Obesity paper’s conflicts causing indigestion

2 minute read


The landmark Lancet commission on obesity diagnosis comes with a hefty declaration of interests section.


Of the 56 global obesity researchers and experts who contributed to the Lancet Diabetes and Endocrinology commission paper, which aims to change how obesity is defined and diagnosed, only 11 did not declare an interest with a drug or food company.

The declaration of interests section, the academic equivalent of fine print, takes up close to two pages of the document, which proposes not only moving away from BMI as the primary diagnostic tool for obesity but also creating two new categories of obesity: pre-clinical, for those with preserved organ function, and clinical, for those with loss of organ function and limitations in their day-to-day lives.

According to Australian commission member Professor John Dixon the recommendations will, if adopted, “overhaul” existing ideas about diagnosing and treating obesity.

That makes it probably worth noting the conflicted elephants in the paper.

Drug company Novo Nordisk – maker of blockbuster obesity drug Wegovy and diabetes medicine Ozempic – is mentioned in the conflicts section 62 times, while Eli Lilly – maker of obesity drug  Zepbound – is mentioned 39 times.

Food giant Nestle appears twice, with authors reporting financial ties to other pharmaceutical companies including AstraZeneca, Johnson & Johnson, Sanofi, Pfizer and Merck.

While the shift away from BMI doesn’t seem likely to benefit these players commercially, the language around obesity as definitively a disease – one you have or are about to have – could nudge GLP-1 drugs further into the clinical sphere as weight loss treatments, where they are more likely to attract government funding and a larger market.

In Australia, semaglutide is approved under the Ozempic brand name for diabetes and as Wegovy for weight loss but only the diabetes version attracts a PBS subsidy.

“In the absence of a functional health care system, we have drugs – effective and without deleterious side effects for some people, but for the great majority, highly expensive and hard to get,” Food Politics blogger Marion Nestle wrote.

“This commission appears as an arm of the pharmaceutical industry. Its findings require careful scrutiny.”

Send declarations of story tips to penny@medicalrepublic.com.au.

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