The global economic impact of obesity in 2035 is expected to be comparable to that of COVID-19 in 2020, according to a new report by the World Obesity Federation.

According to its data, half of the world’s population will either be considered overweight or obese by 2035. Even more concerning, childhood obesity rates are on track to double between 2020 and 2035.

The economic impact of obesity is expected to reach $4.32 trillion annually by 2035, the World Obesity Federation said in its yearly atlas release this week.

“This year's Atlas is a clear warning that by failing to address obesity today, we risk serious repercussions in the future. It is particularly worrying to see obesity rates rising fastest among children and adolescents. Governments and policymakers around the world need to do all they can to avoid passing health, social, and economic costs on to the younger generation,” said Louise Baur, president of the World Obesity Federation.

Beth Czerwony, a registered dietitian with the Cleveland Clinic, said convenience is a big factor in rising obesity rates.

“For the kiddos — they aren't able to eat at home or they just certainly don't want to,” she said. "Or perhaps they're working at a fast food restaurant, and it's just easier for them to eat there. So there's a lot of contributing factors to that disease of obesity… When when we have somebody who has a higher BMI, you're more likely, again, to have issues with type two diabetes, heart disease, we know that having obese obesity and having increased fat stores causes more inflammation. So that has been directly correlated with some cancers, as well.”

In the U.S., obesity rates have gradually increased year after year. According to the Centers for Disease Control and Prevention, 33% of American adults were considered obese in 2021. That’s up from 27% in 2011. The CDC also noted jumps in adolescent and childhood obesity in the U.S. from 2011-19.

While obesity has long been a problem in the U.S., it is a growing problem throughout the world, especially in modernizing nations.

"If we do not act now, we are on course to see significant increases in obesity prevalence over the next decade,” said Rachel Jackson Leach, director of science at the World Obesity Federation. “The greatest increases will be seen in low and lower-middle income countries, where scarce resources and lack of preparedness will create a perfect storm that will negatively impact people living with obesity the most."

The new year is usually a time to jump-start healthy habits. But millions of Americans need medical assistance to manage their weight, and they likely aren't getting it.

"We're still in a state today where the average primary care doctor, the average psychologist, even the average dietitian doesn't really have a strong background in obesity management to support most of their patients," said Dr. Scott Kahan, the director of the National Center for Weight and Wellness.

Kahan says over the last decade, the FDA has approved about six weight-management medications. The problem is that some of those medications require injections, and insurance may not cover them. Also, few people or professionals know about them.

"While some of them can do just fine without medication and others might do very well with bariatric surgery, there are quite a lot that are very good technical candidates for medications and would likely have a much better course in terms of managing the obesity and in terms of long term health and prevention," Kahan said.

Kahan says people who are ideal candidates for weight management medication include people who are roughly 30 pounds or more overweight and have health-related issues like diabetes, high blood pressure, joint pain or sleep issues.

"Those are especially important considerations, where the obesity is getting more in the way of your life and your health and where a modest amount of weight loss may significantly improve many of those things," Kahan said.

The FDA could consider another weight management drug for approval as early as this year.

There's more evidence that the pandemic has contributed to another public health crisis — an increase in the obesity rate.

New federal data shows that 16 states have adult obesity rates of 35% or higher. That's an increase from 12 states in 2019 and just nine states in 2018.

The problem has exploded over the last two decades. In 2000, no state had an adult obesity rate of 25%. Today, there are only a handful of areas where the obesity rate is currently below 25%.

The nonpartisan, non-profit group Trust For America's Health has been tracking the issue.

"It's about the design of our neighborhoods and ensuring that neighborhoods have walkable and bikeable paths, that people have the ability to engage in physical activity or access to parks and community centers and gyms," Trust For America's Health CEO and president Nadine Gracia said.

The group says high obesity rates have a systemic, social, and economic impact on the country — and the pandemic has only made those issues worse.

In communities of color, the obesity rates have an even higher impact.

The new data shows that 22 states had adult obesity rates at 35% or higher among Hispanic residents. For Black Americans, 35 states have obesity rates at 35% or higher.

