Rae Woods (00:02):
From Advisory Board, we are bringing you a Radio Advisory, your weekly download on how to untangle health care's most pressing challenges. My name is Rachel Woods. You can call me Rae. Last October, I spent a few days in Las Vegas with 12,000 other leaders at the HLTH conference. And one of my favorite parts about this event is how HLTH runs at the big, messy problems in healthcare. And frankly, I love speaking at events like this. I love to moderate complex conversations, I love to interview industry leaders. But what I love even more is bringing those conversations to you, our Radio Advisory listeners. You're about to hear a conversation with an all physician panel about the state of GLP-1s, the providers who administer them, the purchasers who cover them, and the expanding web of players attempting to provide the holistic weight management support that will actually decrease the total cost of care.

(00:59):
And these providers are, in real time, trying to understand how to best navigate the world of these novel and innovative drugs. They're no longer disruptors. They are our new status quo. But as this conversation reveals, we are still flying a bit blind. We don't necessarily have the best data, which can lead to inappropriate care. We don't always have the right wraparound support, which can shrink the drug's ROI. And perhaps most importantly, over-indexing on weight as the proxy for overall health can limit the true impact of GLP-1s in healthcare.

(01:37):
I'm so excited for you to hear this conversation. Let's dive in.

(01:42):
So with that, I'll invite my panelists to go ahead and introduce themselves to all of you.

Florencia Halperin (01:50):
Hi, I'm Florencia Halperin, and I'm an endocrinologist and obesity specialist. I am the chief medical officer at Form Health, where we deliver comprehensive obesity care through telehealth, and work often with employers as part of their health benefits.

Nathan Wood (02:07):
I'm Nate Wood, internal medicine, obesity medicine, lifestyle medicine, assistant professor at Yale, where I'm also the director of culinary medicine. And so I think a lot about how to combine food, nutrition, food as medicine, with medications like GLP-1s to improve metabolic health.

Angela Fitch (02:22):
Hello, I'm Angela Fitch. I am board certified in internal medicine and pediatrics, as well as obesity medicine. And I am the co-founder and chief medical officer of knownwell, we're the first of its kind click and mortar patient-centered medical home for metabolic health and patients with overweight and obesity. We have clinics in six states and 50 state telemedicine care, as well.

Spencer Nadolsky (02:43):
Spencer Nadolsky, board certified in family medicine, then obesity medicine and lipidology. Created a program called Sequence a few years ago, got bought by Weight Watchers. I had since left them, and wanted to create a new, more evolved version of a comprehensive direct care model. And I make a lot of funny social media posts as well.

Rae Woods (03:02):
So if we were having this conversation this time last year, I think we would still be considering GLP-1s a disruptor to healthcare. Today, they are our new industry status quo. In fact, they have sparked an entire industry, many of which are represented here on stage with me. Before we get into the landscape of where we are, level set with our audience. What do you think the healthcare industry is getting most wrong about the current state of GLP-1s, the current state of obesity care? Spencer, I'm going to start with you.

Spencer Nadolsky (03:35):
I think a lot of it is just over-hyping these medicines without having a lot of data behind them. We see a lot of people pushing certain doses, micro-doses, all sorts of things, compounded versions. Without good data, we need to be optimistic, but cautious, I think. What do you think, Angela?

Angela Fitch (03:53):
Well, I think we're doing the largest uncontrolled, un-consented human experiment of our time, with the most revolutionary Nobel Prize-worthy treatment that we have before us. And I would love to see us use that in a coordinated population health fashion, and real holistic care.

Nathan Wood (04:10):
Yeah. Spencer talks about the hype for these meds, and there's so much hype. And I think sometimes the docs get in the way and they're like, "Okay, let's tamp down on the hype." I don't know. I feel like, what are the hype men for these meds? I think they're really amazing. But I think we're trying to get people on these meds at all costs, or even if we are getting folks on these medications, not doing so with appropriate nutrition considerations and other lifestyle modifications that are really good for the prevention of obesity, but also for the treatment along with these medications. Which also, at the same time, besides improving efficacy, also improve the tolerability. So I see that going wrong a lot.

