Architecting Future Health with DocAi: Disrupting Obesity

"Looking for the Master Switch in Weight Regulation"

Once upon a time, as a young resident surgeon, I spent hours operating on stomach ulcers. These were nightmare cases, often fatal. We believed excess acid caused ulcers and treated them by cutting stomach nerves. Despite numerous studies and debates, this extensive surgery didn't really seem to work. Then, biologists revealed the true cause: H. pylori bacteria. Treating the infection eradicated ulcers, rendering the surgeries obsolete. This paradigm shift underscores a vital lesson: accurate diagnosis is crucial.

In 1985, medical data doubled every 7 years; by 2020, every 73 days. Now, it’s even faster. No human can keep up. Much of the data is flawed, requiring discerning minds to interpret it correctly. The gap between knowledge and practice can be deadly. DocAi believes addressing this is one of medicine’s most critical issues today.

The Misdiagnosis of Obesity

We've been treating obesity incorrectly. Conventional wisdom focuses on food and exercise, but this approach has failed, with increasing rates of obesity globally. Obesity's impact on future health is immense. Consider one aspect, the declining global birth rates. Obesity triples the risk of infertility and miscarriage for women.

The Invisible Epidemic

Obesity, though pervasive, is often ignored or stigmatized. Obese individuals face discrimination, affecting their education, career, and personal lives. Obese children usually grow into obese adults, who are unfairly blamed for their condition.

Obesity underlies most chronic diseases. Solving obesity will free people from chronic disease, in turn freeing up dollars spent on health to dollars spent on living.

• 55% of cancer diagnoses in women, 24% in men
• 90% of coronary heart disease patients
• 75% of people with osteoarthritis
• 90% of diabetes patients
• 43% of individuals with high cholesterol
• 80% of people with schizophrenia
• 43% of those with depression

Global Impact and Geopolitical Consequences

In the United States, 41% of adults and 19.7% of children are obese. Black Americans (49.9%) and Latinos (45.6%) are disproportionately affected. In China, 29.4% of children are obese, expected to rise to 58 million by 2030. Obesity hinders military recruitment, with 71% of young people ineligible due to obesity.

Economic Costs of Obesity

Employers should support obesity treatment. Obesity-related absenteeism costs businesses significantly—up to seven extra sick days per year for the severely obese. Productivity losses due to obesity range from $271 to $542 per employee annually, totaling $13.4 to $26.8 billion nationally in 2016.

Understanding Obesity’s True Cause

Obesity isn't a choice; it's partly genetic. Epigenetic changes, influenced by lifestyle and environment, alter gene expression, leading to overeating. The brain’s weight regulation master switch fails to adjust to our food-abundant reality. Urban stress, workplace pressure, and cultural factors exacerbate the issue. We need to address these epigenetic changes to reverse obesity.

Innovative Treatments: Surgery and Pharmaceuticals

Surgery, especially laparoscopic, has been effective in treating obesity, significantly reducing chronic diseases. However, recent pharmaceutical advances, such as GLP-1 medications, offer new hope. These drugs curb hunger, making them a breakthrough for many.

The Future of Obesity Treatment

Treating obesity early is key to future health. Focus should shift from end-stage rescue to early intervention, preventing severe obesity and its transmission to future generations. As quantum computing advances, it could revolutionize obesity treatment, creating precise medications to regulate weight.

Addressing Obesity Won't Bankrupt the Country, But Transparency is Key

Contrary to Bernie Sanders' concerns, solving obesity will not bankrupt the country. However, it is crucial to follow the money trail to understand the financial dynamics at play. Many stakeholders, from pharmaceutical companies to individuals requiring obesity medications, are involved, each with their own financial interests.

Pharmacy benefit managers (PBMs) play a significant role in this chain, often contributing to the variability and lack of transparency in drug pricing. As a result, these costs are frequently shouldered by individuals rather than insurance companies, especially since most insurers dropped coverage for GLP-1 drugs in 2024.

Shout out to JP Morgan—you get it. The ripple effect of your projection that the market will exceed $100 billion by 2030 is likely correct. It is not only the food and beverage industries that should take note but also the business of health.

Call to Action

Medical professionals and the medical establishment must embrace early detection and treatment of disease, disrupting the status quo. The focus on early intervention can free up resources for other health challenges, shaping a healthier future. The battle ahead will determine whether we can prevent obesity from overwhelming humanity.

Follow the money and join us in creating a future where early-stage detection and treatment prevail. The disruption continues.

Next week, we’ll explore aging, disability, orthopedics and the impact on future health.