PBS NewsHour | How new weight loss drugs are treating obesity | Season 2023

GEOFF BENNETT: While there are no quick solutions or pills that easily solve the problems of obesity, a new crop of anti-obesity drugs are proving remarkably effective, cutting body weight by an average 15 to 22 percent.

These medicines, including Ozempic and Wegovy, could trigger a shift in how doctors treat this.

But the drugs come with a hefty price tag, some costing over $1,000 a month, and many insurance companies won't cover them.

In a moment, William Brangham talks with a specialist about this.

But, first, let's hear from some people taking these drugs.

NANCY BARNES, Louisiana: My name is Nancy Barnes.

I live in New Iberia, Louisiana.

In a year-and-a-half, I have lost 107 pounds.

TESIAH COLEMAN, California: I'm a nurse practitioner, I use she/her pronouns.

And I'm based out of California.

JANET ROGALLA: I'm Janet from Chicago, Illinois.

And I have been on weight loss medicine for a couple months, and recently found out that my insurance no longer covers it.

NANCY BARNES: People say, well, if you would just quit eating, you would be fine.

And I truly believe that the stigmas associated with being overweight is so wrong, and compared to celebrities.

They're doing it to lose 10 pounds to get into a dress.

The rest of us just want to feel better.

We want our knees to quit hurting.

We want the inflammation to be gone.

TESIAH COLEMAN: Like, a side effect has been losing weight, but that's not what my -- necessarily my aim was.

My aim was really to stop, like, kind of the thought patterns and the binge eating-like cycles that I was going through.

And the Wegovy acts as kind of like a shutoff switch, I guess is the best way to describe it.

JANET ROGALLA: I started taking it and instantly felt so much better, like, had energy, had no cravings for any kind of sweets, and then went again to get my second-month refill at the beginning of January.

And, again, it was $25.

Then, just recently, I had to get my next month, and the -- they told -- the pharmacy told me it would be $2,000.

And she goes, do you realize that it's $2,000?

And I'm like, no?

TESIAH COLEMAN: I think making these medications more accessible is really important, because not only is it super expensive, which I have had - - but even when your insurance does cover it, I have had to spend hours and hours on the phone with my insurance company.

And that's me, as a medical provider, like, understanding how to navigate the system.

And I have had to spend so much time just to access my medication every month.

JANET ROGALLA: At this point, it's really kind of up in the air.

I'm not sure what's going to happen.

And, to me, it's kind of scary, because it's something that's working for me finally, and for it to be taken away is very heartbreaking.

NANCY BARNES: And I just feel better.

I mean, the whole point, to me, my blood pressure's not 205 over 140.

It's normal.

And I can walk my dog.

WILLIAM BRANGHAM: So those are some of the many people who are taking these drugs and seeing some real benefits.

But soaring demand for these medications has also led to shortages, which can leave diabetic patients who also use some of these drugs stuck.

So, for a medical perspective, I'm joined by Dr. Fatima Cody Stanford.

She's an obesity medicine physician at Massachusetts General Hospital and a professor at Harvard Medical School.

For the record, she is a consultant to several pharmaceutical companies, including the one that makes Ozempic.

Dr. Stanford, so good to have you on the "NewsHour."

I wonder, what is your take on these medications?

Do you see them as this remarkable new evolution in treatment?

And, if they are working, why are they working this way?

FATIMA CODY STANFORD, Harvard Medical School: Absolutely.

First of all, thanks for having me.

And I'm so happy to finally hear a conversation where we're beginning to address this chronic disease that is obesity.

And these medications really spend their time acting primarily on the brain to up-regulate one of the pathways that tells us to eat less and store less, while down-regulating a pathway that tells us to eat more and store more.

So, that's the primary way and where these medications work.

And so, when we listen to those individuals that have had a chance to experience, the benefits of these medications, you will hear about how it's influenced just their daily life.

And that's how these medications work.

Now, there are several medications, in addition to these ones that we're talking about today, that also influence how the brain sees weight.

And so it's important for us to recognize that all things don't work for all people.

Even people with obesity have differences in how their bodies navigate,different agents to help them treat obesity, including the medications that we're talking about today.

WILLIAM BRANGHAM: So people who do have the disease of obesity, if they are taking these medications, do they take them for life?

Is that correct?

FATIMA CODY STANFORD: Yes, that is.

And I really have thought about this quite a bit, William, trying to figure out like, how do I explain this to people?

No one expects to eat one healthy meal and expect that to last them indefinitely.

Nobody does one great workout and expects that to last indefinitely.

Similarly, these medications are acting on different portions of the brain.

And while they're being used, they're effective.

As soon as you pull them back, they're no longer acting on the body, much like, if you're no longer eating a healthy diet, you're no longer exercising, those things aren't working on the body.

So I think that, if we think about the need for chronic, healthy diet, chronic exercise, that, for those people that these medications are effective for, we do need to use them chronically.

WILLIAM BRANGHAM: We heard in the voices prior to this that some patients were having trouble paying for it because their insurance had run out.

Do you believe, from your expertise, that -- on balance, that these provide enough benefit that they ought to be covered by insurance?

FATIMA CODY STANFORD: You know, I really am a strong advocate for coverage of this chronic disease, what we know to be the largest chronic disease in human history, affecting over 42 percent of the population.

And that's based on 2018 numbers.

As you know, we're in 2023, so those numbers are much likely higher.

We know that obesity leads to over 230 other diseases, so why not treat the one that's contributing to, unfortunately, many others?

I think we -- the cost/benefit ratio is one that we have to be aware of.

And we also know from a lot of data that these medicines improve both your cardiovascular health and non-cardiovascular health.

What do I mean, by that?

We know it reduces the rate of stroke, heart attack, admission for heart failure.

These are things that we can't discount.

And so, if we know this, if the data shows that and we have robust data showing that, then why not utilize these medications in individuals that could benefit?

WILLIAM BRANGHAM: As you will know, there's this ongoing discussion about the disease of obesity and how we treat it, whether it's something to be -- quote, unquote -- "cured" or not.

There's so much shame and stigma attached to it as well.

Where do you come down on that?

And how do these medications fit into that discussion?

FATIMA CODY STANFORD: Well, I do know that shame and stigma are very, very pervasive.

The two most common forms of bias in the U.S. are race bias, followed very closely by weight bias.

We judge, we devalue, we dehumanize individuals that struggle with this disease, and we don't feel like they deserve any forms of therapy.

We believe that they have done this to themselves.

After treating over 10,000 patients with obesity, I can tell you, that is not the case.

They have tried.

They have struggled.

And we have not been able to offer them any benefits from other things that we would do for chronic diseases, which are medications, which are surgical interventions that sometimes people often need.

This is a chronic disease.

And so there is no magic pill, there is no magic injection, there is no magic surgery, but we can treat that person over the long term for their disease and help improve their overall health and just their ability to navigate the earth.

One of the things we heard in one of the, I guess, outtakes was that a woman talked about, hey, I just want to be able to walk my dog.

That's not something that a lot of us have to think about.

We're able to do that with ease, without any stress or strain.

Why shouldn't every human have that ability?

WILLIAM BRANGHAM: Dr. Fatima Cody Stanford, thank you so much for being here.

FATIMA CODY STANFORD: Thanks so much for having me.

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