Shifting Perspectives: Obesity as a Chronic Health Issue

Our understanding of the causes of obesity and overweight is evolving. We now know that underlying metabolic, genetic, and environmental influences increase obesity risk. Social determinants of health (SDOH) such as poverty, poor nutrition, lack of access to care, and emotional and behavioral problems can all make overweight and obesity more likely. We also understand that losing weight is not as simple as counting calories.

What the science says

When the American Medical Association (AMA) recognized obesity as a disease in 2013, the primary objective was to change how the medical community tackles this complex issue in order to drive better prevention and management of obesity-related conditions. The recognition of obesity as a chronic condition marked a significant shift away from the belief that obesity is the result of personal choice or a lack of willpower. 

While obesity itself is a chronic condition, it also plays a role in other common chronic conditions known as cardiometabolic diseases. These diseases include heart attack, stroke, diabetes, insulin resistance, and non-alcoholic fatty liver disease. In addition to cardiometabolic diseases, obesity is linked to 200+ comorbidities¹ and 18 different cancers.² 

Treating obesity as a chronic condition can pay huge dividends in individual health outcomes and for society at large. Employers, health plans, and legislators are now following the lead of this clinical guidance to effect change.

The big picture and the healthcare landscape

When we understand that obesity is a chronic condition, we can take a long view on management. Treating obesity as a chronic condition facilitates acceptance and insurance coverage for evidence-based treatments, including behavioral therapy, weight-loss medications (such as the latest generation GLP-1s), and bariatric surgery. Providing fully covered benefits that treat obesity as a chronic condition acknowledges the complex biological and societal factors that contribute to this epidemic.

Health plans in particular can be the catalyst for improving access to science-backed treatments while employers can facilitate utilization. On the legislative front, the Treat and Reduce Obesity Act (TROA) will soon be voted upon by the House of Representatives and includes provisions to cover weight-loss medications and intensive behavioral therapy.³

New treatment options, but there are no quick fixes

In the past, health conditions were more likely to be treated individually. Today, healthcare providers place greater emphasis on holistic health, or the interconnectedness of the body’s systems and overall wellness. 

Within the spectrum of treatment options for patients with overweight or obesity, hormone-based medications are filling the gap between traditional obesity medications and surgical solutions. While the medications are truly game changers for weight health, they don’t guarantee that people will follow a healthy diet and lifestyle. 

Research shows that taking a full-spectrum, personalized approach to weight health offers the best possible health outcomes. In a recent study, compared to those who used weight-loss medications alone, those who combined the medications with our coaching and behavior change program lost 11% more weight.⁴ Members who participated in WeightWatchers Diabetes Program lowered their HbA1c by 0.75 at six months.⁵

The WeightWatchers behavior change coaching approach is grounded in principles of motivational interviewing, cognitive behavioral therapy, and the biopsychosocial model. This guides members toward making changes that will help them reach the weight loss and wellness goals that matter to them.

Looking ahead, it will be vital to further understand and optimize complementary behavioral and lifestyle therapies to help individuals effectively translate the biologic impact of the hormone-based medications into a healthy diet, increased activity, and sustainable weight loss.

The importance of treating obesity as a chronic disease

Treating obesity as a chronic condition helps shift the focus from weight lost to health gained.  With new obesity treatment options available, employers and health plans have vital roles to play in expanding access to quality weight healthcare and improving health outcomes. 

All parties stand to gain by managing the risks of obesity and containing healthcare costs. The National Institutes of Health reports that a 5% to 10% weight loss can significantly improve health and quality of life.⁶ The financial impact is also significant. When individuals with at least one chronic condition lose sufficient weight to move from being obese to overweight, annual healthcare expenses are reduced by 20%.⁷

WeightWatchers for Business is a trusted partner that can provide integrated, whole-person weight healthcare across the full spectrum of behavioral, community, and clinical care. Let’s talk about how we can partner with you to help manage cost pressures and optimize outcomes.

1 AMA. Obesity. https://www.ama-assn.org/topics/obesity. Accessed July 1, 2024.

2 https://www.wcrf.org/latest/news-and-updates/new-study-links-overweight-and-obesity-to-more-cancers-than-previously-shown/

3 https://www.congress.gov/bill/118th-congress/house-bill/4818

4 Based on an analysis of virtual clinic member data at 4 weeks of membership comparing those who initiate WW’s behavior change program and those who don’t completed in Jan 2024.

5Apolzan JW, LaRose JG, Anton SD, Beyl RA, Greenway FL, Wickham III EP, Lanoye A, Harris MN, Martin CK, Bullard T, Foster GD. A scalable, virtual weight management program tailored for adults with type 2 diabetes: effects on glycemic control. Nutrition & Diabetes. 2023 Apr 6;13(1):3.

6 NIH. Overweight and Obesity Treatment. https://www.nhlbi.nih.gov/health/overweight-and-obesity/treatment Accessed June 2024.

 7 Thorpe K, Toles A, Shah B, Schneider J, Bravata DM. Weight Loss-Associated Decreases in Medical Care Expenditures for Commercially Insured Patients With Chronic Conditions. J Occup Environ Med. 2021;63(10):847-851.