Speaker 1: From Bloomberg News and iHeartRadio. It's the big take. I'm Wescasova. Today.
Speaker 1: New drugs to treat obesity really work. The question is
Speaker 1: who will get them and who won't. There's been a
Speaker 1: lot of news coverage lately about ozepic and other drugs
Speaker 1: like it that are shown to be effective at helping
Speaker 1: people living with obesity to lose weight. The downside, you
Speaker 1: often have to stay on them, and they are expensive
Speaker 1: thousands of dollars a year. Some insurance companies are reluctant
Speaker 1: to cover them, even with a doctor's prescription. And this
Speaker 1: is stirring up all kinds of questions about taking obesity
Speaker 1: seriously as a disease and about how healthcare is often
Speaker 1: very different from people who can afford to pay for
Speaker 1: costly treatments and those who can't.
Speaker 2: And now you know, we're at a point where people
Speaker 2: are more accepting of it is more about people's chemistry
Speaker 2: than about their character, right, This is not a character
Speaker 2: of law. This is a biochemical process that creates the
Speaker 2: disease of obesity, just like you know, similar to what
Speaker 2: was a struggle for mental health for very many years
Speaker 2: until there was an increased awareness and increased focus.
Speaker 1: That's doctor Angela Fitch. She specializes in treating obesity, and
Speaker 1: we're going to hear more from her later in the show. First,
Speaker 1: Bloomberg reporters am A Court and Robert Langreth. They've been
Speaker 1: covering the upsides and downsides of these medications and the
Speaker 1: back and forth over who should foot the bill. Emma,
Speaker 1: can you start by telling us how do these drugs work?
Speaker 3: The drugs have a bunch of different names. I think
Speaker 3: people are maybe most familiar with ozembic, which is actually
Speaker 3: not specifically a.
Speaker 4: Drug for weight loss.
Speaker 3: It's a drug for diabetes that happens to produce some
Speaker 3: weight loss. Basically, there's a group of these drugs ozempic.
Speaker 3: The one that's been specifically approved for obesity right now
Speaker 3: is called Wagovi. There's an earlier one called Sexenda. There's
Speaker 3: one that's sort of going through the regulatory process soon
Speaker 3: for obesity called Munjaro. These drugs are all part of
Speaker 3: a class called GLP one receptor agonists, and basically the
Speaker 3: way they work is they help people feel full, they
Speaker 3: eat less, and people lose weight. The catches that people
Speaker 3: may need to take them long term to keep the
Speaker 3: weight loss off they've done some studies where people quit
Speaker 3: taking the drugs and they regained a lot of weight.
Speaker 3: But the main factor here to think about is these
Speaker 3: are drugs that replicate a hormone that exists naturally, but
Speaker 3: at pretty high pharmaceutical levels of sort of mimicking this
Speaker 3: hormone in the body, and it comes with some side effects.
Speaker 3: A lot of people have nausea, diarrhea, constipation, but they're
Speaker 3: considered relatively safe because they have been studied in diabetes
Speaker 3: for many years.
Speaker 5: The interesting thing to me watching the pharmaceutical industry for
Speaker 5: so many years, there's been a long history of attempts
Speaker 5: to develop weight loss drugs that have run into lots
Speaker 5: of problems or have been many examples of previous weight
Speaker 5: loss pills that had to have recalls for safety reasons.
Speaker 5: This class, which is showing, you know, more efficacy than
Speaker 5: previous weight loss drugs before, in some sense, kind of
Speaker 5: came out of left field. It really came out of
Speaker 5: diabetes research. These GLP and hormones that they're essentially mimicking
Speaker 5: in these drugs. It turns out that in addition to
Speaker 5: helping regulate blood sugar, which is the reason they were
Speaker 5: originally discovered these hormones also have important roles in sending
Speaker 5: fullness signals to the brain. And when they did some
Speaker 5: of the early trials or the early versions of these
Speaker 5: drugs and diabetes, you know, they discover that people with
Speaker 5: diabetes they lost weight, but for a long time that
Speaker 5: wasn't the main focus the research and drug companies didn't
Speaker 5: until recently really pursue the weight loss angle of them
Speaker 5: as an O B city standalone agent. So that's only
Speaker 5: started accelerating recently as they've developed much more potent, longer
Speaker 5: acting versions of these drugs and lo and behold, when
Speaker 5: they did that, the amount of weight loss that was
Speaker 5: produced in some of these trials, you know, went up dramatically,
Speaker 5: and that's kind of the big surprise. It has tons
Speaker 5: of drug company executive just like you know, almost like
Speaker 5: salivating over the potential enormous market size.
