I assumed the 30% was not so much about misinterpretation, but rather a high BMI for people who are muscular rather than overweight. The number did seem high to me for that reason, so perhaps there were other reasons it’s considered wrong.
Anyway, I can’t remember exacty where I read that, but it was in the last few days. I’ll see if I can find it again.
ETA: I think I found where that number ultimately comes from. This study here:
My first post misused the term radius when diameter was wanted.
I am unsure the number of larger people who are “metabolically healthy”, but fifteen to thirty percent or higher would not surprise me in some populations. Much depends on definitions, diabetes is a spectrum but is a serious disturbance, metabolic syndrome X can be as well, a rise in some cholesterol subtypes might not be so significant.
The Washington Post article effectively tells us here, without giving the details:
Treatment, at least, is bound to improve because, for those who can afford it, it already is improving. And cost of medical treatment will decline.
Just about the magic year of 2035, apparently long-term effective weight loss medications will go off patent, and poor countries will then be able to afford them for their national health system. Middle income countries will be able to afford them before that.
I realize that a big word in the last paragraph is “apparently.” When I read this, I thought that we are probably at the beginning of the end for obesity as a commonplace. What impressed me wasn’t the amount of weight loss, but that after 72 weeks, patients on medium doses weren’t gaining back – a tremendous problem, at that point, with almost all previously existing treatments. Even it gain-back does occur after 72 weeks, that increasing the dose over time should allow beating back morbid obseity for many years.
Of course, we don’t know what will be approved on-label, and if the medications can beat back extreme obesity for decades. But, more broadly speaking, I think that treatment is what countries will do about the problem, and that the younger people on this board, at least, will see it working well in their lifetimes.
Also see:
I’m not yet convinced that those drugs are overall good for most people’s health. There may well be downsides to widespread use that we haven’t figured out yet. Even the article linked, despite its generally upbeat tone, included this paragraph well down in the text:
The new treatments are not without their flaws. For one thing, there are side-effects, including vomiting and diarrhoea, which were severe enough to cause 3% of patients to stop using them in a survey conducted by the Mayo Clinic, an American hospital. In addition, they are supposed to be taken as part of a broader programme of dieting and exercise—although it is not clear how essential this is to the weight loss. Semaglutide, specifically, appears to increase the risk of a rare type of pancreatitis. There are also concerns over the use of the drugs during or just before pregnancy. And studies in animals have shown a higher incidence of thyroid cancer.
And it’s necessary to keep taking them. I’m sure the companies making them would be ecstatic to have as much of the population as possible defined as needing medical treatment for their weight, given that said treatment amounts to a perpetual market.
I wouldn’t predict the elimination of extreme obesity (all I really care about) by 2035, or even 2100. I just think the OP is mistaken to project current trendlines.
It’s true that the existing new drugs will not be an option for many, either because of real side effects, or because of fear of the unnatural, or because of, even after they go generic, cost. The two new drugs now approved in the U.S.(one approved but still off-label for weight loss) are self-injectables, and many won’t go for that. And we can’t rule out an approval being pulled, as sometimes happens. But there are more weight loss drugs in the pipeline; no big drug company can ignore the high revenue now proven as possible for drugs in this class.
As for whether a new class of drugs, that will be taken for decades, is truly good for health, that’s another question. It probably takes at least 50 years to know for sure. Most likely, this will result in some drugs being no longer used while others remain popular.
Of course, I am not giving medical advice.
The OP’s fact that half the world will be overweight or obese is a massive triumph in a historical sense. I mean food insecurity, malnutrtiion, and starvation/famine have been a constant specter looking down on every society on Earth since time immemorial.
To have enough food that half of all people get too much is kind of astounding when you think about it. And it likely means that a good chunk of the other half get enough to eat- certainly more than they would have in the past anyway.
That said, it is as large of a public health crisis as starvation would be. I’m not sure what the answer is, and I don’t even think the causes are clear, except in the broadest strokes.
This is true, and is how the approval studies were undertaken. And that confuses me a bit.
Evidence from loads of set point theory research is that when people reduce their calorie consumption, either voluntarily or otherwise (such as during a war), they, on average, bounce back to a higher weight in a few years. Everyone? No, there are many who keep off lost weight for life. But on average, yes, dieting, with or without exercise, has been extensively trialed and generally shows short-term success followed by long-term harm.
Suppose that there was a cancer treatment that, more than half the time, made disease long-term worse, but, less than half the time, made it better. Would a study of a new cancer drugs require that you combine some past treatment protocol that didn’t pan out with the new one you hope will work?
By analogy, this seems to me a weakness of the semaglutide and tirzepatide studies. Maybe the researchers thought that the people in their study – and those who purchased the pharmaceutical if approved – would likely be trying dieting and exercise, off and on, no matter what the study protocol said about it, so they might as well ask for it.
The implication here for the OP idea is just more of – we don’t know, which means that the evidence for the claim about half the world is utterly lacking.