Staggering in its scope, obesity is a chronic condition on pace to disrupt the lives of 1 in every 2 U.S. adults by 2030. Healthcare costs related to obesity surpass $1.7 trillion each year as obesity causes or worsens a range of conditions, including diabetes, hypertension, musculoskeletal issues, sleep apnea, mental health conditions, and contributes to infertility and cancer risk. Beyond health, obesity negatively affects workplace productivity and hampers economic earning potential, particularly for women. For example, for a middle-aged woman, losing 60 lbs is the economic equivalent of achieving a Master’s degree.
Of course, we can’t talk about obesity without discussing GLP-1 medications, which are both highly effective (when used appropriately) and expensive. For employers, the cost PMPM spending on GLP-1s increased from $4.34 in 2022 to $19.19 in Q1-Q3 2024. The value of GLP-1s is also undermined by discontinuation, with over 50% of patients stopping GLP-1s within the first year due to side effects, challenging access to the drugs, and lack of comprehensive support.
Traditional Approaches to Obesity Care Continue Falling Short
Despite growing awareness, obesity is still too often approached in a ‘one-size-fits-all’ manner—whether it’s the latest fad diet, excessive exercise, or specific medications. But obesity is complex and driven by a number of factors, including genetics, lifestyle, and environmental influences. Therefore, effective treatment requires a personalized treatment plan.
To properly address obesity, we need to match individuals to the most effective treatment and take a whole-person approach that includes nutrition and exercise, mental health and well-being, and addresses social determinants of health.
Gaps in coding, a limited number of properly trained obesity specialists, and a dearth of integrated programs make this difficult. Historically, obesity has been under-coded in healthcare claims, making it difficult to track its impact on patient outcomes and healthcare costs. In 2024, new ICD-10 codes for obesity were introduced, but adoption and use will take time.
Obesity medicine specialists represent less than 1% of the United States’ physician workforce. Success on any treatment—including GLPs—is about more than the medication alone. Individuals need education, support managing side effects, as well as nutritional and lifestyle guidance, and psychological support. When care is delivered by providers without training in obesity medicine or in practices with the ability to support broader care, patients are far less likely to succeed.
The Conscious Coupling of Clinical Expertise with AI = Personalization & Value
AI should not replace providers but rather enhance and augment obesity care. Providers should remain the heart and center of care, guiding each patient with expertise and empathy. But when paired with AI, care becomes more effective, efficient, and personalized.
AI can easily combine a wide range of data points across medical records, patient-reported information, and biometrics to provide a clear view of the individual’s current state. It can also analyze factors such as dietary habits, activity levels, metabolic rates, and psychological health. This enables clinicians to personalize care plans—whether that be surgery, pharmacotherapy, or cognitive behavioral therapy—with greater accuracy and speed, while also identifying in real-time which individuals may be struggling and need additional support.
By identifying trends and recommending interventions, AI can help providers deliver the right care at the right time. AI can also be used to localize and personalize nutrition and physical activity recommendations to better align with each individual’s goals and needs.
The result of coupling clinical expertise with AI: better matched treatment, higher engagement, and improved clinical and financial outcomes.
Conclusion: Moving Toward Smarter, Scalable Obesity Care
There is a lot at stake—personally, financially, and societally—in getting obesity treatment right at scale. Linked to 200+ conditions, obesity shortens lifespan, worsens existing disease, and drives healthcare costs when new diseases arise. Obesity continues to contribute to lost work productivity, increased disability claims, and limits earning potential. A report estimated that in 2023, the cost of obesity and overweight to employers exceeded $400 billion.
As we approach the mid-point of 2025, more providers than ever are offering obesity care, yet we’re not seeing the impact. Obesity remains the greatest health crisis of today, driving both clinical and financial consequences.
To truly address obesity at scale and enable long-term success, we need to move beyond a ‘one-size-fits-all’ approach. This means integrating clinical expertise with technology and AI to personalize care, drive adherence, and proactively support those at risk. By matching the right patient to the right treatment at the right time and providing them with the right holistic support, we can deliver sustainable outcomes by improving health, quality of life, and financial value.
Elina Onitskansky
Elina Onitskansky is an experienced healthcare executive committed to enhancing access, affordability, and equity in healthcare. She is currently the CEO of Ilant Health, a value-based center of excellence for obesity and cardiometabolic health. She previously held a variety of leadership roles, including Senior Vice President & Head of Strategy at Molina, Chief Growth Officer at Help at Home, and Associate Partner and Co-Leader of the commercial service line at McKinsey. Elina has been recognized as one of Rock Health’s 2024 System Disruptors. Elina holds an MBA with distinction from Harvard Business School & an A.B. in Chemistry & Physics magna cum laude from Harvard College.