Speaker 1: How much weight can you lose on them? Like? How
Speaker 1: much more effective are they than previous efforts to make
Speaker 1: a weight loss drug.
Speaker 5: Well, there are some of the most significantly effective drugs
Speaker 5: of single agents that have ever been developed from what
Speaker 5: we see so far, especially the newer ones and some
Speaker 5: of those with GOVI, which is Nova Noordius drug, which
Speaker 5: is a higher dose version of a zempeic that produces
Speaker 5: around thirty pounds of weight loss. And Eli Lilly has
Speaker 5: a diabetes drug called Munjaro that's also testing for obesity,
Speaker 5: and in their early big trial, in their first big
Speaker 5: trial of that drug, that produced at high doses around
Speaker 5: fifty pounds of weight loss, which is kind of like
Speaker 5: almost an unprecedented thing, you know, for a single drug
Speaker 5: and a big trial. The sense is like almost all
Speaker 5: sorts of drug companies just kind of racing to get
Speaker 5: in the field.
Speaker 1: They clearly work, but there's kind of a big downside.
Speaker 1: They are not cheap, is that right, Emma?
Speaker 3: Yeah, So these drugs, you know, depending on which specific
Speaker 3: drugs you're talking about, like the class generally costs more
Speaker 3: than ten thousand dollars a year, with GOV specifically is
Speaker 3: more like seventeen thousand dollars a year. And you know,
Speaker 3: typically insurance pays for medication, right, I mean, they don't
Speaker 3: pay for everything, and they might give you a hard time,
Speaker 3: but if you have a disease, typically you know, you
Speaker 3: can get insurance coverage for treatments, you know, more or less.
Speaker 3: In this case, though, obesity is treated pretty differently from
Speaker 3: other conditions, and that there isn't like sort of routine,
Speaker 3: regular coverage for weight loss drugs. And so, you know,
Speaker 3: we found in like our reporting that you know, whether
Speaker 3: you're looking at private insurers, like if you work at
Speaker 3: a big company and you have private insurance, whether you're
Speaker 3: getting insurance through Medicare, which is for elderly people in
Speaker 3: the US, to get health insurance coverage Medicaid, which is
Speaker 3: for low income people, generally, coverage is really really spotty.
Speaker 3: You know, a minority of insurers are covering drugs like
Speaker 3: these for weight loss. Medicare isn't covering it at all,
Speaker 3: and there's been a big push from pharma to try
Speaker 3: to change that.
Speaker 5: We surveyed all fifty states Medicaid plans and only roughly
Speaker 5: eleven states provided you know, broad coverage for BC drugs,
Speaker 5: and many many states excluded it entirely. Private insurance coverage
Speaker 5: was maybe a little bit better, but it varies all
Speaker 5: over the map. Roughly from the surveys, we see maybe
Speaker 5: a quarter of private plans we'll cover BCD drugs. It's
Speaker 5: one of those rare categories in the US. Insurance feel
Speaker 5: they can just like blanket not cover and not get
Speaker 5: too much pushback.
Speaker 3: So what that means is if you're a person and
Speaker 3: you have a body mass index of over a certain
Speaker 3: threshold for OBCD it's thirty plus. So you go to
Speaker 3: the doctor, your doctor weighs you, they say, you have obesity.
