BY TZVI DORON4 MINUTE READ
What has hundreds of millions of views on TikTok videos about it, daily headlines breaking down what you need to know about it, and thousands of people asking, “Where can I get it?”
No, I’m not talking about how to get Taylor Swift tickets. I’m talking about a new class of medications offering a first-of-its kind promise for those with weight-loss goals: glucagon-like peptide 1 (GLP-1) agonists, or Wegovy, to name one for easier googling.
GLP-1 medications support weight loss by sending signals to the brain and body that help regulate appetite and help patients feel full and satiated longer. With GLP-1 medications and lifestyle adjustments, patients can anticipate losing 10% to 18% of their body weight over the course of a year. It’s not often that there’s this groundswell of excitement about new prescription medicines. Put simply, the results seen with GLP-1 medications are game-changing.
Brushing off this new class of medications as a fad or social media trend—as we’ve seen headlines and even some doctors do—is a mistake. It highlights the legacy of weight bias and the failure to recognize obesity as a complex chronic condition.
GLP-1 medications, in reality, represent a clean slate for how we treat one of the most common chronic conditions in the U.S. As a physician trained in obesity medicine, I think it’s critical we seize this opportunity.
STOP BLAMING PEOPLE FOR THEIR WEIGHT
We can do this only if we first stop blaming people for their weight. Yes, the country has seen a steady rise in people who are overweight and/or with obesity—climbing to more than 70% of adults today. But this is not due to a lack of willpower on their part. Nearly half of American adults try to lose weight each year. Most fail. In fact, in a recent survey of weight-loss patients, half had tried four or more weight-loss methods.
The uncomfortable truth is that the advice to change one’s diet and exercise habits alone does not help most people lose weight or keep it off. This is due to powerful biological signals from the brain that work to maintain our body weight. Most patients living with obesity are motivated to address it, so it’s high time we put aside weight bias and support them with the most effective means of weight loss.
REMOVE BARRIERS TO GLP-1 MEDICATIONS
The second thing we need to do is expand access to GLP-1 medications for more patients. The Food and Drug Administration has so far approved Wegovy and Saxenda to treat adults with obesity or overweight plus at least one weight-related condition. Another medication, tirzepatide, which is branded as Mounjaro, is actively seeking approval to use for weight loss this year and has shown an astounding 20%-plus weight loss in a clinical trial. Approval of one or more other promising GLP-1 medications would add options to the toolbox of effective medications to treat obesity.
There remain two major blockers to access—providers’ hesitancy to prescribe them to those with obesity, and insurers’ insufficient coverage of them. Neither clinicians nor health insurers extend these access limitations to GLP-1 medications for treating diabetes. This practice—positioning obesity as somehow less deserving of treatment than diabetes—is another sign of weight bias. It is also shortsighted, considering obesity’s role as a risk factor for many other diseases, including heart attacks, strokes, mental health conditions, and some types of cancer.
It is not an either-or scenario to treat those living with one chronic disease or another, as some news coverage has painfully implied. The shortage of GLP-1 medications is serious—as are any drug shortages—but shaming a set of patients for seeking treatment does the shortage no good and precipitates further discrimination. The answer to drug shortages should never be to pit patients with different diseases against each other. The answer to drug shortages should be to fix the shortages.
Patients with obesity, whether they are family, friends, or a celebrity we see on television, deserve access to this incredible tool. If these revolutionary medications were for other chronic diseases, there would be no question about that. Everyone deserves to benefit from treatment options available through their provider and insurance coverage.
TREAT OBESITY AS A CHRONIC CONDITION
Lastly, we need to accept obesity as the chronic condition it is and provide the same type of care for it as any other chronic condition. This means engaging patients and providers in a partnership with frequent touchpoints and open communication. This is important, as patients receiving treatment with GLP-1 medications frequently experience side effects and start on a lower dose before progressing up as deemed safe and appropriate by their doctor. Unfortunately, it can be difficult for patients to get this kind of care in our system that’s plagued by provider shortages, long wait times, and short visits with doctors.
Telehealth shows great promise for improving obesity care for patients—easing access, improving the experience, and supporting greater treatment adherence. This is not entirely new; it’s been the case for other chronic diseases. As more patients learned during the pandemic, telehealth can help overcome geographic, mobility, and affordability barriers to care. These advantages are well-suited to be paired with prescription GLP-1 medication to more conveniently connect patients with safe, high-quality care.
For decades, people have been told their struggle with weight is a failure of self-control or discipline. The science of obesity tells us nothing could be further from the truth. We must support people determined to lose weight by giving them access to both the prescription treatment and provider-led care they need to succeed. Let’s seize the opportunity we have to transform obesity care and help millions of people live healthier, longer lives.
Tzvi Doron is the chief clinical officer of Ro, the direct-to-patient healthcare company, and is board-certified in family medicine, obesity medicine, and clinical lipidology.