Confronting obesity on World Health Day: A call for a new standard of care

This World Health Day, it is time to confront obesity. Despite advances in obesity treatments, the obesity epidemic continues to skyrocket. By 2050, over half of adults and a third of children and adolescents will be overweight or have obesity, placing enormous pressure on global health systems. The Centers for Disease Control and Prevention (CDC) estimates obesity costs the US healthcare system almost $173 billion. Likewise in the UK, the NHS spends £6.5 billion per year treating obesity-related conditions.

This article was authored by Shantanu Gaur, the Founder and CEO of Allurion Technologies, a company with a mission to end obesity. Follow him on social media @allurionceo.

Novel therapeutic approaches - including GLP-1 medications - are promising, but they’re not a cost-effective long-term solution. In short, a new standard of care is needed to drive long-lasting change.

We’re treating symptoms, not the root causes

Obesity is a chronic disease. Our goal should not only be to treat it, but to also put it into remission. Like any chronic disease, its causes are multifactorial, including genetic predispositions, unhealthy diets dominated by ultra-processed foods, sedentary behaviour, excessive alcohol intake, and complex physiological mechanisms related to hunger and satiety. No single intervention can solve such a complex health issue.

Single-solution approaches are falling short

Current treatments reflect this complexity. For instance, GLP-1s can lead to substantial weight loss, but up to 40% of the lost weight can come from lean mass (including muscle) and adherence after 1 year can be as low as 25%. Bariatric surgery is proven to be clinically effective, but only 1% of eligible patients receive surgery. Non-surgical devices like intragastric balloons can lead to satiety induction, but without lifestyle counselling, only lead to temporary weight loss. Fully digital approaches, while affordable and safe, often lead to little-to-no weight loss. Any new standard of long-lasting care must integrate multiple approaches into a treatment plan – one which facilitates sustainable lifestyle and behaviour change.

We need a better definition of success

I believe we need to broaden our focus beyond weight loss towards what I call metabolically healthy weight loss. Simply put, this is losing weight, keeping it off, and preserving muscle. Achieving this involves multiple modalities of therapy which are customized and personalized to the patient.

What integrated care can look like

For example, we have trialled the Allurion Program -which combines a non-invasive intragastric balloon with behaviour change and remote monitoring - with a low dose of GLP-1s. The combination approach stimulates two different mechanisms of action: early satiety through the balloon and reduced hunger through the GLP-1. Lower doses of GLP-1s also means fewer side effects, resulting in greater adherence and promoting longer term weight loss. Additionally, behavioural coaching combined with real-time remote muscle mass monitoring encourages muscle preservation and an increase in lean body mass percentage. In an initial group of 52 patients, average weight loss was 20%, lean body mass percentage increased by 15%, and adherence to GLP-1 therapy remained at 100% after eight months.

This isn’t the only way - but it shows what’s possible

While certainly not the only pathway, this combination represents a sustainable, healthy approach to tackling obesity.

On World Health Day, as obesity care professionals, we must broaden our clinical vision. Rather than chasing “miracle cures”, we should advocate for comprehensive, multi-modal, personalized treatments that prioritise metabolically healthy outcomes.

Doing so isn't just clinically imperative - it's socially necessary. Imagine the possibilities if we redirected the billions spent annually treating obesity-related illnesses into other vital areas of healthcare, significantly easing pressures on stretched budgets and workforces.

So, to all of us on the front lines of obesity care: what is stopping us from adopting a new standard of care? By failing to consider new possibilities, we have so much more to lose than just pounds on the scale.