Speaker 3: We're going to prescribe you this new, cutting edge medication
Speaker 3: that works really well to help people lose weight. You
Speaker 3: try to get that prescription covered by insurance, and it
Speaker 3: is going to be a big battle, and chances are
Speaker 3: you're going to lose that battle.
Speaker 1: Bob. What is the insurance industry's reason for not covering
Speaker 1: these drugs.
Speaker 5: One of the reasons is simply cost. There's roughly half
Speaker 5: the adult population would qualify under the label, under the
Speaker 5: official FDA label you know, for these drugs, So if
Speaker 5: everyone used it that could potentially qualify, the costs would
Speaker 5: just be enormous. Some industry financial analyst estimates are estimating
Speaker 5: that this class of drugs could eventually have sales of
Speaker 5: one hundred and fifty billion dollars a year between obesity
Speaker 5: and diabetes, like basically making one of the best selling
Speaker 5: you know, classes of drugs ever.
Speaker 3: You know. I think another piece of it is they
Speaker 3: don't have to cover it. There is a precedent for
Speaker 3: not covering it. Medicare doesn't cover it. Medicare is sort
Speaker 3: of the gold standard for coverage, right. If Medicares cover something,
Speaker 3: private insurers typically follow. But it's interesting because there is
Speaker 3: pressure already to cover the stuff, and it's going to
Speaker 3: only increase as you know, Novo Nordisk, the maker of
Speaker 3: ozembic and magov puts more money into this fight. You know,
Speaker 3: if Eli Lilly gets approved for obesity, you're going to
Speaker 3: have more and more companies coming into this space, lobbying
Speaker 3: in Washington to change coverage, pushing private plans. You already
Speaker 3: have patients going to their HR office and saying, you know,
Speaker 3: why don't you cover with goov? You know, my companies
Speaker 3: to have this great health insurance. You know, I'm paying
Speaker 3: top dollar for why aren't you paying for this drug?
Speaker 4: You know.
Speaker 5: One of the points that insurers make is that, yes,
Speaker 5: these drugs do cause a lot of weight loss. Are
Speaker 5: not disputing that, but they say that the drugs, you know,
Speaker 5: haven't been proven to reduce you know, kind of hard
Speaker 5: clinical health outcomes, like they haven't been proven to reduce
Speaker 5: heart attacks and strokes, So they haven't been proven to
Speaker 5: reduce sleep apnea or other complications of obesity, and the
Speaker 5: insurers are right about that. And what the drug companies
Speaker 5: are doing in response is they're actually doing so called
Speaker 5: outcomes trials trying to prove that if you give their
Speaker 5: drugs to someone who's a bee that though, you'll reduce
Speaker 5: the rate of heart attacks and strokes, or you'll prevent
Speaker 5: complications of sleep apnea, or in someone who is abese
Speaker 5: with heart failure, to prevent heart failure related events. So
Speaker 5: they're trying to do that and those trials, which should
Speaker 5: start reading out as soon as this summer, those are
Speaker 5: going to be very, very important to determine what kind
Speaker 5: of coverage that these drugs get over the long term.
Speaker 3: And this kind of speaks to the bigger question of
Speaker 3: like what is obesity? Is obesity inherently a disease? And
Speaker 3: about a decade ago, the American Medical Association said, yeah,
Speaker 3: obesity is a disease. And part of the reason they
Speaker 3: did that is they wanted doctors to start diagnosing it,
Speaker 3: they wanted health insurance to start paying for it. What's
Speaker 3: interesting about that is if obesity is a disease, then
Speaker 3: weight loss alone might be enough to make a difference
Speaker 3: with this disease. You don't normally see a company having
Speaker 3: to run more trials than just this sort of initial
Speaker 3: trial to get coverage like this, Like this shows that
Speaker 3: the bar for proving these drugs work.
Speaker 4: Is higher, and question about why is it higher?
