“The prevalence of obesity has more than tripled since the 1970s and continues to grow. So it is clear that something has to change” says Dr. Chakravarthy, a physician-scientist who specialises in metabolic disease. “Healthcare systems are already under severe pressure and simply will not be able to cope if the incidence of obesity continues to grow unchecked. At the same time, our current approaches to managing obesity are doing little to slow its growth or reduce its related significant societal impact. At Roche, we are focusing on not only understanding the complex biology driving the interdependencies between obesity and its comorbidities, but also taking a more patient-focused approach to holistically address the complexity of clinical care for people living with obesity.”
A prime example of this interdependency is the link between obesity and type 2 diabetes – a disease that affects over 400 million people worldwide.4 “People with obesity are seven times more likely to develop type 2 diabetes than those with a normal body mass index,” says Dr. Chakravarthy. “However, we are now seeing that this link also provides opportunities for new treatment approaches as weight loss in people with obesity and type 2 diabetes has been shown to put their diabetes into remission.”
While lifestyle changes (such as diet and exercise) can drive weight loss, the level of sustainable weight loss required to change the risks associated with obesity is approximately 10% to 15% of total body weight, which cannot be reached and maintained by many people without additional medical therapies.5 “Studies have shown that even in a clinical trial setting, a medically supervised weight management programme might only produce an average weight loss of around 6% over five years. Also, this is not something that can be sustained outside of such a tightly controlled environment,” says Dr. Chakravarthy. Despite recent advancements in the treatment of obesity and type 2 diabetes, there remains a significant need for novel treatment approaches to address a number of current key limitations such as better quality and maintenance of weight loss.
Another frequently underestimated factor is the stigma and language around obesity that can also act as a significant barrier to patients accessing and maintaining treatments.6 Over 60% of patients report experiencing ‘weight stigma’ as part of their journey, which can further increase their distress, impacting both their physical and psychological health.6 “It is vital that the view of obesity as a ‘willpower problem’ becomes a thing of the past. People with obesity are fighting a battle against their own biology, just as with any other chronic disease like cardiovascular disease or diabetes,” says Dr. Chakravarthy. “While we as researchers and clinicians are all working to find the best therapeutic interventions for obesity, it is also crucial that we broaden our approach and show greater understanding of the reality that many patients face throughout their daily lives such as keeping up with their children, difficulties with work related physical activity, or sleep issues.”
One of the ways we can consider making a simple change is in the language we employ in connection to obesity, to change both how we view the disease and patients. “Obesity" itself is a word that carries stigma and can reflect the incorrect viewpoint that it is something that patients have inflicted unto themselves. If we instead adopt and view it as ‘Adiposity-Based Chronic Disease’ (ABCD), this would more accurately represent the complex causes of the disease and its relationship to other comorbidities,” says Dr. Chakravarthy. “At Roche we are focused on this holistic approach. Adopting the use of ‘ABCD’ could be more respectful and patient-centric for the people that we serve. Additionally, through a greater understanding of disease biology we might be able to better manage ABCD as one disease continuum. In doing so, we could have a real shot to alter this current trajectory and improve the lives of people across the globe.
References
World Obesity. 2023. Economic impact of overweight and obesity to surpass $4 trillion by 2035. Available at:
Rethink Obesity. 2024. Complicatiobs/comorbidities of obesity. Available at:
National institiute of diabetes and digestive and kidney diseases (NIDDK). 2023. Health Risks of Overweight & Obesity. Available at:
World Health Organization (WHO). 2023. Diabetes Fact Sheet. Available at:
Ryan DH, Yockey SR. Weight Loss and Improvement in Comorbidity: Differences at 5%, 10%, 15%, and Over. Curr Obes Rep. 2017 Jun;6(2):187-194. doi: 10.1007/s13679-017-0262-y. PMID: 28455679; PMCID: PMC5497590.
World Obesity. 2023. Weight Stigma. Available at:
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