Editor’s note: This story is based on discussions at Abarca Forward, a conference in San Juan, Puerto Rico, hosted by Abarca Health, a pharmacy benefit manager. MedCity News was invited to host and attend the event. Accommodations for the team were covered by Abarca. However, company officials had no input in editorial coverage.
GLP-1s like Ozempic and Wegovy are making waves for their potential to improve obesity rates. But they shouldn’t be the sole focus when it comes to achieving meaningful and sustainable weight loss, according to one health executive. Rather, there should be a focus on lifestyle changes like food.
“Evidence-based medicine says, ‘Optimize therapeutic lifestyle first for six weeks and then initiate drug therapy. … That’s what you’re taught in medical school, but none of us do that. I think we have to go back to the roots of medicine. If you remember 2000 years ago: ‘Let food be thy medicine, medicine be thy food.’ But we don’t prescribe what we don’t know. And doctors don’t know anything about food,” said Dr. Robert Graham, founder of FRESH Medicine, during a panel discussion on GLP-1s last week at the Abarca Forward conference in San Juan, Puerto Rico.
“That’s how I see GLP-1s. That’s how I see therapeutic lifestyle changes and food-as-medicine as an intervention,” he continued. “I really believe that the food-as-medicine movement, if prescribed correctly, will change how healthcare is delivered in the next five to 10 years, with or without the use of GLP-1s.”
When it comes to the prescribing of food, Graham gave the example of a patient who sprained his ankle and broke his fifth metatarsal. He had to prescribe this patient medically tailored meals for a certain number of weeks and provide nutritional support from a dietitian or health coach. Medically-tailored meals are meals that are designed by a registered dietitian. Eventually, the patient was transitioned to a produce prescription, which is a prescription for fruits and vegetables. However, since the patient didn’t know how to cook, he was given education on how to prepare the food.
Graham noted, however, that food alone isn’t going to solve the obesity problem either. His company, FRESH Medicine, stands for the five ingredients of health: food, relaxation, exercise, sleep and happiness. He added that it’s important to understand why we’re struggling with obesity.
“The reason why we’re overweight and obese is not just because of our food,” Graham said. “It’s because of how we love, how we exercise, how we don’t sleep, how we’re unhappy, how we’re so depressed. So looking at either a drug therapy for a complex thing like weight loss, or a food approach for just weight loss is never going to get us there. Because people’s root cause of obesity is larger than just the food that they eat…. Until we start really getting serious about why we are obese, we’re never going to get there. We’re going to be throwing more drugs, more doctors, more pharmacists, more health coaches.”
Stacie Hueller, senior HR director of Americas benefits at Medtronic and another panelist, shared her personal story with weight loss. Her father passed away at the age of 58 about 20 years ago. He had three strokes by the time he was 55 due to a “combination of lifestyle and unfortunately not good genes,” Hueller said. She added that she started to see herself “going in that direction.” She looked into a GLP-1 but decided to go a different route because her health plan only covered four prescriptions per year.
“I found a program. .. My workouts are delivered to me through an app,” Hueller stated. “I have a menu of things that I know are easy for me to eat. I have been successful and have lost 30 pounds. Now, if I had gone with the GLP-1 space, I might have been in the same boat but this has become more of a lifestyle and I really think for employers that’s where it needs to start. I do think that there’s a place for them to pay for and support that. But it has to be this holistic approach.”
Anand Iyer, chief analytics officer of Welldoc, stressed the importance of personalization.
“It’s not a one-size-fits-all. A GLP-1 is just another arrow in the quiver of how a person is going to manage — with the guidance of their healthcare provider and team — their outcomes and get to a better place,” he said.
Sarah Kempton, manager of clinical programs at Blue Cross of Idaho, added that the key to sustainable weight loss is “engaging early and having a mix of human coaches and digital solutions to really help members meet their goals.”
Photo: fcafotodigital, Getty Images