Speaker 3: You know, I think some people would say this is stigma,
Speaker 3: this is discrimination, But I think there is a really
Speaker 3: interesting question at the heart of this of you know,
Speaker 3: many many people in America are considered to have quote
Speaker 3: unquote excess weight. But are all those people sick? Well,
Speaker 3: we know a lot of them aren't, right. We know
Speaker 3: many people with these higher BMIs don't necessarily have all
Speaker 3: these other diseases, right, They don't necessarily have diabetes or
Speaker 3: heart disease. And it gets into all these thorny, complicated,
Speaker 3: difficult questions.
Speaker 1: After the break, with so much demand for these drugs,
Speaker 1: will the price start to come down? Emma, you report
Speaker 1: that obesity can sometimes get in the way of doctor's
Speaker 1: ability to treat people for serious illnesses. What did you find?
Speaker 3: Something that is not super well known is that there
Speaker 3: are body mass index limits, often for medical equipment. So
Speaker 3: if you're trying to get certain kinds of scans you
Speaker 3: might not be able to if you you know way
Speaker 3: too much. There are also body mass index limits for procedures,
Speaker 3: often and you know, ostensibly to make them less risky.
Speaker 3: Carolina Povian, who's a obesity doctor at Brigham and Women's
Speaker 3: Hospital in Boston, told us she has patients who because
Speaker 3: of their body mass index, can't qualify for literally organ transplants.
Speaker 3: We're talking heart transplants. People can't qualify for because of
Speaker 3: their body mass index. And yet they they also can't
Speaker 3: get access to a drug that would help them unless
Speaker 3: they're quite wealthy or they work at a company with
Speaker 3: exceptional insurance benefits.
Speaker 5: There have been some big wins for the Coalition to
Speaker 5: Doctors and advocates and companies are pushing for better coverage.
Speaker 5: And one of the most concrete examples of improving coverage
Speaker 5: is the Federal Employee Benefits Plan, and that's a big
Speaker 5: cluster of plans that covers federal employees. We're talking eight
Speaker 5: million people are in this. The federal government this year
Speaker 5: put out a rule that is requiring insurers in that
Speaker 5: plan to cover at least one of these GLP one
Speaker 5: drugs for BC. That's a big change that adds a
Speaker 5: lot of people onto the coverage roles.
Speaker 3: We also found in our analysis of state medicaid plans,
Speaker 3: So this is Medicaid is the program that ensures low
Speaker 3: income individuals in the US, and it varies a lot
Speaker 3: by state to state.
Speaker 4: And what we found as part of this is policies
Speaker 4: are changing.
Speaker 3: So a couple of states have actually started covering obcit
Speaker 3: drugs in recent years. A bunch of states, about eight
Speaker 3: told us that they're actually looking at maybe covering So
Speaker 3: it does seem like things are changing incrementally.
Speaker 1: What did the drug companies say about why these drugs
Speaker 1: are so expensive.
Speaker 5: I've done a lot of reporting on drug pricing over
Speaker 5: the years, and I found when you ask a company
Speaker 5: you know about the price, it's very hard to get
Speaker 5: a clear answer why they price it the way they do.
Speaker 5: But you know what Eli Lilly and Novadora say is,
Speaker 5: you know, the price of the drugs reflects the value
Speaker 5: and clinical benefits that they provide. Now, I will note
Speaker 5: that the Munjaro that's Eli Lilly's drug, is only approved
Speaker 5: right now for a diabetes, So they're talking about diabetes.
Speaker 5: And there's another strange aspect of the pricing that's going
Speaker 5: on in that Novo Nordisk when it came out with
Speaker 5: a higher dose version of a zempic called the GOVI
Speaker 5: that's only approved for obesity, it decided to price it
Speaker 5: about forty percent higher than ozempic, even though it's just
Speaker 5: a modestly higher dose of exactly the same drug.
Speaker 1: And why do they say they did that?
Speaker 4: We asked Novo Nordisk about this.
Speaker 3: Basically what they say is that with gov is more
Speaker 3: effective than their previous weight loss drug called Sexenda.
Speaker 4: You know, that's why they priced it that way.
