In the News: 60 Minutes on Obesity

60 Minutes started off the new year with a compelling segment on obesity and one of the promising new weight loss medications. According to the report, nearly half of American adults are obese, or rephrased properly, have obesity. Yes, I noticed their subtle phrase which recognizes that obesity is actually classified as a disease. This is one of the many things I liked about their video, which I’m including below:

Obesity deserves much more recognition and those of us who suffer from the disease deserve much more understanding. This video is a good start, but in some ways it falls short.

Probably the most glaring flaw is the conflict of interest between the program and its sponsor, maker of Wegovy Novo Nordisk. While the reporter accurately portrays Wegovy and sister drug Ozempic as effective new medications to battle obesity, she fails to specifically mention similar medications such as Saxenda and Mounjaro, and no doubt there are several more that I’m not familiar with.

Getting back to the positive, I do like that the report mentions set point weights (1). This concept became clear to me when I visited the Mayo Clinic Bariatric Center in Jacksonville, Florida. It wasn’t overtly stated, but when completing the patient history about milestones in my life, how much I weighed at these dates, and how long those weights were maintained, it became evident. Also, I was instructed to maintain a lower weight, nearer to my goal, for 6-12 months before attempting that final goal.

In the 60 Minutes video, it was suggested that the COVID-19 pandemic may have contributed to our obesity problem and upped our set-point weights. Additionally, they explained the extraordinarily low success rates of rapid weight loss programs, such as the television series, The Biggest Loser. Without any time to gradually adjust to reduced caloric intake, increased exercise, and abrupt weight changes, it can be nearly impossible to maintain rapid weight loss. This has been proven by studying weight maintenance in former contestants (2). The concept of set-points can be applied to our own weight maintenance journeys.

Also of interest was the discussion of health insurance and prescription drug coverage of what could be a life-changing treatment for a disease. This is something I experienced first hand. When I began my last weight loss journey, my endocrinologist (3) proposed that I take Wegovy and see a bariatrician. It took months to get into the program, then months to find out that Wegovy or Saxenda coverage would be denied. Finally, the bariatrician suggested that I try a different drug, but by that time, I had gone below a 27 BMI, and would no longer be eligible. Success I suppose, but still a frustrating process! For those with more serious obesity disease, this could lead to a very negative outcome.

The situation with insurance coverage will likely continue until effective medication becomes less expensive than the cost of treating the conditions obesity causes. This makes financial sense when merely considering the direct, short-term medical costs of obesity. However, if we could quantify the indirect and long-term costs of decreased mobility, the psychological toll of fat-shaming, reduced preventative medical care due to prejudicial treatment, lost productivity because of poorer health, and so much more, I feel that coverage for obesity treatment would be vastly improved. Currently, there is insufficient incentive for insurance companies, and insufficient health care for those suffering from obesity.

I hope you’ll find time to watch the above video. Next time, I’ll share a video critiquing the 60 Minutes report. I’d love to hear your thoughts on this topic!

(1). https://www.bidmc.org/about-bidmc/wellness-insights/nutrition/week-one-the-science-of-set-point

(2). https://www.health.harvard.edu/diet-and-weight-loss/lessons-from-the-biggest-loser

(3). I see an endocrinologist at the Mayo Clinic for parathyroid and thyroid diseases, not for any type of diabetic condition. Insurance coverage would likely be different for those with diabetes or pre-diabetes.