Getting to the Root of Obesity

From fat shaming to self-love, America’s debate over weight often overlooks a critical point. Obesity is a dangerous and chronic health condition that drives both cardiovascular disease and Type 2 diabetes.

So explains, “Root Cause,” a joint policy paper released by the Diabetes Policy Collaborative, the Alliance for Patient Access and the Partnership to Advance Cardiovascular Health.

A Dangerous Web: Obesity, Diabetes & Heart Disease

The scope of the challenge is daunting. Classified as a disease by the American Medical Association in 2013, obesity now affects 42% of American adults and costs the health care system as much as $210 billion a year. 

Prevalence of Type 2 diabetes and cardiovascular disease is also reaching epidemic proportions. That’s not a coincidence.

Obesity overworks the heart, clogs the arteries and increases bad LDL cholesterol, raising the danger of a heart attack, heart failure or stroke. Obesity also fuels and complicates diabetes, which affects more than 34 million Americans and accounts for $327 billion in health care spending each year.

“Winning the fight against these two chronic diseases,” the paper argues, “is inseparable from addressing America’s long-standing struggle with obesity.”

The Better Way to Treat Obesity

That victory requires a shift in how policymakers and the health care system approach obesity. The paper explains that patients could benefit specifically from:

  • Comprehensive care delivered through a team-based approach. Providers must work together across specialties, the paper reasons, to treat the whole patient rather than the individual symptoms. 
  • A multi-pronged treatment plan that couples diet and exercise with FDA-approved treatments and medical procedures, depending on individual patients’ needs.

Treatment options, the paper notes, are “more advanced and numerous than ever before.” The Food and Drug Administration has approved five new obesity medications since 2012. And, just this year, it approved the drug semaglutide, which treats Type 2 diabetes, to also treat obesity. 

What Policymakers Can Do

Government policymakers and insurers, however, have not yet embraced the value of patient-centered obesity treatment. 

In addition to public awareness and a team-based care model, the paper calls for policy that allows access to the full range of treatment options, including FDA-approved obesity medications. These drugs are excluded from Medicare Part D and are rarely covered by Medicaid. They can be excluded from commercial insurance coverage, too. 

Meaningful reform requires several layers of policy changes, the paper notes:

  • At the state level, policymakers can improve Medicaid and private insurance coverage. With better coverage and fewer barriers, physicians can develop and implement personalized treatment plans for their patients.
  • At the federal level, policymakers can advance the Treat and Reduce Obesity Act. The bill would expand Medicare benefits to incorporate additional health care providers, including dietitians, psychologists and specialty physicians. It would also expand coverage of FDA-approved medications.

Keeping policy up to pace with innovation can be a challenge, “Root Cause” acknowledges. But with leadership from state and national policymakers, the paper concludes, “it can be done.”

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