Just a few weeks ago, a GLP-1 medication was released in pill form for the first time.
And McKinsey partner Lars Hartenstein says this kind of innovation is just the beginning.
GLP-1s, which help to lower blood sugar and reduce appetite, have already proven to be a game changer.
Know that it's at the moment on track to be probably the biggest drug class we have ever seen.
But despite the positive effects these drugs have had for many people when it comes to overall metabolic health, they're not a magic bullet.
It's not that this drug class is going to solve obesity or metabolic health.
It is a very important tool, the most important new tool for sure.
This is the McKinsey Podcast, where we help you make sense out of the world's toughest business challenges.
I'm your host for today, Roberta Fasaro, and we're here to talk about a recent McKinsey report titled The Path Toward a Metabolic Health Revolution.
What makes metabolic health and obesity such a pressing global issue today?
Lars explains.
Right now, approximately a billion of adults are living with obesity globally.
And that's a cause of many, many health effects and creates a lot of diseases down the road.
Therefore, obesity is a very big focus for everybody who is interested in global health, essentially.
What has changed is that we have new classes of drugs.
For many years we've really treated obesity as an intractable condition, and now it is a treatable disease.
So now that changes the conversation, because metabolic health is a much bigger notion than just obesity.
So overall, I see this as a giant opportunity economically and also for health.
And it's really going to disrupt and create many opportunities through many different industries.
Which industries do you think would be most affected?
If we start with a consumer or an individual that is maybe very interested in metabolic health, looking at their glucose levels in a continuous way?
So maybe they scan the barcodes and so forth to get information about the products when they're going to the grocery store.
So the food industry is involved as well, as well as the broader wellness industry that needs to do offerings.
And then, of course, the more standard medical industries around pharmaceuticals and healthcare, med devices and so forth.
So the impact is widespread.
The report argues that we face this choice between two different paths, path one being treatment-focused versus path two being prevention-focused.
Can you explain, Lars, the difference between the two paths?
So path one is we follow the trail of innovation.
There are these new drug classes and they are adding health value and also economic value, in the sense that we are able to treat obesity in a different way.
The focus though, of this path really is Those that are already living with obesity, or perhaps those that are overweight and have significant risks in addition.
Path two is altogether more ambitious.
We call it a big climb towards a metabolic health revolution because it's strenuous.
There, the ambition level is that we really deliver metabolic health for all.
That means we can't just build only on the innovation we have.
We need to mobilize across investments and leadership across societies.
Some of the different industries I mentioned, but also governments, education and civil society, to change the environment that we live in that allows us to be more metabolically healthy.
And in our analysis we've seen that the health effect of PATH2 can be three to four times larger than if we are just looking at treating obesity.
That sounds incredibly transformative, right?
But we know that that's not going to just happen automatically out of the blue.
In the report Lars, you talk about five big shifts that are needed to happen to make this PATH2 possible a reality.
The five levers advancing science, improving measurement, using technology for personalization, aligning incentives, driving societal change.
Tell us a little bit more about these five shifts.
Yeah.
So number one, advances in science.
We don't have a clear definition of what a metabolic health is from a medical, scientific perspective.
It's not aligned.
So therefore, we need to be able to really clearly define what metabolic health means for everybody, not just for a person who is already not doing well, but really define it on a spectrum first, from being not metabolically healthy at all to really optimize metabolic health with all the different elements within that.
That may include blood glucose, blood pressure, blood lipids, organ function of kidney, liver and so forth.
So then another shift is we need more transparency as individuals.
Most people do not know what their metabolic health is.
They may know at some point when they're running into trouble, but we don't individually have transparency on our metabolic health.
We know little aspects of my cholesterol is high.
We know little aspects, yeah.
And when do we start testing for cholesterol?
Maybe it depends on the country and environment, maybe at 50, you know?
But like, it is very useful to talk about the metabolic health of a child.
Not only whether they're obese or not, but how metabolically healthy are they are.
They already building some insulin resistance early on in their lives?
So it's really the notion that applies to everyone, also for the so-called healthy individuals, which is a tricky notion.
So therefore, the second one is transparency.
And the third one is technology and innovation, because how do we bring this to the individuals?
We need offerings for the individuals that work for them.
We need innovation in the notion how we talk about things also, so we can talk about our metabolic health as we talk about how many steps we do in the day.
And that requires consumer-oriented technology innovation that allows folks to really understand, engage and also identify ways to optimize and improve their metabolic health, be it through physical activity, be it through the way they eat, their sleep which is also affecting your metabolic health or other ways.
Fourthly, and that's perhaps the most tricky one, we need to change some things in terms of our economic setup, so there's better incentives to provide choices in life be it how we move, how we eat and so forth that are affordable, available and attractive, that we also want to have.
Because we are all struggling with facing choices that we find attractive, that are not necessarily good for our health.
Everybody has that.
That's a reality.
And then the last one is really changing communities and society through education and engagement.
A lot of that is already starting to happen.
We've talked with economists about the concept of nudging and moving people in the behavioral directions that you want.
How do we start to achieve these different states?
Who needs to get involved with this?
The answer is everybody needs to get involved.
It needs to be a societal priority issue and the private sectors, across different industries, as a role to play, but certainly also government, civil society and frankly, all of us as individuals.
It is a true moonshot.
That's cross-sector, cross-society that is needed if we want to accomplish metabolic health revolution.
And the case we are making and our report of the McKinsey Health Institute is to say it's worth it.
The return on investment is huge and therefore it merits the kind of attention that is needed.
