Raising awareness and driving innovation around new drug therapies to overcome our national obesity crisis.
Obesity in America
Obesity is a serious threat to public health and is growing at a rate of epidemic proportions in our country.
The Obesity Action Coalition (OAC) estimates that nearly 93 million Americans are affected by obesity, and that number is predicted to climb to 120 million within the next five years.
If you add in the number of Americans considered to be overweight, less than one-third of US adults are at a healthy weight. This epidemic does not discriminate; the prevalence of obesity has steadily increased in recent years across genders, ages, and diverse ethnic groups.
The American Academy of Child & Adolescent Psychiatry found that when one parent is affected by obesity, there is a 50 percent chance that their children will also develop the condition. However, when both parents have obesity, the chance of their child developing obesity jumps to 80 percent.
Individuals affected by obesity are more likely to experience a diminished quality of health and life. This is often compounded by bias and stigma found everywhere from employment to education to health care. As highlighted by OAC, obesity is the last socially acceptable form of discrimination in our society.
This disturbing national trend needs an aggressive medical solution.
A Gateway Disease
Few conditions threaten our nation’s health more seriously than obesity, a significant risk factor for the development of numerous other health conditions. The Centers for Disease Control and Prevention (CDC) lists chronic conditions that are associated with obesity, such as heart disease, cancer and chronic lower respiratory diseases, as the leading causes of death and medical expenditures in the United States.
Other chronic conditions that accompany obesity are Type 2 diabetes, high total cholesterol or high levels and triglycerides, sleep apnea and respiratory problems, liver and gallbladder disease, osteoarthritis, reproductive health complications such as infertility and complications with pregnancy, and forms of dementia including Alzheimer’s Disease.
Obesity is also projected to derail great strides in cancer prevention. In a December 2009 study published in the New England Journal of Medicine, smoking rates in the US have fallen by 20 percent while obesity rates have risen by 48 percent. If these rates continue, obesity will soon eliminate the health benefits gained by declining smoking rates.
According to the American Cancer Society (ACS), patients struggling with obesity have an increased risk for many types of cancer, including cancer of the breast, colon, endometrium, esophagus, kidney, pancreas, gall bladder, thyroid, ovary, cervix and prostate, as well as multiple myeloma and Hodgkin’s lymphoma.
A 2010 study published in the Archives of General Psychiatry has also identified the correlation between depression and the onset of obesity, and obesity and onset of depression. Persons with severe mental illness (SMI) such as schizophrenia are 1.5 to 2 times more likely to develop obesity than the general population. According to the National Association of State Mental Health Program Directors, these patients have long been known to suffer significant early mortality, dying as much as 25 years earlier than those without SMI from a range of conditions that are exacerbated by their obesity. Newer drugs for the treatment of psychotic disorders can also cause significant weight gain, likely leading to even earlier mortality than has traditionally been the case.
Though obesity is the precursor to the development of many life-threatening conditions, treating chronic illness and other health conditions associated with obesity is where the costs are truly incurred.
The CDC estimates that in 2008 dollars, medical costs associated with obesity totaled about $147 billion nationwide.
In a study conducted by Stanford University and the RAND Corporation, “The Economics of Obesity,” per person lifetime medical costs related to diabetes, heart disease, high cholesterol, hypertension and stroke among persons affected by obesity were shown to be $10,000 higher than among those not affected obesity. Yet, lifetime medical costs among these individuals can be reduced by $2,200- $5,300 following just a modest reduction in body weight.
The National Heart, Lung, and Blood Institute (NHLBI) concludes that a modest reduction in weight will achieve the goal of significantly improving health outcomes and reducing health care costs.
Providing a wide range of treatment options for individuals affected by obesity can greatly enhance their quality of health, reduce present and future medical expenditures, and begin to instill healthy lifestyle behaviors that will be passed down to our nation’s children throughout time.
Current research indicates that drug therapies, along with diet and exercise, can help motivated adults with obesity lose weight, keep it off and prevent related chronic illness.
Investing in Obesity Treatment
The United States needs to address the drivers of chronic illnesses. Though much of the national dialogue is focused on preventative measures with a strong emphasis on children, we must recognize that the treatment of obesity among today’s adult population is essential in the prevention Type 2 diabetes, cancer, cardiovascular disease and other serious and costly medical conditions. Current public health approaches to the prevention and treatment of these conditions have not proved adequate to the task; simply put, diet and exercise, while important to any weight-loss strategy, are not effective in all patients and are not likely to reduce the overall rates of obesity.
Because there is no one-size-fits-all approach to treating obesity, access to the continuum of care should be a priority. Obesity must be viewed as a medical condition and its treatment must be managed as such. Patients affected by obesity must be provided with options and doctors must help patients select a treatment course that best fits their individual needs. The public and the medical community must put aside their bias towards those affected by obesity and support a comprehensive approach to treating this serious medical condition in the same fashion society currently supports a broad array of treatments for those who suffer from other chronic diseases such as diabetes and heart disease.
