Want to read Slashdot from your mobile device? Point it at m.slashdot.org and keep reading!

 



Forgot your password?
typodupeerror
×
Medicine

Weight-Loss Surgery Down 25% as Anti-Obesity Drug Use Soars (harvard.edu) 121

A new study examining a large sample of privately insured patients with obesity found that use of drugs such as Ozempic and Wegovy as anti-obesity medications more than doubled from 2022 to 2023. During that same period, there was a 25.6% decrease in patients undergoing metabolic bariatric surgery to treat obesity. From a report: The study, by researchers at Brigham and Women's Hospital, in collaboration with researchers at Harvard T.H. Chan School of Public Health and the Brown School of Public Health, is published in JAMA Network Open. "Our study provides one of the first national estimates of the decline in utilization of bariatric metabolic surgery among privately insured patients corresponding to the rising use of blockbuster GLP-1 RA drugs," said senior author Thomas C. Tsai, a metabolic bariatric surgeon at Brigham and Women's Hospital.

Using a national sample of medical insurance claims data from more than 17 million privately insured adults, the researchers identified patients with a diagnosis of obesity without diabetes in 2022-2023. The study found a sharp increase in the share of patients who received glucagon-like peptide-1 receptor agonists, or GLP-1 RAs, during the study period, with GLP-1 RA use increasing 132.6% from the last six months of 2022 to the last six months of 2023 (from 1.89 to 4.41 patients per 1,000 patients).

Meanwhile, there was a 25.6% decrease in use of bariatric metabolic surgery during the same period (from 0.22 to 0.16 patients per 1,000 patients). Among the sample of patients with obesity, 94.7% received neither form of treatment during the study period (while 5% received GLP-1 RAs and 0.3% received surgery). Compared to patients who were prescribed GLP-1 RAs, patients who underwent surgery tended to be more medically complex.

Weight-Loss Surgery Down 25% as Anti-Obesity Drug Use Soars

Comments Filter:
  • by ZipNada ( 10152669 ) on Thursday October 31, 2024 @10:28AM (#64908933)

    “Metabolic bariatric surgery and GLP-1 RAs are both effective interventions for patients with obesity, yet less than 6 percent of patients in our study received either form of treatment.”

    Understandable in a way. The drugs are expensive and can have serious side effects. The average cost of bariatric surgery ranges between $17,000 and $26,000, but it reportedly is relatively safe and often results in significant weight loss.

    https://www.saintalphonsus.org... [saintalphonsus.org]

    • "...and often results in significant weight loss" True, but they weight can come back over time.
      • >> weight can come back over time

        Very true, you have to keep taking the expensive weight loss drugs that have side effects but the bariatric surgery is a one-time thing.

  • When you're eating enough to be fat enough it is having a serious negative effect on your life and you're not willing to reduce your food intake... That's a mental issue. A behavior you can't manage to change.

    Drugs and surgery are temporary corrections of the symptom, if you don't deal with the problem - wanting and consuming too much food - you're going to need more drugs or surgery, or you're going to get fat again.

    • by AmiMoJo ( 196126 ) on Thursday October 31, 2024 @10:43AM (#64908975) Homepage Journal

      Over 2/3rds of Americans are overweight or obese. That seems to rule out mental problems, because what is a normal mental state is defined by the behaviour of the majority. Few people believe in little green men so that's a delusion, but a lot of people believe an omnipotent being controls their life and responds to flattery, so that's perfectly normal.

      Would you also say that people who are addicted to tobacco products also have a "mental issue"? It's not an unreasonable comparison. Food companies are strongly motivated to create products that are addictive, and then use every means they can to induce you to buy them.

      • If you have the capacity to change your behavior and you're suffering because you won't... It's a mental issue no matter how common it is. This can be heavily influenced by your environment and culture, but the truth is that if you WANT to be healthier, it's not impossible to do so without and easy/quick fix solution. You can even eat healthier in addition to eating less, and save money while doing so.