Florencia Halperin (04:42):
Yeah. And I guess just to add a little bit of a different spin, I think we're focused too much on weight. This is really not about the number on the scale. This is about treating a health condition, which has been stigmatized and treated as a second class citizen in the world of diseases, and we need to be focused on health and the improvement. And oftentimes you don't need to lose that much weight, and you don't need to be on the highest cost medication, to drive all of the health benefits. So I think when you ground the conversation in, "This is a health issue, and we need to be improving people's health," that's when you can really talk about the ROI and a lot of other things. As opposed to kind of selling it to people who don't have the BMI to even qualify for the drug the way that it's been studied in clinical trials, et cetera.

Rae Woods (05:30):
As you can see, we're not going to shy away from the tough conversations here. I want to do what Florencia just said, which is, ground us for a moment. So let's talk about where the landscape is today. The landscape is for these drugs, and for the traditional delivery system, and this new industry that's been sparked. I want to start with what these drugs can do today. What is the latest on the types of conditions that GLP-1s can actually treat? Because it's expanding.

Angela Fitch (06:00):
Well, they definitely treat obesity. They definitely treat diabetes. We now have data on metabolic associated steatohepatitis, as well as cardiovascular disease and cardiovascular risk reduction in patients that have overweight or obesity. Instead of talking about how can we actually get access for these patients, we're just talking about how can we get people off these drugs, because they cost too much. And we have a lot of expensive treatments in the United States, but we don't make them be cost-effective before we treat them. And so I think, how can we really sit down and change the outcome of so many people? Because they do have so many clinical benefits.

Rae Woods (06:40):
And even more indications coming. I mean, the manufacturers are looking at Alzheimer's. They're looking at addiction. I mean, the list goes on.

Angela Fitch (06:48):
We don't have that data yet. We have to really focus on getting some of that data, even if it's real world data.

Spencer Nadolsky (06:54):
Yeah. I'd say there's a lot of longevity folks that are trying to push this stuff for all sorts of things that just haven't been studied, and putting them on doses that just haven't been studied. So I always, "Dampen it down. It's great for obesity, cardiometabolic care. We know it reduces cardiovascular disease."

Florencia Halperin (07:11):
So in addition to the things you said, sleep apnea and kidney disease, those are established indications approved by the FDA. There are legitimate clinical trials. And I think what's so exciting is, some of them are still in the cardiometabolic space. For example, heart failure and peripheral artery disease, and Type 1 diabetes are being legitimately studied. And now there is this alcohol, opiate and tobacco use disorder. We don't know yet, but there are real clinical trials being done. There's also interest in cancer, endometrial cancer, breast cancer, other cancers for which we know that obesity is a risk factor, legitimately being studied whether these drugs could prevent recurrence. So there is legitimate science going on in all of these indications outside of the more traditional cardiometabolic disease.

Rae Woods (07:59):
So bottom line, the population for end users using these drugs is only likely to grow. And that doesn't even account for the fact that there are more than 150 agents in Phase 2 and Phase 3 trials, alone. The field is going to get a lot more crowded. Let's do a quick lightning round. Do you think there's going to be a world in which the vast majority of Americans are on these drugs?

Spencer Nadolsky (08:27):
Yes.

Angela Fitch (08:27):
Yes.

Nathan Wood (08:28):
No.

Florencia Halperin (08:29):
I'm also a no.

Rae Woods (08:31):
Let's start with the nos. Nate, I want to start with you. Why do you think no?

Nathan Wood (08:34):
Yeah, a lot of people are going to qualify for them, but will the vast majority, whatever that is, 70, 80%, actually end up on them? I don't think so, but I think a lot of people are going to try them, and a lot of people are certainly going to qualify for them.

