Weight loss drugs are not the only answer: Why we must redefine the obesity journey

The disease of obesity has reached pandemic status. According to the World Obesity Foundation, more than half of the world's population is expected to be overweight or obese by 2035 and the economic impact of rising obesity rates could reach more than $4 trillion annually. This increase would likely exacerbate health inequities, while proving unsustainable for individuals, their employers, health systems and economies.

Unfortunately, this trend is well underway. Today, people with obesity or overweight diagnoses have higher out-of-pocket costs. In 2021, Americans with large employer coverage with an obesity diagnosis faced an average of $789 in added out-of-pocket costs.

While glucagon-like peptide 1 agonists (GLP-1) have been identified as a miracle drug for weight loss, they should only be part of a comprehensive and sustainable solution and not used in a silo. Rather than pursuing quick fixes, we should seek approaches that prioritize whole-person, high-quality care and sustainable change to deliver better long-term health and affordability.

In the US, large, self-insured employers, paired with innovators across the economy, are best positioned to drive this change as they expand their weight management benefit offerings. With the advent of GLP-1, there exists a unique opportunity to do it right and rapidly demonstrate results.

Maintaining a healthy weight is a lifelong journey. High-quality weight management solutions should start with a deep understanding of the individual, personalizing their treatment to develop a sustainable plan that is also affordable for the recipient and those who subsidize such programmes. The place to begin is with a simple question to the individual: why is this important to you? Once health can be tied to successful quality of life and why that’s important, a comprehensive programme can be implemented.

Employers should take a longitudinal approach, shifting the focus from the one-off, high-cost weight-loss solutions to a sustained, affordable, comprehensive health and care strategy. This approach should be led by a multidisciplinary team of clinical experts who can seamlessly address physical health, mental health and lifestyle management for better outcomes.

Will your employee’s care plan be informed by obesity medicine specialists? Have those clinicians been successful in delivering care?

Obesity is a disease. Like any chronic condition, the best outcomes are realized when a team of quality clinicians is at the helm of the care plan. The team should include board-certified obesity medicine specialists and endocrinologists, registered dieticians and nutritionists using evidence-based practices across medical nutrition therapy, intuitive eating, diabetes education and adult weight management. This comprehensive approach extends beyond basic nutrition education, which can be offered by almost anyone. A high-quality weight management solution should include a team that has deep experience implementing holistic and integrated care plans that lead to better outcomes.

Does the care experience incorporate lifestyle management and surgical and pharmaceutical offerings on one platform? Are the best standards of care being followed?

Clinical appropriateness should be prioritized when individuals are being evaluated for any weight management treatment plan, which may include options such as nutrition management, behavioural health, bariatric surgery and prescription pharmaceuticals, such as a GLP-1. Despite their general effectiveness, GLP-1s may not align with each person’s clinical goals. Some individuals may need them for a brief period ahead of bariatric surgery. Others may benefit from bariatric surgery as opposed to a long-term plan that includes extended use of GLP-1. But for many, GLP-1 will be the right choice. These drugs are unequivocally altering the future of cardiometabolic healthcare.

Are your employees healthier in the long term? Are they able to maintain a healthy weight? Is there an ROI?

Obesity management is a health journey that can be challenging. The goal, however, should be to help your employees achieve a healthy weight and engage them with the tools they need to maintain that weight for the long term. Together with the individual, the clinical team should set realistic goals and be able to measure them with digital and in-person care. Smart technology and AI should power the personalized experience needed for better outcomes. Data should flow back and forth across the team, making the experience easier for the individual and helping them determine the next best step. Incorporating virtual and digital behaviour change support and medication adherence has also been critical to scaling these programmes and is a must to pair with any weight management solution. Making it easy for users of the programme is key to success.

Is the most cost-efficient care being delivered? How are you mitigating costs for your employees while balancing your fiduciary responsibilities?

With obesity at pandemic proportions, making weight management care accessible and affordable is an important talent retention differentiator for employers. A high-quality weight management programme must account for the delivery of the most cost-efficient care for each employee. Programmes must be able to deliver results and be sustainable relative to costs and member engagement, balancing individual costs to both employee and employer.

Separately, significant reductions in treatment costs are necessary if GLP-1 and other new medication-based treatments are to scale. This can include pre-negotiated rates for medications and value-based arrangements (pay for results.) What employees pay for care and the price at the pharmacy counter is usually what matters most to individuals and will help keep them engaged in their care.

Weight management is a journey, not a destination. By embracing a high-quality, comprehensive strategy that prioritizes integrated personalized care, digital health, education and community support, the narrative can shift around weight management from short-term fixes to lifelong well-being. It's time to empower individuals on their journey to a healthier and happier self.