demand for popular weight loss# drugs like Ozempic and Wegovy.

In fact, those drugs are in such demand,# there's a nationwide shortage of them.## Pharmaceutical companies# are scrambling to keep up.

Ali Rogin has a look at the demand and the# questions lots ALI ROGIN: Government surveys show that as much as## 40 percent of the U.S. population in 22 states, at least 35 percent of adults# are obese, mostly in the South and Midwest.

Medications, including the latest FDA-approved# drug Zepbound from Lilly, provide hope to patients## looking for sustainable weight loss, but they# also raise questions related to high costs,## insurance coverage and long-term# effectiveness.

Depending on the## drug and insurance, they can cost patients# thousands of dollars a year to stay And research suggests people may need to# stay on them to maintain that weight loss.

To help look at some of these concerns,# I'm joined by Katherine Saunders.

She's## an assistant professor of clinical# medicine at Weill Cornell Medicine and## specialist in obesity and weight-related medical# complications at New York Presby Dr. Saunders, thank you so much for joining us.

You prescribe these medications to your# tr eatment plans.

And I want to talk about# all of that.

Why have these medicati become so popular in recent years?

And# does it have to do with the medical## community's rethinking of what factors# contribute to obesity in some cases?

DR. KATHERINE SAUNDERS, Assistant Professor of# Clinical Medicine, Weill Cornell Medicine: Yes, so## tw One is tha the most effective anti-obesity medications were# associated with 5 percent to 10 percen body weight loss, which is absolutely what# we consider to be clinically significant.

If you think about any diet# or any behavioral intervention## being associated with 3 percent# weight loss, on average, 3 to 5,## 5 to 10 was pretty good back then.

But the# medications that have come out over the last## few years are considerably more effective,# at 15 percent and now upwards of 22 percent.

So, one is the increase in efficacy# in the studies and effectiveness that## we're seeing among our patients.

And two# is that there's greater recognition that## obesity is a disease that requires medical# management for the vast majority of people## to effectively lose weight and then, more# importantly, keep that weight off long term.

ALI ROGIN: And what are some of the risks that# are associated with being on these medications?

DR. KATHERINE SAUNDERS: So, each of the# medications has its own risk-benefit profile.

Our typical patient has lost and gained weight# so many times over the years that they come t us saying: I have been so successful# in so many other aspects of my life,## and I just absolutely cannot# lose weight and keep it off.

So, for somebody like that, who has had a very# difficult time losing weight with nonme intervention, the risk-benefit profile is really# different.

So if you take a look at nausea,## reflux, constipation, those are the# main complications that we're seeing## with GLP-1-type medications.

It's# a different risk-benefit profile.

We can absolutely do so much in terms of dietary# management, behavioral change to mitigate those## side effects.

So the hype that we're seeing is# because patients are either on too high a dose,## they're inappropriate candidates.# But those side effects generally,## if you weigh the risk-benefit profile# of having untreated obesity relate so many other health complications, for# each person, it's an individual decision.

ALI ROGIN: You have talked about# the importance of coming up with## a detailed treatment plan with your patient looking with them to see if other interventions# might work Why are those things so important.# And are you concerned that right now## doctors may be overprescribing these medications?

DR. KATHERINE SAUNDERS: Yes, I# think that's a fabulous questi There is such a tendency that we're seeing patient with obesity and say, oh, I have a# medication that can finally help you lose## weight.

Here's a prescription for one of the# medications without the appropriate education## and support and the associated required# lifestyle interventions like diet exercise,## behavioral change that are really necessary# for comprehensive obesity treatment.

So, it's really not just about one medication to# as many people as can be taking this medication.## It's really about seeing each patient as an# individual, doing a very thorough evaluation## of everything in their history, everything in# their medical conditions that are leading to## weight gain, everything preventing weight# loss, and then optimizing lifestyle.

ALI ROGIN: There's been a lot# of talk about people who want## to pursue these drugs to reach a goal weight,## and then are planning to get off the drugs and# sustain that goal What is your take on that# approach?

Is that sustainable?

DR. KATHERINE SAUNDERS: So,## we get so ma Obesity is a chronic disease, meaning that# it doesn't just go away, meaning that we,## unfortunately, right now can't cure# it.

Maybe, one day in our lifetime,## we will be able to.

But if you think# about other chronic diseases that you## classically think of as chronic diseases,# like high blood pressure, high cholesterol,## diabetes, people who have these conditions that# are not managed by lifestyle intervention alo expect to start a medication and expect# to stay on that medication long term.

So if they stop that medication, their blood# pressure goes up, their cholesterol goes up, blood sugar goes up.

And we expect that.

With# obesity, there's been this long-held belief that## it's just a lifestyle problem, and that it's such# a massive industry that's really preying on very## vulnerable individuals who are looking for a quick# fix or something that can cure their obesity.

We're not there yet.

So, right now,# when we start a patient on a medication,## it's a long conversation about the need# to take that medication long term.

If## you take a look at their SURMOUNT-4 trial,# which was published in the last few weeks,## this trial showed that, when# people stopped taking Zepbound,## they regained about two-thirds of their# body weight over the next several months.

ALI ROGIN: We mentioned that there are# shortages of many of these medications.

In your opinion, what needs to change about the# availability of these drugs, as them?

Because even for people who can access# them, they might not be able to afford them.

DR. KATHERINE SAUNDERS: Yes.

these medications.

We need better# coverage.

We need the prices to be## lower.

And we need more providers who know how# to prescribe these medications appropriately.

It's interesting that Ozempic, which we were# using before Wegovy came out in 2021, there## really weren't supply issues until Wegovy hit the# market.

Wegovy and Ozempic are the same compound,## just marketed for weight versus diabetes.# And as soon as Wegovy was FDA-approved and## people realized that Ozempic was the same# medication, we started to see shortages.

So, now that Zepbound is approved -- this is# the latest one to be approved last month -- the## medication Mounjaro is the same medication.

And# so Eli Lilly is concerned about shortages of## both of the medications, and they have opened# new facilities in order to increase supply,## so that we don't see what we have been# seeing with Wegovy and the Ozempic shortages.

But the demand is just so# high that it's a big problem.

ALI ROGIN: A big problem and a very hot topic.

Dr. Katherine Saunders with Weill Co thank you so much for your time.

DR. KATHERINE SAUNDERS: Thanks for havi