New medications signal a long-overdue 'rebrand' of obesity
Zepbound adds another tool to the arsenal for obesity treatment while sparking a conversation that can change public perception of the chronic disease
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Obesity has long been seen as a personal failure, but recent advancements in the understanding of obesity have begun to change the way people view the chronic disease, as well as those who have it.
While harmful stigma still exists, the introduction of new medications and interventions for people who have tried to “eat less, move more” for their entire lives is proving that this disease, like any other, needs to be treated and viewed as such.
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Lisa Schaffer, Executive Director with Obesity Canada, has experienced obesity from both sides of the coin—in her personal life and in her professional life. She spent much of her life dealing with “feeling like the biggest kid in the room,” and it wasn’t for a lack of trying.
“I was always very active regardless. I was in ballet, tap, dance, all different things in theatre,” she said. “I wasn’t really shy, but I definitely understood that I was different my entire life.”
Learning and unlearning what obesity really is
Lisa notes that people on both sides of her family have dealt with obesity in their lives as well, and the notion of having obesity from a young age became “all-consuming.”
“That becomes a bit of a thing that really shapes you as a person, you know. When you’re worried about the tensile strength of a chair since a small age, that sticks with you. That kind of determines how you navigate some aspects of life,” she said.
When she was a child, conversations surrounding her weight with healthcare providers made Lisa feel like she wasn’t involved and as though they were “happening around me, but not with me.”
Being shut out of her own care from the beginning of her journey with obesity led to the internalized bias and shame that many people with obesity live with because of the faulty narrative surrounding the disease.
“I became a really high-achieving person in all these other places, and it wasn’t until I could take this breath and kind of understood obesity differently that I could look over my shoulder and go, ‘Oh. I was trying to be really compliant in every way I could because I felt so fundamentally flawed as a person,’” she said. “I’ve always had great careers. I’ve had great friends. I’ve been a bridesmaid more times than any girl should be a bridesmaid. But I could never seem to get a handle on this one aspect of my life, which was my weight.”
Lisa viewed her weight as an indicator of her overall health, but she was also running five and 10ks, half marathons, and exercising regularly without seeing any scale changes—a common remedy given to people who live with obesity from people who don’t yet understand the complex nature of the disease. She focused on the scale, but didn’t consider that her level of control might not be due to willpower or an inability to do enough, given her body’s natural ability to stay active through activities like dance, running, surfing, climbing, and mountain diving. Because of that, and an epiphany she had after hearing a doctor speak about obesity as a disease for the first time, Lisa was able to shift her perception of obesity in herself and in others.
“I want that for more people all over the place, so that’s really what I’m passionate about as well, is changing that narrative and that conversation.”
A rise in obesity calls for more urgent action
With obesity rates rising in Canada, the need for more understanding surrounding the disease has never been more critical. That said, the approval of more medications in Canada is a step in the right direction for access to care for people who live with obesity, which can also showcase just how wrong people are when they say that people with obesity have chosen that path.
For example, Zepbound, a new dual-action medication that activates two receptors that play a role in obesity, has recently been approved by Health Canada. The drug tackles two pathways, thus giving people living with obesity another option to try if they do not respond to medications that are already available, or perhaps by offering a new first-line therapy that provides a more effective approach to weight loss.
Dr. Sean Wharton, Medical Director of the Wharton Medical Clinic for Weight Loss, an expert in obesity medicine and trial research, notes that this new approval gives people an effective strategy toward obesity management that wasn’t available before. It can also shine a new light on awareness of what it actually means to live with obesity, making it a small step toward conquering stigma.
“For an individual, an individual living with obesity who gets access to this medication, it is clear that it works,” he said, later continuing. “Anything that brings attention to people living with obesity and the medical struggle they have is a positive story. This medication brings light to the fact that there are millions of people living with obesity that are looking for care.”
He continued, “I believe that the more attention there is, the more chance we have to combat the bias, the stigma, the discrimination, and improve access to care, so the greater amounts of attention will lead to great amounts of compassion and understanding.”
Rebranding obesity
For people like Lisa, who have “counted 10 almonds every day for my life for many, many years,” this new medical approval and the conversation it sparks is a much-needed conversation that can allow people to come out from under the cloud of shame society’s misunderstanding placed them under for so many generations.
“There’s a great photo of my grandmother standing in a field, rural Alberta, dirt floor. She stood on her feet, did laundry all day long. She and I have more in common in our body size than not, and that was not a lady that was sitting around eating processed foods,” said Lisa.
“We need to rebrand obesity. It just needs a marketing refresh, and now look what we’ve done, like this toothpaste is a little bit out of the tube, but it’s really important for us to be able to frame obesity as this chronic disease and not just a lifestyle issue,” she continued.
According to Lisa, the step forward now that more drugs like Zepbound are becoming available is working on access and challenging not the people living with obesity, but the systems and structures that are in place that perpetuate bias to correct itself and see obesity for what it truly is: a complex chronic disease that requires medical intervention first, with lifestyle alterations being a secondary, or even third management approach.
“We have a true once-in-a-generation opportunity here to get something right that hasn’t been right for a long time,” she said. “It starts with, let’s have the conversation.”
Dr. Wharton seconds that sentiment.
“We can make a change here, but we have to have the advocacy, the will, and the collaboration from multiple levels,” he said. “But government has to be involved to be able to see an effective change, and if government is involved, it means that people are involved, that people are advocated for … so we’re in charge. We have to make the change happen.”
