The doctor prescribed a medicine for obesity. His insurer called him “vanity”.

“Access to drugs for the treatment of obesity is dismal in this country,” said Dr. Fatima Cody Stanford, a specialist in obesity medicine at Massachusetts General Hospital and Harvard Medical School.

But even if a patient’s insurer covers weight-loss drugs, most doctors don’t suggest the drugs and most patients don’t ask for them because they don’t realize there are good treatment options, a said Dr. Scott Kahan, a specialist in obesity medicine in Washington, D.C. And, he added, even though doctors and patients know there are FDA-approved drugs, many believe that they are “dangerous or badly studied and that everyone regains their weight”.

The medical system bears much of the blame, Dr. Stanford said. Only 1% of physicians in the United States are trained in obesity medicine. “It’s the biggest chronic disease of our time, and no one is learning about it,” she said.

Data on patient drug use predates newer, more effective and safer drugs made by Novo Nordisk and Eli Lilly. Still, doctors specializing in obesity medicine say they doubt the number has changed much from previous studies that found less than 1% of eligible people got one of these drugs. That’s about the same percentage as those who have bariatric surgery, which most insurers, including Medicare, pay.

“The perception is, ‘If you’re heavy, get out of your bootstraps and try harder,’” Dr. Kahan said.

And that, he adds, is a perception shared by many patients, as well as doctors, which makes them reluctant to seek medical help or prescription drugs.

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