The rapid growth in GLP-1 use could reshape the U.S. agricultural landscape

Abstract The diffusion of glucagon-like peptide-1 receptor agonist medicines (GLP-1s) could reshape food systems through reduced food intake, but its economy-wide consequences remain unclear. We combine Bayesian projections of adoption, discontinuation, and reinitiation of GLP-1s in the United States, Canada, and Mexico with RCT-anchored dietary responses to estimate a recursive-dynamic computable general equilibrium model. By 2030, U.S. active treatment prevalence reaches 15.6% under current eligibility and access conditions and 28.4% under expanded weight-management access, generating food-demand reductions of 3.9–6.4% and 7.1–11.6%, respectively. Markets absorb these shocks through changes to domestic production, imports, exports, and prices rather than through changes to domestic production alone. Broader North American diffusion primarily reshapes bilateral trade, whereas expanded access scales U.S. adjustments. Agricultural land rents fall 2.3–2.4% under current conditions and 4.1–4.2% under expanded access, while wages and capital returns change little. These conditional counterfactuals show how pharmaceutical innovation can reshape food-system outcomes.