Can you give us an example of something that's working right now?
The maybe unexpected one is a government initiative, like in Singapore, to materially increase the physical activity of the population.
So for 10 years now Singapore has been doing very successfully a step challenge with incredibly high numbers of participants to fundamentally increase the activity of an increasingly sedentary population.
That contributes to metabolic health.
Very interesting example.
Let me give you a very different example.
Yooka is an app that you can scan barcodes in the grocery store.
So you see in the grocery store exactly how healthy the food is that you're about to buy.
At the point of purchase.
It influences, or you can have support in terms of what you want to purchase.
Another one very differently that is coming from a life of a reinsurance company like Swiss Re.
Swiss Re... is publishing and doing thought leadership on metabolic health and insulin resistance.
You wouldn't necessarily expect that, but they have identified that, let's say, ill metabolic health is a major potential risk in their portfolio and they are thinking what, as a reinsurer of other insurance companies, like life insurance companies, they can do about that.
So I think that's a very encouraging.
It's a different stakeholder stepping up and doing something in the field of metabolic health.
What's also interesting is the notion of food as medicine, particularly also the United States, happening that in particular situations food is almost prescribed, if you want particular types of food, so people are better instead or in addition to drugs.
That sets new types of incentives between those that are selling the food and the insurance companies.
That's a very encouraging example.
Lars, thinking about those five shifts, do they all need to happen together?
I think all of the five are needed for sure.
But like we can't run before we can walk, right?
All of them are needed, but it will take time.
That's okay.
I wanted to come back, since you liked Jukka, I wanted to emphasize something from the consumer perspective, which is really this continuous biofeedback.
There's emerging evidence more and more that if you know how well your body is functioning on a particular thing, that has implications, at least for a number of people continuous glucose monitoring, so measuring all the time how much glucose you have in your blood.
It's originally something for diabetic patients, or at least for those who already have metabolic health conditions, but it's exceedingly used also in quotation marks healthy individuals to inform as a consumer value proposition, to monitor how they're doing and, frankly speaking, learn about their individual metabolism.
And that can change behavior.
So I wanted to make a shift for us, because one of the shifts that's already making headlines is the surge of GLP-1 medications.
These are medications that are being called a breakthrough.
Can we talk a little bit about what that means?
So these medications are transformative in this space.
There are things we don't know but, for all we know, they are transformative, because they enable many of those that take it to lose more than 10 of their body weight.
And for some, in the region of 20%.
Given how important too much weight is as a risk factor for so many diseases, that's tremendous news.
And it has enabled us to shift away from this conversation that is not very productive, that everybody's responsible for their weight, you blame those that have too much, and so forth, because now we have tools that are enabling changes in a very different way, and it opens up the compass and we recognize it more as a condition or disease and it enables us to then discuss really more what experts know for a long time what are the real drivers of it and what do we do about it.
That really helps to open up this conversation.
That then allows us now to talk about metabolic health.
Having said that, there are a lot of things we don't know about this drug class yet.
We know that it's at the moment on track to be probably the biggest drug class we have ever seen.
Of course, predictions vary, but extremely large.
We don't know fully the long-term effectiveness.
We don't know the long-term safety profile in healthy individuals.
The in diabetic patients, but not in healthy individuals.
So we don't know that yet.
We don't know of major problems to watch or so.
There are some, but for now we haven't picked up big things that would change the picture I've just characterized.
On the upside also, these drugs that may give you a sense of if you're on satiety slows the food processing, also have work via the brain, maybe have also positive implications for other things.
They studied for alcohol and so forth.
So we may still learn a lot of things about this drug class.
So definitely a thing to watch.
It's just one piece of a larger puzzle, right?
I'm thinking Lars, about things like policy education, community engagement, maybe that last shift that you had talked about earlier.
What role do they play in making prevention the easier default path out of the two that we've outlined in the report?
Let me give you a simple example.
When I remember my school days...
I remember exactly one class where we were educated about, let's say, our metabolic health in a meaningful, practical way.
I still remember that our biology teacher gave us a list of foods.
He asked us to underline the healthy and the unhealthy food in different colors, or something like that.
Yeah.
That's the only one.
I think there is tremendous opportunity to do more and to embed this already in education.
That includes, of course, also the type of meals that are provided in schools, for sure.
And the employers, of course, have a big role to play.
Because many, many people eat a meal a day at their employer.
How much you're moving about, very much influenced by your employer and your working conditions.
And the employer has a chance to improve or influence working conditions.
So therefore, every company.
It's an ecosystem that can be more or less conducive to metabolic health.
That's really across industries.
If you could speak directly to business leaders and individuals, what's the one action you'd urge them to take starting tomorrow?
So I think two angles.
For individuals, I think there's an obligation to get more educated.
I think it's good to understand metabolic health and what drives it, and then make choices, right?
That's an important thing for individuals just to try to understand more what's actually happening, how your body is functioning, not in a biological way, but just to get more educated and try and also distinguish the fats from actual information.
And then for leaders of organizations, There's so much opportunity and such a dynamic here.
I'd say, don't be afraid to be the first.
Because there is a momentum driven by the enormous investment that's flowing into the space.
It's worthwhile to take some calculated risks and think about your industry.
What does this mean for you?
And where are some things where there may be an opportunity and try to seize it?
Because the underlying trends are very strong.
Lars, thanks so much for taking time to record with us today.
And thanks for the information.
Thank you very much.
That was fun.
Thanks so much for listening to the McKinsey Podcast.
I'm Lucia Raheli.
And I'm Roberta Fasaro.
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