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Potent new anti-obesity drugs can reduce body weight by 15-20%. However, regulation and costs limit who can take them. In America, the Food and Drug Administration (FDA) has approved just one of the new drugs, Wegovy, for weight loss—and only for patients with a body-mass index (BMI) above certain thresholds. The cut-off is 27 for people with weight-related illnesses, and 30 otherwise. For someone 1.7 metres (5’7”) tall, these correspond to 78kg (172lb) and 87kg. People with lower BMIs can try to get a prescription anyway. However, insurers rarely cover such “off-label” use of the $1,000-per-month drugs.

BMIs vary between racial groups. According to the National Health and Nutrition Examination Survey, run by the Centres for Disease Control and Prevention, Asian-Americans aged 18-75 have an average BMI of 25, compared with 29 for whites, 30 for Hispanics and 31 for black people. As a result, few Asians meet the FDA’s criteria.