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# From pharmacy to pantry

## How GLP-1 drugs are shifting consumer preferences and shopping patterns

WF Agri-Food Institute digs into the data with NielsenIQ on GLP-1 use, consumer purchase trends, and how companies can tip the scales in favor of more profitability.

One in eight adults have reported taking a GLP-1 medication, either for chronic health conditions such as type 2 diabetes or for weight loss, according to a May 2024 KKF poll. Beyond the widespread medical benefits of these drugs, their increased usage is starting to have a measurable impact on how much those taking these medications buy at the grocery store and what they buy. These shifts in consumer behavior, preference, and spending seem to vary overtime and differ based on use case – such as those taking the drug for weight loss versus diabetes management. NielsenIQ has been studying these impacts, so we asked Sherry Frey, Vice President of Total Wellness, to share what they are seeing, how the findings are evolving, and where the opportunities may lie.

Q: First, what are GLP-1 drugs and how do they work?

GLP, or glucagon-like peptide, is a hormone that helps the body release insulin and slow down digestion. GLP-1 medications do this by increasing the amount of insulin a body creates, which helps keep blood sugar in a desirable range and makes you feel full after eating.

GLP-1s have been around since 2005 to treat type 2 diabetes. In 2014, Nova Nordisk’s GLP-1 drug Saxenda was approved by the FDA as a treatment for obesity, and since then, others have followed. These drugs support weight loss by suppressing appetite, but have also come with commonly experienced side effects, including fatigue, digestive issues, and muscle loss.

Q: Who is taking these drugs?

In our most recent data set, we still see most users taking GLP-1s for diabetes, however the percentage of users taking GLP-1s for weight loss continues to trend up.

Q: Why do users take GLP-1 medicines

- 48% take for diabetes only
- 31% for weight loss only
- 19% for both diabetes and weight loss

Initial findings found distinct differences between those taking GLP-1s to manage diabetes versus for weight loss. For example, diabetes GLP-1 users were more likely to be older, with no kids, and lower household incomes (less than $50K), compared to those taking the drug for weight loss, who were more likely to be younger with children and higher household incomes ($150K+).

The age of those starting on these medications for weight loss is also consistently trending younger.

NielsenIQ segments new consumers who have started taking the medication in the latest 1-3 months, 4-6 months, and 7-11 months, and interestingly, in the latest 1-3 month data set, the newest users index even younger.

Q: How has the rise of these medications impacted grocery store sales?

Overall, what we are currently seeing is that weight loss GLP-1 shoppers are buying more compared to a year ago, while diabetes GLP-1 shoppers appear to be buying less over that same time period. And, we see differences when segmenting users by when they started taking the medicine. For example, when looking at GLP-1 users who just started in the last 1-3 months, GLP-1 weight loss users spent 22% more (compared to the same 13-week period a year ago), while diabetes users spent slightly less.

We believe there are a variety of factors affecting the initial increase in unit volume for GLP-1 weight loss users. Notably, consumers who may be experiencing digestive issues may be seeking to have more control over their food, and as a result, are eating at home instead of eating out.

GLP-1 weight loss shoppers are valuable store shoppers overall, spending more, on average, than the total panel. For those weight loss users who have been on the medication for 7-11 months, behaviors began to change even prior to starting the GLP-1. While there are declines in spend for these shoppers over the last 52 weeks across all store aisles, the latest 13-week unit sales data shows purchases climbing back up.

Q: Which grocery store aisles are most impacted by these shifts?

While weight loss GLP-1 users tend to spend more in the store overall, especially early in, Health and Beauty Care is an area experiencing sizable gains.

Q: Top five category gainers in Health and Beauty Care

Expanding beyond Health and Beauty Care, Beverage is another category with shifts in spend among GLP-1 weight loss users. In particular, non-alcoholic beverages and energy drinks posted big gains in spend and unit volume, while soft drinks also saw significant gains, especially when comparing to purchases of non-GLP-1 users.

From the center of the store to the perimeter, increases in volume and dollars spent among weight loss users are both intuitive and intriguing. For example, in the produce aisle, increases are observed in fruit (up 14%) and mixed vegetables (up 38%). You also see increases in milk products (up 17%), cheese (up 16%), and fresh meat (up 15%). Diving into the center of the store, we see an increase in salty snacks (up 14%), cookies and crackers (up 17%), and fruit snacks (up 66%). As noted below, avocados, kiwi, and frozen fruit are notably big winners among the weight loss users.

The reality of the GLP-1 consumer journey, especially for weight loss, is that users’ purchasing fluctuates over time. It’s also important to recognize those 7-11 month GLP-1 weight loss shoppers were very strong shoppers when they started taking the GLP-1, so shifts can appear more pronounced in the beginning.

