Sisyphus, the myth of a person condemned to a futile task of rolling a boulder uphill for eternity, has long been an apt metaphor for obesity medicine. He still is, said Donna Ryan yesterday at the Louisiana 2025 Obesity Conference in New Orleans. But the narrative has shifted dramatically, she explained.

Source: Donna Ryan at LA25AOC

Before this shift, the impossible task was to treat people with medicines that were inadequate for many people who needed help. For that task, the boulder has turned in to a snowball – it’s rolling downhill, getting bigger, and gathering momentum.

But for a related task – providing access to these treatments at scale – we are very much still on the Sisyphus side of that tipping point. It seems like an impossible task.

Years of Sisyphus

Ryan described many years in obesity medicine (she’s a recognized Master of Obesity Medicine) where it felt like she was rolling that rock up a hill:

“I was trying to tell people for years that five to ten percent weight loss has very important benefits – and it really does. But patients simply were not buying it.”

Now, she says, the disease modifying properties of these new drugs makes it plain that these are serious drugs. People have to take them seriously because they can help with a whole host of chronic diseases that result from obesity. Heart disease, sleep apnea, liver disease, and kidney disease are just a few of the conditions where treatment with these potent drugs seems to have great value.

Now the Snowball

And thus, these drugs have momentum in popular culture that makes our head spin. But they are serious drug with serious safety issues that require careful prescribing. Dispensing them willy-nilly in beauty salons is a terrible idea. These are serious drugs with serious benefits and serious safety issues, she said.

Trivializing them, calling them “weight loss drugs,” is a serious mistake.

The Big Rock Still to Push

The big rock we are now pushing is the task of delivering obesity care at scale. At present, less than ten percent of the people who need access to obesity care are getting it. Payers are resisting it. A skilled workforce to deliver it has not yet been trained. Health systems are not ready for it.

In the closing presentation of the day, ConscienHealth’s Ted Kyle explained why advocacy is essential for progress in obesity. The progress to date has been great. The task that remains is daunting.

Click here for the slides from Ryan’s outstanding presentation and here for Kyle’s slides.

Donna Ryan at the Louisiana 2025 Obesity Conference, photograph by Ted Kyle / ConscienHealth