According to new research on obesity may permanently alter how the brain responds to food intake, leading some doctors and public health professionals to demand for insurance to cover drugs for obesity.
According to the National Institutes of Health, approximately 31% of adults in the United States are medically overweight and over 42% of adults in the country have been diagnosed with obesity. Since 2000, the prevalence of obesity among adults, kids, and teenagers has steadily increased.
Nutritional Sensing And Obesity
Experts in obesity and new research on obesity medicine from Yale School of Medicine discovered that even after medically obese patients shed weight by diet and exercise, they still had a nutrient-sensing deficiency. The new research on obesity is very rigorous and quite comprehensive.
The new research on obesity and brain chemistry, which was published in the journal Nature Metabolism, focused on the striatum, a section of the basal ganglia that governs the motivational components of food intake that control eating behaviour. Dopamine, a neurotransmitter that controls mood, pleasure, and pain, was also being measured by the researchers in the subjects.
Body-mass index, or BMI, was used to divide the participants into “lean” and “obese” groups. Participants were fed through a feeding tube to avoid the oral enjoyment of eating and concentrate solely on nutrient intake. When fed with both carbohydrates and fats, lean study participants were shown to have decreased striatal activity and increased dopamine levels, resulting in feelings of fullness or satiation.
However, neither carbohydrates nor fats had any effect on the striatal activity of the obese participants, nor did dietary fat have any effect on dopamine levels. These findings suggest that patients with obesity have less neurochemical processing power for nutrition intake and sanitization. When obese participants who lost 10% of their body weight in 12 weeks underwent the same testing again, it was discovered that there had been no alteration in the brain chemistry associated with satiation.
“People still think obesity is caused by a lack of willpower,” Mireille Serlie, lead author and investigator in the study, told SciTech Daily. She explained, however, that the results have “shown that there is a real difference in the brain when it comes to nutrient sensing. “This may be why people overeat despite the fact that they’ve consumed enough calories. And importantly, it might explain why it’s so hard to keep weight off,” Serlie said.
Potential public health measures
The Washington Examiner quoted Angela Fitch, president of the Obesity Medicine Association and a director on the board of the Obesity Action Coalition, as saying that the study’s findings are positive since they support what practitioners have seen in practice. We’ve been informing people for years that obesity is a disease with fundamentally faulty biological mechanisms, according to Fitch.
The new research on obesity and findings of the Nature Metabolism study suggest that, rather than treating obesity only with diet and exercise, the malfunctioning link between the gut and brain has to be addressed like other diseases rather than being stigmatised as a personal failing. “I guarantee there won’t be one person who says you can just will it away if you ask ten people on the street ‘How do you treat breast cancer?'” said Fitch.
Fitch suggests that medical insurance should pay for both surgical procedures and anti-obesity drugs like Wegovy and other semaglutide products.According to Fitch, “Obesity as a disease state needs to be a standard benefit on all policies, including Medicare.”
Anti-obesity drugs are now starting to be covered by some private insurance policies. Since January of this year, all government employees have access to coverage for weight-loss drugs. According to new research on obesity that also found obesity causes some changes in the brain.
Fitch believes it would be possible to improve access to care at a rate that meets the “huge demand” for anti-obesity medication with the help of health insurance providers, pharmaceutical companies, and pharmacy benefit managers. “Let’s just fix it,” Fitch remarked. “We are in control.”
However, determining who should be covered for obesity medicine care and how that care should operate could make it more difficult to put Fitch’s suggestions into practise. Health insurers evaluating candidates for more thorough obesity medicine therapy may find it difficult to assess applicants given the evolving definitions of obesity.
Due to its association with “historical harm,” “racist exclusion,” and white norms of health, the American Medical Association last week established a new policy that discourages the use of BMI as the primary indicator for obesity.
BMI is a helpful standardisation that is simple to compute, but it has also come under fire for not clearly differentiating between fat and muscle weight, making it an unreliable tool. Insurance companies may have issues in providing coverage for weight loss and weight maintenance if patients are unwilling to take their drugs as directed.
Because semaglutide has appetite-suppressing qualities, according to Jens Juul Holst, an endocrinologist at the University of Copenhagen who worked on the development of Wegovy and Ozempic, patients are unlikely to voluntarily stay on it.
In a Wired interview, Host explained, “What happens is that you lose your appetite and the pleasure of eating.” “I just don’t see that picture,” continued Holst, “that a significant portion of the population will be put on Wegovy and will remain on Wegovy for the rest of their lives.”
Obesity is a huge and growing demand on public health resources, despite the difficulties of tackling it in the future. Over half of the world’s population will be overweight or obese by 2035, according to estimates from the World Obesity Federation and the World Health Organisation. This might cost as much as 3% of the world GDP yearly, or about the same as what would be spent on COVID-19 in 2020.