WeightWatchers goes all-in on GLP-1 Meds; the Year of Ozempic; Poison Control Centers increase in Calls related to Semaglutide; 63% of Older Adults want to take Meds for Obesity.
WeightWatchers CEO Sima Sistani says we ‘…got it wrong…’ and ‘…The science has changed…’ such that WeightWatchers announced the launch of a ‘…GLP-1 Program to provide tailored behavioral support for individuals.’
‘…Poison control centers across the US say they are seeing a steep increase in calls related to semaglutide…’ in reporting at CNN.
Twin Health, a Silicon Valley startup with an AI-based dynamic model of each individual’s unique metabolism, announced a $50M funding raise this week.
Weight management programs that ‘…may require diet and exercise before granting access to the medicines [GLP-1s]…’ are being deployed by U.S. employers in an attempt to curb costs, fromPatrick Wingrove at Reuters.
Dr. Dhruv Khullar, a physician at Weill Cornell Medicine, writes in the New Yorker on The Year of Ozempic.
The University of Michigan National Poll on Healthy Agingreports that ‘…63% of all adults age 50–80… have an interest in taking prescription medication for weight management in the future.’
NEWS
In a press release this week, WeightWatchers announced the launch of a ‘…GLP-1 Program to provide tailored behavioral support for individuals on a GLP-1 medication…’ that was ‘…scientifically designed to help support the unique behavioral and nutritional needs one faces while on a GLP-1 journey.’
The program seeks to solve ‘…a gap in the market as members navigate life on new weight loss medications…’ with adequate nutrition, healthy habits, and movement goals.
Dr. Gary Foster, Chief Scientific Officer at WW notes ‘…it is important to help people focus on dietary protein and activity to minimize the loss of muscle mass…’ for those on GLP-1 medications.
Whilst a big shift from the 60-year old Points Program that has been used across the globe, I think this is less of WW moving away from a lifestyle program for weight management, and more toward the all-encompassing approach of medication therapies that are taking the world by storm.
How to ensure that WW does not become another GLP-1 pill mill, driven toward satisfying the needs for a weekly jab irrespective of counselling, nutrition and exercise therapies, is yet to be seen.
WeightWatchers CEO Sima Sistani says we ‘…got it wrong…’ and ‘…The science has changed…’ where ‘…behavior change alone was not enough…’ as per The Telegraph newspaper.
Pertinently put by reporter Charlotte Lytton, ‘…It will either save the company or seal its fate.’
This new approach squarely puts WW on the radar of counterparts such as Noom with its Noom Med program, and Ro that also offers GLP-1 drugs to its subscribers.
So is dieting ‘…now a dirty word?’
On costs of the meds, Sistani is a proponent and ‘…believes the US government should pay for jabs for those most in need.’
Megastar and media icon Oprah Winfreysays in People ‘…Obesity is a disease. It’s not about willpower — it’s about the brain…’ in a revelation that ‘…She Uses Weight-Loss Medication as a Maintenance Tool.’
I do love the power and purpose behind her comment that ‘…I’m absolutely done with the shaming from other people and particularly myself.’
Once on the medication, during Thanksgiving ‘…instead of gaining eight pounds like I did last year, I gained half a pound . . . It quiets the food noise.’
In a frame to the risks of prescription medications, ‘…Poison control centers across the US say they are seeing a steep increase in calls related to semaglutide…’ in reporting at CNN from Brenda Goodman.
Last year, ‘…America’s Poison Centers reports nearly 3,000 calls involving semaglutide, an increase of more than 15-fold since 2019…’ mostly from dosing errors.
Dr. Joseph Lambson, director of the New Mexico Poison and Drug Information Center said ‘…We were getting reports of people giving themselves doses we had never heard of before…’ at up to ten times the prescribed dose, leading to vomiting, abdominal pain and nausea.
To be frank, 3,000 calls when up to 2 million Americans are on a GLP-1 drug is a very small proportion; certainly not something to ignore, but also not a revelation.
OptumRx will ‘…launch Weight Engage, aimed at offering a flexible solution to the high cost GLP-1s, to employer sponsors…’ in January 2024.
The program ‘…offers weight management and cardio metabolic disease solutions to support better health outcomes and manage consumer drug spending…’ with a focus upon ‘…coverage of GLP-1s for weight loss purposes.’
The approach is certainly to address GLP-1 costs, without compelling data today for a valid return on investment.
The U.S. Preventive Services Task Force, an independent, volunteer panel of national experts in disease prevention and evidence-based medicine, published a draft recommendation statement ‘…that children and adolescents age 6 years or older with a high BMI receive intensive (26 or more contact hours) behavioral interventions.’
The Task Force fell short of recommending pharmacologic therapy, citing a lack of evidence, with behavioral interventions should be the primary effective intervention.
The evidence review incorporated data from 58 randomized control trials, with nearly 9,000 individuals; of which eight studies were on medication therapies.
Twin Health, a Silicon Valley startup with an AI-based dynamic model of each individual’s unique metabolism, provides members individualized, precise, timely guidance across nutrition, sleep, activity and stress, announced a $50M funding raise this week.
Jahangir Mohammed, Founder and CEO of Twin Health, noted the ‘…funding will help propel our strategy to scale the availability of our transformative technology and the way it’s deployed to even more health plans and employer partners, achieving lower costs, better outcomes and higher satisfaction.’
Twin Health has ‘…expanded its reach with strategic partners in the employer and health plan domains, covering over 4 million lives…’ with data to support ‘…a significant reduction in HbA1c in the intervention group (2.9% reduction from 9.0 to 6.1).’
Kevin Johnson, former CEO of Starbucks, who is on Twin Health’s board of directors, said ‘…Twin is delivering on its promise of happier and healthier people with significant cost savings to households and employer healthcare plans. A step forward for humanity.’
