The healthcare system is rethinking obesity

Illustration of a tape measure around a bottle of pills.

Illustration: Shoshana Gordon/Axios

Doctors and medical experts are leading a rapid cultural shift around obesity, seeing it as a disease rather than a lifestyle choice.

Why is this important: This change opens up new treatments and better care – but also new controversies about who can access these treatments and how best to use them.

What they say : “Obesity is a widespread chronic disease characterized by excessive accumulation or distribution of fat that poses a health risk and requires lifelong care. Virtually every system in the body is affected by obesity,” recently wrote six obesity advocacy organizations in a joint statement. .

  • “Every obese person should have access to evidence-based treatment.”

Driving the news: An existing class of diabetes drugs has shown tremendous promise for weight loss, offering a ray of hope for millions of obese Americans.

Yes, but: Many insurers, including Medicare, will not cover these weight loss drugs. And they can be unaffordable without insurance coverage.

  • Wegovy, which is conditionally approved for weight loss, has a list price of $1,349 for a one-month supply.
  • “The majority of my patients can’t afford to pay $1,300 a month, especially for a drug they need long-term,” Veronica Johnson, an obesity specialist at Northwestern Medicine in Chicago, told NBC News.

The other side: Kristine Grow, spokesperson for U.S. health insurance plans, recently told Axios that the therapies have limitations and “have not yet been proven for long-term weight management and may have complications and adverse effects on patients”.

  • The same class of drugs can also be misused. Some digital health startups are advertising and prescribing the drugs to people who aren’t overweight, The Wall Street Journal reported this week.

Between the lines: The treatment landscape is rapidly changing for both children and adults.

  • New guidelines released last month by the American Academy of Pediatrics recommend not delaying treatment for obesity in children and argue that doctors should be proactive about approaches such as intensive health behavior and treatment of obesity. lifestyle and, in some cases, prescription drugs or surgery.
  • But the councils are already backing off. Eating disorder specialists, for example, warn it could backfire, NPR reported this week.
  • “We run the risk of doing a lot of harm to 6- and 8-year-olds by telling them they have a disease…simply based on their weight,” eating disorder expert Kim Dennis told NPR. .

What we are looking at: A An unusual array of interest groups is already pushing Medicare to cover obesity drugs, reports STAT.

  • And more generally, the existence of an effective treatment raises big questions about how to prevent another prescription drug from being commonly misused – and how to balance access to treatment for obesity and the risks of perpetuating stigma.

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