Fifteen-year-old Lexi, for example, has been on a long road of trials and tribulations with her obesity situation, largely impacted by her rare genetic condition called MC4R deficiency. Though undeterred, ever her resolution face to obstacle, she still faces stark challenges, most notably that of accessing the best possible medications. Lexi’s challenges highlight the realities of obesity as a chronic disease. They shine a light on the financial barriers families face and what it takes to get treatment.
Lexi ended up being diagnosed with MC4R deficiency, a genetic condition that makes it almost impossible for her to lose weight. At 12 years old, Lexi got a type of bariatric surgery where they removed 80 percent of her stomach. This surgery allowed her to lose 29 kg, a sufficient amount of weight loss to move her obesity classification from class 3 (extreme) to class 2 (severe). Unfortunately, nine months after the surgery, Lexi began to put on weight again, and with that her extreme hunger—a symptom of her condition—came back.
To keep her appetite in check, Lexi now uses an oral appetite suppressant, Qsymia. Since then, she got a prescription for Wegovy. This weight-loss medication, phentermine-topiramate, is approved by the U.S. Food and Drug Administration (FDA) for use in people age 12 and up. Wegovy is one of a new class of injectable medications that was initially developed to treat Type 2 diabetes. Surprisingly, though, it has surfaced as one of the most promising long-term solutions for sustained weight loss.
Still, Wegovy’s financial burden is massive. One month’s supply costs about $1,350—a burden of more than $16,000 per year. This exorbitant cost creates great anxiety for Lexi and her family about whether they will be able to afford these life-altering treatments.
For Brandy, Lexi’s mother, the injectable GLP-1 drugs first seemed scary because of the stigma and ideas surrounding injection drugs. She remembers the frustration of trying an earlier weight loss program that just didn’t cut it.
I still vividly recall the very first weight loss hospital we visited. “It will improve the quality of reality,” Brandy said. Then they gave us a sort of portion plate and kicked us out!
Brandy is well aware that we are on the cusp of a major shift in obesity treatment and stresses that improving options will always be an ongoing process.
She added, “the access and the choices for folks, it’s wonderful, [and] it has to continue moving forward.
Though this acknowledgment of progress is welcome, Brandy is still on guard about what’s happening with her daughter. She highlighted the irreversibility of surgical procedures, explaining, “Surgery is final … there’s no reversing it.”
Beyond the physical health issues, Brandy goes on to express the psychological and emotional components of managing obesity. “The psychological and emotional aspects, such as body image, potential dependence on medication, and identity formation, should be openly discussed,” she advised.
Lexi still struggles with feelings of defeat each day as she faces the battle of choosing a treatment path. Her candid remark reflects the frustration many young individuals with obesity feel when facing limited resources: “You just feel kind of defeated because you’re like, ‘what am I supposed to do when my options run out?’”
Healthcare professionals are waking up to the idea that obesity is a complex disease, not just a consequence of poor lifestyle decisions. Leading expert in the field Dr. Fatima Cody Stanford has been at the forefront of this shift in understanding. What Dr. Stanford said was that people are starting to understand obesity as a complex, chronic disease. It’s been shifted away from the perception of a simple lifestyle-related issue.
She goes on to counsel families to think about the long-term effects of various obesity treatments, including medications and surgery. Dr. Stanford said families need to focus on what makes life better. As a second overarching benefit, he pointed to the remarkable decrease in health risks associated with obesity as a key plus.
Lexi’s family has some very difficult times ahead, but they are hopeful. They ask for improved access to affordable treatment alternatives that will give Lexi the tools she needs on her path toward a healthier, happier future.