        It takes some effort. Culturally, we're not that big on effort. Most people pretend - taking up a new

        • by AmiMoJo ( 196126 )

          Consider that these medications are not cheap, and a hefty chunk of change every week is a pretty big motivator. Between that, the people fat shaming them, the desire to look conventionally attractive, the health problems obesity causes, the daily inconveniences, the rising cost of food, you would have to assume that the majority of Americans are extremely lazy and willing to put up with a hell of a lot just to avoid your easy and effective solution.

          A more likely explanation is that it is in fact far harder

          • >the people fat shaming them

            I'd never do that. I consider it more or less a choice they've made. As long as they don't demand that I find them attractive or pretend that it's healthy, it's generally none of my business.

            >it is in fact far harder than you realize.

            I've lost weight. And gained. And lost. Not on a huge scale, but I have been heavy enough my doctor told me I should be quite a bit lighter. I'm still slightly above where I should be, but I know when my weight is going to fluctuate signi

            • You are getting fat because you are eating more than your body requires to sustain itself. Or you're staying fat because you are eating enough to sustain your body at that mass.

              It's not as simple as that. In the first place, you can be on a ketogenic diet in which you eat a diet fairly high in protein, VERY high in fat, and with small or negligible carb content. You might be consuming 3,000 calories a day, and you will still lose weight; and you'll keep it off, as long as you avoid those carbs - especially the simple ones, and most especially the refined ones. I'm not saying carbs are unimportant, as some of them are our only sources of vital minerals, vitamins, and other compoun

              • That's a lot of text just to clarify to 'eat too much of digestible food'.

                • That's a lot of text just to clarify to 'eat too much of digestible food'.

                  So protein and fat aren't digestible? Good to know! You should publish a paper to that effect - I'm sure the entire scientific community will hail your wisdom and insight.

      • by skam240 ( 789197 )

        That seems to rule out mental problems, because what is a normal mental state is defined by the behaviour of the majority.

        Does it? The number of obese Americans has tripled in the last 60 years https://usafacts.org/articles/... [usafacts.org] which pretty much means there's a mental issue at some level here for a lot of people regardless of whatever "normal" is. Everyone knows eating lots of sweet treats will put pounds on, everyone knows fast food will too. The choice to continue heavily consuming such items despite being able to physically see the negative effects on one's health (the expanding belly) is a mental one.

        And sure, things like

        • by AmiMoJo ( 196126 )

          So your theory is that more than 2/3rds of Americans have developed mental problems, as opposed to the far more likely hypothesis that foods and eating habits have changed dramatically over the last 60 years?

          • by skam240 ( 789197 )

            No, my theory is that roughly a third of Americans are making bad decisions in regards to their health. Obesity and being overweight has been a thing since well before the current epidemic of it and as I eluded to before those with such predispositions have my sympathies and should consider these drugs as many of them have needs that go beyond what diet and exercise can accomplish. Never the less, there's about a third of the population that clearly just arent taking responsibility for their actions given h

        • Maybe its just the kind of food people are being fed.

          "The rising obesity epidemic in the U.S., as well as related chronic diseases, are correlated with a rise in ultra-processed food consumption. The foods most associated with weight gain include potato chips, sugar sweetened beverages, sweets and desserts, refined grains, red meats, and processed meats"

          https://smhs.gwu.edu/news/proc... [gwu.edu]

      • by CubicleZombie ( 2590497 ) on Thursday October 31, 2024 @11:14AM (#64909065)

        Would you also say that people who are addicted to tobacco products also have a "mental issue"? It's not an unreasonable comparison. Food companies are strongly motivated to create products that are addictive, and then use every means they can to induce you to buy them.

        When my overweight wife would get hungry, she had exactly the same symptoms as when I would be in withdrawal from nicotine.

        • by AmiMoJo ( 196126 )

          I heard the same thing from a friend, and I'm ashamed to say I didn't believe them at the time.