OPINION
Weight management programs that ‘…may require diet and exercise before granting access to the medicines [GLP-1s]…’ are being deployed by U.S. employers in an attempt to curb costs, from Patrick Wingrove at Reuters.
Boeing, Hilton, and Fortune Brands have allegedly ‘…signed up for or expanded deals with virtual healthcare providers…’ that include one to three months of lifestyle therapy; which is no different to the approach to have a patient be ready for life-changing bariatric surgery.
‘Blue Cross Blue Shield of Michigan, a health insurer with more than 5 million members, said next year it will offer employer clients an option for patients to sign up for Teladoc’s weight management program that involves six months of diet and exercise before patients can get Wegovy or Zepbound…’ and further must ‘…continue the diet and exercise requirement in order to keep being prescribed the drugs.’
Additional roadblocks to medication therapy may include a centers of excellence approach – again, this has been tried with bariatric surgery and may lead to greater delays in initiation of treatments that are effective and durable.
Venture capitalists was to ‘…put their money behind startups that benefit from the drugs’ rise but don’t rely on prescribing them…’ from Rebecca Torrence at Business Insider.
Sari Kaganoff at Rock Health wants to figure out how ‘…we get much more nuanced in our approach to treating people with obesity…’ with a general heeding to the recent fall of Calibrate, and ‘…patient complaints of long response times and medication denials…’ at Ro too.
Michael Greeley at Flare Capital is ‘…not geared to invest in the actual drug…’ as it ‘…feels like it’s done.’
Alyssa Jaffee at 7wireVentures said she’d be more likely to back ‘…a company promising an off-ramp for people who want to stop taking the drugs while maintaining weight loss…’ which is admirable if true, though unproven to date.
Alfie Health, an AI-powered clinical-decision support for obesity, and Phenomix Sciences, a Mayo Clinic spinout, are taking a data-based approach to risk stratification.
Cardiovascular startups are also in the picture, with the recent data of a reduction in major adverse cardiovascular events of up to 20% in patients on GLP-1 medications, and perhaps even musculoskeletal startups such as Hinge Health too.
My take is that we need a platform-based approach to multimodal obesity care, that acts as the honest broker between the multitude of options available, to enable healthier and happier populations.
Dr. Dhruv Khullar, a physician at Weill Cornell Medicine, writes in the New Yorker on The Year of Ozempic.
From a historical bent on the development of insulin, and the merger of Novo and Nordisk to form Novo Nordisk, Khullar explores the first iteration of GLP-1 drug liraglutide, also known as Victoza.
Stories on the onward profound data on weight loss, the emergence of Eli Lilly and Novo Nordisk as corporate powerhouses, and obesity going from a choice to a chronic disease, are elegantly retold.
Costs of the medications, supply shortages, suspected fake Ozempic pens, and the so-called Ozempic revolution are covered; importantly, the fact that the medications don’t work for everybody.
Overall, Dr. Khullar believes ‘…our post-Ozempic world will be better than the one we lived in before. For the first time in years, I’m reading from a new script. This one has a more hopeful ending.’
DATA
The University of Michigan National Poll on Healthy Agingreports that ‘…63% of all adults age 50–80… have an interest in taking prescription medication for weight management in the future.’
From the almost three thousand persons surveyed, ‘…83% agreed that health insurance should cover prescription medications that have been FDA-approved for weight management.’
One in four, or 27% reported being overweight, and one in six, or 16% ‘…have taken a prescription medication for weight management.’
There is ‘…strong awareness and interest in these medications, and in access to them through insurance…’ in a statement from Dr. Lauren Oshman, who was involved in the study.
This is certainly a push toward Medicare Part D coverage of GLP-1 medications, which would be highly effective, though also grossly expensive to the U.S. taxpayer.
An under reported, though deeply important area, regarding GLP-1 medications, is on their use during pregnancy and whether there is a significant risk to the unborn baby, considered in a JAMA article this week.
Data was compiled from over 3.5 million pregnancies, across four Nordic countries, the United States and Israel, resulting in just over 50,000 women who were suffering from diabetes.
A mere 938 women were utilizing GLP-1 drugs, or just about 6% of the evaluated population.
The authors found ‘…no elevated risk of MCMs [major congenital malformations] after periconceptional exposure to GLP-1 receptor agonists.’
Whilst this data is reassuring, ‘…confirmation from other studies is needed, and continuous monitoring will provide more precise risk estimates in the future as data accumulate.’
Whilst the risk seems to be minimal, clinically indicated criteria are important for the prescription, and onward maintenance of women of reproductive age on GLP-1 anti-obesity medications.
From the desk of Dr. Louis Aronne and colleagues, comes a scientific publication in JAMA on the role of continued tirzetapide, or Zepbound, to maintain weight loss in adults with obesity, also known as SURMOUNT-4 study.
Just shy of 800 subjects received once weekly tirzetapide injections, over a 36 week period; resulting in a mean weight reduction of almost 21% – wow!
For a further 52 weeks, half of the group were put on a dummy placebo drug, and the other half continued on tirzetapide; the former regained 14% total body weight, whilst those remaining on the drug lost an additional 5% of their body weight, to an overall weight reduction of 25%.
This is impressive data, though also has been reported previously in terms of the total weight loss achievable, and that stopping a medication for the chronic disease of obesity leads to resurgence of the disease.
Dani Blum at The New York Timeswrites on the recent JAMA study on patients who stopped taking Zepbound after 36 weeks, with the note that people ‘…may have to stay on it for the foreseeable future.’
In a counter approach, Dr. Melanie Jay, director of the NYU Langone Comprehensive Program on Obesity says ‘…Nobody wants to take medicine forever.’