Florencia Halperin (08:46):
And I say no, not because I don't think it will be helpful to the majority of Americans who have obesity and these other conditions, but we know how to treat hypertension. We know how to treat Type 2 diabetes. We have cheap drugs in that space. Also, at least a third of Americans don't have primary care doctors, or don't see them. So I think we have a lot of kind of structural healthcare barriers to get to that.

Rae Woods (09:09):
And what do the yeses think?

Spencer Nadolsky (09:11):
So there's a new study that just came out about the prevalence of obesity using different anthropometric measures, not just BMI. But waist circumference, waist to height, waste to hip ratio. And with that data, it's around 70%. Then you start adding on the alcohol use disorders, PCOS, and all sorts of other things. I think we're going to see primary prevention, so preventing that first heart attack from ever happening. I think we're going to see young kids being put on this to prevent obesity in the first place.

Angela Fitch (09:41):
We've got to use all this brain power, and use it for good chronic disease management. Because we're getting it so episodically today. The problem is we have a commodity disease, and we have a specialty drug.

Rae Woods (09:53):
And this drug, I want to be clear, is a tool, right? We often talk about GLP-1s, and I hear folks refer to it as a miracle, as a remarkable drug. And it is, but it is still a tool. A tool that, by the way, doesn't address the root cause of obesity. And there are many root causes, if we think about the social determinants of health, if we think about the structures of healthcare, if we think about the structures in society. I'm curious, as you all represent physicians who are trying to get the kind of holistic care that patients need to as many people as possible, or as many people as need it. How do you think about also continuing to improve the structural challenges of obesity?

Florencia Halperin (10:40):
The model of you get sort of shipped a medication, or you go once a year to a PCP and you get a prescription, it really doesn't work. We need comprehensive care. We need to address healthy nutrition. We need to address physical activity, behavioral health. And we're starting to see data that in the real world, when you don't put these things in place, you don't get the same outcomes as in clinical trials. So we need to continue to do all of those things. By the way, all of those things have health benefits by themselves, and so they each independently should be things that a healthier population should be doing. But they also optimize their results, if we are going to spend the money, and put the patient on these medications.

Nathan Wood (11:22):
Yeah. I think about the prevention of obesity and the treatment of obesity as being really different, and if we're thinking about the prevention of obesity, the goal is perhaps to prevent people from getting on one of these medicines to begin with. Although I love your points about using these meds as prevention, too. But in the largely Medicaid population that I work with at Yale we're thinking about, "How do we get these folks access to healthy foods in our built obesogenic food environment, where it's really easy to get hyper palatable ultra processed foods?" You're up against a lot, and that's not to mention that the cost of these ultra processed foods is much less. They're much easier to get.

(11:54):
We have time poverty, we don't have time to cook and acquire healthy foods. Maybe you don't have a neighborhood where it's reasonable to get safe physical activity. Or if you're working a couple of jobs to make ends meet, and you can't sleep and you're stressed, and you can't access a mental health provider because there's too few to go around. The structural contributors to obesity are so many that of course we should be prescribing these medications to those who need them, but if we really want to prevent obesity, these things have to be addressed. And they're big things to address.

Spencer Nadolsky (12:21):
Yeah, I always say it's a false dichotomy to go, "It's environment versus the drugs." We need them both-

Rae Woods (12:26):
Yes.

Nathan Wood (12:26):
Yes.

Spencer Nadolsky (12:26):
... and I see people make that false dichotomy all the time.

Angela Fitch (12:28):
That's one of the big things, to your original question, around what people get wrong, right? This is not people's fault that they have obesity, but yet-

Rae Woods (12:36):
Yes.

