There are 262 million adults in the US, of whom 74% are overweight, 42% have obesity, and 10% have extreme obesity. This tsunami of an epidemic threatens to capsize the healthcare system while creating immense suffering for the population grappling with this disease. We know that obesity is a metabolic disease state associated with over 200 comorbidities. It is driven by a complex set of factors, some of which are still unknown.
The good news is that we are actively studying the mechanisms behind the disease, gleaning a better understanding of physiology and resulting in targets for effective treatment. As a result, we now have multiple FDA-approved medications on the market, with more to come. While none of these drugs are perfect, we are making headway.
Dr. Fran Broyles, a Seattle-based endocrinologist at Rainier Clinical Research Center, has seen the excitement — and the consequences — up close. “The allure of rapid weight loss can blind people to the potential downsides,” says Dr. Broyles. “They may lose weight, yes, but they’re often losing something vital in the process — muscle.” Muscle loss, Broyles points out, not only affects long-term weight management and the potential for regain but also hampers overall health, which is something many of her patients simply can’t afford. “It’s very easy to celebrate the quick results of weight-loss drugs, but when 20 to 40% of the weight lost is muscle, we are missing the bigger picture,” Broyles says. Muscle plays a key role in metabolism, mobility, and even immune health, all of which are essential for long-term well-being. Losing muscle, Broyles warns, could potentially slow down a person’s metabolism, making it harder for them to maintain a healthy weight in the future.
In Washington, where diverse communities of Native American, Black, and Hispanic residents face some of the highest obesity rates in the nation, the stakes are particularly high. Dr. Broyles’ patients often grapple with not only the physical challenges of obesity but also a web of social factors that complicate their health journeys — limited healthcare access, financial barriers, and fewer resources for healthy living.
What makes this landscape even more troubling is that many of the fast-track weight-loss drugs dominating headlines haven’t been thoroughly tested on the populations most affected by obesity. For Dr. Broyles, this isn’t just a gap; it’s a fundamental flaw in how trials are designed. “Our healthcare system has often assumed a one-size-fits-all approach to weight loss, but the reality is far more complex,” she explains. “We’re treating obesity as though it affects everyone the same way, which just isn’t the case.”
For people battling obesity, weight loss isn’t about aesthetics or fitting into a certain size. It’s about reducing life-threatening health risks, moving without pain, and reclaiming a quality of life they may have lost to chronic conditions like diabetes and hypertension. And while these medications are the first to finally address some of the causes of obesity effectively, there is still a long way to go to address societal, cost, and cultural issues.
In her practice, Dr. Broyles sees patients who are not only struggling with weight but also with systemic obstacles — from limited access to healthcare to economic pressures that make it harder to pursue lasting health changes. These patients aren’t just looking for a quick fix; they need solutions that support sustainable health.
Dr. Broyles isn’t alone in her concerns. Across the country, more voices are calling for weight-loss solutions that consider the full picture of health. That means developing treatments that are better tolerated, don’t sacrifice muscle for the sake of the scale, and create therapies that support each person’s unique health journey. “As a clinician, it’s my responsibility to question not just whether these drugs work, but whether they work for everyone who needs them — and in a way that improves overall health long term.”
This is exactly why Dr. Broyles is overseeing a new clinical trial at Rainier Clinical Research Center. The study seeks to redefine weight-loss treatments by focusing on approaches that support total health — preserving muscle mass, improving mobility, and adapting to the unique health profiles of diverse populations. “Health should never be about quick fixes,” she says. “It’s about helping people live stronger, healthier lives, and that’s what we can’t afford to forget.”
In a world captivated by quick fixes, Dr. Broyles’ approach serves as a reminder that true health demands a deeper commitment. At Rainier Clinical Research Center, Dr. Broyles is currently involved in several studies that are evaluating investigational medications for weight management. For those seeking a healthier path forward, these trials explore what weight loss could look like in the future.
