It’s always a successful day at the office for
Fatima Cody Stanford, MD, MPH, MPA., when you can review a patient’s history, see a diagnosis of diabetes, high cholesterol or hypertension and see the progress in their health or the resolution of a health problem.
Shanna Tucker, MD, an obesity medicine specialist at NYU Langone Health, has a similar standard. If you can reduce the dose or stop prescribing medications for one of these diseases, you will know your patient is on the right track.
When obesity medicine specialists help patients lose weight, their overall goal is much greater than achieving lower numbers on the scale. When treating a patient’s obesity, specialists also help patients manage and resolve other chronic conditions that threaten their overall health.
“Most of my patients have been with me for a decade or more, so this is a lifelong commitment to their chronic disease of obesity,” said Stanford, an associate professor of medicine at Massachusetts General Hospital and a physician. scientist in obesity medicine. “I want to help them eliminate diagnoses from their history, from obesity itself to diseases associated with obesity.”
Obesity can
reduce life expectancy because it generally increases the risk of other chronic conditions and diseases, such as diabetes, heart, kidney and liver disease. And it can also contribute to sleep problems, joint pain, mental health problems, and some types of cancer. It was also found to be a major risk factor for Covid-related hospitalization and death.
Rising rates of obesity have created a major public health problem in the U.S. More than
1 in 3 adults and 1 in 5 children lives with obesity, the US spends more than $147 billion one year on obesity-related healthcare.
Tucker said many patients come to her frustrated because they are already eating well and exercising. They have lost some weight, but they can’t seem to lose any more or their weight has started to go up. They are also battling chronic diseases that are made worse by obesity.
“There may not be enough medical providers who understand that sometimes additional treatment is necessary for many patients,” Tucker said.
The benefits of anti-obesity medications.
Obesity medicine specialists design plans for patients that may include a combination of lifestyle management, medication, and, in some cases, surgery.
Anti-obesity medications (AOMs) have received a lot of attention in the media, and many public figures attribute their weight loss to the use of these medications. While anti-obesity drugs are not new, the FDA was the first to start
approving them in 1959 — the current class of GLP-1 medications such as semaglutide have become household names (Ozempic/Wegovy and Mounjaro/Zepbound) for their ability to help people achieve significant weight loss.
While weight loss achieved through GLP-1 medications grabs the headlines, obesity medicine specialists take a broader view of the benefits of the medications and see how they can offer faster resolution to chronic diseases. TO
meta-analysis (a review of many studies) shows that anti-obesity drugs can contribute to a significant reduction in cardiovascular events, such as heart attacks and strokes, and hospital admissions for heart failure in people with type 2 diabetes.
Tucker said people living with obesity don’t have to lose a lot of weight to see results. Even just one
5%-10% weight drop It may help improve high cholesterol or high blood pressure. Weight loss may also be important for improving quality of life, such as allowing people to move more easily, sleep better, experience less joint pain, and have more energy.
“I know many people don’t want to start taking a new medication, but when treating obesity, I have had patients who have lost a significant amount of weight and were able to start lowering the dosage of their diabetes medication or even stop their diabetes medications. high blood pressure or high cholesterol,” Tucker said. “I say consider the bigger picture about the potential benefits of anti-obesity drugs.”
Barriers to obesity treatment
Although effective obesity treatment can improve health outcomes and generate substantial savings for the nation’s healthcare system, many Americans do not have access to obesity care.
There are not enough health care providers trained in obesity medicine, Tucker said, and the cost of the medications themselves can prevent patients from being able to obtain them. There is also no guarantee that the drug will be covered by insurance or available to Medicaid and Medicare beneficiaries.
“I think we’re really doing a disservice to these patients,” Tucker said. “They already sought help, made an appointment and came to my office. “To get this far and not be able to prescribe a medication because of insurance is very disappointing.”
Since each state Health insurance Although the plan has its own policies for coverage of obesity treatment, many people do not have access to anti-obesity medications. And, at the federal level, Medicare Part D still prohibits AOM coverage for most patients, even though people covered by the Veterans Affairs/Department of Defense and Federal Employees Health Benefits plans have access to full continuum of care for obesity. Stanford said he hopes Law to treat and reduce obesityFirst introduced in Congress in 2012 and reintroduced every session since, it will become federal law to help expand coverage for Medicaid and Medicare patients.
See: Congressional Report: Ensuring patient access to effective treatments for obesity >>
Stanford said he has seen older adults who have made significant progress in eliminating chronic diseases through treatment lose all of their progress when they enroll in Medicare and can no longer afford their medications if they lose coverage.
Stanford also pointed out other disparities in who is most likely to have access to treatment.
“The populations most likely to benefit, particularly racial and ethnic minorities here in the United States, are struggling to get these medications,” Stanford said. “We have to get over the idea that people simply need to eat less and exercise more, which is not based on science. I want to change that narrative. “We can do better to help those in need.”
Still, for people struggling with obesity and other chronic health conditions, Tucker said it’s worth talking to your healthcare provider to see if some type of obesity treatment can help.
“I know some patients may want to avoid the topic and I can understand why for many reasons,” Tucker said. “There is a lot of prejudice against obesity or weight in the medical community. I encourage people to at least ask their [healthcare provider] “What resources are available if they are interested in losing weight so that they have all the information and resources that will help them take the best next step.”
Help us increase access to obesity treatment >>
This educational resource was created with the support of Novo Nordisk, a member of HealthyWomen’s Corporate Advisory Board.
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