OW2024: Five Thoughts We’re Taking Home from ObesityWeek

We have a lot to think about. Well over 3,000 people spent the better part of the week absorbing new science and insights into obesity – not to mention a momentous election. So as everyone sets about the task of catching up with routines, here is a quick take on five thoughts about what we’re processing from ObesityWeek 2024.

New Options, Opportunities, and Energy

This meeting was filled with energy from quite a number of new people, new options, and new opportunity. This was the largest meeting yet for ObesityWeek since the pandemic. That means a big infusion of new people bringing fresh energy and perspectives.

The coming proliferation of new options for treating obesity underpins this excitement. Scientists presented detailed neuroscience on the activity of CagriSema on amylin and GLP-1 receptor systems. Another new drug targeting amylin receptors, petrelintide, garnered attention with a presentation of phase 1b data suggesting the possibility of advantages for effectiveness and tolerability. Viking generated buzz with phase 1 and phase 2 data on VK2735, a GLP-1/GIP co-agonist in an oral formulation. Then AstraZeneca pushed Viking out of the spotlight with data on their oral GLP-1 agonist, which also has the advantage of being a small molecule that might be easier to manufacture.

The list of new drugs for obesity in early stages of development is quite long. Though many of them might not make it to market, it is clear that the opportunity is great because the unmet medical need is tremendous.

A Better Understanding of Obesity

The old, simplistic understanding of obesity held that this “diet-related” disease was hardly a disease at all. It was viewed at best as a behavioral risk factor – the consequence of eating too much and moving too little.

For some time, the scientists who study the biological basis of obesity have understood how wrong this thinking is. The more current, more accurate understanding was on display in the meeting halls and articulated throughout diverse sessions. Better yet, it is creeping into public discourse.

On top of that, we got a sneak peak at the Lancet Commission work to define clinical obesity. You can expect to see a full publication in mid January. In our view, it will move us all to a clearer distinction between people who are at risk for health impairment and people who have a genuine clinical diagnosis of obesity. It will also prompt a robust discussion about the disease.

All Eyes on the Long Term

Some of the most compelling clinical data of this meeting came from presentation of three-year outcomes from the SURMOUNT-1 study of tirzepatide. Preventing diabetes in 99% of people with pre-diabetes and obesity is indeed compelling. The full publication of these data in NEJM next week is something we are awaiting eagerly.

This is just one reading from a growing body of research that focuses on long-term health outcomes. A detailed dive into insights from the SELECT study offered further evidence. Obesity care increasingly focuses on delivering major improvements in long-term health outcomes. The scope of benefits from effective obesity care is becoming quite broad.

Equity and Access

These compelling benefits have little value without equitable access to care. The focus on this concern was evident from the very beginning of ObesityWeek with the presidential plenary. It was woven into every day of the meeting. And equitable care means care that is free from stigmatizing and often implicit weight bias.

Delivering the Care

The nitty gritty details of delivering obesity care at scale received attention far more at this meeting than it has in prior years. A joint symposium of TOS, ASMBS, OAC, OMA, and the STOP Obesity Alliance regarding the implications of new ICD-10 codes for use in reporting obesity care might sound like an excursion deep into the weeds. But it drew a standing-room-only crowd. That’s just one sign of the focus on delivering care.

Another indication is the enthusiastic reception of the report of success in delivering obesity care through a large primary care in rural North Carolina. The need is great and so is the enthusiasm for scaling up the delivery of obesity care.

A Needed Boost

We needed this boost of inspiration and energy. Despite all the progress on many fronts related to obesity, much work remains to be done. In San Antonio, we met many of the fresh, new faces of people who will get it done.

Flying Home, photograph by Ted Kyle / ConscienHealth

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November 7, 2024