What Do You See as The Next Phase of Obesity Innovation?

Brian Hilberdink, president of U.S. Human Pharma, Boehringer Ingelheim, who has worked in the obesity space since the earliest days of modern pharmacologic treatment and previously spent 26 years at Novo Nordisk, discusses how the next phase of obesity innovation must move beyond a narrow focus on weight loss to a broader concept of metabolic health.

In the video, Hilberdink explains that the evolution of obesity care mirrors the transformation seen in type 2 diabetes, where the field shifted from blaming patients for “causing” their disease to recognizing it as a complex metabolic condition. He believes obesity is now at a similar tipping point: clinicians, and increasingly the public, are beginning to understand it as a multifactorial metabolic disease rather than a simple failure of willpower. This reframing, he argues, is essential to reducing weight bias and grounding care in evidence-based solutions.

Hilberdink emphasizes that success in obesity treatment should not be defined solely by pounds lost on a scale. Instead, he calls for a more sophisticated assessment of outcomes that includes the quality of weight loss and its impact on key aspects of metabolic health. Hilberdink highlights the importance of reducing “bad” visceral fat, especially the fat that accumulates around the abdomen and vital organs, and ensuring the liver remains healthy, given its central role in overall metabolic function. He also stresses the need to preserve lean muscle mass while treating obesity.

According to Hilberdink, this broader lens on metabolic health represents the field’s necessary next step: shifting from a simplistic, weight-centered model to a more nuanced, disease-focused paradigm that prioritizes organ health, body composition, and long-term metabolic stability alongside weight reduction.