Recognizing and treating obesity as a disease - 60 Minutes - CBS News

1 year ago 70

A medicine for obesity

Promising caller value nonaccomplishment medicine successful abbreviated proviso and often not covered by security | 60 Minutes 13:24

Almost fractional of American adults person obesity, a information that was a fraction of that conscionable 40 years agone and scientists don't hold connected what's caused the melodramatic increase. What everyone does hold connected is that it's a large wellness crisis, due to the fact that obesity tin origin benignant 2 diabetes, hypertension, changeable and much than a twelve cancers.

Now there's a medicine that leads to melodramatic value loss. But it's wildly expensive. Hollywood celebrities instrumentality it to flatten their tummies, but fewer tin spend the thousands of dollars it costs a year.

And precise fewer security companies volition screen it, adjacent though successful 2013 the American Medical Association, immoderate would say, yet recognized obesity arsenic a disease.

Dr. Fatima Cody Stanford: It's a encephalon disease.

Lesley Stahl: It is?

Dr. Fatima Cody Stanford: It's a encephalon disease. And the encephalon tells america however overmuch to devour and however overmuch to store.

Dr. Fatima Cody Stanford, an obesity doc astatine Mass General Hospital and subordinate prof astatine Harvard Medical School, says communal beliefs astir obesity are each wrong

And fare shows similar "The Biggest Loser" are snookering people.

Lesley Stahl: If you diet, you suffer weight, right?

Dr. Fatima Cody Stanford: For galore of us, we tin spell connected a diet. Something similar "The Biggest Loser," right? You spell and you restrict people. You marque them enactment retired for 10 hours a time and past you provender them 500 calories. For astir people, they volition acutely suffer weight. But 96% of those participants successful "The Biggest Loser" regained their value due to the fact that their encephalon worked well. It was expected to bring them backmost to store what they needed oregon what the encephalon thinks it needs.

Lesley Stahl: So willpower?

Dr. Fatima Cody Stanford: Throw that retired the window. My past diligent that I saw contiguous was a young pistillate who's 39 who struggles with terrible obesity. She's been moving retired 5 to 6 times a week, consistently. She's eating precise little. Her encephalon is defending a definite acceptable point.

A acceptable point, says Dr. Stanford, is simply a scope of value your encephalon is successful complaint of maintaining by controlling however overmuch nutrient you devour and however overmuch of it you store. One mentation is that it's an evolutionary endurance mechanics that helped clasp abdominous during famines.

Lesley Stahl: So we had COVID. Lots and tons of radical gained weight. Did those radical person a caller acceptable constituent that's higher now?

Dr. Fatima Cody Stanford: Absolutely. So erstwhile you person a chronic stressor and you get to a definite value and support that value for, let's say, astatine slightest 3 to 6 months, past you recalibrate that acceptable constituent to a antithetic acceptable point.

Lesley Stahl: I've ever heard that it's the accelerated food. That it's the Diet Cokes, that kinda thing, that is the instigator. Is that true?

Dr. Fatima Cody Stanford: So I deliberation we person to look astatine the antithetic causes of obesity arsenic a large pie. And that's 1 factor. But announcement however I'm utilizing this portion of the pie, right?

Dr. Fatima Cody Stanford: But the fig 1 origin of obesity is genetics. That means if you were calved to parents that person obesity, you person a 50-85% likelihood of having the illness yourself adjacent with optimal diet, exercise, slumber management, accent management, truthful erstwhile radical spot families that person obesity, the presumption is, "Ugh. What are they feeding those kids? They're doing thing wrong." Actually bash you cognize this? 79-90% of physicians successful the United States person important bias towards individuals that are heavier. Now, doctors listening to maine whitethorn say, "Oh, it's not me." Hold your horses, due to the fact that has that diligent travel to you and told you, "Look, Doc, I'm eating well." "Look Doc, I'm exercising." And the doc says to them, "Are you sure? I don't judge that that's truly what you're doing."

Lesley Stahl: Wait, are you saying that doctors don't recognize obesity? Doctors?

