Policymakers must take obesity seriously

More than two years after the American Medical Association declared obesity to be a disease, we still are not using all of the tools available to us to help reduce this costly – and deadly – condition. 

In fact, federal law overtly prohibits Medicare from paying for patients’ obesity medications – even though the U.S. Food and Drug Administration has approved medicines as safe and effective for the treatment of obesity. That is a mistake, and Congress must change that as soon as possible.

First, let’s look at the challenges we face. 

{mosads}In the past 30 years, the percentage of American adults who are obese has doubled, driving a sharp rise in chronic conditions such as diabetes, heart disease and hypertension. The increase in the obesity rate is so steep that there are now more American adults who are obese than those who are overweight, according to a report this year in JAMA Internal Medicine. 

Recent research has shown that the risk of mortality is far greater for older people who are significantly overweight than it is for younger adults. Obesity at an older age carries with it an array of downstream health problems, including diabetes, asthma and heart disease. Overall, chronic diseases are responsible for 70 percent of deaths each year in the United States, and treating chronic diseases accounts for 86 percent of our nation’s health care costs, according to the CDC.

Take diabetes, for example. The number of Americans diagnosed with diabetes more than tripled between 1980 and 2011 – from 5.6 million to 20.9 million, according to the CDC. And we know obesity is prime driver in the number of diabetes cases.

The ramifications for health spending are significant. Annual health costs for obese individuals are more than $2,700 higher than for non-obese people. That adds up to about $190 billion every year. And many of these costs are borne by Medicare, which will spend a half-trillion dollars over the next decade on preventable hospital readmissions alone.

Those chronic diseases are killing more and more of our family members and putting a massive strain on our health system. In fact, a recent study in the American Journal of Public Health shows that three times more deaths than previously thought are related to obesity – both among men and women, and at older ages.

That, quite simply, is unacceptable. We need personal solutions – and we need policy solutions to get obesity under control.

First, personally. This is one that we have been pushing for years. We must take personal responsibility by eating less, eating healthier and exercising more. We must have the discipline to eat smaller portions; decline seconds (or thirds); eat our fruits, vegetables and other healthy options; and take walks, ride a bike or other everyday activities that can help burn calories. 

That is the basic formula for losing weight. We all know that.

But, for a wide variety of reasons, moderation and exercise alone don’t work for everyone.

That’s where the policy solution comes in. 

In 2013, the American Medical Association rightly classified obesity as a disease. That sparked an important conversation about treatments and coverage of obesity under Medicare and other insurance plans. The Treat and Reduce Obesity Act, which currently has robust bipartisan support – 11 Senate cosponsors, and more than 100 cosponsors in the House – would provide Medicare beneficiaries struggling with obesity access to the therapies they need. 

Medicare Part D must begin covering medicines to treat obesity because chronic diseases are a primary driver of higher costs in the Medicare system – and, as we know, obesity is a primary cause of chronic disease. Common sense tells us that if Medicare begins covering these medicines, it would reduce the long term costs associated with obesity-related chronic diseases. 

The American public agrees. In a poll conducted last year, 64 percent said Medicare should cover obesity medicines – while just 21 percent were opposed. That is because people recognize the burden obesity causes. In fact, 76 percent of Americans believe obesity is a problem in their state.

The federal government already recognizes the need to cover these medicines. The Office of Personnel Management – the human resources department for government – issued a directive in 2014 that health plans for federal employees should pay for obesity medicines, under appropriate circumstances. 

Obesity is a disease that we would be wise to treat early and often, because the other conditions that often afflict obese patients carry painfully high costs, in terms of both dollars and lives. If we are serious about improving the health and wellness of the American people, while also reducing the costs of chronic care, we have to stop waiting for people to get sick before providing care. Whenever possible, we have to take decisive steps earlier in disease progression to stop patients from worsening.

A great first step in the right direction – one that already has bicameral, bipartisan support – would be to allow Medicare Part D to cover obesity medicines.

Thompson, a Republican, was secretary of Health and Human Services from 2001 to 2005 and governor of Wisconsin from 1987 to 2001.