Dr Boris Hansel, endocrinologist: “Recognize obesity as a chronic disease changes care”

What are the advances in the face of obesity have marked in recent years?

Dr Boris Hansel, endocrinologist: I would note three things:

• The first is the recognition of obesity as a chronic patient and the fact that this information can be disseminated. Admittedly, there is still a long way to go, but it’s a good start. Where progress is necessary, it is on the management of patients: as obesity is not recognized as a “long -term” disease, there is no 100%financial care. However, recognizing obesity as a chronic disease – which it is – completely changes the way of treating patients. We no longer take care of a person having “bad will” but indeed a sick person. This is a medical care.
• The second advance relates to “digestive endoscopy”; An emerging technique that reduces patient appetite. This alternative to surgery based on a stomach suture has good efficiency and very few side effects.
• As for the third advance, it relates to the drugs of the GLP1 family. It is an additional therapeutic weapon to reduce appetite, and therefore to reduce calorie intake.

Only brakes on these innovations? The lack of reimbursement of these drugs. Medicines, which, I remind you, are not accessible to all patients. They do not replace their nutritional management.

What do you think are 2024?

I sincerely hope for access to GLP1 drugs, but also a clarification of surgical indications. The latter date from 2019, however, we have made a lot of progress since.

What can this change in the daily life of patients?

Lots of things, because patients come to see us now with precise demand. However, no drug, behavioral, surgical or dietetic treatment heals obesity. It is a disease that evolves, but which one cannot cure.

Thus, it is rather the right treatment, at the right time that can work for a time. But any obese patient will often have to use these different “tools” successively during his life.

Do you think there is a research track that could revolutionize your field?

I would say the evolution towards treatments which act both on the regulation of appetite and metabolic expenditure. Because obesity is an imbalance between contributions and expenses. Obesity patients have trouble increasing their expenses – physical activity is not enough. I therefore deeply believe in these new molecules in full development, in these new major advances.