Obesity and diabetes can be devastating.
Louisiana has an obesity rate of 36.8% — and is the state with the fourth highest obesity rate in the country.
Diabetes takes its toll in Louisiana, not only in the health of the 505,468 people (more than 14% of the state's adult population) who were diagnosed with it in 2021, but it also has a high cost to go along with that. Diagnosed diabetes costs the state an estimated $5.7 billion each year, according to the American Diabetes Association, which also says:
- An additional 113,000 people in Louisiana have diabetes but don’t know it, greatly increasing their health risk.
- 1,243,000 people in Louisiana, 34.4% of the adult population, have prediabetes with blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes.
Metamor, a program focused on the advanced treatment of those debilitating conditions at Baton Rouge's Pennington Biomedical Research Center, is looking for a solution for the problems associated with both obesity and diabetes — problems that go far beyond physical appearance or a limited diet.
While there's no magic pill to make the problems go away, Metamor is throwing decades of clinical research to help fight both obesity and diabetes and the range of negative health conditions that go along with them. Some patients, like Linda Brown, say her treatments have worked so well, it's almost like magic has occurred.
Since 2020, Metamor (initially named the Bariatric and Metabolic Institute) has made an appreciable impact in tackling obesity and diabetes in Louisiana. A partnership between Pennington, Our Lady of the Lake, the State of Louisiana and the LSU Health Sciences Center, it hosted more than 8,000 visits with patients talking to doctors about weight loss last year alone, while carrying out over 530 bariatric operations.
Metamor's director, Dr. Philip Schauer, said obesity in particular could lead to a wide range of debilitating health issues.
"Obesity is a chronic illness," he said. "At some point folks begin to feel the medical effects of obesity, whether it's diabetes, high blood pressure, (high) cholesterol, pain in their joints, arthritis or sleep apnea. There are 200 conditions or diseases that we know are caused in a large part by obesity."
Metamor has "an integrated and multidisciplinary approach" to treat obesity and diabetes. For those at the lesser end of the obesity scale (between 30 and 50 pounds overweight), various methods including lifestyle coaching, diet, exercise, combination therapies and medications are explored.
For people more than 100 pounds overweight, bariatric surgery is often the go-to option. Surgical procedures are performed in state-of-the-art facilities at Our Lady of the Lake Regional Medical Center.
While the program has changed hundreds of lives, it does have its challenges. These often center around insurance.
"There are so many people who need our services," Schauer said. "However, there are people that, unfortunately, we have to turn down at the door because they don’t have insurance coverage. It's kind of wild: Often their insurance policy will cover other conditions that are secondary to obesity — high cholesterol, blood pressure, diabetes — but won't necessarily cover the underlying cause, which is obesity (itself)."
Another issue is patient access to the new crop of weight loss drugs, such as Ozempic and Mounjaro. As many of the drugs are relatively new, and were originally designed to tackle other issues, getting insurance to cover them can prove problematic.
It's something that Brown in Baton Rouge, who has lost around 70 pounds during her time at Metamor, has had to deal with. Brown said Mounjaro had been responsible for most of her weight loss; however, she has been forced to go from pharmacy to pharmacy to get her prescription filled, and now has to drive two hours to do so.
"Pharmacies are not all together on this. How can I get it filled at one place, but (if I go) somewhere else they're telling me I can't get it done?" she said, sounding exasperated.
Nevertheless, prescription problems aside, Brown said working with Metamor's doctors had proved to be a life-changing experience.
"I didn’t even realize some of the issues I was having because I was learning to live with all of my ailments," she said.
With Mounjaro, participants in a study lost an average of 12-22% of their body weight over about 68 weeks when using the highest doses of Mounjaro (10-15 mg) along with diet and exercise. For someone weighing 200-300 lbs, this could equate to 25 to 45 lbs of weight loss.
Brown says the difference the drug has made for her has been life-changing. She recognizes she looks better, but she also feels better. She says her overall health is improving significantly.
"I was getting winded, I was always tired … getting off work I couldn’t do anything else but going home and trying to catch a breath," Brown said.
She had many of the problems that go along with being overweight, including high blood pressure and high cholesterol.
"But now I've joined the gym, which I go to three times a week," she said. "I have energy. I don’t have any more back pain. I just feel so much better and more confident."
In the future, Metamor plans to expand a pediatric program to help adolescents and teenagers, a group that is underserved in Louisiana. It also aims to further bring a positive economic impact to the region through a variety of sources, not least outsiders visiting the facility.
"We plan to be a destination where people come from other cities, other countries, to get specialized care here," Schauer said. "For example, there are people we're treating who are more than 700 and 800 pounds, and those folks need very specialized care: we are experts in handling that type of obesity."
It's already made a large change. There's more to come.
"A lot of the ingredients were already here, (it was a matter of) just pulling them together. Especially with Pennington, which has a 30 year history of being at the top in terms of obesity research," Schauer said. "Bringing those assets together to create this very special obesity treatment center ... that was the goal."