Speaker 3: One common answer as well, it's a higher dose than nozepic.
Speaker 4: But it's not that much of a higher dose.
Speaker 1: As you continue to cover this, what are you looking for?
Speaker 1: What do you think comes next?
Speaker 5: Well, I want to see will any of these other attempts,
Speaker 5: you know, develop other follow on drugs, Will any of
Speaker 5: them come to fruition, Like one of the things that
Speaker 5: could help will be something that's not an injection that
Speaker 5: could be taken as a pill on. You know, some
Speaker 5: other drug companies like fives are working on but it's
Speaker 5: not clear whether those are going to have as much efficacy.
Speaker 5: So we'll get to know that in a few years.
Speaker 3: I do think there's going to be a lot of
Speaker 3: pressure to expand insurance coverage. I also think there's gonna
Speaker 3: be a lot of resistance to paying for it. It
Speaker 3: feels like things are going to come to a boil
Speaker 3: pretty soon.
Speaker 1: Emma, Bob, thanks so much for coming on the show.
Speaker 4: Thank you, thank you.
Speaker 1: When we come back, I talked to a physician about
Speaker 1: these weight loss drugs and the challenges of treating obesity.
Speaker 1: Let's hear now from someone who confronts these questions every day.
Speaker 1: Doctor Angela Fitch specializes in the treatment of obesity. She's
Speaker 1: president of the Obesity Medical Association, and I caught up
Speaker 1: with her at the group's spring conference in New York City. Angela,
Speaker 1: the American Medical Association ten years ago classified obesity as
Speaker 1: a disease. What is the importance of this distinction?
Speaker 2: So obesity really is a disease like other chronic diseases,
Speaker 2: and the path of physiology behind it is much more
Speaker 2: complicated than just the idea of eating less and moving more. Right,
Speaker 2: there's a lot of diseases hypertension, high cholesterol, heart disease
Speaker 2: that have lifestyle factors involved with them. But for many
Speaker 2: years it was felt even by personally, by patients, by society,
Speaker 2: that obesity was just people's fault, that it was just
Speaker 2: their own responsibility, and that they were just eating too
Speaker 2: much and not moving enough. And so this importance of
Speaker 2: classifying it as a disease was that it really is
Speaker 2: a disease because it's more complicated than just eating less
Speaker 2: and moving more and the AMA you know, declaring it
Speaker 2: a disease in twenty thirteen, you know, that's a long
Speaker 2: time ago, but over the course of this time, I
Speaker 2: really feel like we're finally at an awareness currently that
Speaker 2: it is a disease. You know, I liken it to
Speaker 2: mental health issues as well. For longest time, people didn't
Speaker 2: think depression or anxiety or other types of mental health
Speaker 2: issues was a disease state. It was more of just
Speaker 2: a you know, the person's own issue that they're dealing with.
Speaker 2: It was very stigmatizing, and now you know, we're at
Speaker 2: a point where people are more accepting of it is
Speaker 2: more about people's chemistry than about their character, right, This
Speaker 2: is not a character law. This is a biochemical process
Speaker 2: that creates the disease of obesity, just like you know,
Speaker 2: similar to what was a struggle for mental health for
Speaker 2: very many years until there was an increased awareness and
Speaker 2: an increased focus on treating the disease in a comprehensive
Speaker 2: chronic disease management fashion.
Speaker 1: You mentioned treating the disease. How does classifying obesity as
Speaker 1: a disease change the treatment? What are the practical effects
Speaker 1: of that?
Speaker 2: Yeah, because what we're leveraging for is better insurance coverage.
Speaker 2: We're leveraging for coverage of the whole spectrum of the
Speaker 2: disease process, from lifestyle management to medications, pharmacotherapy to bartic surgery,
Speaker 2: which is a very comprehensive approach to the treatment of
Speaker 2: a disease state. You know, much like cancer. You have
Speaker 2: a surgery for cancer, you have chemotherapy, you have radiation treatment,
Speaker 2: you have mental health treatment, you have lifestyle treatment that
Speaker 2: affects cancer. You know, a lot of cancer centers offer
Speaker 2: yoga and other types of mindfulness based treatment to help
Speaker 2: their patients live a longer, healthier life. And a lot
Speaker 2: of those times, those types of services can be covered
Speaker 2: under certain plans or by employers because of the fact
Speaker 2: that they are part of the overall comprehensive disease treatment.