Angela Fitch (12:37):
... every day they come in, and when I tell them, "This is not your fault, this is a disease, just like cancer or heart disease," or other diseases that have a lifestyle component, for sure. We have to incorporate all of that together, and that's medicine. We have 80% of our patients that stay on their GLP-1 at one year, at knownwell. We just looked at our data recently, 80% of them are staying on their medication at one year, and that's-

Rae Woods (13:01):
Which is 30% better than traditional.

Angela Fitch (13:04):
Someone said, "How are you doing that? " And I said, "Well, it's kind of just good medicine. That's what we're doing."

Rae Woods (13:09):
It is good medicine in the sense that, I'm sure all of you were trained as physicians. And in that sense, you all actually represent the kind of core of healthcare delivery, but you also don't. Because at least three of you now operate a third party, you operate companies that are separate from the traditional delivery system, that try to give access to these drugs to real people, while also providing wraparound support, the kinds of support that Nate was just describing. My kind of blunt question here is, can the traditional delivery system provide that kind of holistic wraparound support? And if so, what would it take for them to be able to do that?

Spencer Nadolsky (13:49):
I don't think that they can, honestly.

Rae Woods (13:51):
Let me go the other way, because you do represent new third parties. And the question that came in from the audience, which is about what you think about other third party programs that are providing access to these tools without this kind of wraparound support. Why is that the wrong move?

Spencer Nadolsky (14:09):
Side effect management, that's when people stop the medicine, regain their weight. We don't know what happens when they start yo-yo-ing.

Angela Fitch (14:16):
You get worse, right? We know it's harder to lose weight the next time. We would have employers come to us and the first question would be, "Well, what's your off-ramp strategy?" And I go, "We don't have an off-ramp strategy, because-"

Spencer Nadolsky (14:25):
There is no off ramp.

Rae Woods (14:25):
[inaudible 00:14:27]

Angela Fitch (14:26):
... that's malpractice." But to actively say to someone today, "I want to take you off this drug because I think it's the right thing to do medically," is actually wrong. If a patient comes to me and says, "I really want to try to be off this medication," sure, we can help them. And say, "Let's lower it down. Let's watch your weight. Let's make sure it doesn't go back up," because weight loss is not normal. It's not normal to lose weight, as a human body. And so fighting back against the metabolic adaptation that occurs to try to put our weight back on, is very challenging biologically. And that's what people don't appreciate, in today's world.

Spencer Nadolsky (15:02):
Agreed.

Florencia Halperin (15:02):
I mean, I think we see problems when you don't have the wraparound care. First of all, we don't drive maximal health benefits, because just exercising improves mortality and so many other things. So you are not getting the full health benefits. We see problems with adherence. The available data on adherence for these drugs is terrible, but in places where you provide better treatment, that's just not what we see. We see much better. And then, the other thing is, there are studies of real world of semaglutide, which in clinical trials has a 16% average weight loss, and they're only seeing like 5% weight loss. So you're not even getting the optimal weight loss results when you don't provide everything else. And that's not to mention all of the safety concerns that we've been talking about, about people getting doses that aren't tested, compounds that are not the actual molecule that was studied in clinical trials, and things like that.

Spencer Nadolsky (15:51):
Yeah, I've seen at some of these places, they don't even help them adjust their blood pressure medicine as they're losing tons of weight. So some of these people are passing out, and having to go to the ER. Or throwing up, have to go to the ER, and get hospitalized, so that's not good either.

Rae Woods (16:51):
There is such a complicated story in healthcare business about the ROI of these drugs, but I have a lot of empathy for the purchasers out there, for the health plans. I especially have a lot of empathy for the employers who are staring down the barrel of seven, 9% cost growth this year alone. Many of you work with employers. How do you work with them to make sure that they're seeing the ROI on their employee population, curbing their costs which are entirely unsustainable, while providing the kind of outcomes that are important for the patients. And in their case, the employees.

