Dr Boris Hansel, endocrinologist: “Recognizing obesity as a chronic disease changes treatment”

Dr Boris Hansel, endocrinologist: “Recognizing obesity as a chronic disease changes treatment”

Overweight and obesity continue to increase in Europe. But in the face of this scourge, new weapons are available. Dr Boris Hansel, endocrinologist at Bichat hospital, sheds light on the major advances that will change patient care.

What progress has been made in the fight against obesity in recent years?

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

  • The first is the recognition of obesity as a chronic illness and the fact that we can disseminate this information. Of course, there is still a long way to go, but it is a good start. Where progress is needed is in patient care: as obesity is not recognized as a “long-term” illness, there is no 100% financial coverage. However, recognizing obesity as a chronic disease – which it is – completely changes the way we treat patients. We no longer treat a person with “bad will” but rather a sick person. This is a matter of medical care.
  • The second advance concerns “digestive endoscopy”; an emerging technique that helps reduce patients’ appetite. This alternative to surgery, which relies on stitching the stomach, is very effective and has very few side effects.
  • As for the third advance, it concerns drugs from the GLP1 family. It is an additional therapeutic weapon to reduce appetite, and therefore to reduce caloric intake.

The only brakes on these innovations? The lack of reimbursement for these medications. Medicines, which, I remind you, are not accessible to all patients. They do not, moreover, replace their nutritional care.

Which ones do you think will mark 2024?

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

What can this change in patients’ daily lives?

A lot of things, because patients now come to see us with a specific request. However, no drug, behavioral, surgical or dietary treatment cures obesity. It is a disease that progresses, but from which there is no cure.

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

NO to diets, YES to WW!

In your opinion, is there a line of research that could revolutionize your field?

I would say the evolution towards treatments which act on both the regulation of appetite and metabolic expenditure. Because obesity is an imbalance between intake and expenditure. Obesity patients find it difficult to increase their spending – physical activity is not enough. I therefore believe deeply in these new molecules in full development, in these new major advances.