This blog is part of an ongoing series, A Brave New World: Therapeutic Area Deep Dives

Obesity affects more than 40% of U.S. adults and continues to increase, creating a mounting clinical burden and a rapidly evolving market landscape¹. Once dismissed as a lifestyle-driven choice, obesity is now being recognized as a chronic multifactorial disease , reshaping payer policies, provider practices, and pharmaceutical strategies. The complexity of the metabolic disease landscape is due to the central role that obesity plays across a wide spectrum of comorbidities which magnify the clinical and financial stakes. The resulting ripple effects extend well beyond individual health, driving higher systemwide healthcare costs, straining clinical infrastructure, and accelerating demand for innovative therapies. For life sciences companies, success will depend on more than just delivering effective drugs. It will require strategies that address the comorbidities of the patients they serve and innovative approaches to overcome the social determinants of health that currently limit access to care. At the same time, there is an intense race among pharmaceutical companies to develop and acquire next‑generation anti‑obesity medications, with billions of dollars being invested to capture share in this rapidly expanding market.

The rising global burden of obesity across all demographics and regions

The global burden of obesity is intensifying, with prevalence rising across all geographies. Current forecasts indicate that by 2050, nearly two thirds of adults will be considered overweight or obese, a staggering figure that underscores the urgency of the challenge². In the U.S. alone, the affected population is projected to grow rapidly, with age-standardized prevalence rates climbing across all demographics. This growth is not limited to adults. Alarmingly, the prevalence of obesity among children and adolescents is expected to increase by 121% over the coming decades, signaling a generational shift in disease burden².

Regional trends reveal that while North America leads in prevalence, significant increases are also anticipated in Asia and Africa, further expanding the global market and the need for innovative therapeutic solutions. Obesity is defined by body mass index (BMI) thresholds, with overweight classified as a BMI of 25 to 29.9 and obesity as a BMI of 30 or higher. These definitions provide a standardized framework for epidemiological tracking and market segmentation, but the sheer size and growth trajectory of the affected population, estimated at 3.8 billion adults worldwide by 2050, demands a strategic response from pharmaceutical companies².

Navigating obesity’s comorbidity landscape

Obesity is closely linked to a wide range of chronic conditions spanning cardiometabolic, musculoskeletal, gastrointestinal, neurological, and mental health disorders. These overlapping conditions increase the overall disease burden and complicate both diagnosis and treatment. The National Institute of Diabetes and Digestive and Kidney Diseases highlights that obesity also raises the risk of osteoarthritis, fatty liver disease, kidney disease, sleep apnea, gallbladder disease, gout, and depression³. This breadth of comorbidities underscores why obesity treatments are increasingly positioned not only to address weight and metabolic health, but also to reduce the cascading risks across musculoskeletal, neurological, and organ‑specific conditions. Recent findings from the American Cancer Association further identify obesity as a significant risk factor for several cancers, including breast, colorectal, and pancreatic, reinforcing its impact across multiple therapeutic areas⁴.

The American Heart Association’s new Cardiovascular Kidney Metabolic (CKM) Health model reframes obesity as the earliest stage in a chain of interconnected diseases, driving risks that extend from diabetes to kidney disease and cardiovascular complications⁴. GLP‑1 therapies stand out as the most effective weight‑loss treatments ever approved, with growing evidence of their ability to reduce this downstream burden, reinforcing why they are rapidly gaining indications across multiple conditions. For pharma, this shift creates both opportunity and disruption, as obesity assets offer a long runway to address diverse conditions while potentially decreasing demand for healthcare resources in specialties once considered unrelated. Findings from an IQVIA analysis illustrate the significant overlap between obesity and its comorbid conditions, highlighting their role as key drivers of overall risk. As a patient’s BMI increases, both the likelihood and number of comorbidities rise in tandem, creating a compounding effect that intensifies disease burden and reinforces the importance of early intervention.

The prevalence of obesity-related comorbidities varies by payer type, largely due to differences in age of patient populations. Medicare patients, typically aged 65 and older, show significantly higher rates of comorbid conditions, such as hypertension, stroke, and dyslipidemia, compared to those with commercial insurance. As individuals with obesity age, their risk of accumulating chronic conditions nearly doubles, compounding the disease burden by the time they reach Medicare eligibility.

