OW2023: Five Things We Will Remember

The week that was OW2023 is history now, leaving us to reflect on what we will remember from this gathering of the top minds in obesity science, clinical care, and health policy. The meeting comes at a pivotal time for obesity care, so we have much to learn from the people who came together here.

1. Tirzepatide and More
Raising the Bar

The big new release of data came from the SURMOUNT-3 study of tirzepatide in obesity. These were stunningly good results that clearly go far beyond the help that the old eat-less-move-more could offer. What’s more, we heard about a host of new agents progressing through clinical development – activin targeting agents, dual and triple agonists, , to name a few examples. They offer the prospect of a robust armamentarium of medical treatment options to complement the substantial benefits of metabolic surgery.

2. The Price Tag for Health

But here’s the thing that has many people worried. How much are the lives of people with obesity worth, anyway? “The cost of treating obesity could put companies out of business!” says one Wall Street executive. Elaine Chen reports for Stat News that drug companies worked hard at OW2023 to argue their drugs offer good value despite a high price tag.

This is a tricky argument for two reasons. One, the pricing is opaque by design. Pharmacy Benefit Managers (PBMs) demand big secret rebates on these drugs, cutting the price by half or more. But those discounts often don’t pass through to patients or the people who pay for health insurance. So PBMs are under pressure to reform.

Two, suggesting that people are not worth the expense of treating them would never fly for most other diseases. Cancer drugs carry huge price tags, but people demand treatment. By comparison, people with obesity have long been dehumanized and dismissed. This is offensive.

3. Voices and Lives

The voices and lives of people who live with obesity were more visible than ever before at OW2023 and this may be what we remember most. Sarah Bramblette spoke movingly about her lifetime of dealing with obesity and lipedema. Patients, researchers, and advocates presented a symposium on the integration of lived experience into obesity research. Robyn Pashby and Maya Cohen presented on addressing the corrosive effects of weight stigma. These themes were pervasive in the meeting.

4. An Overwhelming Environment

While the options are expanding for care of people with obesity, we saw less innovation in strategies for reversing the increasingly obesogenic environment in which we live. Tera Fazzino and colleagues presented a host of abstracts about hyper-palatable and ultra-processed foods.

But we keep hoping for a more complete consideration of the diverse factors driving obesity and policy interventions that will have a measurable effect on obesity trends.

5. Systems and Standards for Care

The systems and standards for care in obesity are struggling to catch up with advances in biotechnology. One spark of good news came with TOS President-Elect Jamy Ard announcing an initiative to develop standards of care for obesity in collaboration with a broad range of stakeholders in obesity.

Bring it on. All too often, people with obesity get substandard care.

The Gate of Memory, painting by Dante Gabriel Rossetti / WikiArt

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October 19, 2023