Handle with Care

Getting a Handle on Better Obesity Care

It’s a little hard to tell if we’re making progress toward better obesity care. Maybe that’s why it’s important to start a conversation about obesity care with National Obesity Care Week.

It’s not like we’re lacking for headlines about obesity. You can find lots of talk about obesity everywhere you turn.

The problem is that all that talk really isn’t helping because it’s so focused on a symptom of obesity — excess weight — while ignoring the actual medical condition and the need for good medical care for the chronic disease of obesity. Primitive thinking about obesity assumes that if you want it bad enough, you can make obesity go away through sheer force of will. We would never think that about diabetes, or heart disease, or cancer, but it’s the kind of thinking that dominates the public’s thinking about obesity. So people living with obesity are often left to figure out out on their own. Yes, we definitely need a conversation about medical care for obesity.

We don’t have any cures for obesity — it’s a chronic disease. But we have plenty of good, evidence-based tools for keeping it under control and preventing the other chronic diseases that result from obesity — diabetes, heart disease, and cancer to name a few. Yes, there’s even good evidence that aggressively treating obesity can help with the risk of cancer.

But the dominant, primitive thinking about obesity means it’s slow going for professionals who make the commitment to deliver obesity care. They face constant battles with health plans that would rather put off the bills for obesity care and hope they don’t get stuck with much bigger bill for the chronic diseases that result.

For people developing innovative obesity treatments, it’s even tougher. Vivus, Arena, and Orexigen are three small, innovative firms that spent years developing new drugs for obesity, hoping for a blockbuster if they could reach even a small percentage of people with obesity. But reimbursement hurdles and the small number of doctors ready to actually treat obesity meant that none of these treatments have yet to reach enough people to pay a significant return on the considerable investment to bring them to market.

The latest entry into the market — Saxenda (liraglutide 3 mg) from Novo Nordisk — is showing signs of changing that dynamic. Launched earlier this year with modest expectations and a relatively high price, this injectable treatment has already exceeded forecasts. Last week, Novo Nordisk reported “a significant positive contribution from the US launch of Saxenda” to their third quarter sales results. They report that:

Market access for Saxenda is improving, launch activities are progressing as planned and early feedback from patients and prescribers is encouraging.

These results are especially encouraging when you consider that Saxenda is an extension of Novo Nordisk’s standout drug for diabetes — Victoza. Because of the close relationship between type 2 diabetes and obesity, it may well be that Saxenda is enhancing the image of Victoza in the diabetes market. Indeed, despite new competition, Victoza (already a multi-billion-dollar drug) is growing robustly, up 24% so far in 2015.

If this success continues, pressure will build on other innovators in diabetes care to take obesity more seriously. They may have to do it to stay competitive. If even half of the resources that go into diabetes care were to flow into the realm of obesity care, everyone would benefit. People with obesity would have more options, research would accelerate, and providers would get fair compensation for delivering obesity care.

We can hope.

Click here for an interview with obesity medicine physician Justin Puckett about National Obesity Care Week.

Handle with Care, photograph © Manuela Hoffmann / flickr

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November 3, 2015