The OBSERVE Study: Insights into Anti-Obesity Medication Perceptions and Barriers

Sponsored by Eli Lilly and Company

Since the American Medical Association officially recognized obesity as a disease in 2013, we have seen significant progress in the way obesity is understood and treated. In particular, obesity pharmacotherapy has evolved significantly in the last decade, and today there are multiple anti-obesity medications (AOMs) approved for use in the United States by the Federal Drug Administration.ⁱ While AOMs are approved for the treatment of overweight (BMI ≥ 27 kg/m²) with a weight-related comorbidity and obesity (BMI ≥ 30 kg/m²) in combination with a reduced-calorie diet and increased physical activity, only a small portion of eligible persons report using AOMs.ⁱⁱ

Obesity is a chronic, progressive and relapsing disease that may require medical interventions. However, when it comes to obesity management and care, it is often not treated as a medical disease. Obesity does not receive the same level of diagnosis, medical care, insurance coverage, or care support as other chronic diseases.ⁱⁱ And despite the availability of treatments, AOMs still are often not discussed as a component of obesity treatment plans or covered under insurance in many cases.

Beyond this, obesity is misunderstood by the people who are most impacted – from people living with the disease to their healthcare providers (HCPs) and even employers. Many still view obesity as a choice and see diet, exercise and willpower alone as the cause of – and solution to – addressing obesity.

With the prevalence of obesity continuing to rise in the United States, and approximately half of all adults expected to live with obesity by 2030, it is imperative that we understand the misperceptions around obesity and its treatment in order to improve care and outcomes. ⁱⁱⁱ

About The OBSERVE Study

To gain a better understanding of the underlying reasons for limitations in obesity care, Eli Lilly and Company initiated a nationwide survey study, named OBSERVE, in collaboration with Cerner Enviza and key opinion leaders.

The OBSERVE study (PerceptiOns, Barriers, and OpportunitieS for Anti-obEsity Medications in Obesity CaRe: A SurVEy of Patients, Providers, and Employers) digs into the drivers and barriers that influence obesity care and treatment to uncover the core misperceptions about obesity and AOMs. Study participants include people living with obesity, HCPs and employers, who each play a unique role in influencing obesity care.

Lilly will be announcing the quantitative findings from the OBSERVE study this year, but first let’s look at what the OBSERVE study is and what we’ve learned from the qualitative findings so far.

Deep Dive into the OBSERVE Qualitative Results

The qualitative phase of the OBSERVE study, released in 2021, revealed underlying patterns of biases, misperceptions and education gaps about AOMs across various participant groups. ^ivvvi,vii

• People living with obesity shared that they do not identify themselves with the term “obesity” and those who do, tend to view it as a self-modifiable condition rather than a long-term disease. There was also a pattern of self-blame, amongst even those who are accepting of AOM use and acknowledge how it can support lifestyle adjustments.^iv
• HCPs acknowledged obesity as a life-long disease but viewed AOMs as short-term solutions rather than long-term solutions and expressed hesitancy in prescribing them. Prescribing concerns included a lack of safety and efficacy data on current treatments and an overall limited understanding of obesity management. ^iv,v
• Employers perceived AOMs as “low demand” due to low prescribing rates among HCPs, leading the group to deprioritize coverage considerations when developing benefits packages. Employers also expressed a lack of understanding of AOMs, leading them to suggest corporate wellness programs that do not include access to AOMs as a default option.^vi

Additional study results, which took a deeper look at people with obesity’s perceptions toward the disease and challenges in care, were released in 2022.

This initial quantitative study phase found that two-thirds of participants living with obesity shared that they do not categorize their weight as “obese.” 50% of individuals also agreed that obesity is a disease, while 45% shared that it requires treatment by an HCP. 86% of participants also agreed that obesity impacts long-term health and increases the chance of developing other health problems and comorbidities like physical function (82%) and emotional well-being (77%). ^viii

When asked about obesity treatment options, almost three-quarters shared that lifestyle and behavioral changes are the best options for sustained, long-term weight loss, with 64% unaware that prescription AOMs could help manage weight. ^vii,ix

Despite the fact that most people living with obesity were aware of the potential long-term health effects and complications associated with this chronic disease, a considerable number still believed that they could manage obesity alone, without the help of AOMs. There are many who are either unaware of the existence of AOMs or do not perceive them as necessary as well. ^vii,viii

The OBSERVE findings reinforce the idea that misconceptions about obesity and AOMs are prevalent and affect people living with obesity.

What’s Next for OBSERVE

Lilly is continuing analysis of the OBSERVE study as perceptions of HCPs was presented at the American Association of Clinical Endocrinologists (AACE) 32nd Annual Meeting in 2023, with plans for future presentations towards the end of the year. These findings will provide further insights into the drivers and barriers that influence obesity care and treatment for key stakeholders: HCPs, employers, and people with obesity.

Lilly conducted this research with the hope that the results will help guide decisions, improve education and shift perspectives to implement effective evidence-based approaches to obesity care.

Additional Resources

Learn more about the OBSERVE study on Lilly.com.