Speaker 2: So it's about gaining access for patients, you know, access
Speaker 2: to coverage for these services by their insurance versus having
Speaker 2: to pay for so long, obesity was something patients were
Speaker 2: expected to pay out of pocket for in order to
Speaker 2: get access to that care.
Speaker 1: The treatment that we're talking about today are obesity drugs,
Speaker 1: this new class of drug that seems to be very effective.
Speaker 1: Are you using these drugs in your own practice?
Speaker 2: Yes, I've been practicing obest medicine. Now. I was a
Speaker 2: primary care physician double bordered in inter medicine and pediatric,
Speaker 2: so I see the full spectrum of the disease from
Speaker 2: young childhood, you know, through even older adulthood, so that
Speaker 2: full spectrum of treatment. You know, we offer pharmacotherapy as
Speaker 2: part of that treatment in the appropriate patient that it's
Speaker 2: indicated for, because it is much more effective than lifestyle alone.
Speaker 2: You know, a person with a blood pressure of one
Speaker 2: hundred and eighty over one hundred in my office, you know,
Speaker 2: I'm not going to just recommend lifestyle therey to start with,
Speaker 2: because that person has a disease burden of hypertension that
Speaker 2: is so strong for them, whether that's genetic or environmental,
Speaker 2: or maybe they have one kidney because they lost one
Speaker 2: in surgery. You know, the point is that they have
Speaker 2: a disease state that's bothering them, and if we don't
Speaker 2: treat it with a medication, they might have a stroke
Speaker 2: or a heart attack or some other thing happen.
Speaker 4: And the same is.
Speaker 2: True as obesti as a disease. You know, this has
Speaker 2: a lessyle component to it that is effective, but also
Speaker 2: it's much more effective. We're talking ten times more effective
Speaker 2: to reach your goals by adding pharmaco therapy, which is
Speaker 2: very similar to other chronic diseases that we manage diabetes, hypertension,
Speaker 2: cardiovath but disease, etc. Biologically, as humans, we are not
Speaker 2: designed to lose weight. It goes against everything in mother
Speaker 2: nature for us to lose weight. It's not the normal
Speaker 2: process for us. So trying to alter mother nature takes
Speaker 2: more than usually what we can sort of will away,
Speaker 2: if you will.
Speaker 1: What's been your exp eperiencing trying to get coverage for
Speaker 1: patients you prescribe these drugs, so it is very variable.
Speaker 2: I'm very fortunate that in New England where I'm practicing
Speaker 2: right now, we have excellent coverage by our commercial payers.
Speaker 2: So one of the things that we're trying to fix
Speaker 2: here at the OBC Medicine Association for which I'm president
Speaker 2: right now, is advocate that obese treatment would be a
Speaker 2: standard benefit on the insurance plan right now, the problem
Speaker 2: across the country and all commercial payers is that it's
Speaker 2: not a standard benefit, so employers have to choose to
Speaker 2: add it for an extra cost onto their coverage. Employers
Speaker 2: sometimes don't do that, they don't know they have to
Speaker 2: do it. Maybe there's a lot of reasons, you know,
Speaker 2: for that.
Speaker 1: In recent years, we've seen the rise of a body
Speaker 1: positivity movement, which says that just because you have a
Speaker 1: large body doesn't mean that you're sick. That there are
Speaker 1: people who are obese under the clinical definition but lead
Speaker 1: healthy lives, and there's people who are not clinically obese
Speaker 1: who have diseases. What is your view on that.
