Telephone Conversation

Telemedicine or Telehealth for Obesity?

Before the COVID-19 pandemic, we could find lots of talk about the potential of telehealth – and see its potential for extending the reach of obesity care. Translation into action and care delivery, though, was very slow. When the pandemic became a constraint for face to face care delivery, that changed overnight. Telehealth care for chronic diseases – including obesity – gained sudden broad acceptance. Many patients are benefitting. New businesses are emerging.

But with that sudden growth we are seeing some very clear growing pains. So it’s worthwhile to consider the difference between a very narrow definition of telemedicine and a much broader concept of telehealth.

A “Wild West” of Online Prescribing

Recently in Stat, Katie Palmer wrote about the very narrowest implementation of telemedicine for obesity care. It is a growing surge of online prescribers that seemingly exist solely to deliver prescriptions for new, advanced obesity medicines. Obesity medicine physician Scott Kahan explained to Palmer:

“A lot of these companies, unfortunately, hold the GLP-1s up and sort of dole them out like candy.

“When you create these conveyor belt treatment programs, I think that’s where you risk more blanket inappropriate care, or really stretching the bounds of what’s medically appropriate.

“When you have a hammer, everything looks like a nail.”

So with a very narrow vision for telemedicine in obesity, the inevitable problem is that obesity is a complex chronic disease that requires chronic care. And that’s different from simply handing out prescriptions.

Thinking Through the Full Potential of Telehealth for Obesity

With a new review for Advances in Therapy, Nigel Hinchliffe and colleagues offer an excellent overview of the full potential for telehealth in obesity care. They see great promise for delivering better chronic care more efficiently. But they caution that thoughtful implementation will be necessary to realize this potential:

Digital health solutions have the capacity to improve access to obesity care and reduce health inequalities. But careful consideration is needed to avoid digital health becoming available only to those who can afford the technology or have the digital literacy to take advantage of it. Otherwise, existing inequalities will only be exacerbated

Purely profit-driven care models will not bring us to a better place in obesity care. We need purpose-driven providers and health systems that focus on unmet needs for better health in diverse populations. In short, we need systems built to deliver real care, not just haphazard products and services because they’re billable.

Click here for the reporting in Stat and here for the Hinchliffe review. For further perspective on the emergence of telehealth for chronic disease care in the pandemic, click here.

Telephone Conversation, lithograph by Moriz Jung / Wikimedia Commons

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.


August 10, 2022