If you’re not careful, you might miss the single biggest transformation happening in healthcare. I am not talking about artificial intelligence. I am talking about an opportunity to completely reshape the way that we treat chronic disease, and with it, the role of the healthcare system as a whole.
As it stands, our healthcare system is optimized for management. To meet the modern patient where they are, we must pivot away from managing chronic diseases to preventing them entirely, replacing a legacy system of triage with a new model that emphasizes proactive, personalized prevention. In doing so, we will transform the nature of the patient-provider relationship to modernize it for a new era of proactive health engagement.
The first stages of this shift are already underway, and the evidence is visible right in your living room. If you watched the Super Bowl earlier this year, and looked past the AI overload, you likely noticed that a remarkable share of this year’s ads belonged to healthcare companies and products, particularly those in the GLP-1 space. Super Bowl ads are, by design, a consumer medium. They reflect not just where dollars are being spent, but where cultural attention is being captured. The presence of GLP-1 therapies on that stage was an indicator that the shift in chronic disease management has already started, and it’s beginning with GLP-1s and obesity.
Back in 2013, the American Medical Association formally identified obesity as a disease. Prior to then, medicine and society largely perceived obesity as a moral failing. This shift was crucial because it created the clinical and reimbursement pathways necessary to treat obesity systemically. Obesity specialties were launched, and cash pay practices that focused on obesity management grew steadily. But as medical infrastructure pivoted toward systemic management, a critical question remained: could any of these therapies match the staggering scale of the obesity epidemic?
A quick look at the data underscores just how daunting a challenge obesity represents. More than 100 million people – one in eight globally – suffer from some measure of obesity, defined as a BMI greater than 30. In the U.S. alone, an estimated 107 million adults lived with obesity in 2022. That number has more than tripled since 1990, and is projected to keep growing toward 126 million – or 47% of the adult population – by 2035.
That scale poses real challenges, not only for the individual lives of those living with obesity, but on the medical system as a whole. Obesity is a “first-order” disease, meaning its presence can lead to a domino effect of “second-order” diseases like hypertension or sleep apnea, while also contributing to the downstream orthopedic epidemic around ‘mechanical failures’ like joint and cartilage breakdown, back issues, and more.
Traditionally, our system is built to “medicalize” obesity: to parse it up into stages, triage the ‘sickest’ and wait for the less sick to reach a point worth managing. It is clear that this approach is not working: obesity rates continue to rise and the downstream effects continue to multiply, causing issues for the individual patient’s health and the medical system as a whole. Addressing the obesity epidemic requires a shift in our approach. The discovery and implementation of a long-acting form of GLP-1 offers our best opportunity to do that.
For starters, the efficacy of GLP-1s offer a pathway for individuals to effectively manage their weight long-term in ways that reactionary, management-style treatments do not.
Equally important though, is the fact that GLP-1s are empowering consumers to engage with their health in a new way – one that more closely resembles a gym membership than it does a trip to the physician’s office. People are interacting with GLP-1s not as “patients,” but as consumers. It’s easy to see why; as a chronic disease, obesity has more consumer flavor than something like hypertension. You can see it in the mirror, or in your clothing size. It is pressured by society through social media. It impacts every component of private and public life. Nobody complains or judges you because your blood pressure is 165 / 95, yet nearly every person has felt judgement in some way for the size or shape of their body. GLP-1 companies understand this, and are reaching their customers by engaging with them as consumers, not patients.
Take a look at the first two drug companies to innovate and create the breakthrough GLP-1 products, Eli Lilly and Novo Nordisk. Both have crafted a portion of their business model to be consumer-focused (see Super Bowl ads). There is always a consumer story in drug launches, but these product and launch evolutions are telling a different story. It is not just in the advertising: currently, over 50% of prescriptions are being delivered through their direct-to-consumer portals. Seeking treatment has largely been placed into the hands of consumers. Some of the largest prescribers are digital interfaces (involving physicians, to be sure), with a large number of prescriptions being driven by more consumer-oriented, personal care businesses like Hims and Hers, or Ro.
This shift marks the first step toward our new model for healthcare, one which sees the individual less as a “patient” being managed within the system, and more as a person who aspires to not become a part of that system. With this, the role of the provider must adapt as well.
By 2030, 18 million people will have access and be on a GLP-1. They will be looking to their providers less for management, and more for proactive health engagement. They want to engage with their providers in a way that reflects their whole being as a person, not a patient: tapering of medications, blending therapies, activities, diet, and other aspects of their lives into a personalized framework around specific targets that they understand and see. In this way, consumerism, health, longevity, personal care, self-care, and healthcare flatten out.
Emergencies, surgical intervention, and traditional tertiary care are and will remain the domain of the traditional healthcare system. But when it comes to dealing with diseases like obesity, we now have a form of preventative treatment that empowers individuals to take control of their own wellbeing, and with it, the most significant moment in our lifetimes to redesign our healthcare system.
This shift is as consequential as the advent of insurance in the post-war period. While some incumbents may resist the disruption of the legacy healthcare model, the reality is that the momentum is already with the consumer. The change is inevitable, and so the system will be forced to adapt. If we embrace this re-design, meet consumers where they are, and demand a system that prioritizes our personal health goals over clinical triage, then we can finally move beyond a system of management toward one that prevents chronic disease from appearing in the first place. That is a transformation that should not require debate.
Photo: marchmeena29, Getty Images
Jack Stockert, MD, is a Managing Director at Health2047. He is passionate about driving system-level change through collaboration and innovation to improve the way people live and the way physicians practice in the healthcare system. Jack’s experience as a physician, combined with his strong analytic capabilities and a healthcare system view that was refined at McKinsey & Company, delivers a broad skillset and contextual depth of understanding of the challenges and opportunities in healthcare. Jack also has entrepreneurial experience building a venture-backed company, HealthEngine, global health exposure working at the WHO, and financial and investment experience at Morgan Stanley. He received his medical degree from the University of Chicago Pritzker School of Medicine and his MBA from The University of Chicago Booth School of Business. He earned his AB, with honors, from the University of Chicago.
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