Speaker 2: I would say that one thing we're trying to work
Speaker 2: on too is to get rid of the word obese
Speaker 2: from our vocabulary, because what we talk about is obese
Speaker 2: sort of defines a person by their disease, and we
Speaker 2: don't like to use that terminology. And so when you
Speaker 2: have the disease of obesity, it's a disease that you
Speaker 2: have and you live with It's not something that sort
Speaker 2: of defines you, like I am an obese person, right,
Speaker 2: that sort of defines who I am versus I have obesity.
Speaker 2: The disease, as you pointed out, not everybody has the
Speaker 2: same severity of the disease is the issue. So what
Speaker 2: we're really looking at is identifying what each individual person's
Speaker 2: risk factor is related to that disease, like we do
Speaker 2: with any disease state, and then deciding in an individual
Speaker 2: shared decision making fashion between the patient and the clinician
Speaker 2: if treatment is warranted for them at this time, because
Speaker 2: even if they might be very healthy without other comorbidities,
Speaker 2: their obesity may be preventing them from running around as
Speaker 2: much at the playground with their grandchildren or fitting into
Speaker 2: the airline seat when they're traveling a lot because that's
Speaker 2: what they do for work. There's other reasons besides just
Speaker 2: general health or metabolic health that people choose to make
Speaker 2: changes to their weight, and they certainly should be accepted
Speaker 2: no matter what size they are, so reducing the bias
Speaker 2: and stigma around size is very important. At the same time,
Speaker 2: if they want to change their size, they should have
Speaker 2: the access to do that.
Speaker 1: Is there a concern that if these drugs are so
Speaker 1: widely available and are so effective that people will depend
Speaker 1: on them instead of living a healthy lifestyle where they
Speaker 1: eat well and they exercise, that this will become something
Speaker 1: that actually exacerbates a problem instead of addressing the core cause.
Speaker 2: We really are addressing the core cause with pharmacotherapy. Again,
Speaker 2: to assume that the core cause is poor eating or
Speaker 2: lack of physical activity is a biased assumption. Many people
Speaker 2: living in larger bodies with obesity are very active. So
Speaker 2: just assuming that someone has OBCs not active. I mean,
Speaker 2: I have patients who the Boston Marathon recently, and I
Speaker 2: didn't run the Boston Marathon. I can't do that, but
Speaker 2: they can because that's what they do and they practice
Speaker 2: for it. Right, And there's many people who eat a
Speaker 2: very healthy lifestyle, and that's why it's a disease state.
Speaker 2: You know, just like if you get cancer, right, it's
Speaker 2: not your fault. It's not maybe something that you did,
Speaker 2: maybe you didn't smoke, but at the same time you
Speaker 2: ended up with lung cancer. Now that being said, we
Speaker 2: all in the United States of America have to choose
Speaker 2: to live differently than our current environment because our current
Speaker 2: environment is very obesogenic. We have very large portion sizes,
Speaker 2: we have more ultraprocessed food around us, we have less
Speaker 2: physical activity. It's good for us to eat healthier, it's
Speaker 2: good for us to eat more vegetables, to eat more
Speaker 2: fiber and not eat the ultra processed food, right, but
Speaker 2: it doesn't always treat the disease of obesity. So again
Speaker 2: we need that comprehensive approach, and all of us at
Speaker 2: the OBC Medicine Association that practice OBC medicine take a
Speaker 2: comprehensive approach to treatment. You know, we're not just sort
Speaker 2: of dolling out drugs, so to speak, talking about some
Speaker 2: of these other lifestyle factors that are involved, because again
Speaker 2: it's optimizing that whole patient journey. That is really what
Speaker 2: all of us do as physicians and clinicians that practice
Speaker 2: medicine every day, you know, with any issue that our
Speaker 2: patients have, is to help them holistically, you know, to
Speaker 2: reach their health and wellness goal.
Speaker 1: Doctor Angela Fitch, thanks for speaking with me today.
Speaker 2: Thank you so much, Bess as a pleasure.
Speaker 1: Thanks for listening to us here at the Big Takes,
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Speaker 3: M