The Next Era in Obesity Care

This article was originally published on TheAtlantic.com and is reposted with permission.

For years, a myth has persisted that obesity is merely a willpower problem. Healthcare practitioners didn't have much more to help their patients than recommending lifestyle changes. But as new GLP-1 therapies revolutionize medicine, patients and physicians are replacing the old narratives about weight loss with a critical question: Is society ready to stop treating obesity as a personal failing and start managing it as a chronic condition?

This idea guided the discussions at a recent event at Century Park in Los Angeles-"Redefining Obesity Care: The GLP-1 Revolution"-hosted by AtlanticLIVE and sponsored by Amgen, a leading biotechnology company, delivering innovative medicines to fight some of the world's toughest diseases. An emotional fireside chat between patient advocate Kevin Stephens and ConscienHealth founder Ted Kyle centered on how obesity care must put the patient first - confronting bias, redefining success and better supporting long-term care and the lived experience of patients. Their dialogue also challenged the notion that novel interventions, like GLP-1 medications, constitute a "quick fix" for patients.

The "Easy Way Out" Myth

Kevin Stephens' struggle living with obesity reveals the complexity of managing this chronic disease. Throughout his life, Stephens assumed he was personally responsible for his size, even though he has lived with obesity since childhood. As a result, he felt a psychological weight in addition to his physical weight. He considered his lymphedema, high blood pressure and prediabetes to be moral failings.

He lost 220 pounds in 2011 after undergoing gastric bypass surgery, but received little guidance on maintenance and preventing his prediabetes from escalating to full-fledged diabetes. For several years, the medical intervention kept his weight in check, but he regained 45 pounds over a decade later. When he inquired about GLP-1s, his physician dismissed him, saying: "Kevin, you already did it the easy way."

Stephens disputed the idea that weight loss surgery is easy. "You still have to do the work and maintain your health, eat the right food, exercise," he said. "This is not an instant cure." His exchange with the doctor points to a longtime gap in how obesity treatment is understood. For years, the medical industry has treated surgical and pharmaceutical interventions as the end of a patient's journey instead of what they actually are: milestones. "It's not something that's one and done, losing weight," Kyle said.

Fed up with being dismissed and misunderstood, Stephens found a different doctor. His new physician recognized obesity as a chronic disease that requires a robust toolkit to manage effectively.

The 98 Percent Problem

Susan Sweeney, executive vice president of obesity and related conditions at Amgen, introduced the conversation between Stephens and Kyle with a staggering statistic: Only about two percent of people with obesity are receiving treatment currently. This flies in the face of the idea that everyone, including people who don't need intervention at all, are using weight loss drugs.

In fact, patients in dire need of treatment often navigate a healthcare system filled with insurance barriers and bias, Stephens said. Those who successfully obtain care commonly run into another issue navigating what maintenance looks like over time. When Stephens reached his ideal weight, his doctor reduced his GLP-1 dosage. "Why can't we have a drug just for maintenance?" Stephens asked. The question hints at the next chapter in medicine, one in which pharmaceutical interventions will move beyond acute weight loss to long-term health management.

A Call for Compassionate Care

For years, Stephens obsessed over the number on the scale. But his focus has shifted now that he's in his maintenance phase. "I'm not worried about that number anymore," he said. He simply wants to be healthy.

A shift in focus from "weight loss" to "health gain" reduces stigma for patients living with obesity. For Stephens, that shift occurred when he finally heard the words: "It's not your fault." No one had ever said that to him before.

The idea that obesity is the patient's fault may contribute to the vast majority of people with the condition not getting treatment for it. Amgen intends to change that.

"There's still so much more to do across the world," Sweeney said. "We're excited about bringing in potential future treatments to the market and hearing about how we can make an impact."

Stephens wants to make an impact too.

"I see how so many people are going through these hoops. Obesity can be managed if treatment barriers are erased," he contends. "I hope that my story really has an impact on people and on how you develop future treatments for us, for people like me."