Pragmatic Approaches to the Obesity Epidemic
When Morgan Spurlock’s attention-grabbing documentary, “Supersize Me,” came out seven years ago, it met with various reactions. Some found it fascinating, while others were just repulsed by the thought of eating that much McDonald’s. Across the pond in England, outspoken chef Jamie Oliver spearheaded the “school dinners campaign,” in which he tried to remove unhealthy options from school cafeterias—a campaign he has since brought to the US as well. Both men continue fighting to make a difference and change the populations’ weight trajectory, but their passion and health-conscious arguments seem to be having little immediate impact, as rising obesity rates indicate that this will be a long-term battle.
Although Americans have been successful at changing some health-related behaviors—heart attack rates have dropped 24% since 2000, thanks in large part to cutting down on smoking and lowering our cholesterol—as a nation we still haven’t found the balance between caloric consumption and expenditure. In fact, between 2007 and 2009, 2.4 million more Americans were diagnosed with obesity, bringing the total to 72.5 million (27% of the population), and since 2009, the rate has risen to a staggering 30%.
Therefore, the federal government has taken the pragmatic and realistic approach of incorporating obesity-specific coverage into the recent healthcare reform bill. One such change stipulates that insurance companies must provide coverage for preventive services, such as obesity screening and nutritional counseling. Additionally, insurance companies will be prohibited from instituting policy rescissions (except in the case of fraud); with “height and weight” as one of the most common reasons given for a rescission, a greater number of people will be able to afford healthcare. On the service side, the Department of Health and Human Services has produced resources specific to providing optimal care to patients who are obese. http://www.win.niddk.nih.gov/publications/PDFs/medcareobesebw.pdf
In the meantime, states are trying to find ways to counter likely cost increases, as well as encourage changes in behavior. Arizona, for example, is considering charging an additional $50 per year to Medicaid patients who do not heed doctor’s orders to lose weight for health reasons. In addition to the cost impact of higher utilization of prescription drugs overall and inpatient and outpatient care due to greater morbidity, there are also products and procedures focused on preventing or treating obesity itself, e.g., drugs to prevent the absorption of fat and gastric bypass surgery.
The additional coverage also means that the healthcare industry has an incentive to continue to adapt to the needs of the increasingly obese population. Creating (or expanding) a nutrition division could capitalize on this opportunity. Furthermore, producing more medical equipment geared towards a larger population makes sense; MRIs, for example, can feel like a squeeze for even the slimmest of patients. There is also a need for larger-scaled versions of less high-tech items, like blood pressure cuffs, phlebotomy needles, and tourniquets.
The activities of Morgan Spurlock and Jamie Oliver have not gone unnoticed, and hopefully, someday, they and others focused on prevention will make a lasting impact on health. For now, though, everyone involved with paying for and providing healthcare should take note of the needs of the increasing obese population and develop a long-term business strategy that includes appropriate products and services.
