Progress in fight against obesity

Viruses might have dominated the headlines for the past three years, but they are not the only threat to our health – or even the main one. Non-communicable diseases are on the rise, already responsible for nearly two-thirds of yearly deaths, globally.¹ From heart disease to diabetes, obesity is one of the key root causes and for now there is no magic cure.

Low-income households and poorer countries are disproportionately affected by obesity. Latest research points to two key culprits – sugary fizzy drinks² and ultra-processed food,³ which also often includes complex sweeteners, such as high fructose corn syrup.

Eating better seems like a simple solution, but there are issues around affordability and availability of good foods, as well as a need for more education. And it’s not always clear what is healthy. Fruit juice, for example, was once seen as a health food but is now recommended only in small doses due to the high sugar content. The perfect healthy diet as prescribed by the EAT-Lancet initiative, is arguably too expensive for large swathes of the global population and is not tailored by region or country.

Even when the right diet is possible, it won’t necessarily save from obesity. Factors such as stress and sleep deprivation increase the risks. Studies also suggest that there is a strong likelihood of second-generation obesity, irrespective of diet quality, activity level and stress management. 

Fortunately, there are signs of a step-change in how obesity is viewed. For a long time, it was seen as a lifestyle choice, which brought a lot of stigma to sufferers. Today, there is a growing realisation that obesity requires a multi-pronged approach tackling both medical and lifestyle aspects. Insurers are becoming more willing to cover treatment. The American Medical Association, for example, has officially recognised obesity as a disease and Medicare includes obesity as a disease that warrants treatment – although it does not yet cover all possible treatments. From next year, The Office of Personnel Management has mandated that health benefits for US civil service employees should cover anti-obesity medication and address obesity care for children.

The hunt for cures

The prospect of better funding coincides with new developments in terms of treatment and prevention.

Wegovy, a weight loss drug developed by Novo Nordisk, has won the green light from US regulators, while Mounjaro, a weekly injection treatment from Eli Lilly, is on fast-track for approval. Clinical data suggests that both drugs could help patients lose as much as 15-20 per cent of body weight, with analysts estimating that sales could total billions of dollars.⁴ The global obesity treatment market could top USD54 billion by 2030 from just USD2.4 billion in 2022, according to Morgan Stanley.⁵

Beyond traditional drugs, there is a growing industry for alternative ingredients which reduce the need for sugar and/or fat and help keep insulin levels more stable. An enzyme solution from Novozymes, for example, promised to boost sweetness of dairy products, allowing manufacturers to use less sugar.

At the more experimental end of the scale, scientists are investigating the impact of gut bacteria, known as microbiomes, on the propensity for obesity. Although it is still very early days, a trial has suggested that adding certain microbes into the gut can reduce chances of weight gain in mice.⁶

A holistic approach

Holistic treatments are also crucial. There is already a big market for health-related apps and wearable devices, as well as a new trend for companies to offer multi-layer solutions. That could include accompanying a weight loss drug programme with video classes, or selling exercise equipment and creating an active online community to promote its continued use.

As society becomes more accepting of obesity as a complex disease, we could see a shift by insurers and national health services towards funding more preventative and digital solutions.

Last but not least, regulators also have a key part to play. A number of countries, including Mexico, UK and South Africa, have already experimented with sugar taxes. So far, analysis suggests that these have reduced consumption, albeit it usually by relatively modest amounts. Arguably a bigger impact has been through encouraging shifts within the food industry, with increased transparency in food labelling as well as the development of more no- and low-sugar beverages – trends which are likely to continue.

There is also scope for better targeted agriculture taxes and subsidies. Some campaigners, for example, argue that high fructose corn syrup should be made less attractive to produce.

We have seen with renewable energy how governments can put in place ambitious plans and subsidies to solve really big problems. Obesity deserves to be another candidate for such a pro-active approach. That – together with innovation in science and technology and increased consumer awareness – could help stave off a deadly global epidemic.