      • by wyHunter ( 4241347 ) on Thursday October 31, 2024 @11:37AM (#64909133)
        "Mental problems," no, but knowledge lack, yes. YES I'm 25 pounds overweight so I'm not on my high horse - but what I see in terms of food with minimal nutrition in people's shopping carts is astounding. OF COURSE people eat too much - they are fat, but starving, because they aren't getting enough nutrition.
    • by piojo ( 995934 ) on Thursday October 31, 2024 @11:12AM (#64909063)

      I dunno about you, but I eat a lot of real food--things that used to be plants and animals. I'm grateful to be in a position to be able to do that. So would I reduce my food intake without altering my appetite? Maybe someone that eats like crap could say "one fewer bag of crisps per day", but what would I say? One less spoon of chicken and black beans? 25% less olive oil in the hummus? Eat smaller fruit? Unless your food comes from cans and boxes, you can't just eat less. You can do something more nuanced, like alter your appetite, learn to detect fullness earlier, or be hungrier.

      When you're eating enough to be fat enough it is having a serious negative effect on your life and you're not willing to reduce your food intake... That's a mental issue.

      Food for thought: if you eat 1% too much, you will gain over two pounds per year.

    • There are a wide range of physiological reasons why people become obese. I've been packing on some pounds because of back problems making it hard to do the sort of exercise I used to do to keep fit. Also most simply when you gain weight your body creates more cells to store fat but when you lose the weight you don't lose those cells they just get smaller. Basically if you've gotten fat once it's permanently harder to keep the weight off.

      This is before we get into all the gut bacteria problems many of wh
  • by Murdoch5 ( 1563847 ) on Thursday October 31, 2024 @10:34AM (#64908947) Homepage
    * Not everyone does, there is a population that does need real medical intervention, and aren't just lazy, and unwilling to change, this is NOT about that group.

    Okay, how many people are on these drugs, but take no real responsibility? I can name a handful of people, all women, who are on Ozempic, who DO NOT NEED IT. What do I mean, when I say they don't need it? All the people I'm thinking of have the same few points in common:

    1. They have terrible diets.
    2. They've all tried the fad diets, including Keto (which is for intractable epilepsy in kids, who "normal" meds don't work for).
    3. They're very stationary, and their active outputs aren't useful.
    4. This is important, they don't take responsibility!

    Fad dieting, is NOT a method for weight loss, if you move between Keto (which you should NEVER do), Fasting (starvation), FOD MAP (which is nonsense on overdrive), and all the others, you're asking for your body to react negatively. If you eat pasta 4x a week, you're not going to lose weight. If you mix random shakes full of nuts, powders, and fruits, chances are, you're not going to lose weight because, you don't really know what's in the mess you're drinking. Stabilize your diet, so your body knows what to expect, look at what people eat who have low-fat levels, body builders and strongmen. Notice how they share the same diet, protein + simple carbs, and then just copy it adjusting for your body weight.

    Once you have a real diet, that is balanced, then get to the gym, and or get active! You need to be moving, so move weights around, have some cardio, and make sure you're meaningfully and usefully active. If you sit at a desk for 8 hours a day, 5 days a week, you can't be shocked when you put on the pounds, so honestly, get a standing / sitting desk, get a little treadmill and walk while you work. Also, go to the gym, 3x a week, and try to get into some sports if you can, which can be substituted for the gym.

    If you're done those things for a year or two, and you're still gaining weight, then you might actually have a problem, but, doctors today are prescribing Ozempic because after trying Keto 4 times, and FOD MAP for 1 week, after sitting on your ass for 80 hours, you had a cry session that you're a cow, and it's not your fault your fat, it's societies. All the people I'm thinking of, could get active, get a better diet, and stop making excuses, and they would be in better overall health for it. They would ALL get mad at me for saying this, while also trying to eat 10kg of pasta for dinner, covered in thick sugary sauce, with a side salad covered in equal amount of sugar dressing, then insisting I'm not a woman, so I can't understand, then laying down because "Oh, I just don't feel well."
    • by AmiMoJo ( 196126 )

      Human beings evolved when the food supply was unreliable. Plants and animals had not been bread to be larger and higher in fat, or pumped full of hormones.

      Modern foods are produced by people who have a vested interested in selling you as many calories as possible. The US, where this problem is the worst, also has very low food standards compared to other developed nations. Life now doesn't give people much time to prepare or even seek out healthy food.

