“The main thing people misunderstand is treating this field as one-size-fits-all,” Elina Onitskansky, CEO of Ilanto Health, said in an email.
She posits that either GLP-1 agonists and related classes of drugs are the right treatment for everyone dealing with obesity, or that GLP-1 agonists are the wrong treatment for everyone. I’ve seen many people who are.
“Part of that comes from a food culture mindset that we just can’t shake,” she says. “The persistent idea that we can all ‘solve’ obesity by going on a keto, paleo, grapefruit diet or just taking GLP. We need to get to a more individualized picture.”
Some plan members may be able to control their weight problems with intensive behavioral therapy, and others may need bariatric surgery, she said.
Irant estimates that behavioral therapy can help many people lose up to 5% of their weight, but anti-obesity drugs and bariatric surgery can help them lose even more weight.
Iranto: Onitkanski is a former McKinsey consultant and Molina Healthcare executive who founded Iranto after battling his own issues with weight management.
Ilant employs board-certified physicians, nutritionists, and mental health professionals to help provide and manage obesity care. Its services include providing plan participants with ready access to bariatric care providers and determining which participants are most likely to benefit from certain types of care. Masu.
Background: Onitzkansky is in a field transformed by the discovery that relatively new antidiabetic drugs with acceptable risk profiles can help people dealing with obesity achieve significant weight loss.
In response, drug companies have set a list price of about $1,000 per patient per month.
Obese people have been competing with people with diabetes over access to medicines.
Employers will be required to cover GLP-1 agonists by increasing the net price by approximately two-thirds for employers seeking to provide patients with expensive drugs using controlled use drugs. They blame drug companies and pharmacy benefit managers for making it nearly impossible. Medicines are most urgently needed.
Some obese people point to the success of new weight loss drugs as vindication of the idea that obesity is primarily a metabolic disease and that drugs and other medical interventions are the only practical treatment strategies. Some people do.
Onitskanski’s thinking: Onitskanski argues that people who think the only acceptable responses to weight problems are diet and exercise, and those who believe that drugs, surgery, and other physical medical interventions are the only sensible responses. It falls somewhere between those who believe that it is an effective intervention.
“In fact, we have decades of research showing that most people are not successful with diet and exercise alone,” Onitzkanski said. “That doesn’t mean it doesn’t work for anyone, but about 50% of the U.S. population is currently obese, and that level of obesity leads to other chronic diseases such as diabetes, cardiovascular disease, and musculoskeletal problems. ”
Countries need to help people use effective strategies to control their weight, she said.
“But that doesn’t mean behavioral changes, exercise and access to healthy foods aren’t part of the answer,” Onitkanski said. “they are.”
Most people dealing with obesity also seek help with improving their eating habits, increasing their physical activity and managing their stress levels, she said.
“So it’s not really an either/or,” she said. “It’s about giving people the tools and support to live healthier, longer, more productive lives through a combination of medical and lifestyle support.”
Psychology: Onitzkanski also believes in the importance of psychological support for obese patients, even if counseling has little effect on weight loss.
“Obesity is literally a disease, and a lot of it affects how we see ourselves and how the world sees us,” she said. “There can be a lot of self-awareness and mental health involved in that experience.”
Because of these concerns, Onitzkanski said mental health support is part of the services Ilanto provides to all patients in the program.
