2023! Will This Be the Year?

Jennifer C. Seger, MD, FOMA, is the Co-clinical Editor of Bariatric Times; Diplomate, American Board of Obesity Medicine; Medical Director, Bariatric Medical Institute of Texas, San Antonio, Texas.

Dear Readers,

There is so much buzz in our space these days, I can’t help but think we are on the cusp of a major shift in the way society views obesity. Perhaps this is the awakening needed to help more people recognize that obesity is a disease and that it can and is being treated successfully.

With articles in The Washington Post,¹ The New York Times,² and The Wall Street Journal,³ glucagon-like peptide-1 (GLP-1) and GLP-1/gastric inhibitory polypeptide (GIP) receptor agonists are a hot topic. 

These articles highlight some of the obvious challenges patients face, most notably the cost of these medications. But there are other concerns as well. Patients choosing to use these medications off-label are being publicly ridiculed and accused of creating a shortage and depriving patients with diabetes of not being able to access them.

The creation of GLP-1 receptor agonists has certainly had a profound effect on patients’ lives. Originally for diabetes, the weight loss achieved with these medications is proving to be a game changer for the treatment of obesity. With the increased usage of this class of medications, achieving 15 to 22 percent of total body weight loss is becoming more the norm now rather than a stretch goal. Semaglutide, marketed as Wegovy for obesity and Ozempic for diabetes, and the newest GLP-1/GIP receptor agonist, Mounjaro (tirzepatide), are flying off the shelves. Word is spreading like wildfire, thanks in large part to social media, and patients are flocking to their doctors to get started on these medications. High demand for these medications has even generated supply chain issues. According to an article in Endpoints News, Ozempic brought in $2.3 billion for Novo Nordisk in the third quarter alone.⁴

Another recent event has also helped elevate the topic of obesity. The release of the movie The Whale, for which the lead actor, Brendan Fraser, has received some Oscar-worthy reviews, has created quite a stir. While the movie is not without controversy, Fraser has become quite outspoken about obesity and the struggles patients face in terms of bias, stigma, and access to care.

Fraser was quoted saying, “[N]ot only can we maybe amend or change the dialogue surrounding how we discuss and how we refer to people who live with obesity, it could send someone to a place where they could get help. It’s not a film that’s a public service announcement, but it is a film that does challenge us to change our hearts and minds.”⁵

Circling back to the topic of medications, should it really be off-label to prescribe semaglutide or tirzepatide for weight loss? Like it or not, using semaglutide (or tirzepatide), no matter the brand name or how it is packaged, works for weight loss. It’s the same drug. Patients who are using these medications for weight loss should not face ridicule and should not have to pay more than a patient using it for diabetes. That is discrimination. PERIOD. We should not withhold these life-changing medications from anyone who might need them, regardless of their disease process. Let us not forget that losing 15 to 20 percent of body weight often puts diabetes into remission. It happens daily in practices like mine all around the country. Why isn’t this being highlighted more by medical societies and the media? This is huge! Perhaps with this increased awareness of the dramatic benefits possible with successful weight loss, our lawmakers will finally pass the Treat and Reduce Obesity Act, improving access to care. Perhaps then, we can convince insurance carriers to universally include comprehensive obesity treatment, and finally, obesity treatment will be taken seriously. 

In health,

Jenny Seger, MD, FOMA

References

1. McGinley L, Bernstein L. New drugs to battle obesity: what you need to know. The Washington Post. 19 Dec 2022. https://www.washingtonpost.com/health/2022/12/19/obesity-drugs-faq/. Accessed 27 Dec 2022. 
2. Blum D. What is ozempic and why is it getting so much attention? The New York Times. 22 Nov 2022. https://www.nytimes.com/2022/11/22/well/ozempic-diabetes-weight-loss.html. Accessed 27 Dec 2022. 
3. Wainer D. New weight-loss drugs can fatten drugmakers’ profits. The Wall Street Journal. 5 Aug 2022. https://www.wsj.com/articles/new-weight-loss-drugs-obesity-treatment-obese-11659646078. Accessed 27 Dec 2022. 
4. DeFeudis N. Novo Nordisk addresses off-label ozempic use as it grapples with multiple shortages. Endpoints News. 13 Dec 2022. https://endpts.com/novo-nordisk-addresses-off-label-ozempic-use-as-it-grapples-with-multiple-shortages/ Accessed 27 Dec 2022.
5. Truitt B. With ‘The Whale,’ Brendan Fraser wants to change ‘hearts and minds’ about people living with obesity. 20 Dec 2022. https://www.usatoday.com/story/entertainment/movies/2022/12/20/the-whale-brendan-fraser-new-role-obesity/10905530002/. Accessed 27 Dec 2022.  

Tags: Dr. Jennifer Seger, Editorial Message

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