Why Does The Distinction Between Weight Loss and Meaningful Metabolic Health Matter?

Brian Hilberdink, president of U.S. Human Pharma, Boehringer Ingelheim, explains why shifting the conversation from simple weight loss to meaningful metabolic health is critical for both patients and the broader healthcare system.

Hilberdink begins by underscoring the looming burden obesity places on health systems, driven by a wide array of comorbidities that extend beyond diabetes and cardiovascular disease. Addressing obesity effectively, he argues, means getting to the “root of the problem” so that these downstream complications, and the associated societal costs, can be reduced. From a population standpoint, that is why focusing on metabolic health rather than just weight is “super important.”

Hilberdink then narrows to the individual patient experience. He questions whether patients are truly being set up for long-term success if the primary outcome is a temporary improvement in how they feel in front of a mirror, without real progress in underlying metabolic health. He reiterates the distinction between “good” and “bad” fat, emphasizing that visceral fat around the organs is particularly harmful. Reducing this visceral fat, he suggests, is central to meaningful improvement.

He also highlights the liver as a critical organ in this equation, noting that about 75% of people living with obesity already have metabolic dysfunction associated liver disease (MASLD). Without a healthy liver, achieving robust metabolic health is difficult.

For Hilberdink, the essential shift is to look beyond the scale to parameters that capture organ health, fat distribution, and long-term metabolic resilience, so that treatment outcomes reflect genuine health gains rather than cosmetic or short-lived weight changes.