March 2, 2017 Comments are off OCAN

Economics of Obesity: Implications for Productivity and Competitiveness

OCAN Blankets Capitol Hill – Meeting with over 150 Congressional Offices to support TROA and NOCW

On February 27, 2017, the obesity community joined together for the first Obesity Care Advocacy Network (OCAN) Advocacy Day of 2017 — with 120 attendees visiting more than 150 congressional offices. During their visits, OCAN members educated legislators and congressional staff about both the Treat and Reduce Obesity Act (TROA) and a congressional resolution that would designate the week of October 29 – November 4, 2017 as National Obesity Care Week (NOCW).

Sandwiched in between morning and afternoon Hill visits, attendees paused to join legislative staff for a special congressional lunch briefing sponsored by OCAN and Novo Nordisk, inc. regarding the “Economics of Obesity and its Implications for Productivity and Competitiveness.” The briefing, which featured economists, patient advocates and the former Mayor of Nashville, Tennessee, highlighted how obesity and excess weight is an expanding health problem for more than 60 percent of Americans, and how a new study by Hugh Waters and Ross DeVol finds that it’s a tremendous drain on the U.S. economy as well. The authors of the study discussed how the total cost to treat health conditions related to obesity—ranging from diabetes to Alzheimer’s—plus obesity’s drag on attendance and productivity at work exceeds $1.4 trillion annually.

The day ended with a reception hosted by the Academy of Nutrition and Dietetics Political Action Committee (AND PAC), which featured Senator Tom Carper (D-DE) – one of the Senate sponsors of the Treat and Reduce Obesity Act and the Senate National Obesity Care Week resolution. Over 50 OCAN members attended the AND PAC sponsored reception, including representatives from the American Society for Metabolic and Bariatric Surgery, The Obesity Society, the Obesity Medicine Association and the Obesity Action Coalition.

Weight Shaming Falls as Medical View of Obesity Grows

New research to be presented at ObesityWeek 2016 indicates that weight shaming may be easing a bit. At the same time, the public increasingly understands that obesity is a medical condition. Between 2013 and 2016, public perception of obesity as a “personal problem of bad choices” has dropped from 44% to 34%. On top of that, public agreement that people with obesity need medical help increased significantly over the last year.

trends-in-agreement-with-four-obesity-narrativesThe research included data from more than 100,000 interviews with Americans since 2013. Bias against people with obesity is a daunting problem that discourages people from seeking medical care and can make obesity harder to overcome. In recent years, concerns about “fat shaming” have captured public attention and even sparked controversy in the U.S. campaign for president. Rebecca Puhl, Deputy Director of the Rudd Center for Food Policy and Obesity and Professor at the University of Connecticut, was senior author of the study. She commented on the importance of the research, saying:

We see encouraging signs here that the public may begin to reject some of the bias directed at people with obesity. Weight bias remains a significant source of harm to people living with obesity. It makes prevention and treatment of obesity much harder.

The Obesity Action Coalition (OAC) sponsored the research. President and CEO Joe Nadglowski commented:

Putting an end to fat shaming and bias against people with obesity is one of our most important goals. Shame and blame only makes obesity worse. So these numbers tell us that we’re making progress, but we still have a long way to go.

This research was selected by the Obesity Society as one of the top-scoring studies at the ObesityWeek meeting and singled out for a special presentation on Thursday evening. Lead author Ted Kyle pointed to the growing agreement that people with obesity need medical help for their condition. He said:

For years the public and even healthcare professionals have looked at obesity as a personal failure and not one that should require help from medical professionals. We now see that the 2013 decision by the American Medical Association to classify obesity as a chronic disease was an important milestone. And this year, for the first time, more Americans agree than disagree that obesity is a disease that requires medical help.

This trend is gradual. It’s uneven. But it’s progress.

Click here for a pdf of the poster. If you’re attending ObesityWeek in New Orleans, be sure to come for the Poster Education Theater on Thursday at 7 pm, where co-investigator Diana Thomas will present the study.

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Health Plans Often Stand in the Way of Obesity Care

New research from two separate studies presented at ObesityWeek in New Orleans demonstrates that health plans often stand in the way of obesity care. In one study, researchers from Harvard, ConscienHealth, and the Obesity Action Coalition found that most Americans report they don’t have health insurance that will pay for obesity care recommended in evidence-based guidelines. These include dietary counseling, medical obesity treatment, and bariatric surgery.

Even for people with employers that are targeting obesity in their wellness programs, more often than not, people do not believe that their health insurance will even cover dietary counseling by a registered dietitian. Reported coverage for medical obesity treatment (43%), obesity medicines (37%), and bariatric surgery is even lower. Ted Kyle presented the results on Thursday.

Ruchi Doshi presented research from the Bloomberg School of Public Health at Johns Hopkins. She reported that most health professionals (57%) believe that better insurance coverage for weight management services is important for providing better obesity care in clinical practice. Scott Kahan, director of the National Center for Weight and Wellness in Washington, DC, and a spokesman for the Obesity Society commented:

While self-management strategies, such as following a commercial diet or increasing exercise, can help in some individuals, most people with obesity, especially those with severe obesity, can benefit from a comprehensive approach that includes healthcare professional support.

Joe Nadglowski, President and CEO of the Obesity Action Coalition, added:

Our members report heartbreaking struggles to obtain insurance coverage for services like bariatric surgeries and obesity medicines that are necessary to reduce and prevent the obesity from ravaging their health. Sometimes they are outright denied coverage. Sometimes they are presented with absurd hurdles that have the same effect.

Harvard Obesity Medicine Physician Fatima Cody Stanford participated in the coverage gap research and commented on its implications:

Without coverage, many people must go without good medical care for obesity. The irony is that untreated obesity leads to a host of chronic diseases – like diabetes and heart disease – that wind up costing health plans even more. The current situation makes little sense, financially or medically.

Click here for the abstract of the study presented by Kyle and here for the study by Doshi et al. Click here for Kyle’s slides.

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Discipline and the Obesity That No One Wants to See

OrderDiscipline – or the lack of it – is something that is sometimes offered up as an explanation for obesity. Public health professionals, employers, and physicians gathered at a medical forum in Baltimore last week to discuss obesity and how health plans can address this growing health concern. One physician who is medical director for a large health insurer asked at the end of a presentation on the physiology of obesity:

This is all very interesting, but isn’t obesity simply a matter of self-discipline? I mean the food might be available, but does that mean that you have to eat it all? Why do we pretend obesity is a medical issue?

As a matter of fact, complex physiology regulates how our bodies energy absorb, use, and store energy as fat. In obesity, that physiology causes the body to store fat in an unhealthy way. Obesity is no more a failure of discipline than high blood pressure is. It is a failure of physiology. It requires care, not blame…

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