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Today, 42 percent of U.S. adults have obesity. This figure has been climbing every year.
On its own, obesity can cause acute ailments, including breathlessness and back pain. Worse, it often leads to other chronic conditions, like diabetes, heart disease, and cancer. Obesity is now the second-leading cause of preventable death in the United States, right after smoking.
In addition to the burden of poor health, obesity imposes financial burdens on the individuals affected and their insurance programs. If we can reduce obesity, we can reduce chronic disease. We've never had better tools to do so than we do today. It's time for our health care system to expand access to them.
Some mistakenly believe that the source of obesity is a lack of individual willpower. Shaming people over their weight accomplishes little and fails to take into account the major societal forces in play: Working life has become ever more sedentary and technology ever more adept at gluing us to our screens. Our food is often highly processed and includes added sugars and empty calories. Stress and environmental factors—like a lack of nearby access to public places to exercise—also contribute. We have an opportunity to tackle this problem at the public policy level, and efforts must start with prevention.
Recent estimates suggest that obesity is associated with $385 billion in annual health spending. Since Medicare and Medicaid pay about a quarter of that total, reducing obesity would reduce costs for the government and taxpayers. Employers also stand to save from lower health care costs.
For adults with employer-sponsored insurance and a body-mass index (BMI) of 30—the clinical definition of obesity—a 5 percent reduction in weight would cut the amount they spend on health care each year by nearly 10 percent. The savings are more dramatic for those with higher BMIs. For someone with a BMI of 45, a 25 percent BMI reduction would lower health care costs by more than 44 percent.
Recent studies have estimated similar reductions in spending for Medicare patients. Most Medicare beneficiaries are 65 or older, and many have multiple chronic conditions. A 65-year-old with a BMI of 30 who achieves a 5 percent reduction in BMI would reduce personal health care spending by more than 6 percent per year. If that same 65-year-old dropped their weight by a quarter, annual health care costs could go down by more than 28 percent.
It's been more than a decade since the American Medical Association declared obesity to be a disease. Public recognition of just how significantly that disease affects patients' quality of life and financial well-being is long overdue.
The good news is that proven interventions can help people achieve significant, sustainable weight loss. The Diabetes Prevention Program, for instance, has aided countless individuals in attaining a healthy weight through dietary and lifestyle changes. Bariatric surgery, which reduces the size of the stomach in order to lower appetite, is effective for many patients. And now, new medications known as GLP-1 agonists have demonstrated impressive results, with some patients losing more than 20 percent of body weight.
Currently, patients face many barriers to accessing these treatments. But a recent CMS proposal to cover anti-obesity medications under Medicare Part D and Medicaid for obesity treatment and in the Diabetes Prevention Program represents a shift toward better access to preventive interventions and treatment. This change in coverage could greatly enhance access to these innovative treatments, potentially lowering obesity-related health care costs and improving public health.
Our society's outdated view of obesity as a personal fault rather than a complex medical condition has led to inadequate prevention, treatment, and support for people affected. By prioritizing prevention and investing in evidence-based weight loss treatment, we could dramatically improve the health and quality of life for millions of Americans with chronic diseases like obesity. Nationwide, we could see improvements in life expectancy and lower health care costs.
With health care costs spiraling and chronic diseases on the rise, we can't afford inaction.
Kenneth E. Thorpe is the Robert W. Woodruff Professor of Health Policy at Emory University and the chairman of the Partnership to Fight Chronic Disease.
The views expressed in this article are the writer's own.
