Identifying Drivers and Barriers to Antiobesity Medicine Use in Obesity Care

Obesity is a chronic, progressive disease that impacts 650 million people worldwide, and — despite its severity and prevalence — obesity wasn’t recognized as a disease until 2013 by the American Medical Association (AMA). Nine years later, it’s still largely thought of as a condition related to lifestyle choices, with low rates of consideration for drug therapy. Antiobesity medicines (AOMs) are often not even discussed as an element of obesity treatment plans.

About the OBSERVE Study

Lilly believes people with obesity deserve access to comprehensive care, similar to other chronic and metabolic conditions. We see a critical need for broader acceptance of obesity as a chronic, treatable disease and solutions that offer access to effective pharmacological treatment options. With this in mind, we initiated the OBSERVE study in collaboration with Cerner Enviza to better understand the underlying reasons for limitations in obesity care and the slow uptake of AOMs to help manage the disease.

As the first U.S. nationwide study focused on understanding AOM use, OBSERVE aims to dig deeper into the drivers and barriers that influence care within the obesity landscape, and uncover the core misperceptions that are the root of inadequate care. Study participants include people living with obesity, health care providers (HCPs) and employers, each of which play a unique role in influencing approaches to obesity care.

Results Revealed Underlying Biases, Lack of Understanding That Impact Care

Phase 1

Results of the Phase I research were unveiled in late 2021 and revealed underlying patterns of bias and misperception across each key group of participants including people living with obesity, HCPs and employers that make coverage decisions.

Among participants, many people living with obesity said they don’t identify themselves with the term “obesity” and those who do, tend to view it as a self-modifiable condition rather than a long-term disease.

Results also showed a pattern in self-blame among people living with obesity, with even those who are accepting of AOM use viewing it as a means to bolster their own lifestyle changes.

On the contrary, nearly all HCPs shared an opposing view that obesity is considered a long-term disease. Even so, many of these HCPs expressed hesitancy to prescribe AOMs, explaining that they viewed them as short-term solutions rather than long-term treatments. HCPs that spoke to their hesitancies expressed concerns from lack of safety and efficacy data on current treatments to limited understanding of obesity management overall. 

Results showed that since there are low prescribing rates among HCPs, employers perceived a low demand and tended to deprioritize coverage considerations for AOMs when building benefits packages. This led to insufficient awareness of the impact of obesity and resulted in challenges with coverage and out-of-pocket costs for people who may benefit from AOM use. Many employers also expressed lack of understanding of AOMs overall and default to corporate wellness programs as solutions for obesity.

With evident patterns of biases, misperceptions and education gaps about AOMs across three of the most influential groups in the obesity care pathway, it is clear that challenges in obesity care are vast and deeply rooted.

Phase 2

In 2022, Lilly revealed additional results of the OBSERVE study that dove deeper into the perceptions of persons with obesity toward the disease itself and potential treatments, including AOMs.

When looking specifically at perceptions of obesity, the next phase of results reiterated what was seen in phase 1 — about two-thirds of participants don’t categorize their weight as “obese” and only half believe obesity is a disease. However, this time around, we learned that despite scientific evidence, a small number of participants viewed obesity as the primary result of body dysfunction, and just over half believe obesity is a disease. Findings also showed that although 86% of participants agreed that obesity impacts long-term health and increases the chance of developing other health problems like physical function (82%) and emotional well-being (77%), only 45% felt it requires treatment by a healthcare provider.

So, Lilly looked closer at how people living with obesity viewed treatment options. When participants were asked about obesity treatments, almost three-quarters believed that lifestyle and behavioral changes are the best options for long-term weight loss, with 64% being unaware of prescription AOMs that could help manage weight.

While most people living with obesity seem to understand the serious, potential long-term health effects and complications associated with obesity, a significant amount still believe they can battle the disease single-handedly. There are also many people who don’t feel AOMs are necessary or are unaware they even exist. For these reasons, it’s become evident that more education and awareness are needed to understand obesity is a disease that requires not only lifestyle changes, like diet and exercise, but medical interventions.

Looking Ahead to a Brighter Future

These OBSERVE findings continue to underscore that the misperceptions and stigmas around obesity are having a domino effect across several key players and more education is needed. We hope the insights gathered from OBSERVE can guide decisions, improve education and ultimately shift perspectives of the disease to implement effective evidence-based approaches to obesity care.