Tufts Experts Confront New Weight-Loss Medicines

Research suggests that the new weight-loss drugs have other benefits, including increasing kidney function, reducing sleep apnea, and having side effects. many are good for the heart muscle, heart rate and overall heart function. Image: Shutterstock

Shouldn’t we be eating and exercising to lose weight?

If covered by health insurance at all, medicine or surgery is usually only covered for those with a BMI of 30 or higher, or 27 and higher if the person has other medical issues such as heart disease, sleep apnea, diabetes or high blood pressure. .

Tufts experts stressed that people taking new weight loss drugs still need a healthy diet and exercise plan. «It’s really an advancement in the care of chronic disease, which is what we now know is obesity,» says Siegel. «Medical surgery or weight loss is part of the package.» treatment that includes a nutritional plan that emphasizes as many unprocessed foods as possible. You should eat a lot of fresh fruits, vegetables and whole grains. You should make sure that you get enough sleep. Eating more protein, along with regular strength training, can help maintain muscle mass. «

Dariush Mozaffarian, director of the Food is Medicine Institute and Jean Mayer Professor of Nutrition at The Friedman School of Nutrition Science and Policy, asserts that ultimately a combined GLP-1 agonist-Food Is Medicine approach will be the most cost-effective and equitable way to best use these new drugs to attack the obesity epidemic.

«In trials showing the effectiveness of GLP-1 agonists, researchers have seen that weight loss is common after 12-18 months, however patients should continue to take the medication throughout their lives to keep their weight down,» says Mozaffarian, who is also a cardiologist. and former dean of the Friedman School.

What about Access and Cost?

In one analysis, if Medicare Part D (the part of Medicare that covers prescription drugs) were to cover the weight loss medication semaglutide for all Medicare beneficiaries with obesity, the cost would be more 90% of what Medicare currently spends on all other drugs. shared. Medicare currently does not cover medications if they are prescribed solely for weight loss, but they may cover them if they are approved by the FDA and prescribed for a medically recognized health benefit, such as reducing the risk of stroke.

It is not clear that additional drug costs will reduce the health care costs of treating diseases related to overweight and obesity.

«Even accounting for their health benefits, one study showed the average annual health care costs for drug addicts doubled in the first year, from about $13,000 per person before starting the drug to $26,000 after,» Mozaffarian says.

The same study showed that only 25% of patients on one of the weight loss medications continued to take it for a long time, Mozaffarian says.

«We know maintaining good habits can be difficult, especially for people who lack money and access to healthy food and regular exercise,» Mozaffarian notes.

Food Is Medicine programs that include a grocery or diet program, coaching, and telehealth or digital behavioral support may cost less than weight-loss drugs and may work, although they may They are not as effective at first as these medicines.

«Our best course of action may be to develop and evaluate combined GLP-1 agonist/Food Is Medicine programs that, in the long term, may be effective in reducing weight, and be more cost-effective and fit,» Mozaffarian says.

It’s still Early Days

«If this is a nine-inning game, we’re still in the early stages of learning what these drugs can do,» says Greenberg.

It’s no wonder people gain weight when they stop taking these new weight-loss drugs, he says. Greenberg notes:

People may stop medication for many reasons: temporarily due to pregnancy, or longer due to a change in insurance or a change in what drugs their insurance will cover. «For those who are followed closely, who work well, and have insurance coverage, I suspect that adherence will be very high,» says Siegel.

Patients currently take blood pressure medications, statins, and many other medications for life to treat health conditions. «As these new types of weight loss medications come to market, they will be more acceptable to many patients to continue taking them for a long time,» says Greenberg.

Greenberg says that research shows that when a person is overweight, even a 5% weight loss results in significant health benefits. He admits: “Ignoring how much these drugs cause a person to lose weight may not be as much of a problem as it seems.

“The financial costs and benefits of obesity drugs are also in their early stages of evaluation. As other similar drugs become available, we can expect competition to reduce costs,» Greenberg adds.

«Obesity is a major cause of type 2 diabetes, which is a chronic, long-lasting disease that also causes blindness, kidney failure, loss of nerve function,» says Greenberg. , stroke and heart attack. “All these situations are huge burdens for insurance companies and patients. Once cheaper drugs can be taken to reduce these health problems of obesity, cost analysis may become more competitive in terms of cost containment for insurance companies in prescribing medications. this one.»

Greenberg believes that perhaps the most important benefit of this new class of medicine is that «doctors and patients are now accepting that obesity and its problems are treatable.»