‘Treatment not enough;  social perspective toward obesity needs to change’

‘Treatment not enough; social perspective toward obesity needs to change’

The loss of routines in the lives of Korean people caused by Covid-19 appeared to have affected their physical states by, for instance, growing a muffin top.

According to the “2017-2021 Nutrient Deficiency and Obesity Statistics” released by the Health Insurance Review and Assessment Service on April 21, there were 31,170 obese patients last year, more than double the 14,966 in 2017.

Obesity increases the risk of diabetes, high blood pressure, cardiovascular disease, and various cancers and death, which incurs social costs. Last year, the National Health Insurance Service estimated the socioeconomic loss due to obesity to be 13.8 trillion won ($10.6 million) in 2019. Medical expenses accounted for almost half of the loss, with 7.39 trillion won.

The government has also concluded that the obesity problem is getting worse in Korea and has developed an interagency countermeasure called the National Obesity Management Comprehensive Measures that encompasses nutrition, diet, and physical activity, in 2018.

Against this backdrop, Novo Nordisk, a Denmark-based multinational pharmaceutical company, is making outstanding efforts to help Korea resolve its obesity problem.

The company is well known in Korea for launching innovative obesity treatments, such as Saxenda (ingredient: liraglutide), the world’s first and only drug for treating obesity with glucagon-like peptide 1 (GLP-1).

Korea Biomedical Review met with Novo Nordisk Korea Clinical, Medical & Regulatory Affairs Director Sidi Mohamed El Amine Taha Dahaoui and Novo Nordisk APAC Obesity Medical Director Mariana Mercado Garcia to talk about obesity treatments and social perception toward obesity.

Two Novo Nordisk officials explained the current trend in obesity treatment, the stigma patients suffer, and the company's treatment during a recent interview with Korea Biomedical Review at Novo Nordisk Korea headquarters in Songpa-gu, Seoul.  They are Sidi Mohamed El Amine Taha Dahaoui (left), Novo Nordisk Korea's clinical, medical & regulatory Affairs director, and Mariana Mercado Garcia, Novo Nordisk APAC obesity medical director.
Two Novo Nordisk officials explained the current trend in obesity treatment, the stigma patients suffer, and the company’s treatment during a recent interview with Korea Biomedical Review at Novo Nordisk Korea headquarters in Songpa-gu, Seoul. They are Sidi Mohamed El Amine Taha Dahaoui (left), Novo Nordisk Korea’s clinical, medical & regulatory Affairs director, and Mariana Mercado Garcia, Novo Nordisk APAC obesity medical director.

KBR: What is the trend in obesity treatment in Korea?

dahaoui: Obesity patients in Korea are going and asking for treatment first. So the discussion about obesity is coming from the patient, which means the topic of obesity is no longer a taboo or something that patients wait for the doctors to start the conversation.

However, during the Covid-19 pandemic, people’s priorities moved away because people avoided going to the hospital, which, in turn, led to the discussion and treatment for obesity becoming a second priority.

Garcia: Many people realized during the Covid-19 pandemic that having obesity could lead to a worse outcome when infected with the virus.

Such information made more people realize that obesity is not just an aesthetic problem but a chronic disease that needs a long-term approach to managing weight.

Doctors also realized that obesity management was not just about losing weight and confirmed that they could improve outcomes by improving the patient’s lifestyle.

So Covid reduced hospital visits for obesity treatment, but it also gave information on managing obesity better.

KBR: How do you see the current status of the obesity management environment such as policy, medical environment, healthcare professionals, patients, and the general public in Korea?

dahaoui: Compared to some regions, Korea’s healthcare professionals know that obesity is a social problem, and there are doctor societies focused on obesity, such as the Korean Society for the Study of Obesity. Also, Korea has a significant number of clinics that specialize in treating obesity.

However, as not all obesity management and treatment receive reimbursement, this could be one of the barriers that can help patients target body weight loss when the physical activity and diet are insufficient.

Garcia: Korea has an advanced obesity management program and many specialists with interest, knowledge, and training in treating obesity.

However, even with this knowledge, there are still challenges. Such challenges include recognizing obesity as a chronic disease and providing the right reimbursement, and patients having more knowledge about the cause of obesity.

KBR: How can we raise awareness of obesity in Korea?

Garcia: I usually advise my friends and acquaintances to take the implicit bias test developed by Harvard University.

This is a questionnaire where people can test their own bias against different things, including obesity, as it is important to understand what kind of bias a person has against obesity.

Understanding the causes of obesity is also a crucial factor.

When people understand the cause of obesity, they start to see obesity like any other chronic disease and not just an illness caused by overeating.

I want to add that the press and journalists should also help raise awareness and change the social perception of obesity.

When looking at the world obesity federation page or the Obesity Canada page, people will find something that we call “first people language,” which means putting the patient first rather than the illness and using phrases such as people living with obesity instead of obese people .

This is important as the disease does not define who the patient is. It’s just that the patient is dealing with the disease.

The media also needs to take better care of the images they share.

When people browse a website like Google and search the word obesity or research obesity, they will find many stigmatized images of people living with obesity.

Such images may show just the stomach area of ​​the patient without the head, eating a hamburger, or they are watching television.

These images damage our work and also create a stigma against obesity.

dahaoui: We have been trying to have our campaign against obesity in Korea and to upgrade the World Obesity Day to a level similar to that of World Diabetes Day.

And of course, when we do those campaigns, we will invite and allow everyone to participate as it will not be just a campaign for people living with obesity.

This is because family matters, and the environment and those close to a person living with obesity also need to understand and change their perception.

KBR: There is much attention to when Novo Nordisk will launch Wegovy in Korea. How long will it take the drug to get approval from regulators?

dahaoui: We expect that the next generation GLP-1 will become a tool that can help healthcare professionals treat diabetes and obesity.

So this medication is already undergoing an approval process in Korea. Of course, the timelines depend on the local authorities’ review, and we cannot give an exact date, but we are making good progress.

KBR: How is Wegovy different from the previous famed obesity treatment Saxenda?

dahaoui: Long-term treatment is a burden for all chronic disease patients, including obesity, as they always have to remind themselves to take an injection or pill.

Even if the treatment has high efficacy, adherence to the treatment will be low due to the high inconvenience of taking the drug once a day, which, in turn, will make the patients not follow the correct treatment plan.

However, Wegovy resolves all that as patients only have to receive the treatment once a week.

Also, although Wegovy and Saxenda work the same, their results may be different as studies have shown that when combined with diet and exercise, people taking Wegovy had lost significantly more weight than those taking Saxenda.

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