Angela Fitch (17:30):
We just published a paper, $3,000 to $4,000 of total healthcare spending savings in the first year of treatment in just patients with obesity. So it does save money for us to treat obesity, it's just that right now, it doesn't save enough money. So there's a lot of extra waste in the system that we need to just sit down and handle. Right now on Lilly Direct, tirzepatide for 15 milligrams a month is being sold for $8 a milligram. $8 a milligram at five milligrams a week would be $40 a week, and we could get 15% weight loss in a large chunk of America, and really make a difference with actual longevity, with actual chronic disease state, for the price of a Starbucks a day.

Florencia Halperin (18:15):
The ROI calculations are dependent on the inputs into the models, and the cost of the drugs is a huge one, and we're seeing a dramatic change. I mean, even compared to where we were sitting on this stage last year, as you guys have said, now for direct to consumer prices at around $500 a month, that's significantly cheaper and that's going to drive down the market prices. You also have to see the outcomes, because I think a lot of the return on investment for treating obesity is that you prevent diabetes which is hugely costly, and things like that. And for that, again, you need the comprehensive care that drives the full benefit, and the full health improvement for the person. And it's also, I think, a little bit of a timeline issue.

Rae Woods (18:58):
Exactly. The timeline problem is a huge one when we think about ROI, because employers aren't necessarily going to see the cost benefit of their employee reducing their diabetes risk over time, if that employee then gets another job a year later. Even maybe three, five years later. And that's what complicates the story about curbing spend. I'm curious, when it comes to the purchasers, have any of you encountered new, kind of experimental approaches to how we manage spend? Maybe even value-based agreements?

Angela Fitch (19:32):
Well, we would love to see that. I mean, we would love to partner with anybody that wants to do that at knownwell, because that's what we created it for, was to show that there is that ROI in the longitudinal state. You just said, "We can't afford it here. That employer's only going to have it for two to three years," but we need to do this as a society. Like if this was the cure for cancer that we were talking about, I think we'd all be like, "How can we get it to more people?" But instead, because it's a marginalized disease, it's not a standard benefit on your healthcare. It's not a standard benefit, yet it's our biggest disease we have.

Spencer Nadolsky (20:03):
It's not treated seriously. I just think in a few years, when these other companies jump in, the prices are going to come down. We got the small molecule GLP-1 or Orforglipron. It's a lot cheaper to make. The answer is not doing the compounded Wild, Wild West, and trying to say that is standard of care. We should be getting the studied, approved drugs to everybody at a lower cost.

Angela Fitch (20:21):
I just wish we could do it faster, given that we've had GLP-1s now for 20 years.

Rae Woods (20:25):
Yes.

Angela Fitch (20:26):
Let's get it done.

Florencia Halperin (20:27):
Payers pay for a lot of other treatments that have a similar ROI, that is maybe cost-effective, but not ROI positive. I mean, cancer care, colonoscopies, antivirals, we cover a ton of things in healthcare because they are cost-effective and they improve people's health. Even without a massively positive ROI.

Rae Woods (20:48):
I think that's one of the big complicated questions that's out there in the context of GLP-1s specifically. So if we look at the spend data from 2023 to 2024, as an entire country, drugs accounted for 10, 11% rise in spend. Of that rise, half of it is attributed to GLP-1s. This brings up an important, bold question I want to ask, which is, what if these drugs don't actually reduce the total cost of care?

(21:20):
And I'm thinking about this from a couple of different lenses. First, the cost of the drugs as they stand today for the population that could qualify for those drugs. I'm thinking about the cost of managing the side effects associated with those drugs, side effects that you all named. And we have clinical evidence that shows that this is more expensive for patients who are even on semaglutide. And then I'm thinking about the goal of reducing the cost of chronic disease over time. Those things feel intention to me. What if these drugs don't actually reduce the total cost of care?

Spencer Nadolsky (21:51):
They will.

Florencia Halperin (21:52):
They do.

Spencer Nadolsky (21:52):
I think they do.

Angela Fitch (21:52):
They do.

