Top Obesity Developments of 2012
10. Shifting Focus to Obesity and Health.
The George Washington University brought experts and stakeholders together for a consensus building process that culminated in August with the issuance of a report calling for FDA to shift their focus in reviewing new treatments for obesity away from weight loss outcomes and toward outcomes more relevant to the medical management of obesity. This very shift in perspective can be seen in approvals for two new obesity treatments, as well as other trends that point to improved access to obesity in the future. Once again, much work remains to be done.
9. Reimbursement for Treatment.
Good news for reimbursement of obesity treatment came in a variety of forms in 2012. Yes, there’s much work left to be done before people have the same access to obesity treatment as they do to the treatment for any other chronic disease, but the progress was real. The Centers for Medicare and Medicaid Services (CMS) began in March to cover intensive behavioral therapy of obesity, which they announced late in 2011. The U.S. Preventive Services Task Force (USPSTF) issued broad recommendations for screening and treatment of obesity in adults. These have important implications for reimbursement, because under the Affordable Care Act (ACA or Obamacare) health plans must cover all “A” and “B” rated services recommended by the USPSTF. Finally, private payers offered some encouraging news with Aetna declaring that obesity treatment is medically necessary in a national coverage bulletin and the largest pharmacy benefit manager, Express Scripts, announcing that they will cover the new obesity treatment, Qsymia.
8. New Treatment Approvals.
For the first time in 13 years, FDA approved two new treatments for obesity, Qsymia and Belviq. This follow an abysmal 2010, when FDA issued four negative decisions for obesity treatment, rejecting three applications for new treatments and removing another treatment, sibutramine, from the market. Observers attribute the change to a shift in focus away from weight loss and toward the imperative for medical management of obesity.
7. Commitment to Innovation.
We saw signs in 2012 that multiple stakeholders are beginning to press forward for innovation in the fight against obesity. Francis Collins, the Director of NIH, went on record in JAMA with an editorial calling for the bold research agenda we will need to reverse the obesity epidemic. Leadership of The Obesity Society opened a dialogue with NIH leadership to advance this agenda. The pharmaceutical industry, encouraged by recent obesity treatment approvals, began to invest again in obesity research.
6. EEOC Takes on Obesity Discrimination.
Congress passed an amendment to the Americans with Disabilities Act protecting people who are more than 100% overweight from workplace discrimination and the EEOC is effectively enforcing it. This is good news for our ability to combat weight bias that too often poisons efforts to fight the disease, rather than helping the people affected by it.
5. Appreciation for Obesity Risk at Birth.
At least among policy makers, an appreciation is growing that obesity is driven by biological forces that often are determined at birth. A study from researchers at Harvard University and Imperial College, London, attracted a great deal of attention and lent further credibility to this notion by showing that an infant’s risk of obesity could be accurately predicted at birth, based on just five factors.
4. Hints of Better Trends for Childhood Obesity.
A number of reports provide a hint that childhood obesity statistics may start heading in a better direction. Some local health departments are reporting statistics that they believe reflect successful community initiatives to turn around the trend in childhood obesity. And CDC researchers recently published a finding in JAMA that obesity rates in pre-schoolers from low-income families have dropped ever so slightly. We’re far from declaring mission accomplished, but the news has everyone paying attention to figure out what it means.
3. Good, Bad, and Ugly Childhood Obesity Activity.
Disney stopped accepting advertising for junk food in its media that targets kids and families, saying “this is not altruistic, this is about smart business.” In the not so good category, Disney had to scrap plans for a “Habit Heroes” exhibit after critics pointed out that it did more to perpetuate weight bias than promote health. In the ugly category, the crown goes to Children’s Healthcare of Atlanta which persists in running an appalling childhood obesity ad campaign aimed at shaming parents into fixing the problem. The campaign seems to be grounded in an old PR concept that as long as they’re talking about you, it doesn’t matter what they say. Unfortunately, the marketers behind this are ignoring research and childhood obesity experts that say this campaign does more to promote weight bias than health.
2. Food Industry Initiatives.
2012 brought a succession of stories about food industry initiatives to improve the quality of the food supply, offer healthier choices, and nudge consumers toward better nutrition. These stories ranged from an FTC report that the industry had cut back on marketing unhealthy foods to kids, to news that companies are cutting salt in their products, and that McDonald’s and others are making stealth changes in the products to combat obesity. Industry critics scoffed, while others insisted we’ll get nowhere without engaging the industry.
1. NYC Big Gulp Ban to Prevent Obesity.
Mayor Michael Bloomberg ignited a national debate when he proposed and won approval in September to ban the sale of large sugary drinks in New York City. He also provided some great material for fake news comedians. Some cheered it as bold action to blunt the obesity epidemic. Others decried the end of freedom. The beverage industry promptly sued to block the ban. Click here to an economist’s analysis of the ban in The New Yorker.
Soda Bubbles Image by Spiff / Wikimedia Commons