Age remains one of the strongest drivers of comorbidity risk and overall disease burden, a pattern clearly reflected in payer segmentation. Medicare populations, by virtue of age, carry a higher prevalence of obesity‑related conditions such as cardiovascular disease, kidney disease, and diabetes, making integrated care models essential to improve outcomes and manage costs. In contrast, commercially insured groups tend to be younger, where earlier intervention provides an opportunity to slow disease progression and reduce the long‑term strain on the healthcare system. Segmentation highlights these differences, but it is the compounding effect of age and chronicity that ultimately shapes the trajectory of obesity‑related disease. By intervening before patients transition into Medicare, stakeholders can meaningfully alter the course of disease burden and create more sustainable models of care. This underscores a primary challenge in establishing the true value of treating obesity as disease: How can cost of treatment be incurred today when the value of treatment is realized years or decades later?

Social determinants of health and the unequal burden of obesity

Obesity is deeply intertwined with socioeconomic factors that influence both the risk of disease and access to effective care. Communities experiencing increased rates of poverty, limited insurance coverage, and reduced access to primary care providers face disproportionate impacts from obesity. These conditions often coexist and reinforce one another, creating structural barriers to disease prevention and treatment. Areas with low provider density tend to have higher uninsured rates and greater economic hardship, which collectively limit access to routine care, early intervention, and chronic disease management. This convergence of social determinants contributes to higher obesity prevalence in at-risk populations and perpetuates health disparities across generations.

Effectively addressing obesity requires more than clinical treatment or pharmacotherapy. It demands structural reform through targeted investments in community infrastructure and policy to help promote information availability, equitable access, and sustainable health outcomes. Solutions must reach underserved populations and account for the complex social realities that influence health behaviors, treatment adherence, and long-term success. Understanding how social determinants shape obesity is critical to developing strategies that are both inclusive and effective.

Identifying treatment gaps and unmet needs

Despite growing recognition of obesity as a chronic disease, access to treatment remains severely limited by payer coverage policies. Many effective therapies, including anti-obesity medications, are restricted by insurance criteria that require comorbid conditions such as sleep apnea for approval. Even when treatments are clinically appropriate, high out-of-pocket costs and inconsistent coverage across plans, especially in the United States, create financial barriers that prevent patients from receiving timely care.

Beyond pharmacotherapy, non-pharmacological interventions like nutritional counseling, psychological support, and physical therapy are underutilized and inconsistently included in obesity treatment plans, despite their vital role in long-term success. These services address behavioral, emotional, and lifestyle factors that medications alone cannot. Without them, care often falls short of meeting the complex needs of patients. Integrating these supports into routine practice through multidisciplinary care, provider education, and better coordination is essential. A holistic approach not only improves patient outcomes but also empowers individuals to manage their health and sustain progress over time.

Strategic imperatives in addressing the growing obesity market

The evolving obesity market highlights the need for pharmaceutical companies to adopt patient-centric, data-driven, and multi-channel strategies. Success will depend on understanding the complexity of the disease, addressing unmet needs, and building solutions that reflect the realities of diverse patient populations and payer environments.

• Develop integrated care models that address both physical and mental health. Collaborate with providers and community organizations to ensure patients receive comprehensive support, including behavioral health and education.
• Segment patient populations by payer type and comorbidity profile. Use real-world data to tailor clinical programs, pricing, and access strategies to the unique needs of each group and population.
• Invest in patient education and engagement platforms. Empower patients with clear information about treatment options, lifestyle interventions, and long-term disease management.
• Address barriers to access through affordability programs. Reduce financial and logistical obstacles to ensure therapies reach underserved and high-risk populations. Design community-specific outreach to improve treatment rates and outcomes.
• Embed social determinants into strategy and execution. Partner with communities to address factors such as provider density, insurance coverage, and socioeconomic status that impact outcomes.

Pharmaceutical companies that embrace these imperatives and build strategies around holistic, patient-focused models will be best positioned to lead in the next era of obesity care. Reach out to IQVIA to learn more about building successful strategies for the obesity market.

Sources:

1. CDC. Adult Obesity Facts. Obesity. March 25, 2025. Accessed October 6, 2025..
2. Ng M, Gakidou E, Lo J, et al. Global, regional, and national prevalence of adult overweight and obesity, 1990–2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021. The Lancet. 2025;405(10481):813-838. doi:10.1016/S0140-6736(25)00355-1.
3. Health Risks of Overweight & Obesity - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. Accessed October 7, 2025..
4. Excess Body Weight and Cancer Risk. Accessed October 7, 2025..