Global Obesity Crisis Weight-Loss Drugs Offer New Hope

The worldwide increase in obesity has become one of the most serious health threats of our time. As reported by the World Health Organization (WHO), over one billion persons have obesity, which includes 880 million adults and 160 million children. The health community expresses alarm that this epidemic is spreading quickly while affecting developed and developing countries.

France is an example of a country facing a disturbing increase in obesity. National statistics suggest that obesity prevalence has nearly doubled in the past two decades: it increased from 8.5% in 1997 to 17% in 2020, and further forecasts predict even higher numbers.

As of recent years, medicine has advanced in the presence of newly available GLP-1 (glucagon-like peptide-1) analogues that were created as a diabetes medication. Several GLP-1 analogues have shown strong efficacy in achieving weight loss and better metabolic health, for instance, liraglutide (Saxenda), semaglutide (Wegovy, Ozempic) and tirzepatide (Mounjaro).

The mechanism of action for these drugs, which is that they stimulate insulin secretion, suppress appetite and delay gastric emptying collectively, engages the person in a way that helps them manage calories. In clinical trials, those who were on semaglutide lost as much as 15% of their body weight over an interval of up to 68 weeks, which is a remarkable achievement that has increased physician and patient optimism. There are caveats; while GLP-1 analogues are promising elements of treatment, they cannot serve as treatment by themselves. According to one established endocrinologist, “these medications are effective but they are tools, not a single answer. Obesity is a complex disease, and it requires more than a weekly injection – it requires complete lifestyle and behavior modification.”

Obesity is caused by complex combinations of genetic, environmental, hormonal and socio-economic factors. Sedentary behaviors, processed foods and constant exposure to endocrine-disrupting chemicals have contributed to what a consortium of experts are now calling an ‘obesogenic’ environment.

Researchers are now focusing on the ‘exposome’ — all the environmental exposures that a person has been subject to their entire life — which also includes the inequalities associated with access to healthy foods and activities.

Additionally, both economic and ethical dilemmas arise with these novel treatments. In France, for instance, the monthly expense of GLP-1 therapy is approximately €300, and the absence of public reimbursement presents it as an equity issue in healthcare.

Health economists and champions of public health argue that prevention continues to be the most practical and cost-effective solution. They advocate for government-supported measures such as education regarding nutrition, urban design to encourage physical activity, taxes on ultra-processed foods, and campaigns to encourage a healthy and balanced diet.

Ultimately, all experts agree that addressing the obesity epidemic calls for a multi-faceted collaborative approach – bringing together practitioners of medicine, nutritionists, policymakers, teachers/educators, and the community at large.

While the introduction and development of novel medications to treat obesity is a valuable tool in the clinician’s armamentarium, only a long-term, preventive and inclusive approach will help alter the trajectory of the global obesity epidemic.