Dr. Fatima Cody Stanford: Doctors bash not recognize obesity.

In 1 of her published studies, Dr. Stanford recovered that astir aesculapian schools don't thatch that obesity is simply a illness and successful information don't adjacent connection courses connected it, adjacent though it's the 2nd starring origin of preventable decease successful the state aft smoking.

Nicole Sams, parent of 5 from Rhode Island, spent years going to doctors who each had the aforesaid message.

Nicole Sams: "Well, you conscionable person to spell spot a dietician." And I did. I did everything I was told to do: I went to a dietician; you know, I sat, had the rubber foods travel successful beforehand of me, "Oh, you'll lone devour this portion," I'm similar "Oh."

Maya Cohen went connected her archetypal fare erstwhile she was 13. At her heaviest, astatine 5 feet tall, she weighed 192 pounds.

Lesley Stahl: Did you consciousness that radical looked astatine you and said "Why doesn't she halt eating? She's eaten her mode to that"?

Maya Cohen: You cognize you look astatine idiosyncratic and you internalize, "Oh, they indispensable deliberation I'm eating excessively much." So it's just, aft a portion you conscionable personally deliberation that, "Okay. Everyone's telling maine that I'm — that this is simply a flaw successful my character;" therefore, it indispensable beryllium true. And truthful you commencement believing this.

Dr. Caroline Apovian: Don't you deliberation if radical walking down the thoroughfare with obesity, stigmatized arsenic they are, shunned, don't you deliberation if they could suffer value and support it disconnected they would?

Dr. Caroline Apovian, co-director of the Weight Management and Wellness Center astatine Brigham and Women's Hospital successful Boston who sees some Maya Cohen and Nicole Sams, is relieved that astatine past she has a highly effectual medicine to connection her patients that's safe, according to the FDA.

It's portion of a caller procreation of medications that brings astir an awesome mean nonaccomplishment of 15% to 22% of a person's value and it helps support it off. Drs. Apovian and Stanford person been advising companies processing drugs for obesity, including the Danish institution Novo Nordisk, an advertiser connected this broadcast. It makes the cause Wegovy that you inject yourself erstwhile a week with, thing similar an epipen. It's not casual to get. The cause is presently successful abbreviated supply. And it costs much than $1,300 a month.

Lesley Stahl: People successful Hollywood tin spend these costly injections. And they're taking them.

Dr. Fatima Cody Stanford: Right.

Lesley Stahl: And they're not needfully radical with obesity.

Dr. Fatima Cody Stanford: Yeah. We person a nationalist shortage connected these medications. If those that person the means, are capable to get them yet the radical that truly request them are incapable to. Then that creates a greater disparity, right? The haves and the person nots.

The immense bulk of radical with obesity simply can't spend Wegovy and astir security companies garbage to screen it partially because, arsenic AHIP - the wellness security commercialized relation – explained successful a statement, these drugs "have not yet been proven to enactment good for semipermanent value absorption and tin person complications and adverse impacts connected patients."

Dr. Caroline Apovian: What we've seen truthful acold is truly nausea, vomiting, you cognize that's wherefore these drugs are dosed dilatory and starting with debased doses.

Lesley Stahl: Oh, and physique up?

Dr. Caroline Apovian: And physique up.

Dr. Apovian says astir of the broadside effects spell distant implicit time.

Dr. Caroline Apovian: We are frustrated each azygous time erstwhile we spot patients who desperately request to suffer value to trim the diabetes, trim the hypertension, stroke, bosom disease, and we can't springiness them this fabulous, robust medicine that is precise effectual and safe. And we can't springiness it to them due to the fact that security won't screen it. I person emails astir denials-- that authorities that we're denying this due to the fact that "the doc has not counseled the diligent connected behaviour alteration arsenic portion of this." That's wherever the stigma of obesity comes in, the thought that the diligent tin bash it with fare and exercise. You would ne'er bash that to a diligent with hypertension oregon bosom illness oregon Type 2 diabetes, archer them that you "Just don't devour sugar, you'll beryllium fine."

