choices. It is reasonable to think that some of the changes observed may be influenced by other concurrent factors, such as the start of closer medical monitoring, nutritional counselling, or greater motivation to change habits when starting a new treatment. In fact, the authors acknowledge this limitation, as well as the absence of relevant clinical data such as body mass index or body composition data, which would help to better contextualise these results.

Even so, the findings fit well with the physiological and clinical evidence accumulated in recent years. We know that GLP-1s not only reduce appetite and increase satiety, but also modulate central circuits related to reward, impulse control, and hedonic response to food. In this context, it is not surprising to see a reduction in the purchase of ultra-processed products, rich in sugars and fats, and a shift towards less processed foods with higher nutritional quality and protein content. The study adds another piece to a puzzle that is beginning to show that these drugs can influence not only how much we eat, but also what we choose to eat.

One of the most interesting questions raised by the study is whether GLP-1 agonists can facilitate more profound and sustained behavioural changes. In clinical practice, we are increasingly observing that these drugs can “silence” food noise, reduce cravings and decrease emotional eating, creating a window of opportunity to work on habits that were previously very difficult to change. This does not mean that the drug replaces behavioural intervention, but rather that it can act as a facilitator of it.

In this sense, the key message would be that the maximum benefit of these treatments is achieved when they are integrated into a multimodal approach: pharmacology, nutrition, exercise and psychological support. Interpreting GLP-1 agonists as a purely “biological” solution would be an oversimplification. Studies such as this suggest that their impact may go beyond body weight, influencing everyday decisions that, in the long term, are decisive for cardiometabolic health and quality of life.