No Mercy / No Malice: America’s Best Bet

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Hey y'all, we make guitar strings right here in Nashville, Tennessee.

Scott grows his business through Amazon.

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Shop small business like mine on Amazon.

I'm Scott Galloway, and this is No Mercy, No Malice.

America has become a giant bet on AI.

A better bet,

GLP One.

America's best bet,

as read by George Hahn.

America is now one giant bet on AI.

If not for the magnificent 10, the markets would be flat for the year.

There's a different technology that offers more asymmetric upside.

If we want to transform the economy and the well-being of Americans, we should focus on GLP-1,

not GPT-5.

More than 40% of American adults, 100 million people, are struggling with obesity.

By 2060, half of U.S.

adults may be obese.

The health care costs of all that extra weight could exceed $20 trillion

over that period.

Our debt, $5 trillion in receipts versus $7 trillion in spending, has become the IED of our economy.

We don't know when or why it will detonate.

If we're going to have an adult conversation regarding spending, all roads lead to the same place, healthcare.

We spend $13,000 per person versus $6,500 in the rest of the G7.

Matching the efficiency of our peers would save us $2 trillion

a year.

Why do we spend double to die sooner while experiencing more anxiety, depression, and chronic illness?

Our problem isn't vaccines, food dyes, or Tylenol.

It's fat.

The Milken Institute and McKinsey have estimated that obesity costs us about $400 billion annually in direct medical costs and lost productivity.

U.S.

healthcare isn't about caring for health, it's about monetizing it.

Just as big tech found the gangster app for shareholder value, RAGE, the industrial food, hospital, and pharma complexes have found obesity.

They get you addicted to sugar and salt, then hand you to the non-health complex for replacements, dialysis, and statins.

They've even rebranded disease as identity.

You're not obese.

You're living your truth.

No, you're finding diabetes.

McDonald's and Coca-Cola celebrate obesity so United Healthcare can monetize it.

These stocks aren't equities, they're obesity indices.

We know exercise, healthier food, and less screen time help,

but they're not enough.

The good news?

Obesity may have peaked in the U.S., and we have the tools to actually reverse it.

Pushing for a radically lower price and rolling out weight loss drugs to tens of millions of Americans could be revolutionary, possibly the best civic investment in recent history.

In sum, our instincts have not kept pace with industrial production, and we gorge.

GLP-1s put scaffolding on our instincts.

Most of us have friends or colleagues we barely recognize after they've taken novel weight loss drugs.

By mimicking a hormone called GLP-1, the medicines suppress hunger and make us feel fuller longer.

The results are dramatic, 15% to 20% reductions in body weight, yet uptake remains small relative to the tens of millions who could benefit.

Coverage is patchy.

Only 30% to 40% of commercial plans and 14 state Medicaid programs cover the cost of GLP-1s for obesity.

The administration is considering a pilot to expand coverage under Medicaid and Medicare, a shift in policy after rejecting a Biden-era plan that would have cost $35 billion over 10 years.

Prices need to fall for the math to work.

If Medicare began covering GLP-1s, researchers estimate 3 million beneficiaries would start using them over the next decade at a gross cost of $66 billion and savings in avoiding healthcare spending of $18 billion for a net price tag of $48 billion.

Costs are moving in the right direction.

Wagovi and Ozempic now run under $7,000 a year.

Costco offers a monthly supply of obesity drugs for $499,

and competition from Lilly and others is driving prices down.

More than 100 next-generation obesity drugs are in development, including pill versions.

President Trump on October 16th vowed to slash GLP-1 prices to $150 a month to match the expense in other developed nations, but no deal yet exists with drug makers.

Investors, however, took him seriously.

Shares of Novo Nordisk and Lilly dropped sharply on the news.

Economist Emily Oster argues the budgetary worries of expanding access are overstated.

Medicaid tends to pay far less than private insurers, and a typical 53% discount could drop monthly costs to $235.

If 10% of eligible patients took the drugs, it would raise Medicaid spending by just 0.4%.

The concerns also miss the upside.

About 5 million U.S.

adults use GLP-1s today.

If 30 million did, Goldman Sachs estimates GDP would rise as much as 0.8%.

At 60 million, the increase could exceed 1%.

America isn't the only country fighting this epidemic.

In Britain, obesity costs the economy 31 billion pounds a year in lower productivity, sick days, and early deaths.

We've created a food system that's poisoning our population and bankrupting the state, says Henry Dimbleby, co-founder of Leon Restaurants, which bills itself as a purveyor of fast but healthy meals.

These drugs aren't a silver bullet, but they are a bullet.

Many people quit taking them within a year or two, often because of cost or gastrointestinal side effects, and lasting success still requires exercise and diet changes.

But alongside those measures, GLP-1s may be the key to fighting a complex disease rooted in physiology, environment, and policy as much as behavior.

In a society addicted to ultra-processed food and sedentary hours lost in front of screens, we need new weapons.

Former FDA Commissioner David Kessler calls GLP-1s a way to defuse the ultra-formulated food bombs that have hijacked our health.

RFK Jr.

has called for lifestyle changes while cutting NIH funding, the moral equivalent of telling people to lift weights while closing the gym.

The administration's Secretary of War, Pete Hegseth, has shamed fat generals but offers no help other than performative masculinity.

Scaling access could prevent adult adult obesity from topping 50%

and push it back toward 30%.

Giving 10 million Americans GLP1s and lowering their monthly cost to $50

would run $12 billion over two years.

That's a bargain.

Targeting the patients most likely to benefit would improve returns further.

Obesity shortens life expectancy by up to 10 years, partly because it increases the risk for more than a dozen types of cancer.

Reducing its prevalence would yield massive health and productivity gains over the next 30 years.

I'm sticking with the thesis I shared with Bill Maher two years ago.

GLP-1s will have a bigger impact on the real economy than AI.

OpenAI's Sam Altman calls Sora the most powerful imagination engine ever built.

In reality, it's an endless feed of digital slop, further blurring the truth.

The real engine of progress comes in a syringe.

Maybe we should put it in the water.

Researchers are aiming to preserve muscle and overcome one of the drawbacks with the first treatments, or eliminate injections altogether.

They're also testing GLP-1s to treat conditions beyond obesity.

Novo Nordisk is betting its drugs can work against Alzheimer's.

Whether or not these efforts succeed, the trajectory is clear.

This technology could reverse the most expensive disease in history.

America's two great growth engines are rage and carbs.

AI monetizes the former, the food complex the latter.

GLP-1s may finally break the loop, shrinking our waistlines, cutting costs, and reminding us that progress isn't digital, it's biological.

The next great platform isn't the neural net,

it's the needle.

Life is so rich.

All right, remember, the machine knows if you're lying.

First statement, Carvana will give you a real offer on your car all online.

False.

True, actually.

You can sell your car in minutes.

False?

That's gotta be true again.

Carvana will pick up your car from your door, or you can drop it off at one of their car vending machines.

Sounds too good to be true.

So true.

Finally, caught on.

Nice job.

Honesty isn't just their policy, it's their entire model.

Sell your car today, too.

Carvana.

Pickup fees may apply.

When will AI finally make work easier?

How about today?

Say hello to Gemini Enterprise from Google Cloud, a simple, easy-to-use platform letting any business tap the best of Google AI.

Retailers are already using AI agents to help customers reschedule deliveries all on their own.

Bankers are automating millions of customer requests so they can focus on more personal service.

And nurses are getting automated reports, freeing them up for patient care.

It's a new way to work.

Learn more about Gemini Enterprise at cloud.google.com

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