A Snow-Trodden Labyrinth in Kärdla Vabriku

The Twisted Path to Better Obesity Medicines

We are clearly on a path toward better obesity medicines, but reflecting on decades of work on this, clearly, the path is twisted. Describing this path, Gina Kolata writes:

“Every so often a drug comes along that has the potential to change the world. Medical specialists say the latest to offer that possibility are the new drugs that treat obesity — Ozempic, Wegovy, Mounjaro and more that may soon be coming onto the market.

“It’s early, but nothing like these drugs has existed before.”

From Discovery to Adoption

Much of the chatter about these early days of actually using these drugs in obesity describes it as a “craze.” As in crazy. This reflects the fact that the use of obesity medicines in mainstream medicine is truly at a very early stage. Compared to standard medical care just a couple of years ago, routine use of obesity medicines seems radical.

In all the years that doctors have been talking about obesity as a problem, the standard approach has been to do very little. “Instruct the patient to lose weight” was the sum of what most healthcare providers would do and that is largely ineffective.

But now, people who live with obesity are driving adoption of these new medicines. In The Daily podcast New York Times reporter Dani Blum describes one successful and one unsuccessful user of GLP-1 medicines. The person who had less success was seeing a nutritionist specializing in intuitive eating, She was “at peace” with food and her weight. But then her doctor suggested Ozempic for weight loss. She went along with the recommendation and it was not a good experience.

The person who had more success drove the process. She is a mental health professional and she sought out a prescription for tirzepatide from a specialist. The only advice from her primary care provider had been simply “to lose weight.”

These are merely anecdotes, but they say lot about these early days of transformation in obesity care. Primary care professionals seem less than fully ready to adopt these new medicines and deliver the patient-centered care that obesity requires. This will take time. Where change is happening, patients who feel a clear need for better care are seeking it out.

The unmet need is tremendous, so demand, even in these early days, is outstripping supply.

Medical Innovation That Takes Time

One thing should be clear by now. Adoption of innovation in obesity care will take time. In Health Affairs, Andrew Bates and Wendy Chapman explained factors that contribute to this. Some innovations gain traction too fast and patient care suffers. Others fail to take hold for years and ineffective care remains the norm for too long.

“Responsive policies have the opportunity to facilitate the diffusion of innovation in health care,” they conclude.

Certainly, diffusion of innovation in obesity care will be an important target for such policies.

Click here for Gina Kolata’s description of the twisted path for innovation in obesity medicines. For the podcast with Dani Blum, click here.

A Snow-Trodden Labyrinth in Kärdla Vabriku, photograph by Hiiumaa Mudeliklubi, licensed under CC BY-SA 4.0

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September 19, 2023