Q. Are we seeing consumer preferences change as a result of these drugs?

Not only are we seeing users’ store purchase behaviors and spends shift, data suggests their preferences change. Some of this can be attributed to changing habits that support better health and weight loss, but some shifts may be the result of the negative side-effects from the GLP-1s, including muscle loss and digestive issues.

Consumer product group (CPG) manufacturers are taking note and responding to those facing the more common side-effects, launching new products to support muscle gain that are high in protein and nutrient dense. This is a trend that we expect to continue.

GLP-1 shoppers also appear to be more intentional about their purchases, choosing products and supplements with health attributes such as brain health, muscle health, and microbiome benefits, indexing higher on products that are sugar-conscious, carbohydrate-free, and low in sodium.

Q. How are retailers responding?

Due to the high cost of the branded GLP-1 drugs, which can top more than $1k a month without insurance coverage, new options have emerged for consumers, including direct-to-consumer access to compounded versions of these medications. Grocery store chains are also getting in the game by launching consumer wellness programs. For example, Kroger, H-E-B, and Hy-Vee are rolling out such programs that include wellness visits, nutritional counseling, private-label products, and access to prescription services that include GLP-1s.

Q. What are the headwinds and tailwinds impacting expansion of GLP-1s?

The use of these drugs is on the rise, and the market for these drugs is substantial, with obesity present in 24% of U.S. households, type 2 diabetes in 13% of households, and pre-diabetes in 7% of households. However, many of those who could benefit from these drugs are in lower income households and with the monthly cost as high as $1k without coverage, these drugs are out of reach for many who need it. With this said, 82% of health insurance plans do cover these drugs for diabetes, but only 2% of plans cover these medications as a treatment for obesity. So, should more plans begin to cover these drugs as a treatment for obesity, this could greatly expand access to GLP-1s to those who need it but can’t afford it.

Q. What should food and agribusiness companies be thinking about?

As use of GLP-1s continues to expand, there are both immediate and long-term actions food and agribusiness companies can take.

- Understand relevancy of impact – How much of my customer base is or will be taking GLP-1s? Can we segment which of our customers are taking GLP-1s for weight loss versus for diabetes or both?
- How could lower or higher consumption of some categories and brands impact my company?
- How could we offset the potential of lost volume in some categories if we are impacted?
- Are there opportunities for product expansion or product tailoring to these users?
- How can we refine our marketing and messaging that speaks to current needs?
- Do we need to think about new financial strategies to expand our offerings?

Q. Can you explain the methodology for your research?

In addition to NielsenIQ’s annual Health Shopper study on their consumer panel, the data included in this research report comes from additional consumer panel research on GLP-1 shoppers for weight loss versus diabetes (compared to non-users and total panel). Segmentation of consumers includes when someone in the household started taking GLP-1.

## Robin Wenzel, Head of WF Agri-Food Institute

## Courtney Buerger Schmidt, Sector Manager

Robin Wenzel is a Senior Vice President and the Head of WF’s Agri-Food Institute, a team of national industry advisors providing economic insights, analytics, research, and reporting across the agribusiness, food, and beverage spectrum. With more than 30 years of commercial and corporate banking experience, Robin leads with a strategic vision and an ability to expand and execute on the team’s deliverables to better support Food, Beverage, and Ag customers and prospects.

Robin received her degree in Business from the University of San Francisco with an interest in Finance and International studies.

Robin has long been recognized for her work as a leading voice in the wine industry in Napa, CA. She is also a recipient of the 2017 North Bay Business Journal Women in Business Award.

Courtney Buerger Schmidt is a Sector Manager within WF’s Agri-Food Institute focused on the protein, cotton, and hay sectors. Courtney originally joined WF in 2014 as a relationship manager within The Private Bank Wealth Management group where she spent two years prior to assuming her current role. Before WF, Courtney spent six years as a commodity broker and research analyst with Frontier Risk Management developing hedge and risk management strategies for Agribusiness clients, and also served as assistant director of the research division that focused on livestock, grain, and oilseed.

Courtney holds a Bachelor of Science degree in Agricultural Economics with an emphasis in finance and real estate from Texas A&M University. Courtney was recently selected for Texas Agriculture Lifetime Leadership (TALL) Cohort XVIII 2022-2024. She is also a member of the Texas A&M College of Agriculture Development Council.

KFF Health Tracking Poll May 2024: The Public’s Use and Views of GLP-1 Drugs | KFF

NielsenIQ, Homescan GLP-1 Panel Survey (Aug/Sep 2024)

MSA through integration of NCP and EMR data as of September 2024

NielsenIQ, Homescan GLP-1 Panel Survey; Total US; Total Outlets; Total Store (All departments), Dollar and Unit % Change vs YA, Latest 52 weeks ending September 28, 2024

Nielsen IQ

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