      It's not the case that people today lack the willpower a

      • That's why you need to stabilize the diet because if you don't fix that first, unless you're genetically lucky, it won't matter. Farmers markets are a great way to find high-quality meat, or, find a local meat distribution company. For the people I'm using as my base, all of them have high-quality meats available. One of them lives within 200 meters of a butcher, in a large city, the others live within a few KM from a butcher, but also near multiple open air food markets during the spring / summer, and ne
        • by AmiMoJo ( 196126 )

          Around here meat is quite expensive relative to other foods, and farmers markets and butchers tend to be higher priced than supermarkets.

          Pasta is cheap and very easy to prepare.

          • I live in Canada, relevant for the medical notes.

            Yes, it's cheap, and easy, but you can't consume crap, and then at the same time whine about your inability to control your weight. The people I'm referring to are all well off, so groceries are not a burden, but, on the other hand, I know someone whose has a burden paying for the basics. He actually has a legit medical reason to need something like Ozempic, but on some sad notes:

            1. Can't afford it (our family offered to cover it for him).
            2. Can't get
    • I mean if you were responsible you just wear a gas mask so that you didn't breathe in all the particulate or you would move to the country so you won't breathing in all the little bits of tire spat out into the air by all the cars.

      What you definitely shouldn't do is consider what the combination of large amounts of gut bacteria destroying plastic and long work hours coupled with cheap junk food that requires a little or no preparation would do to a population.

      Because as we all know there are no suc
      • Actually, you made a good point, I put an asterisk in because it's important to note some people have a real need. Imagine if you smoked a pack of cigarettes a day for 40 years, and then complained when you got lung cancer. Well, it's not like you didn't see it coming, you knew the risks, you accepted the risks, and the risks materialized.

        On the other hand, someone could live a health lifestyle, never smoke a day in their life, and still get lung cancer, the difference is the second person has every ri
  • by MpVpRb ( 1423381 ) on Thursday October 31, 2024 @11:15AM (#64909069)

    ...less curable than cancer.
    Most people who lose weight with dieting gain it all back and more.
    Some believe it's simple and insult those who fail to achieve healthy weight.

    It's not simple!

    Weight loss surgery is a crude and awful approach. The new drugs are a tiny bit better, but still are not the solution. This is a hard problem. We need research, not hate and insults

    • by Tablizer ( 95088 )

      Amen! The human body evolved to hunt, gather, and/or farm most the day. Our metabolism etc. is not designed for desk jobs.

      Exercise helps, but I lose only about 1/3 a pound per average minutes of exercise per day. Thus, if I exercise 45 minutes a day, I'll lose about 15 lbs. It's like a sub-minimum-wage job: work your ass off for dimes.

  • This is a miracle drug. Not only did I lose 110lbs last year, my blood work is all back in the normal for the first time in 20 years. I eat entirely better with an eye towards nutrition. I also quit drinking (addiction breaking is a very common theme in the Tirzepatide groups) ....go figure.
    I was over weight for 20 years (classic yo-yo dieter. I could lose, but it always came back. I put on 40lbs during the two years I ran marathons)

    What is really cool? I turned 12 people on to the same drug. Combined we
    • by Anonymous Coward

      Mounjaro totally reversed my wife's insulin resistance. Her blood sugar doesn't crash when she misses a meal.

  • I'm not saying that these medications don't have a place, particularly for folks in extreme cases you need a jump start, but the idea that one would have to take these medications for the rest of their lives is awful. I think the part that's missing from the "balanced diet and exercise" message is that it is definitely not a "get thin quick" plan. Healthy weight loss is between 0.5-1lb per week. That means following those "balanced" routines takes a lot of time, and killing yourself in the gym for two we

  • Long term effects of Semaglutide: Allergic Reactions, Depression and anxiety, Gastrointestinal Issues, Hypoglycemia, Kidney Issues, Pancreatitis, Thyroid Tumors
  • Insurance won't cover it for pure weight loss, only for its original use for diabetes. If you buy on your own it will run $20,000/year
  • We could just eat healthier?

  • I don't think the data in the paper is a very accurate representation of the true population. Many insurance plans explicitly exclude bariatric surgery from their covered services, and I'd be surprised if those same plans don't exclude weight loss drugs as well.

  • And yet my wife, who is diabetic is virtually unable to get it as it falls under federal pricing guidelines.

"I will make no bargains with terrorist hardware." -- Peter da Silva

Working...