Obesity, a Fledgling Disease, Needs Physician Support

Joe Cantlupe, for HealthLeaders Media , August 1, 2013

After the AMA declared obesity as a disease, legislation was introduced in the U.S Senate and House of Representatives that would require Medicare to cover more obesity treatment costs. The proposed Treat and Reduce Obesity Act, focuses on payments for prescription drugs for weight management and allows providers to be financed to offer intensive behavioral counseling for obese patients.

Whether CMS will declare obesity a disease remains to be seen. The AMA "cannot predict what, if anything, CMS will do in response to the adoption of this AMA policy," Harris says. "While the AMA is not the authority that dictates insurance coverage of procedures and treatments, this policy could potentially encourage the government and other third-party payers to increase their coverage of obesity-related services."

Paul Teitelbaum, a healthcare expert and managing director with Mesirow Financial's investment banking group in Chicago, told me the AMA's action is significant because there will be "an increase in investment and strategic" decisions directed toward medical device innovation for obesity treatment.

All this is certainly well and good. But discussions between patients and physicians may be the most helpful tool for treating obesity. And so far, many physicians haven't done an effective job in treating obese patients.

For one thing, many doctors don't tell patients they have a weight problem that needs to be addressed. An Archives of Internal Medicine study found that only one-third of 5,500 patients who were obese and 55% of overweight participants were told by a doctor about their weight issues.  Moreover, only 30 to 40% of family practitioners compute their patients' body mass index on a regular basis, according to the American Academy of Family Physicians.

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4 comments on "Obesity, a Fledgling Disease, Needs Physician Support"

Ben D (8/2/2013 at 12:11 PM)
Doctors, please refer your patients to Overeaters Anonymous. It is a disease which has emotional, mental, and physical consequences. You can't eat yourself happy. To find meetings, search for your state and Overeaters Anonymous. They have the support and training needed to sustain weight loss.

ljh (8/2/2013 at 10:40 AM)
You say "discussions between physician and patient may be the most helpful tool in treating obesity", but I respectfully disagree. If it were that easy, if speaking to your physician about the quantity of adipose tissue in your body actually helped, we wouldn't have the obesity epidemic we do. Even daily discussions with a physician will not prevent the purchase of a chocolate candy bar or an order of fried potatoes, or choosing the parking place closest to the mall doors. The recidivism rate of obesity is mind-boggling -less than 10% manage to keep 5% (!) of their body weight off 5 years after a weight loss program. Obesity is a reflection of evolutionary drive to consume calorie dense foods when available, coupled with the explosion of technology which gave us those foods in a palatable form with an absolute minimum of effort. While I enjoy chatting with my physician, I doubt he has the ability to thwart a million years of mammalian evolution, even if he's compensated by the Feds. As far as I know, bariatric surgery is the only treatment for obesity that has a success rate over single digits 10 years out, correct?

Christie Osuagwu, MPA, MSN, FNP, PhD (8/1/2013 at 11:20 PM)
I applaud the AMA for making this declaration that is long overdue. Physicians and providers at every level should not hesitate to tell any patient that they are obese. Patients should understand what that means for their health, quality of life and eventually their lifespan. Obesity is a disease with too many unfriendly friends, as it predisposes individuals to major preventable health issues including cardiovascular disease, diabetes,and hypertension,just to name a few. Obesity is a plague and must be recognized and treated as such. We need to stop sugar coating it; we need to educate our patients properly, we need to call obesity its name and not be 'nice' to patients by avoiding the truth of their obese status. We are actually cheating them if we don't. Our nation is drowning in fat and it is preventable!!!!




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