How Do We Feel About 40,000 Unnecessary Obesity Deaths?

It was an interesting day that we spent talking with health policy makers in the Senate yesterday. Refreshing in a way, because the conversations about obesity are so different from the conversations we were having just a few years ago. Not a single person raised the false issue of “personal responsibility” for “being obese.” Only a few years earlier, this would have come up in half of our conversations. Instead, what had more resonance was a question that Bernie Sanders raised in a Senate HELP committee hearing on Tuesday. How do we feel about 40,000 unnecessary obesity deaths?

He was directing that question at the CEO of Novo Nordisk, blaming poor access to semaglutide on Novo’s high price for the drug. But everyone with a role in health policy and health systems is realizing they should be asking this of themselves.

For years, we have been permitting unnecessary obesity deaths by systematically denying people access to obesity care.

A New Study in AHJ

Sander’s question was well-informed. In a new study in the American Heart Journal, Jay Lusk and colleagues analyzed the population in the U.S. that might be eligible to benefit from taking semaglutide to treat obesity and prevent heart attacks, strokes, and deaths. They found that about 4.5 million American adults would meet that criteria. If only half of them received the drug over a four year period, the result would be 22,117 fewer deaths and total of 35,633 fewer major cardiovascular events. The latter number includes heart attacks, strokes, and deaths due to heart disease.

So Bernie simply took the number to 100% utilization and rounded it off to an opportunity for preventing 40,000 deaths. This was a well-informed question.

Obesity Care Is Preventive Care

In the now obsolete way of thinking of obesity, people used to get stuck on a false dichotomy. “We need to spend our money on preventing obesity, not treating it,” they would tell us. But with better options for obesity care and 40% of the population living with this chronic disease, we now know that obesity care is preventive care. It offers an opportunity to prevent the leading cause of death in the U.S. – heart disease. Likewise, it is remarkably effective for preventing diabetes and kidney disease. The list is getting longer.

So the real question is: How long will we tolerate all of the unnecessary deaths and suffering that come from denying people access to care for obesity. Drug prices are part of the problem, but there is much more that needs to change throughout our systems for healthcare.

Click here for the study in AHJ, here, here, and here for other relevant papers.

The Vision of Death, engraving by Gustave Dore / WikiArt

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September 26, 2024