Weight loss is only maintained while taking the drugs; once treatment stops, weight can be regained, and so the costs of chronic treatment, for both individuals and health systems, could be substantial.

Global efforts are on to discover effective drugs for obesity and diabetes. While a simple pill or injection will undoubtedly help some patients, it cannot be the sole basis for addressing the complexities of obesity, notes a recent Lancet article.

The article, which reads like a passionate appeal, explains how obesity is a product of not only an individual’s circumstances and behaviour, but also society at large, shaped by global food markets and trade agreements. “Sugar taxes and curbs on marketing of high-energy, high-fat, ultra-processed foods need to be implemented. Prevention must be the foundation upon which everything else follows,” it states. 

Physical activity needs to increase, says the article. “Walking and cycling for journeys to work or school should be normalised and made easier and safer,” it recommends. 

The article talks about how weight-loss drugs are used not only when medically indicated, but also when someone simply wants to shed a few kilograms. “Manufacturers will no doubt be working to widen the indications for these drugs. Although prescribing medications on a large scale is readily accepted for other common conditions, our understanding of the efficacy and safety of this class of drugs is still at a very early stage. Longer-term surveillance studies of risks and benefits of treatment in different patient groups are essential,” it states. 

Currently, approved medications cost around $300–1300 for four weeks of treatment. “Weight loss is only maintained while taking the drugs; once treatment stops, weight can be regained, and so the costs of chronic treatment, for both individuals and health systems, could be substantial,” says the article. 

However, financial savings associated with effective treatment of diabetes and obesity-related diseases — including many cancers — are potentially huge. The lifetime medical costs for children aged 10 years with obesity in the USA have been estimated to be $9.4–14.0 billion. “Obesity can cause productivity losses including through sick-leave days, long-term incapacity, and early retirement with substantial economic consequences.”

“The costs are not likely to be borne equally by all. Inequity will be increased between those able to pay — and with less need — and those with greater disease burdens in more socially deprived groups and in poorer countries,” it adds. 

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