Let's treat obesity and prevent it!

It's unfortunate and shocking that only in 2013 Obesity was designated as a chronic disease , and only in 2015 the insurance companies have decided to offer  and cover obesity treatments. Sadly, US policy makers have not encouraged medical technology companies to progress and develop treatments as much as the have done with DOD and energy sectors in the past decade. As a result, in the US,  one in three Americans (over 90 million), struggle with obesity and its related diseases today. 

In the past, insurance providers have time and again denied most of obese patients coverage for potentially life-saving treatments. Today, the insurance companies realize that obesity is the root cause of over 20 chronic conditions, but their take on obesity treatment is very primitive. Insurance companies have  forced the medical community  to offer one shot treatment which is either a gastric bypass or sleeve gastrectomy surgery, both involving  invasive removal of 80-85% of stomach and displacement of Gi tract.  In a progressive country like ours, where we spend billions of tax payer dollars studying the remote planet like PLUTO, little or nothing is done in terms of funding obesity research on medical devices. Medical devices have been proven to be the most effective treatment for tackling obesity.

 

The federal government needs to offer: Unconditional funding, (NIH funding process is terribly convoluted, time consuming, the applications dismissed if there are tiny errors. Private entrepreneurs just don't want to spend their time, writing grants to get dismissed by a panel of one track minded academicians who like traditional university like research) the FEDs need to support  young , private, innovative companies who are struggling to bring a product to market, introduce as a special  obesity fund. If not, offer simple measures to investors like "unlimited tax write off incentives" for investors investing in obesity research and innovation activities.
The inactivity of the federal initiative, like the NIH funding ( which in my opinion is very biased to academic researchers), poor regulatory process during 2005-2010, resulted in obesity tech skeletons on the road until recently,  we have seen robust/expedited regulatory and FDA approvals. VCs have just begun to look at new obesity technologies with interest, because the obesity market  suddenly  seems to be a big money  making opportunity as is estimated to reach $137 Billion by 2017 according to MDDI article.
The regulators and policy makers need to continue to approve the obesity products expeditiously. Once FDA approved, the products need to have  their reimbursement codes respectively.

Intuitively, insurance companies will actually, save money on treatment of other co-morbidities caused by untreated obesity, if the obesity treatments are available to the patients early, even before co-morbidities become chronic conditions like heart disease, diabetes, strokes & cancer. We all know that all these conditions  involve life long expensive treatments and hospital stays . I am not sure, what will it take, to get this message across to insurance companies and the healthcare policy makers, CMS and grant agencies.
The biggest effort has been made by National Obesity Foundation, they have we been fighting for your health care rights, they have created programs offering financial assistance and even free surgery to deserving individuals via the their humanitarian award program.

Despite the challenges, the innovation in obesity treatment is at its peak today. The medical device companies are at the forefront, they are targeting obesity with novel technologies. Unfortunately, many of them are focusing on innovations for gastro-enterologist like the  intra-gastric balloon technology like the Orbera balloon from Apollo and DUO balloon from Reshape (both approved by US FDA). Gastro-enterologist are not bariatric surgeons and bariatric surgeons are not trained gastro-enterologist.  Also, patients usually seek the help of bariatric/obesity surgeons to get obesity treatment. There needs to be more companies focused on bariatric surgery innovations.

Believe it or not, today, Medtronic-Covidien, Apollo and J&J-Ethicon  are the known mid sized to large strategic to offer limited options to bariatric surgeons. However, there are a couple of promising new entrants with compelling technologies targeting bariatric surgeons using laparoscopic approach, one of them is Onciomed's GVS system which imitates gastric sleeve surgery without cutting or removing portions of the stomach or intestines.

Today's article is all about tackling US obesity epidemic and addressing the enormous unmet need. I will continue to write about the world wide epidemic of obesity and diabetes. I cannot emphasize enough, obesity is worlds largest healthcare market. Obesity remains the most undervalued segment, at least for now,  it marks a tremendous opportunity for investors both institutional and private.
Lastly, I thought of something corny, I'm no Trump, but, let's make our country healthy again.
Let's treat obesity and help prevent childhood and adult obesity.

India and China have largest number of obese individuals after USA.

The study - titled 'Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: A systematic analysis for the Global Burden of Disease Study 2013' - used data collected by international bodies and organizations in various countries like India over three decades. The US topped the list with 13 per cent of the obese people worldwide in 2013, while China and India together accounted for 15 per cent of the world's obese population, with 46 million and 30 million obese people, respectively. According to the study, number of overweight and obese people globally increased from 857 million in 1980 to 2.1 billion in 2013. This is one-third of the world's population. These are important numbers for investors  (private and institutional) to take notice.
 
 Patients are lining up at obesity clinics in all major metropolitan cities in India. Obesity and diabetes have become the root cause of heart diasese in India. Patients are asking for less invasive surgery or procedure that will help them lose weight. 2010- 2015 saw a shift towards a procedure called the  "Sleeve Gastrectomy "  which means cutting and permanently removing 80% of the stomach, these surgeries pose treat of bleeds and leaks in the hands of inexperienced surgeons.  Now, the Indian population is following the social media and following  the trend of  "Gastric Preservation"  which means, a procedure that does not involve cutting and removing portions of the stomach and Gi tract. New treatments like the Reshape's DUO and Apollo's Orbera balloons recently approved by FDA and the newly introduced Gastric Vest System from Onciomed in clinical trials, show new promise to bariatric surgeons, gastroenterologist and patients who are looking for less invasive technologies.

A country where 270 million people live below the 'poverty line', obesity seems to be a distant issue, meant for the rich kids of first world. But India is under siege: junk food, alcohol and sedentary lifestyle are leading us to silent self destruction, making one in every five Indian men and women either obese, overweight or pre-diabetic.
According to a study published in the noted journal Lancet, India is just behind US and China in this global hazard list of top 10 countries with highest number of obese people.
Question is: Is India and China the next big market for medical devices targeting obesity?

Prejudice Against Obesity Treatment: Obesity is a Orphan Disease

Prejudice  Against Obesity Treatment

At a time when obesity is seen as a serious public health threat, research has found a growing prejudice against fat people. In 2013 American Medical Association designated Obesity as a disease, yet insurance companies do not offer treatment choices to patients.

Already, the social consequences of being overweight and obese are serious and pervasive. Overweight and obese individuals are often targets of bias and stigma, and they are vulnerable to negative attitudes in multiple domains of living including places of employment, educational institutions, medical facilities, the mass media, and interpersonal relationships.

 The Rudd Center for Food Policy and Obesity at Yale University published a study suggesting that male jurors didn't administer blind justice when it came to plus-size female defendants.

Female jurors displayed no prejudice against fat defendants but men -- especially lean men -- were far more likely to slap a guilty verdict on an overweight woman and were quicker to label her a repeat offender with an "awareness of her crimes."

Another recent study by the Center for Creative Leadership found that top managers with a high body mass index were judged more harshly and seen as less effective than their slimmer colleagues by their peers, both at work and in interpersonal relationships. 

When it comes to TREATMENT OF OBESITY: Insurance companies, step on the sidelines. 

Payers, offer more sympathy to those who struggle with psychiatric issues,drugs, alcohol, nicotine, impulsive shopping, sex addictions, pornography addictions, and other problems designated as orphan disease. There are even federally funded programs to pull people from the pits of these addictions. 

Obese patient more often have to gain weight by 50lbs to get interventions. Is this fair?

Obesity can happen to anyone, if you are skinny, it can happen to your kid, someone dear to you.

 

If you have an facebook accont: please fight for obesity: join the obesity treatment advocacy group