Two overweight bellies touching

With obesity rates in the United States having tripled since the 1980s, the health care system now faces an annual cost of $173 billion due to obesity-related complications, such as heart disease, hypertension, joint pain and certain types of cancer. And employers, or health plan sponsors, shoulder a substantial portion of these expenses, prompting the question: Could drugs in the latest generation of medications approved to promote weight loss be a solution?

These medications, originally approved to treat type two diabetes mellitus, are known as incretin mimetics or GLP-1s. They work by mimicking a naturally occurring hormone (glucagon like peptide) that affects insulin and glucagon levels and also regulates appetite. One medication in this class is a dual acting agent that in addition to mimicking GLP-1 it mimics another gut hormone, glucose-dependent insulinotropic polypeptide (GIP) which also affects insulin and glucagon levels.

In 2021, the American Diabetes Association updated diabetes treatment recommendations to include GLP-1s or SGLT-2 inhibitors (another medication class to treat diabetes) as a first line agent for some individuals. Previously the guidelines recommended GLP-1s or SGLT-2s as second line agents after metformin. Subsequently the 2023 guideline update reinforces that obesity is a disease and weight loss goals should be recommended for some individuals.

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