Why don't we give obese patients the care they need?
Today, March 4th, is World Obesity Day, which aims to raise awareness of obesity and the many other diseases that are caused as a result of excess weight and obesity.
The obesity epidemic is one of the biggest health problems we face. It is estimated that by 2025 1.9 billion people globally will suffer from morbid obesity, one in four adults. Among children, obesity will increase by 100 percent between the years 2020 and 2035.The cost to society is estimated at 4 billion dollars.
In Sweden, more than half of all adults are overweight, 18 percent of which are classified as morbidly obesity. Consider that 4,980 bariatric surgeries were performed, and that there are over 400,000 people with type 2 diabetes in Sweden. Obesity is estimated to cost Swedish society SEK 70 billion annually.
The consequences of obesity are immense. In addition to humans suffering from limited mobility, guilt, and shame, there is a high risk of diseases such as type 2 diabetes, high blood pressure, high blood lipids, cardiovascular disease, infertility, pregnancy complications, multiple cancers and chronic pain. Obesity costs society enormous resources, but also burdens healthcare systems and results in limited resources for patients.
So how do we stop this trend? Here are some areas society and healthcare should focus on:
Stop discriminating against the obese. Being overweight today is often met with stigma and shame. Obese individuals are often told that they are lazy,stupid and have themselves to blame. However, obesity is a chronic, largely hereditary disease. At it’s core, those affected experience a hormonal disturbance, where the body cannot properly regulate appetite and satiety. The result is increased hunger, increased calorie intake and gradual increase in fat mass. The reasons are complex and we must take this disease very seriously. Yet, many obese people face discrimination when seeking care, and are all too often given perfunctory, ineffective advice to eat less and move more.
Embrace new medical revolution.There has been a lot of debate about medications in the media recently.Mainly about medicines based on the hormone GLP-1, which is found in the substance semaglutide.The respected medical journal The Science named treatment with GLP-1 drugs for obesity as “the breakthrough of the year” across all categories in 2023. The reason was that these medications, originally developed for type 2 diabetes, have now shown great positive effects on individuals who are only overweight. Beyond weight loss, the medicine decreases the risk of heart failure, heart attacks and strokes. These new medications are highly effective. Let's embrace them and stop debating whether obese patients or those with type 2 diabetes should have priority access to them. The medicine is a revolution in combattingthe obesity epidemic.
Towards a digital care model. Curing obesity requires a series of lifestyle changes. It is not just about medication, but implementing several measures to change one’s lifestyle through dieticians, doctors, personal trainers and psychologists. Offering all this through in-person care is expensive and complicated. Instead, let's look at Britain, which has an even bigger obesity problem.. There, the National Institute for Care and Health Excellence has introduced guidelines stating that obesity care should be provided digitally.
Much of our view of obesity is outdated. This is perhaps one of the reasons why we have struggled to cure this chronic disease.
I would urge everyone in healthcare to prioritise this issue for both the individual and society. I want to urge the public to stop viewing overweight people as lazy and believing they have themselves to blame - they have a chronic disease that often makes it extremely difficult to lose weight.. And not least - I want to address all overweight people - there is hope and help available. Today we know that obesity can be cured.
Martin Carlsson
Professor, doctor and specialist in endocrinology/diabetology and internal medicine and is behind the service Yazen, a digital healthcare provider that works with drug treatment and lifestyle treatment for obesity.
