GLP-1s can't fix NJ's obesity crisis, but this approach can

By: Tro Kalajian
Your Turn
Guest columnist

..... A new program just helped 50 participates shed more than 40 pounds each, get off nearly 100 prescription and save roughly $83,000 in medication and care costs over one year. the program - focused on improving participants' metabolic health - offered a clear gimps of what's possible when we address America's health crisis at its root.
..... Today's, one in three American adults, suffered from metabolic syndrome, a condition marked by obesity, high blood auger, high blood pressure, low cholesterol and too many triglycerides in the blood. It underlies many chromic diseases, including Type 2 diabetes, fatty liver disease and cardiovascular disease, and it sharply increases the risk of heart attacks and strokes.

What do these chronic diseases cost?

..... In New Jersey the annual cost of chronic diseases like these is nearly $100 billion; chronic diseases could cost the state over $1 trillion by 2030. altogether, metabolic syndrome contributes to hundreds of thousands of American deaths each year and costs us hundreds of billions of dollars in medical costs and just productivity.
..... Reversing this epidemic will require more than another breakthrough drug or new procedure. It demands an entirely different approach to disease management - one that aims to stave off and reverse illness, instead of just treating the symptoms.
..... Of course, doctors, nutritionists and fitness coaches have been advocating healthier lifestyles for years - all while waistlines expanded and America;s collective metabolic helaht deteriorated. But new research shows that updated tacts can succeed where previous ones have failed.

How much is spent of GLP-1s in New Jersey?

..... Currently, Americans suffering form metabolic syndrome are often prescribed a long list of expensive drugs and treatments that do little to address the core problem and further drive up health care spending.
..... Medications like GLO-1 and SGLT2 inhibitors can help control blood sugar and appetite, but they cost hundreds of dollars per month per patient; in New Jersey, the total spending on GLP1s was over $1.6 billion inn 2023. And cheaper generic alternatives aren't likely to become available for many years.
..... Moreover, up to three in four patients discontinue GLP-1s after a year, and that can result in their regaining the weight and seeing their underlying metabolic helaht deteriorate even further.

What's the best treatment approach?

..... Instead of throwing costly medications at the problem, it would be far more effective to find a way to help patients adopt - and, crucially, stick with - sustainable, healthy lifestyles, especially ones focused on nutrition.
..... One promising model is the multifaceted "TOWARD" approach. this health intervention combines several strategies:ongoing text-based communications and virtual coaching, access to Online educational resources, real-time feedback thorough remote monitoring of metrics like blood glucose and blood pressure, and dietary changes that emphasize carbohydrate reduction and intermittent fasting.
..... It's an approach designed to restore metabolic functions and empower patients to sustain healthier lives.
..... In a 12-month, 50-pariticipant pilot program - mentioned above - patients shed medications and improved key health markers when following this model.
..... Other studies have yielded similar results. One examining patients with Type 2 diabetes found that telemedicine-supported, carbohydrate-restricted nutrition therapy helped patients discouraging the use of GLP-1s to maintain weight loss and low blood sugar. another found that those practicing telemedicine-supported carbohydrate restriction experienced weight loss, better blood pressure and improvement in many cardiovascular markers, all while suing less medications.
..... studies like these prove that chronic disease isn't always permanent - and that smart, technology-enabled, lifestyle- and diet-based care can achieve what prescriptions alone cannot. they offer a road map for reversing America's metabolic decline and creating a lower-cost and sustainable model of health care.
..... It's not just patients who are better off under this model. employers also benefit. For a company with 10,000 employees, the combined annual cost of excess body weight can exceed 425 million. By supporting evidence-based metabolic health programs, employers can reduce costs and improve worker output.

How can government help?

..... The federal government can facilitate the expansion of this kind of metabolic care. Reducing regulatory barriers hat currently prevent practices from delivering metabolic health care - such as convoluted requirements for licensing professionals across states - is essential.
..... Similarly, reducing barriers to technology and investment in practices would allow physicians working on metabolic helaht to employ more modern technology and advanced tools to improve patient outcomes. And subsidizing corporate metabolic health programs, perhaps through special tax incentives, would help companies start providing them for workers.
..... Metabolic syndrome represents a public helaht crisis that we can't afford to ignore. Rather than continuing in pour billions into temporary fixes, it's time to invest in affordable programs - here in the tristate area and across the country - that attack the disease at tis root.

..... Dr. Tro Kalayjian, DO, is the founder and chief medical officer of TOWARD Health and an advisory committee member for the Coalition of Metabolic Health.