More than four million people die due to obesity every year, a new study warns. Despite the global emphasis on proper diet and exercise, researchers say science could be doing more. Scientists from the United States and Greece believe new gut treatments and gene therapy are not being used enough to reduce this shocking toll.

The study finds doctors are not giving out enough weight loss medications as part of their wellness plans. Additionally, the stigma surrounding obesity leads to patients not coming forward until they are dangerously overweight. According to estimates, half of American adults and 20 percent of children are obese. Researchers also note that health insurance in the U.S. is often too expensive for patients to afford weight loss drugs.

New medicines in development, which combine different gastrointestinal hormones, may provide even more help for people losing weight in the future — when combined with regular exercise. Doctors caution, however, that they also need new vaccines and drug delivery systems to beat the obesity epidemic.

Current weight loss options also show great promise

The existing drug semaglutide can cut people’s weight by 15 percent when combined with regular exercise and has few side-effects. Bariatric surgery can also help people shed 40 percent of their body mass, but it’s an invasive procedure that can result in complications.

“Obesity is the epidemic crisis of our time. The disease leads to serious comorbidities such as diabetes, fatty liver disease and cardiovascular disease and significantly shortens a person’s length and quality of life,” says Dr. Christos Mantzoros from Beth Israel Deaconess Medical Center, in a media release.

“Until recently we did not understand the genetic and hormonal causes of obesity and how obesity leads to these comorbidities. We have recently started to understand the causes of obesity in humans, which is a big discovery that has led to designing effective therapies.”