Navigating the Landscape of Obesity

Today's healthcare leaders are at the forefront of transformation, aiming to drive significant change at the nexus of healthcare innovation and health equity. Within our ecosystem, we recognize the profound opportunity to effect meaningful change in how we interact with and treat each other, both as humans and as patients.

As discussions around obesity treatment evolve, it has become increasingly imperative to consider the intersecting issue of health equity. Our current landscape reveals stark disparities in obesity rates, access to care, and health outcomes across different racial and socioeconomic groups, underscoring the urgent need for comprehensive solutions. While strides have been made in recognizing obesity as a significant risk factor for various chronic conditions, including type-2 diabetes and heart disease, the healthcare system still faces significant challenges in providing equitable access to effective treatments. However, amidst these challenges, there is a growing momentum for change. 

The emergence of novel medications, such as GLP-1s, shows promise in transforming obesity treatment, with an increasing number of employers offering coverage for these medications. However, disparities in access persist, highlighting the importance of addressing systemic barriers and biases. As stakeholders and leaders in healthcare, it is our responsibility to drive meaningful action towards addressing these disparities and ensuring equitable access to care for all individuals. 

Let’s dive into some background on the history of obesity. It wasn’t until 2013 that the American Health Association formally recognized obesity as a chronic disease. Despite this acknowledgment, the healthcare provider community continues to grapple with how to effectively manage and treat obesity, amidst a backdrop of complex social and economic factors that shape access to health and wellness resources. 

The causes and drivers of obesity are intricate, encompassing a myriad of social and economic factors that profoundly affect access to health and wellness resources. As we begin to make progress around obesity treatment, we must ensure that we are having thoughtful discussions around health equity in parallel.

Where are we today? As a chronic disease, obesity stands as the primary risk factor for type-2 diabetes, contributing to a significant portion—between 30% to 53%—of new diabetes cases annually in the United States, as recognized by the American Heart Association.  Furthermore, a staggering 90% of individuals diagnosed with diabetes are either obese or overweight. The ramifications of obesity extend beyond diabetes, serving as a major risk factor for heart disease, hypertension, osteoarthritis, and a causal link to 13 distinct types of cancer. Moreover, obesity is detrimental and significantly impacts quality of life, including mental well-being, highlighting the urgent need for comprehensive management and intervention strategies.

According to the CDC, Black adults in the United States exhibit the highest obesity rates, with 49.9% affected, surpassing rates among Hispanic adults (45.6%), white adults (41.4%), and Asian adults (16.1%). Moreover, according to the NCBI, individuals residing in rural areas are more prone to obesity compared to their urban counterparts, often facing challenges in meeting physical activity recommendations and accessing healthier food options. 

In the realm of healthcare equity, the impact of race on obesity risks and access to care cannot be understated, however, marginalized communities, in particular, face significant challenges in accessing healthcare services, further exacerbating existing health disparities. 

A comprehensive analysis conducted by the Kaiser Family Foundation sheds light on the disparities faced by Black, Hispanic, and American Indian or Alaska Native individuals compared to their white counterparts across various health measures and access to care indicators.

Furthermore, despite advancements in healthcare, racial and ethnic disparities persist in heart disease mortality rates, as outlined by the CDC. Alarmingly, non-Hispanic Black adults under the age of 65 experience disproportionately higher rates of heart disease deaths compared to their peers from other racial and ethnic backgrounds.

These sobering statistics underscore the urgent need for meaningful action to address healthcare disparities. While these disparities have been widely acknowledged, most healthcare stakeholders and leaders have yet to implement comprehensive solutions to mitigate them effectively. We are at a tipping point—we must treat obesity as a chronic, preventable disease, given the impact to lives as well as the cost. The CDC estimates that obesity accounts for approximately $147 billion in annual healthcare costs. Additionally, less than 2% of qualifying adults actually receive obesity medication treatment, and even fewer receive intensive lifestyle intervention.

The momentum for coverage of obesity treatment is gaining traction, particularly with the emergence of novel GLP-1 medications. These medications, when appropriately administered, have demonstrated the potential for substantial weight loss—up to an estimated 18%.

According to recent surveys, there is a notable uptick in employers offering coverage for GLP-1s for obesity treatment, with an anticipated increase from 25% in 2023 to 43% in 2024. However, amidst this progress, disparities in access persist, underscoring broader issues of health equity.

An analysis of over 4 million prescriptions nationwide in 2023 for the drug semaglutide revealed concerning trends. Approximately 85% of prescriptions were dispensed to white individuals, while Black adults, who bear a disproportionate burden of diabetes, obesity, and other chronic illnesses, received only around 12% of the prescriptions.

This disparity highlights the 'Kardashian Effect,' where media attention and celebrity influence inadvertently contribute to medication shortages and heightened demand, ultimately exacerbating access issues for those who need treatment the most.

How do we fix this? As healthcare stakeholders and leaders, it's imperative to address these inequities head-on and ensure that access to life-changing treatments is equitable across all communities. By acknowledging and actively working to mitigate the 'Kardashian Effect' and other systemic barriers, we can strive for a healthcare landscape that prioritizes equitable access to care and improves outcomes for all individuals affected by obesity and related conditions.

The American College of Cardiology and the American Heart Association advocate for a comprehensive approach to obesity treatment, the framework of Calibrate’s program founded in 2020, emphasizes the incorporation of both clinically appropriate medication and lifestyle intervention, which encompasses behavior change strategies. This standard of care underscores the importance of a committed and sustainable collaboration between clinicians/providers and patients, recognizing that successful management of obesity requires a multifaceted approach that addresses both medical and behavioral aspects. By fostering a partnership based on mutual trust, respect, and shared decision-making, healthcare professionals and patients can work together to achieve meaningful and sustainable outcomes in obesity management.

Calibrate's Metabolic Reset program is founded on a robust, evidence-based approach. Our program combines individualized, safe, and effective anti-obesity medication treatment with science-backed lifestyle interventions, resulting in superior and more enduring weight loss outcomes compared to either approach alone. These outcomes are substantiated by published research, positioning Calibrate as a leader in the field.

Our clinicians combine GLP-1s as our medication of choice with a comprehensive program focused on behavior change, proven for sustainable results. 

Calibrate is dedicated to delivering a comprehensive program for obesity treatment, operating within the commercial space to broaden access to care for individuals across the spectrum. Through collaborative and proactive efforts, we strive to effect tangible change and contribute to the creation of a healthcare system that genuinely serves everyone. By prioritizing innovation, accessibility, and inclusivity, we aim to empower individuals on their journey toward improved health and well-being. Together, let's pave the way for a healthier future for all.