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Rx for obesity

February 15, 2016
by Pamela Tabar, Editor-in-Chief
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Obesity is gaining legitimacy as a health epidemic, and seniors are one of the most at-risk groups. Reduced mobility, lack of exercise and multiple chronic conditions spur tendencies toward weight gain. Obesity, in turn, aggravates other medical conditions—creating an endless circle of weight management challenges.

The U.S. health system has long focused its wellness and disease management programs on “the big six” disease-related causes of death—heart disease, cancer, respiratory disease, stroke, Alzheimer’s disease and diabetes. If we’re not more proactive, many clinicians warn, obesity may soar to the top of the list.

So why doesn’t Medicare cover prescriptions medications to treat obesity, which is a well-documented cause of several other chronic diseases, including heart disease and diabetes? Because currently, it’s against the law. Since the Medicare Modernization Act of 2003, Medicare has been forbidden to pay for obesity-related medications.

A new survey published by the Gerontological Society of America (GSA) shows a growing pressure to change that law. Among the more than 1,000 adults surveyed, 71 percent say they think the federal government should reconsider Medicare’s potential role in reducing obesity. Sixty-nine percent feel Medicare should cover prescription medications that treat obesity.

Legislation introduced last year, the Treat and Reduce Obesity Act (H.R. 2404), would reverse the rules and require Medicare to pay for such medications under Medicare Part D. Obesity rates among seniors doubled between 1987 and 2002, and so did the Medicare spending to treat them, the Congressional bill states.

Obesity treatment may be a “pay now or pay more later” situation, especially for seniors, who often have additional comorbidities that are aggravated by obesity. “Public policy and society seldom associate obesity with advanced age,” said James Appleby, BSPharm, MPH, executive director and CEO of the GSA, in a statement about the survey. “But recent research has shown that, for those who are over 65 and significantly overweight, the risk of mortality is far greater that it is for younger individuals with excessive body weight. The preponderance of evidence is clear: Obesity at an older age carries with it a plethora of health problems like diabetes and heart disease and the likelihood of premature death.”

For decades, obesity has struggled with social and medical stigmas, considered the result of “bad habits” rather than a medical condition. Technically, obesity wasn’t even classified as an official condition until 2013, when the American Medical Association (AMA) voted to declare it a disease.

“Recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately one in three Americans,” said AMA board member Patrice Harris, MD, in an AMA statement about the declaration. “The AMA is committed to improving health outcomes and is working to reduce the incidence of cardiovascular disease and type 2 diabetes, which are often linked to obesity.”