Dr. Paul DeLeeuw, a seasoned bariatrician with over a decade of experience in the field, shares his expertise on the challenging journey of weight loss. With a background as a top anesthesiologist in Miami and work at Bariatric Physicians Inc. and Medi Weightloss Clinics in Florida, Dr. Paul DeLeeuw has a wealth of knowledge in the field. Despite recommendations from numerous experts, Dr. DeLeeuw recognizes that there is no one-size-fits-all approach to weight loss, as the same methods can produce vastly different results for different individuals.
Understanding Obesity as a Metabolic Disease
Obesity, once viewed as a personal failure, is now widely recognized as a metabolic disease. This shift in perspective has been a long time coming, with decades of research needed to overcome the prejudices and misconceptions that had taken hold in the medical community.
The conclusion of this research is that, in the presence of abundant and varied food, people will still often become obese. It turns out that most people have built-in limits to how much they will eat when it comes to proteins and fats. However, there is no biological limit on how many carbohydrates one can eat. This is why even when you feel absolutely stuffed after eating a large meal, you can still somehow always find room for dessert. Carbohydrates are not only tempting but also inexpensive, which is why poverty often leads to obesity.
Incretin Drugs – A Breakthrough in Weight Loss
Dr. DeLeeuw has come across a breakthrough in the field of weight loss that he believes can change the game. A new class of drugs called incretins, such as Semaglutide (Wegovy) and Liraglutide (Saxenda), work by targeting specific receptors and are given by weekly injection because they are too large to be absorbed orally. Tirzepatide, even more potent and specific, is also on the fast track for FDA approval. The incretins have proven to be safe and effective, and their effectiveness improves with time as weight decreases and hormones return to normal.
In contrast to previous diet pills, the incretins never lose their effectiveness, and their side effects, such as nausea and GI distress, diminish over time. The biggest obstacle to accessing these treatments is the financial aspect. Medicare has a policy of not covering “diet pills” after a scandal took place in the 1990s where a popular drug, Fen-Phen, was used to help people lose weight. However, the drug was later found to cause serious health problems like heart valve damage and a dangerous increase in blood pressure in the lungs. As a result, it was taken off the market in 1997, and the company faced legal consequences with over $13 billion in damages.
Even Pharmacy Benefit Managers consider obesity to be a behavioral problem, so they also refuse to cover incretin diet injections. The cost of these drugs, along with additional medical charges, can be several thousand dollars a month.
Obesity is a Life-Threatening Condition
It is important to remember that obesity is a life-threatening condition that increases the risk of heart disease, cancer, and diabetes. Losing weight is crucial, and incretins offer a promising solution.
A study published in J Obes Metab Syndr in 2022 showed that many patients lost 10% of their body weight, which can prevent diabetes and its consequences. A 15% weight loss even led most patients with diabetes to no longer need other medications.
Despite their proven success, the biggest obstacle in getting these treatments continues to be the financial aspect, as insurance companies often do not cover the cost of these drugs. Dr. Paul DeLeeuw believes that it is important to fight for fair drug pricing and complete drug insurance coverage, as obesity is a life-threatening condition, and losing weight can prevent many health complications such as heart disease, cancer, and diabetes.
The medical community has come a long way in understanding the complexities of obesity as a metabolic disease. The development of incretin medicines, such as Semaglutide and Liraglutide, has been a game-changer in the weight loss journey of many individuals. Despite the proven effectiveness of these drugs, the financial barrier remains a challenge for many patients seeking treatment. It is the hope of Dr. Paul DeLeeuw, and many others, that insurance companies and pharmacy benefit managers will see the importance of covering these treatments in order to save lives and improve the overall health of those living with obesity. It is time for a change in the way we approach and treat obesity, and incretin medicines could be a crucial step towards a brighter and healthier future.