Star of the Hero

The Best and Worst of 2022

This has been a good year in so many ways. COVID has moved into the background and people have been reconnecting. We’ve seen remarkable progress in understanding and care for obesity. Of course, we’ve hit some low points that help us to appreciate highlights even more. So here for your consideration is our short list of some of the best and worst moments of 2022 related to health and obesity.

1.  Better Obesity Meds

This was an easy pick. Eric Topol calls the emerging generation of obesity meds “an extraordinary advance in medicine.” Before semaglutide, most options for treating obesity (diet, exercise, and earlier obesity meds) were not reliably very effective. Surgery remains a highly effective, but daunting option. With these new meds, we now can expect medical care will make obesity something that people can control. It will no longer need to get in the way of healthy, happy, and successful lives.

Semaglutide was the first of these breakthroughs, but more (like tirzepatide) are coming fast. They signal a new era in obesity treatment.

2.  Real Pediatric Obesity Care

For years now, pediatric obesity care was stagnant. “Eat less, move more, and maybe some of these kids will grow out of it.” That was the standard and often unhelpful advice. But a great shift started with the acceptance of bariatric surgery in policy guidance from the American Academy of Pediatrics. It continues with impressive advances for medical obesity care in kids. New guidelines from AAP that reflect these advances are due in early 2023. We are on a thrilling trajectory for progress.

3.  Serious Thinking About Obesity Causes

John Speakman, David Allison, and Kevin Hall brought together some of the brightest people in this field to dig deeply into the causes of obesity. No simple answers, but a milestone in progress toward understanding this complex, chronic disease.

4.  Attention to Diverse Lived Experiences

This was a year when potent voices stepped up to speak out for the lived experience of people with obesity. Our voices are the essential ingredient for bringing weight bias to an end.

5.  Ozempic 2.0 mg Pricing

Drug pricing in the U.S. is messed up. So when a high dose (2.0 mig) form of the Ozempic brand of semaglutide for diabetes came out at the same price as lower doses, this was good news. It’s not cheap, but the approach is fair. Patients who need a higher dose don’t have to pay a higher price.

1.  Dropping Life Expectancy

This is nothing short of terrible – a jaw-dropping loss of life expectancy in the U.S. Final figures from CDC recently confirmed this shamefully bad news. We can do much better than this.

2.  The Tangled Obesity Care Supply Chain

Problems with an adequate supply of the breakthrough obesity drug semaglutide snowballed in 2022. Those problems are the tip of a much deeper problem with meeting the medical need for obesity care.

3.  Persistent Disparities

Mercy and grace are at the heart of the American Dream, but huge and persistent health disparities are unmistakable features of real life in America. In food security, diet quality, and obesity, these disparities stand out. Disparate access to obesity care and new obesity meds is especially egregious.

4.  Enduring Implicit Bias

To be sure, explicit weight bias is a lesser problem than it once was. But the expression of weight bias has gone from loud to quiet as implicit bias persists. It’s everywhere we turn and people who think it’s not a problem where they live or work are deceiving themselves. This must change.

5.  Wegovy 2.4 mg Pricing

This is, quite simply, a mistake. The same company, which charges no premium for the 2 mg form of semaglutide under the Ozempic brand for diabetes, charges a premium price for the Wegovy brand of semaglutide for obesity. The only reasonable explanation is that this is a symptom of a broken system that puts effective medicines out of reach for many people.

Star of the Hero, painting by Nicholas Roerich / WikiArt

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December 26, 2022