By Tro Kalayjian, DO
A new program just helped 50 participants shed more than 40 pounds each, get off nearly 100 prescriptions, and save roughly $83,000 in medication and care costs over one year. The program — focused on improving participants’ metabolic health — offered a clear glimpse of what’s possible when we address America’s health crisis at its root
Today, one in three American adults suffers from metabolic syndrome — a condition marked by obesity, high blood sugar, high blood pressure, low cholesterol, and too many triglycerides in the blood. It underlies many chronic diseases, including type 2 diabetes, fatty liver disease, and cardiovascular disease, and it sharply increases the risk of heart attacks and strokes.
Altogether, metabolic syndrome contributes to hundreds of thousands of American deaths each year and costs us hundreds of billions of dollars in medical costs and lost productivity
Currently, Americans suffering from metabolic syndrome are often prescribed a long list of expensive drugs and treatments that do little to address the core problem and further drive up healthcare spending.
Medications like GLP-1 and SGLT2 inhibitors can help control blood sugar and appetite, but cost hundreds of dollars per month per patient.
Instead of throwing costly medications at the problem, it’d be far more effective to find a way to help patients adopt — and crucially, stick with — sustainable, healthy lifestyles.
One promising model is the multifaceted “TOWARD” approach. This health intervention combines several strategies: ongoing text-based communication and virtual coaching, access to online educational resources, real-time feedback through remote monitoring of metrics like blood glucose and blood pressure, and dietary changes that emphasize carbohydrate reduction and intermittent fasting.
It’s an approach designed to restore metabolic function and empower patients to sustain healthier lives. In a 12-month, 50-participant pilot program — mentioned above — patients shed medications and improved key health markers when following this model.
Other studies have yielded similar results — one study examining patients with type 2 diabetes found that telemedicine-supported carbohydrate-restricted nutrition therapy helped patients discontinuing the use of GLP-1s to maintain weight loss and low blood sugar. Another found that those practicing telemedicine-supported carbohydrate restriction experienced weight loss, improved blood pressure, and improved in many cardiovascular markers, all while using less medication.
It’s not just patients who are better off under this model. By supporting evidence-based metabolic health programs, employers can reduce costs and improve worker output.
The federal government can facilitate the expansion of this kind of metabolic care. Reducing regulatory barriers that currently prevent practices from delivering metabolic health care — such as convoluted requirements for licensing professionals across states — is essential.
Similarly, reducing barriers to technology and investment in practices would allow physicians working on metabolic health to employ more modern technology to improve patient outcomes. And subsidizing corporate metabolic health programs — perhaps through special tax incentives — would help companies start providing them for workers.
Metabolic syndrome represents a public health crisis that we can’t afford to ignore. It’s time to invest in affordable programs that attack the disease at its root.
Dr. Tro Kalayjian, DO, is the founder and Chief Medical Officer of TOWARD Health and an advisory committee member for the Coalition for Metabolic Health