The Irish Medical Organisation’s yearly conference witnessed discussions that revealed how improved treatments and new medications are set to assign severe and complex obesity to the annals of medical history soon. Prof Donal O’Shea, the HSE’s national clinical lead for obesity, indicated that upcoming doctors might hardly ever come across the type of obesity prevalent today. However, these new treatments come at a substantially high price, which implies that the governments would need to allocate extra funding.
Prof O’Shea further elaborated how HSE’s obesity section’s shift earlier this month from the Healthy Eating, Active Living programme to the Chronic Disease Management one illustrates the broader shift in perception that has resulted in better funding for treatment and patient outcomes. Drugs such as Ozempic mark a significant advance, benefiting approximately 30% of patients immensely and generating positive outcomes for almost as many. The upcoming generation of medications, presently being clinically tested, indicates they are substantially better, benefiting more people, and causing less severe side effects.
The World Health Organisation reports that about a quarter of Irish adults are battling obesity, a condition that is linked to diseases like heart disease, cancer, and type 2 diabetes. Prof O’Shea expressed his excitement about working in the field of obesity, suggesting it is set to become a phenomenon of the past. Nevertheless, he clarified that the costs of these new treatments necessitate additional funds if they are to benefit those unable to afford them themselves before the patents on branded drugs expire, and generics become accessible. He argued that funding these treatments would be economically sensible for governments, considering the wide-ranging costs of obesity and related health conditions.
Prof O’Shea credited the current Minister for Health’s more enlightened stance and funding improvements, making marked changes in attitudes, particularly among politicians who had previously ignored obesity funding. He alleged that these changes culminate from 25 years of work in the field.
“Looking back in history, diseases that were once stigmatised and misunderstood have gained greater degrees of understanding and subsequently, improved treatments,” he remarked. “Take for instance epilepsy, which was once mistaken for demonic possession, or peptic ulcers, a condition initially attributed to stress and smoking until the helicobacter pylori infection was identified as the true culprit.
“When it comes to obesity, the prevailing narrative is ‘eat less, exercise more, and lose weight’. However, this approach is ineffective for the vast majority—90%, to be exact. Our understanding and treatment options for obesity though, are evolving. Obesity is now acknowledged as a chronic disease, necessitating a shift in how we approach its treatment.”
He specifically highlighted the progress made due to “healthcare providers actually listening to their patients and the advent of new treatments, such as Ozempic.” This development influenced attitudes, affirming the concept that “if something can be treated, it’s definitely a disease.”
He did caution that it will take time for new drugs to become widely available. Commenting on Ozempic, he predicted it will ultimately be seen in a similar light to the early, crude blood pressure treatments—effective for some, but laden with side effects and eventually superseded.
He anticipates the future impact of obesity treatment to mirror the improved outcomes seen in the management of type two diabetes.
“I’m hopeful, given that Ireland is set as a demonstration platform for the World Health Organisation (WHO), that pharmaceutical companies will prioritise making their drugs available here. This attention from the WHO could potentially encourage these companies to bring their products to the Irish market sooner. Simultaneously, this could prompt the Department of Health and the Minister for Health to completely subsidise our current model of care, which is only partially funded at 50%—for optimal functionality, it requires full funding,” he added.