Regarding obesity as a disease raises questions about cost of drugs for treating it, and wisdom of diagnosing children too early

Illustration by Shoshana Gordon, Axios

By Caitlin Owens
Axios

Doctors and medical experts are leading a rapid cultural shift around obesity, viewing it as a disease rather than a lifestyle choice. That shift is opening new treatments and better care, but also new controversies over who can access those treatments and how best to use them.

"Obesity is a highly prevalent chronic disease characterized by excessive fat accumulation or distribution that presents a risk to health and requires life-long care. Virtually every system in the body is affected by obesity," six obesity advocacy organizations recently wrote in a joint statement."Every person with obesity should have access to evidence-based treatment."

Some diabetes drugs has shown enormous promise for weight loss, offering a ray of hope to the millions of Americans with obesity. The drugs have become all the rage among some wealthy Americans. Billionaire Elon Musk recently responded to a tweet asking him his "secret" by saying "fasting and Wegovy."

But Wegovy, which is approved for weight loss under certain conditions, has a list price of $1,349 for a month's supply, and many insurers, including Medicare, won't cover suhc drugs for weight loss.

Kristine Grow, a spokesperson for America's Health Insurance Plans, recently told Axios that the therapies have limitations and "have not yet been proven to work well for long-term weight management and can have complications and adverse impacts on patients."The same class of drugs also can be misused. Some digital health startups are advertising and prescribing the drugs to people who aren't overweight, The Wall Street Journal reports.

The treatment landscape is changing rapidly for children as well as adults. Guidance released last month by the American Academy of Pediatrics recommends against delaying obesity treatment for children, and argues that doctors should be proactive about approaches like intensive health behavior and lifestyle treatment and, in some cases, prescription drugs or surgery.

But the guidance is already drawing pushback. Eating-disorder specialists, for example, are warning that it could backfire, NPR reports, quoting specialist Kim Dennis: "We run the risk of doing significant harm to kids who are 6 or 8 by telling them that they have a disease . . . simply based on their weight status."

An unusual array of interest groups is already pushing for Medicare to cover the drugs for obesity, Stat reports. More broadly, the existence of an effective treatment raises big questions about how to prevent yet another prescription drug from becoming commonly misused — and how to balance access to obesity treatment against the risks of perpetuating a stigma.