By Samantha Malnick
The College’s Schools of Science, Business and Nursing, Health, and Exercise Science teamed up with global health care company Novo Nordisk to present the third seminar, “The Biology of Obesity and its Management,” of the four-part lecture series “Understanding Obesity: A Multidisciplinary Challenge” in the Education Building on March 20.
Guest speakers Dr. Jason Brett, Novo Nordisk’s senior medical director of clinical development, medical and regulatory affairs, and Dr. B. Gabriel Smolarz, the company’s medical director for obesity, began the lecture by defining obesity and its relevance to society.
“Obesity is an excessive accumulation of fat that impairs health and/or longevity,” Brett said. “A disease that is affecting nearly 95 million people in the U.S. alone.”
The American Medical Association recognized obesity as a chronic disease in June 2017 to which other professional organizations such as the Federal Drug Association and the American Association of Clinical Endocrinologists Association of Clinical Endocrinologists the American Association of Clinical Endocrinologists soon followed, according to Brett and Smolarz.
“We are in an era where we’re just scratching the surface of understanding the biology and accepting (obesity) as a disease,” Smolarz said.
Meagan Rodriguez, a senior biology major, honed in on the stigmas behind the disease.
“When we talk about eating disorders and weight problems, there isn’t a lot of focus on obesity,” Rodriguez said. “Many people assume overweight people are lazy or unhealthy slobs, and that’s really not the case at all.”
Smolarz simplified the biology by relating it to the logistics behind thirst, analogizing it with the concept of tire pressure.
When humans are thirsty and choose to go grab a glass of water, it is an involuntary action, according to Smolarz.
“When the body is dehydrated, our tire pressure sensors, or osmo-receptors, pick up on this and send signals to the brain to give us a sensation of thirst,” Smolarz said. “Once you drink, the water gets absorbed and that sensor sees that the volume went up again. It then feeds back and says, ‘OK, we don’t need to say ‘thirst’ anymore.’”
The problem with obesity is that this system Smolarz described registers low tire pressure, even when the tires are fully inflated, which causes people to overeat.
“So the cycle continues, and unfortunately for human beings, it’s not the light that goes on,” he said. “It’s a sensation to eat.”
One concerning factor, and one of the main reasons why Novo Nordisk believes obesity should be treated, is because obesity does not always stand alone as a disease. Obesity is associated with many other diseases, or “obesity-related comorbidities,” according to Brett.
“Some of those are metabolic in nature such as Type 2 diabetes or cardiovascular disease,” Brett said. “We can also see mechanical illnesses related to obesity — chronic back pain, obstructive sleep apnea and arthritis, not forgetting mental illnesses such as anxiety and depression.”
If health care professionals were to become more engaged with obese patients, just a 5 percent reduction in weight loss could contribute to a decrease in obesity-related comorbidities, Brett explained.
“With a 5 percent reduction in (body mass index) on a national level, we could avert 3.6 million cases of hypertension, 6.3 million cases of cancer and over 4 million cases of diabetes,” Brett said.
Nationwide weight improvement would also positively contribute to the U.S. economy, saving nearly $230 billion in just a few years, Brett explained.
Although Brett and Smolarz brought up several methods of how to treat problems like obesity, some audience members reacted with some skepticism toward their suggestions.
Rodriguez brought up the concern of the affordability of treatments such as drugs, lifestyle changes and surgeries.
“Obviously not everyone can afford surgery and medicines,” Rodriguez said. “Knowledge is so important and when people try to get healthy and fit, often times they have to pay so much to even get a nutrition plan.”
Access to affordable medications is one of the biggest challenges Brett and Smolarz have seen, which is because many health insurance companies and pharmaceutical benefit managers often treat obesity medicine differently from others.
“One of the approaches that we have to do is not just educate health care professionals and patients, but also educate payers and employers,” Brett said.