According to National Heart, Lung, and Blood Institute (NHLBI) guidelines and the Strategies to Overcome and Prevent (STOP) Obesity Alliance, treatment of obesity should focus on producing slow, progressive weight-loss. Treatment may include diet, exercise and behavioral modification, as well as drug therapies and surgery for some individuals. NHLBI research reveals that a modest weight-loss is associated with improved health outcomes and a reduction in risk factors for chronic disease, including lower blood glucose levels, lower blood pressure and reduced cholesterol levels. Further, treating obesity within our nation’s adult population will, over time, improve the health of nation’s children.
Drug therapies, along with lifestyle changes and patient motivation, could help adults with obesity lose significant weight and keep it off. While many middle-aged people do succeed in losing weight when they diet and exercise, the human body, especially in middle age, has an inherent tendency to try to regain the weight that has been lost. For other adults, obesity has comprised their mobility, making even moderate exercise difficult and in some cases not an option. These patients in particular deserve additional interventions to help them achieve weight loss and continue to maintain a healthy lifestyle.
Dr. Ken Fujioka, a diabetologist and internal medicine specialist with the Scripps Clinic Del Mar in San Diego, summarizes it best. In a June 2011 op-ed published in The Washington Post, Fujiok writes: “Medical professionals have few treatment options that work. Yes, we encourage patients to diet and exercise, but those tools alone are not a realistic solution to the crush of patients I see every day. Diet, exercise and lifestyle modification are starting points. In an environment in which the pressures pushing the population toward obesity are supercharged, we need supercharged interventions.”
A safe and effective medication regimen would be an invaluable new tool to help adult patients fight obesity and related medical illnesses. We must educate the general public and policymakers about need for innovative solutions to treat our obesity-plagued adult population and, as part of the solution, support the US Food and Drug Administration (FDA) in exploring the promise of future drug therapies.
As a great follow-on to Wednesday’s standing-room-only event on Capitol Hill, a briefing on the “Growing Need to Effectively Treat the Nation’s Obesity Epidemic,” hosts Representatives Bill Cassidy, MD (R-LA) and Loretta Sanchez (D-CA) penned op-eds that appeared this week in Politico and Roll Call.
Rep. Sanchez’s op-ed, “Fighting obesity in America on every front” details her concern that “growing numbers of young Americans are ‘too fat to fight,’ as more than 300 retired military leaders warned in a recent report.” According to Sanchez:
“How do we answer the call to fight obesity? When our soldiers go into combat, they are equipped with the latest technology to tackle the mission at hand. Obesity requires a similar response. Let’s provide patients, especially 45-to-64-year-olds, who have the highest incidence of obesity, with a 21st-century approach to help them lose weight, keep it off and prevent other health complications. Healthful diets and more exercise can be effective weapons. But other safe and effective treatment options such as drug therapies and surgery must be available to supplement these efforts.”
And Rep. Bill Cassidy has this to say about the obesity crisis in America and his participation in Wednesday’s event:
“When Hurricane Katrina hit the Baton Rouge, La. area in 2005 I worked with others in our community to turn an abandoned Kmart store into an improvised hospital to care for the casualties. Politics did not matter. This was a natural disaster, and it demanded an all-out, all-hands-on-deck response. The same is true of the national epidemic of obesity.
This is why I co-hosted a briefing this week with Rep. Loretta Sanchez, a California Democrat, to inform Congressional staff and the general public about the physical and financial toll of weight-related problems. The situation is so severe that we should spare no effort and ignore no innovation to help Americans avoid obesity and chronic conditions associated with excess weight.”
The Network to Overcome Obesity Now (NOON) was formed to raise public awareness about the growing adult obesity medical crisis in the US and the need for a wide range of treatment solutions to help motivated individuals lose weight and keep it off. To accomplish this goal, NOON seeks to educate the general public about the need for innovative solutions to treat our obesity-plagued nation and support the FDA in exploring the promise of safe and effective weight-loss medications. New drug therapies are currently in the final phases of FDA evaluation. We support the FDA in maintaining the highest standards with regard to the safety of interventions as well as documenting their effectiveness. However, the excessive morbidity and mortality associated with the ineffective treatment of obesity to date must be a part of the FDA’s risk-benefit analysis.
Objectives of the campaign include:
- Raise awareness about the growing adult obesity medical crisis in America and its impact on the economy, employment, national defense, income, education, population health status and childhood obesity;
- Influence the national dialogue surrounding obesity to help eliminate the bias and stigma that can accompany this condition;
- Empower patients and health care professionals to engage in a meaningful conversation about which obesity treatment options best fit a person’s individual needs;
- Emphasize that advancing medical innovation is an important part of the FDA’s mission of protecting public health; and
- Support the FDA in fully analyzing the nature of the current adult obesity epidemic and its impact on public health against the risks associated with the availability of drug therapies.