The Essential Role of Digital Tools in Ensuring Ozempic’s Success

For patients facing metabolic health issues, access to effective resources can significantly enhance their treatment outcomes and support the necessary lifestyle changes.

Dr. Daniel Drucker, a Toronto endocrinologist, earned the Breakthrough Prize in Life Sciences for his groundbreaking research on GLP-1, a hormone critical for regulating blood sugar. His work in the 1980s revealed GLP-1's appetite-suppressing properties, paving the way for a new category of medications that are transforming obesity and weight management. Initially developed for Type 2 diabetes, GLP-1 receptor agonists (GLP-1 RAs), such as Ozempic, Wegovy, and Mounjaro, are primarily recognized now for weight loss, with 7.1 million prescriptions issued in Canada alone in 2023.

Despite their efficacy, GLP-1 RAs are meant to be part of a broader treatment strategy. In 2020, guidelines by Obesity Canada and the Canadian Association of Bariatric Physicians and Surgeons emphasized the importance of a comprehensive obesity care approach, including personalized nutrition, physical activity, psychological support, and behavioral modifications. Unfortunately, many patients receive insufficient support in these areas.

Dr. Dimitre Ranev, a family physician, highlighted a significant barrier: while patients seek medication, healthcare providers often lack the time and resources to deliver comprehensive care, with fewer than 5% of U.S. patients on GLP-1 RAs receiving behavioral therapy. This gap in support has dire consequences— a 2024 study showed that 30% of patients discontinued their medication within the first month, and only 42% continued taking them after 12 weeks.

To address these issues, Dr. Puneet Seth developed Nymble, an AI-powered platform that provides continuous support through text messages. This tool helps patients manage potential side effects and integrate necessary lifestyle changes. It even assists users in formulating questions for healthcare appointments and combats misinformation by monitoring social media discussions about obesity management. As a complementary resource, Nymble provides essential support between medical visits. Its success has led to partnerships that expand its reach beyond Canada.

Additionally, the reliance on body mass index (BMI) in diagnosing obesity has its limitations. Established in the 19th century and popularized decades later, BMI is a simplistic measure. Dr. Jean-Pierre Després from Université Laval emphasizes that it fails to assess fat distribution, particularly visceral adipose tissue (VAT), which poses greater health risks than total body weight. In Canada, 43% of the population has VAT, a type of fat linked to numerous metabolic health issues.

The challenge is compounded by the prescription criteria for GLP-1 RAs, which are primarily based on BMI thresholds. Individuals with excess VAT but normal BMI often do not qualify for treatment, despite their metabolic risks. Conversely, those with a high BMI but low VAT can appear healthy. While GLP-1 RAs effectively reduce VAT, their use is still linked mainly to weight loss rather than comprehensive metabolic health improvement.

This narrow focus on weight loss, rather than metabolic results, is problematic. Physicians are often conditioned to prioritize scale numbers, neglecting crucial indicators of health like insulin sensitivity and cardiovascular function. Viewing GLP-1 RAs as tools for enhancing metabolic health rather than simply weight-loss medications could shift this paradigm. Nymble’s strategy encompasses a multifaceted approach, including behavioral therapy, nutrition, and physical activity. Addressing obesity as a complex chronic disease is essential for realizing the full benefits of these therapeutic interventions.