diabetesdrug-300x127As medical scientists increase the understanding of diabetes and the role that hormones can play in treating the disease and clinical obesity, doctors, drug makers, insurers, and others in U.S. health care are running smack into familiar, significant problems.

These include issues with public perceptions about weight, diet, and appropriate prescribing of powerful medications, as well as challenges about who pays for what in the nation’s complex health care system.

The latest, evolving tangles concern semaglutide and liraglutide, two drugs in a group that experts at the drug maker Novo Nordisk pioneered to treat diabetes. Investigators developed the drugs as doctors, patients, and researchers suddenly learned more about extreme weight loss through increasingly popular gastric surgeries, finding that the procedures also altered patients’ hormones like ghrelin, popularly dubbed the “hunger hormone.”