"We see, for example, higher job loss and greater food insecurity in households of color," Garcia said. "Black and Latino households had greater rates of food insecurity (during the pandemic). Their children were in virtual learning as opposed to in-person learning, with less access to school meals."

The report from Trust For America's Health points to larger policy solutions, like increased funding to the Centers for Disease Control and Prevention's obesity prevention program. Garcia says that the program currently only has enough money to support 16 states.

"We should close tax loopholes and business incentives for unhealthy food advertising, which disproportionately is directed to youth of color — in particular, Black and Latino youth," Garcia said.

The CDC is now providing community-level data on obesity so it can be addressed on a more local level.

Regulators on Friday said a new version of a popular diabetes medicine could be sold as a weight-loss drug in the U.S.

The Food and Drug Administration approved Wegovy, a higher-dose version of Novo Nordisk’s diabetes drug semaglutide, for long-term weight management.

In company-funded studies, participants taking Wegovy had average weight loss of 15%, about 34 pounds. Participants lost weight steadily for 14 months before plateauing. In a comparison group getting dummy shots, the average weight loss was about 2.5%, or just under 6 pounds.

“With existing drugs, you’re going to get maybe 5% to 10% weight reduction, sometimes not even that,” said Dr. Harold Bays, medical director of the Louisville Metabolic and Atherosclerosis Research Center. Bays, who is also the Obesity Medicine Association’s chief science officer, helped run studies of the drug.

In the U.S., more than 100 million adults — about 1 in 3 — are obese.

Dropping even 5% of one's weight can bring health benefits, such as improved energy, blood pressure, blood sugar and cholesterol levels, but that amount often doesn’t satisfy patients who are focused on weight loss, Bays said.

Bays said Wegovy appears far safer than earlier obesity drugs that “have gone down in flames” over safety problems. Wegovy’s most common side effects were gastrointestinal problems, including nausea, diarrhea and vomiting. Those usually subsided, but led about 5% of study participants to stop taking it.

The drug carries a potential risk for a type of thyroid tumor, so it shouldn't be taken by people with a personal or family history of certain thyroid and endocrine tumors. Wegovy also has a risk of depression and pancreas inflammation.

Wegovy (pronounced wee-GOH’-vee) is a synthesized version of a gut hormone that curbs appetite. Patients inject it weekly under their skin. Like other weight-loss drugs, it’s to be used along with exercise, a healthy diet and other steps like keeping a food diary.

The Danish company hasn’t disclosed Wegovy’s price but said it will be similar to the price of its Saxenda, a weight loss drug injected daily that now typically costs more than $1,300 per month without insurance.

Dr. Archana Sadhu, head of the diabetes program at Houston Methodist Hospital, said Wegovy's usefulness "all depends on what the price will be.” She noted patients' health insurance plans sometime don't cover weight-loss treatments, putting expensive drugs out of reach.

Sadhu, who has no connection to Novo Nordisk, plans to switch patients who are obese and have Type 2 diabetes to Wegovy. It makes patients feel full sooner and increases release of insulin from the pancreas to control blood sugar, she said. Patients would then be more likely to get motivated to exercise and eat healthier, she added.

Wegovy builds on a trend in which makers of relatively new diabetes drugs test them to treat other conditions common in diabetics. For example, popular diabetes drugs Jardiance and Novo Nordisk’s Victoza now have approvals for reducing risk of heart attack, stroke and death in heart patients.

Phylander Pannell, 49, of Largo, Maryland, joined a patient study after cycles of losing and then regaining weight. She said she received Wegovy, worked out several times a week and lost 65 pounds over 16 months.

“It helped curb my appetite and it helped me feel full faster,” said Pannell. “It got me on the right path.”

Shortly after she finished the study and stopped receiving Wegovy, she regained about half the weight. She’s since lost much of that, started exercise classes and bought home exercise equipment. She's considering going back on Wegovy after it’s approved.

Novo Nordisk also is developing a pill version.

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Follow Linda A. Johnson at https://twitter.com/LindaJ_onPharma.

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