Obesity Rates on the Rise: Rethink Strategy in the “War on Obesity”?
March 3, 2015Gallup released the 2014 United States obesity rates and for the third year in a row obesity rates have risen. In 2014, 27.7% of U.S. adults were classified as obese, an increase of two percentage points since 2008. It is the highest obesity rate reported in the seven years of tracking by Gallup-Healthways.
Obesity is defined as a body mass index at or above 30. In 2013, the American Medical Association classified obesity as a disease. In their decision, the AMA noted the complexities of conditions that contribute to obesity. Obesity is a complex, multi-dimensional problem that is influenced by genetic, environmental, socio-economic, and behavioral factors.
Classifying obesity as a disease, the AMA hoped to “Reduce the stigma of obesity that stems from the widespread perception that it is simply a result of eating too much or exercising too little.”
In 1997, the World Health Organization (WHO) declared obesity a worldwide epidemic. In the United States, obesity related illnesses account for 21% of overall healthcare expenditures. There is little argument that obesity is a major public health issue that needs to be curtailed. However, despite the "war on obesity", rates continue to rise each year. Perhaps it's time to explore the barriers that still exist, and consider a different strategy.
A few current strategies:
- Affordable Care Act Mandates - The ACA mandates coverage of obesity screening and counseling. Physicians are required to document a patient's body mass index in their medical record or face penalties when it comes to ratings and reimbursements. The reality is counseling can equate to simply advising the patient to loss weight. I recently reviewed my online medical records from an appointment where the notes indicated the physician suggested an 8-point lifestyle eating plan to me and told me to keep a food journal for two weeks. While she did mention my weight, she did not make the recommendations as documented in the medical records.
- Tax/Ban Soda - Many favor adding a tax to soda, similar to a cigarette tax, as a means to deter the consumption of sugary beverages. Several cities and states have tried and failed to implement such a tax. Most notably was New York Mayor, Michael Bloomberg's attempt to ban all sodas over 16 ounces. However, there was no limit on the number of 16 ounce sodas one could purchase, so in reality I could just drink two 16 oz sodas, instead of a 20 oz, which goes against the overall intention of the ban.
- Posted Calories - Nutritional information has been available for years, but usually it was provided in a brochure or online. Now laws exist that require calorie counts to be posted or printed on menus. I admit the first time I noticed the calories on the menu board it did impact the choices I made. However, calories are only one aspect of overall nutrition and the focus on calories, similar to focus on sodas is based on the myth that weight loss is as simple as "calories in vs. calories out".
New strategies need to address:
- Lack of Treatment Options - Bariatric surgery has been an option for those patients with high BMIs, and the FDA just approved a new implantable device for the treatment of obesity. However, there is a lack of non-surgical treatment options and options for those with BMIs over 30 but less than the requirements for surgery. Recently, the FDA approved several new pharmaceutical options so there are possibilities on the horizon but a lot more research and options are needed.
- Lack of Access to Care - While the Affordable Care Act mandates a doctor to weigh you, and counsel you to lose weight, the law fails to mandate coverage of the treatment of obesity. Insurance companies are still permitted to exclude the treatment of obesity, which means that the newly FDA approved medications are often not covered by prescription plans thus keeping them out of the financial reach of patients.
- Weight Bias - Patients affected by obesity are more likely to encounter weight bias in healthcare. Research indicates that patients affected by obesity are less likely to obtain preventive services and routine cancer screenings, and are more likely to cancel appointments and delay treatment. Avoiding preventative services and delaying treatment only further worsens an already poor state of health.
Take Action and use your voice to push for change!
Urge Congress to support the Treat and Reduce Obesity Act
The Treat and Reduce Obesity Act will provide Medicare recipients and their healthcare providers with meaningful tools to treat and reduce obesity by improving access to obesity screening and counseling services, and new prescription drugs for chronic weight management. (Keep in mind that private insurance often follows the lead of Medicare so such coverage is important for all Americans.)
Visit the Obesity Action Coalition legislative center for an easy way to send a message to your representatives. Take Action Now!
Photo credit: FutUndBeidl cc
 | ABOUT THE AUTHOR Sarah (aka Sarahlicious) has been an active member of ObesityHelp since 2003. Her specific areas of interests are Lipedema, Lymphedema, Obesity, and Health Insurance advocacy. Sarah writes about her life experiences at Born2lbFat. She is a member of the Board of Directors of both the Obesity Action Coalition and the Lymphedema Advocacy Group. Sarah has a Masters in Health Law.Read more articles by Sarah Bramblette! |
References: Puhl, R., 2013. Clinical Implications of Obesity Stigma.
Levy, J., 2014. U.S. Obesity Rate Inches Up to 27.7% in 2014, Gallup Well-Being.
