The Obesity Epidemic: A New Look at the Urgency, Challenges, and Opportunities
Analysis Group collated the research and provided editorial guidance for 13 research, review, and commentary articles in a special issue of PharmacoEconomics journal, “The Economic Consequences of Obesity.”
Rising obesity levels are now responsible for more than one-quarter of total health care expenditures in the United States and may become the single largest driver of mortality other than aging. Worldwide, one in three adults are overweight or obese; in the United States alone, 80 million adults (35 percent) and 12.7 million children (17 percent) suffer from obesity. Obesity is accompanied by a large comorbidity burden, as it is the key underlying driver behind four of the top 10 most deadly and expensive diseases: ischemic heart disease, cerebrovascular disease (e.g., stroke), hypertension, and diabetes. It also has a significant impact on patient wellness, productivity, and quality of life.
Bariatric surgery has emerged as the first (and so far, only) technology associated with significant success against severe obesity and its associated comorbidities for a large proportion of treated patients. Another promising development in the fight against obesity comes from the new wave of approvals for pharmaceuticals that hold promise for clinically meaningful weight loss (in excess of 5 percent, particularly if the intervention is focused on early responders, as recommended by their FDA labels). Despite these innovations, treatment options continue to face significant hurdles, in part because regulatory and funding regimes have not kept pace with the evidence on effective surgical and pharmaceutical treatments.
Changes should include:
Better access and payer coverage for demonstrably effective treatment options
Increased research and development of effective obesity care and prevention options
Development of evidence to guide obesity-related decision making
Increased physician and patient advocacy to drive change, and raise awareness of the opportunities and challenges in the fight against obesity
The June 2014 decision of the American Medical Association to label obesity as a disease is a positive sign of the growing awareness among the scientific community and the general public of the significance of the disease. Globally, policymakers are also now acutely aware of the prevalence of obesity and its burden, and of the need for increased stakeholder engagement to prevent and treat the disease.
Despite this progress, however, investment in anti-obesity interventions remains minor compared to the scale of the problem. A step change is urgently needed to scale the necessary investments to the challenge of the disease and its societal burden if the obesity epidemic is to be curbed. ■