Filling the Gaps in Obesity Care

At the National Academy of Sciences yesterday, the Roundtable on Obesity Solutions presented a workshop with 27 expert speakers covering the full range of challenges in treating obesity. It started with current options. It extended to pathways for innovation and considerations of payment systems and health policy. One thing was abundantly clear. We have many underused options and many gaps in obesity care.

What It Takes to Treat Severe Obesity

Let’s start with severe obesity. It can be disastrous for health. Roughly five million children and 20 million adults are living with it. Ihouma Eneli, Susan Woolford, and Mark Michalsky explained that options ranging from family based care to bariatric surgery can be quite helpful for children with severe obesity. But they described daunting barriers to delivering that care. Only a fraction of children with severe obesity actually receive care that will change the course of the disease.

Louis Aronne explained what it takes to treat severe obesity: a diverse and experienced team, treatments that work, and payment systems that make it possible. Assembling a team is doable. The options for treatment are growing.

But the payment systems are not keeping up. Payment systems, unfortunately, favor treating the complications of severe obesity. Meanwhile, the disease of obesity progresses without treatment. The complications multiply. Medical costs spiral out of control.

Filling the Gaps in Obesity Care

Obesity Society Vice President Steven Heymsfield explained a bit about the growing base of science pointing the way to better therapies. Though much of the risk of obesity is genetic, most often it’s not the result of a simple single-gene defect. Multiple genes play a role.

Those rare, single-gene defects provide a window into pathways that lead to obesity. They also lead to some dramatic cures for a small number of patients.

But even more important, they are providing new targets for new treatments that can benefit even more patients. New peptides, new combination therapies, new metabolic and neurologic pathways, even new medical devices – they’re all offering promise for better tools to treat obesity.

Click here for more on the workshop, here for Aronne’s presentation, and here for Heymsfield’s presentation.

Hadrians Wall, Sycamore Gap; photograph © Gail Johnson / flickr

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April 7, 2017