Florencia Halperin (21:55):
In this article we published, despite the fact that outpatient care went up, to your point, seeing patients in the office, the cost for outpatient care went up a little bit. The amount of savings you had on inpatient care directly outweighed that, and that's where you got the three to $4,000 a year in savings. It was inpatient care.

Rae Woods (22:13):
So let's talk about what it would take to make sure that we're actually achieving the ROI at the patient level for the employer, for the population writ large, and doing this in a way that manages the total cost of care. Spencer, you've pretty boldly said the traditional delivery system is falling short here. What would it take for care delivery, the hospitals, the health systems, the medical groups? Nate, you work for one of those organizations, and are trying to do those efforts now. What change do you need to see within the providers?

Spencer Nadolsky (22:43):
So to me, it's going a more direct model, getting rid of these middlemen

Rae Woods (22:47):
Getting rid of the middlemen, but I want to acknowledge then, the role of the PBM. Because we see PBMs that are honestly trying to mimic what many of you on this stage are doing as well, which is providing that holistic wraparound support, the physical activity management, the nutrition management, the stress management. Is there a positive role for the PBM as a member of the traditional healthcare ecosystem here?

Florencia Halperin (23:11):
The role of the PBMs is a lot in the cost of the drugs. And yes, some of them have programs to provide wraparound care, but traditionally, PBMs are not the provider of the healthcare, in the way that we are, Yale is, knownwell and Vineyard. And I can tell you that, having worked in a large healthcare system and now working here, the access issue. I mean, most of the obesity centers in the US have many months of wait time to get an appointment.

Rae Woods (23:38):
Yes.

Florencia Halperin (23:38):
And so the resources, the specialty of obesity medicine is one that, there are not a lot of clinicians in the country who have the board certification, the expertise, who really want to treat patients with obesity and dedicate their clinic to that. So that is a resource issue that's very hard for the traditional health systems. For us, because we deliver care by telehealth, we are able to match a clinician with expertise to a patient that's very far away from them, and that's been one very important aspect of increasing access to care. And that has nothing to do with the PBM, but more on the medical services provision side. Yep.

Rae Woods (24:18):
There's one other member of the traditional healthcare ecosystem that we haven't really ran at directly, and there's a question here from the audience about this, which is the role of the pharmaceutical companies. The role of the manufacturers. Where do you want them to step in, and where do you want them to step back when it comes to providing these drugs, the innovation that they are responsible for doing, but also in enabling the kind of wraparound support that you all advocate for and provide yourselves?

Angela Fitch (24:45):
I really think we need to make obesity care a standard benefit for everybody. And if it was a standard benefit, then there would be a place for the PBMs and negotiating. All of the current people I've talked to in this space, they're looking to develop a commodity molecule, at a commodity price, because this is something that affects so many people, we need that to happen.

(25:06):
To your point, Rae, we need a hero right now in obesity care. That's what I've been saying for a while. So if anybody's out there that wants to be the hero, we need something at an affordable price that we can get out to millions of Americans, that is going to be covered by their health plan.

Rae Woods (25:23):
What do you want our audience to know is coming next, when it comes to GLP-1 innovation specifically?

Spencer Nadolsky (25:29):
I think we're going to see a lot of the anti-inflammatory type of stuff. So obesity aside, think about psoriatic arthritis, rheumatoid arthritis. I mean, I'm seeing just, anecdotally again, they're studying this right now. I'm seeing patients that never had relief on their biologic with psoriatic arthritis, and all of a sudden they start Zepbound, tirzepatide, and they just feel amazing. But again, we need the data.

Angela Fitch (25:53):
We're going to have many, many more molecules that target different pathways of human metabolism, and we are going to need artificial intelligence and other types of tools, in order to match the right patient with the right medication at the right time. As things expand, we're really going to need to use technology in order to find that right drug for that right patient. And we're going to have so many more opportunities in the future.