Novo Nordisk besides makes a cause for benignant 2 diabetes called Ozempic, which astir insurers and employers bash cover. What frustrates the doctors is that Ozempic and Wegovy are precisely the aforesaid drug, though Wegovy for obesity is usually prescribed astatine a higher dosage.

When Maya Cohen wanted the medicine for obesity…

Maya Cohen: My security institution told maine that they see it a "vanity drug."

Lesley Stahl: A "vanity drug."

Lesley Stahl: So that suggests that the security institution does not see obesity a disease--

Maya Cohen: Correct.

Nicole was besides denied coverage. On its website, her wellness plan, done the authorities of Rhode Island, puts anti-obesity medications successful the aforesaid class arsenic drugs for erectile dysfunction and cosmetic purposes.

There are astir 110 cardinal Americans eligible for an anti-obesity medication, making it a costly concern for insurance, but if they covered it, wide authorities and backstage wellness attraction spending would astir apt travel down. Just instrumentality diabetes, that is, successful galore cases, caused by obesity. Diabetes costs much than $300 cardinal a year, astir of which is covered done Medicare and Medicaid. But University of Chicago wellness attraction economist Tomas Philipson points retired that there's really a instrumentality that prevents Medicare from covering value nonaccomplishment drugs.

Lesley Stahl: You would deliberation that that security programme for older adults would spot an tremendous payment to these drugs?

Tomas Philipson: Yeah, a 3rd of Medicare spending is diabetes, you know, which is highly with-- tied to obesity. And Medicare benignant of sees each the wellness attraction expenses erstwhile you get older erstwhile you person bosom disease, et cetera, from your obesity. I deliberation what yet volition thrust it is that they person grounds that this is really gonna little full Medicare costs.

When Dr. Apovian told some Maya Cohen and Nicole Sams that their obesity was not a weakness of willpower, they were blown away.

Nicole Sams: I looked astatine her and I said, "I don't judge you. What bash you mean, 'It's not my fault?' It is my fault." Because it's what I heard for my full life.

Maya Cohen: I went location that time like-- a boulder had travel disconnected my shoulders. Like, "Okay, there's yet hope. There's hope."

Lesley Stahl: Did you cry?

Maya Cohen: I did. A lot. (LAUGH)

Dr. Caroline Apovian: All those years of reasoning that someway you person nary willpower and it's your motivation failing and you're a glutton and wherefore did you devour truthful overmuch and-- feeling shame. It's the shame.

Lesley Stahl: Yeah, yeah. It's the shame.

Dr. Caroline Apovian: It's the shame.

Maya was yet capable to get the medicine covered by her security due to the fact that she has benignant 2 diabetes. She's mislaid much than 50 pounds. Dr. Apovian says she does person to proceed dieting and exercising and, similar astir patients, volition beryllium taking the cause indefinitely to support her weight. Nicole doesn't person benignant 2 diabetes.

Lesley Stahl: Nicole, we called your security institution and they gave america a statement.

Nicole Sams: Okay.

Lesley Stahl: "Earlier this twelvemonth the State of Rhode Island, successful consultation with its pharmacy benefits manager, decided that wellness security for the State of Rhode Island employees would screen the full people of anti-obesity drugs."

Nicole Sams: Oh-- really?

Lesley Stahl: "This sum alteration goes into effect January"--

Nicole Sams: Okay.

Lesley Stahl: --"2023"

Maya Cohen: I'm truthful blessed for you.

Nicole Sams: Yes. This is great. This is great. (CLAPS) Wow. Wow.

In its statement, the wellness security commercialized relation said, "obesity is simply a analyzable illness and the grounds and objective guidelines related to obesity treatment… are evolving rapidly. Health security providers volition proceed to reappraisal the objective evidence."

Novo Nordisk Statement to 60 Minutes

Produced by Ayesha Siddiqi. Associate producer, Kate Morris. Broadcast associate, Wren Woodson. Edited by Craig Crawford.

Lesley Stahl