The Necessary Scale for Obesity Care and Population Health

The Hovel and the SkyscraperReports of first quarter business results from Novo Nordisk and Eli Lilly this week leave no room for doubt. The utilization of obesity treatment is growing at a rate that has caught both of these companies by surprise. Wegovy sales more than doubled in the first quarter of 2024. On top of that, new prescriptions for Zepbound surpassed Wegovy. And yet the scale of resources to meet the medical need for obesity care is far short of what the challenge requires.

Signals of this gap are easy to find. Perhaps the clearest signal comes from the fine print of Novo Nordisk’s report. The company notes that even after a year of tremendous growth in their obesity medicines, no more than a million people are receiving them. That is roughly 0.1% of the people living with obesity.

So no. Health systems are not even remotely on track to meet the need for obesity care at the scale that people will require. It should be completely unsurprising that these companies cannot keep up with demand.

In comparison to volume of need, the flow of treatment is barely a trickle.

A Luxury for a Few?

Should we be comfortable with the notion that obesity care is presently a luxury for only a few of the people with a real medical need for it? The proliferation of telehealth providers in obesity suggests that quite a few innovators are not. One of these companies, Ro, intends to prove it can close this gap. CEO Zachariah Reitano expressed this in announcing a “look under the hood” at their systems for delivering care:

“High-quality care shouldn’t be a handmade luxury good. As a society, the only way that we have turned luxuries that only the few can access into commodities that everyone can access is through technology. That’s exactly what we set out to do at Ro.”

Delivering Obesity Care at Scale

David Arterburn has explained in compelling terms that obesity medicine, delivered at scale, has the potential to improve population health in ways that decades of efforts to “tackle” obesity have failed to do. He calls it the “bright and bumpy future” of obesity care.

Some of the bumps on the path to this future will come in the development of adequate scale in care systems to meet the need across the population. We imagine this difficult task has great promise.

But it will be up to Ro and a host of other innovators to demonstrate they can deliver on that promise.

Click here for more on the rush to develop telehealth systems for obesity care. Here you can find an analysis (in preprint) of outcomes from one of the telehealth obesity care systems. For more on the potential of obesity care at scale to improve population health, click here.

The Hovel and the Skyscraper, painting by Childe Hassam / WikiArt

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May 3, 2024