Florencia Halperin (26:16):
Yeah. I'm very excited for more drugs coming on the market. It's going to mean that we have a broader repertoire to match. You know, an older patient, we may want to put that person on one of the available agents that doesn't have as much of an effect on muscle mass, because that's really important for an older... So in terms of side effects, in terms of effect, maybe there's one drug that's the best for obesity plus sleep apnea, and another one that's the best for Alzheimer's.

(26:42):
And then I think, also, we're getting smarter about understanding GLP-1 receptor genetics. We're going to be able to test for different people with different genetic variants that affect which molecule may be better for them. So we're going to develop a lot more sophistication as we have more choices for people.

Nathan Wood (26:58):
And I just want to reiterate that it's about all these different indications. So semaglutide went from being for just diabetes to several things in a matter of just a few years, and all of these other things that we've mentioned, alcohol use disorder and several other types of, binge-eating disorder, in addition to other things that have been mentioned. There's going to be more and more and more indications for these drugs in the next decade.

Rae Woods (27:17):
We started off this conversation with me asking what we're getting wrong. As we close, I want each of you to share what does the industry, what do the people in this room and listening at home, need to get right so that we can better manage chronic disease and obesity with these drugs as tools, in the broader context?

Spencer Nadolsky (27:37):
I'd say, if you're going to say you're comprehensive, actually be comprehensive. Comprehensive means actually giving care. You can't just say, "Here's an app with some nutrition stuff, that's comprehensive." No, you actually have to talk to people, and actually deliver the care. I think that's what we're seeing wrong. We see a lot of pill mills. You actually have to have good clinicians, dieticians, and people giving the wraparound service. Not just lip service.

Nathan Wood (28:02):
Mine was going to be the same. So we keep using this term wraparound care, but what are we talking about here? These folks obviously need access to the medications, but then access to a dietician to go over what actual changes can we make to our diet to kind of maximize the benefits of these, and to increase the tolerability, to avoid some of these side effects that have been mentioned before. Access to a graded physical activity program, or a personal trainer. A behavioral health specialist, a health coach. Imagine when you bring all of these different disciplines together, these medications are going to be better tolerated, patients are going to be much happier. The side effects are going to be less, the efficacy is going to be more, and it's the right thing to do.

Angela Fitch (28:36):
And, that's what everybody needs, right? And we don't need to settle on just people with obesity needing that. That's very stigmatizing-

Nathan Wood (28:42):
Definitely.

Angela Fitch (28:43):
... meaning, we all need to work on our lifestyle because our lifestyle is inherently good for us. And so we have to have access to all of these things for the health of it, not the weight of it. We want to be leaner, not lighter. We want to have a better body composition, I want to be able to stand up out of this chair without using my hands when I'm 80. Right? That's what I want to be able to do. And we have to recognize that obesity is not just one disease, it's obesities. And much like we've done with cancer for the past 20 years, we need to really get into obesity, spend some money on it from a research perspective, and figure it out.

Florencia Halperin (29:17):
Yeah. We need to think about how we're going to deal with obesity and cardiometabolic disease in the population, not how we're going to put a bandaid on GLP-1 spend, or how we're going to manage the number on the scale. This is about getting it right, of treating the epidemic of obesity, and all the health outcomes that come along with it.

Rae Woods (29:35):
Let's give a big round of applause for our all-physician panel here, giving the real talk on the state of GLP-1s and what's next. Thank you all so much.

(30:15):
New episodes drop every Tuesday. If you like Radio Advisory, please share it with your networks. Subscribe wherever you get your podcasts, and leave a rating and a review.

(30:25):
Radio Advisory is a production of Advisory Board. This episode was produced by me, Rae Woods, as well as Abby Burns, Chloe Bakst, and Atticus Raasch. The episode was edited by Katy Anderson with technical support provided by Dan Tayag, Chris Phelps, and Joe Shrum. Additional support was provided by Leanne Elston and Erin Collins. See you next week.