Leading a metabolic health revolution in Asia

**Gautam Kumra** (0:06)
I am Gautam Kumra, Chairman of McKinsey Asia, and you are listening to the Future of Asia Podcast Series. The Asian century has begun. The region is now the world's largest economy. As Asia's economies evolve further, the region has the potential to fuel and shape the next normal. In each episode, we are going to feature conversations with leaders from across the region to discuss what Asia's rise means for businesses across the globe. Join us.

**Debbi Cheong** (0:44)
Hello everyone, and welcome to the Future of Asia Podcast. I'm Debbi, and I am your host for today. This episode, we turn to one of the most pressing health challenges of our time, metabolic health. Across Asia, shifting lifestyles, rising obesity rates, and new medical innovations are changing how we think about prevention and treatment. Drawing on insights from the McKinsey Health Institute's report, The Path Toward a Metabolic Health Revolution, we'll explore what's at stake and the opportunities ahead. Now, I'm joined by two distinguished guests, Hemant and Pancho. Could the both of you please briefly introduce yourselves to our listeners?

**Hemant Ahlawat** (1:23)
Thanks, Debbi. Thanks for having us. Hemant Ahlawat, a senior partner with McKinsey in our Zurich office. I train as a medical doctor in India, so I'm Asian at heart and great to be here. I've been working in health care for the last 22 years within McKinsey and before that, as I trained as a doctor in India. Pancho.

**Pancho Georgiev** (1:39)
Thanks, Amant. This is Pancho. I'm a senior partner colleague of Hemant, based out of our Dubai office. I've been with the thermal software about 20 years before that, trained as a surgeon and molecular biologist, and I'm responsible for our health care work across the EMA region, and this is a very, very important topic. I'm very much looking forward to discussing it together.

**Debbi Cheong** (2:00)
It's lovely having the both of you here today. Now, let's just dive straight right in. What exactly are JLP1s and why are we hearing so much about them these days?

**Hemant Ahlawat** (2:11)
Yeah, happy to, Debbi. And maybe before we dive straight into what are JLP1s, let's just for a second step back and talk about what is the metabolic health challenge in Asia given this is about the future of Asia. And maybe there are two, three things which at least I want to point out. One, if you look at just the incidence of type 2 diabetes in Asia between 1990 and 2020, that's almost 2x in Asia now. So just the number of people who have type 2 diabetes. By the way, interestingly, if you age standardized mortality rates and the incidence of deaths happening due to metabolic diseases, that's pretty much the same. So we are not in the middle of some slow change. We are actually in the middle of a fairly significant metabolic health issue in Asia. And diabetes is one thing, obesity rates are actually dramatically increasing. And if you take some of the higher income areas in Asia, 50% of adults are at least overweight. And again, there are different statistics for this, but most sources agree around 20% plus people are actually obese. So this is a big health care issue. We talk about the future of Asia. Children who are obese and overweight is an even more alarming statistic. And that's been increasing dramatically. Again, according to some statistic, between 2010 and 2020, the childhood obesity rates in Asia have gone up by 100, 120%. This is actually quite a big issue. Now in view of that issue, there are various ways we can try to tackle metabolic health.
GLP-1s, to your question, is a pharmaceutical way to handle it. And so what GLP-1s are are essentially drugs which mimic an internal hormone in the body. So when we eat certain substances, most food actually, our intestines secrete GLP-1s, glucagon-like peptides. And they work by having three different effects. Broadly speaking, I'm not going to go into a full medical lesson here, but three main ways they impact things. So they give a signal. Hormones essentially are internal signaling chemical agents, right? So they give one signal which goes to the pancreas and increases insulin secretion, decreases glucagon secretion. These are hormones which manage glucose metabolism and therefore, they actually help you digest and maintain homeostasis and glucose much better. So that's one mechanism. Second, GLP-1s decrease the emptying of the stomach, so decrease the rate at which the stomach empties, the gastric emptying it's called, which gives you the feeling of satiety being a bit more full. And that leads to over time slightly decreased food intake and actually better glucose management curves because the stomach releases the food a bit slowly. And then third, they actually have an impact on the appetite centers in the brain and hypothalamus and decrease appetite. Now these three impacts there, by the way, like many new drugs, we will, I'm sure, over time find many more things on how they work because GLP-1 receptors are all over the body. So since, as I said, this is a normally produced hormone, we have developed molecules which mimic the same effect. The normal hormone lasts in the body only for a few minutes. We have come up with peptides which actually can last for a week. And therefore, when you take those, you actually have that effect for a prolonged period of time, your appetite is decreased, your glucose management is better, and hence you lose weight. It's a very simple description. You can end up losing anywhere between 15 to 20 percent depending on the product and depending on your starting point and all that stuff. But these are very potent, by the way, and some of the most revolutionary products which have come up.