Health Plans Neglecting Children with Obesity
A pair of new publications today in Obesity addresses medical care for children with obesity, leaving us both encouraged and profoundly discouraged. Encouragement comes from the fact that smart people from many different disciplines are finally coming together to solve a serious problem that destroys the lives of millions of children, starting at an early age. The first of these two publications reports on access to systems of care for childhood obesity. The report distills findings from a wide range of experts in pediatrics, obesity, healthcare quality, and health insurance.
Discouragement comes from a clear understanding of just how bad the problem is. In the U.S., more than 4.5 million children and adolescents are living with severe obesity. Yet they are most often denied access to evidence-based care for this devastating condition. In the second of these two publications, Robert Berkowitz and Stephen Daniels explain:
Although evidence-based family lifestyle programs are well established in the scientific literature, there are relatively few of them available to children and their families, relatively few children with overweight or obesity receive them, and there is a need to enhance funding to support evidence-based intervention programs, as most are not financially sustainable.
Treatment programs have not been developed in part because of lack of funding.
Six years ago, the U.S. Preventive Services Task Force concluded with high certainty that evidence-based childhood obesity care will prevent chronic diseases.
But today, the default for a child with severe obesity is to be a target of bullying because of a condition that will, most often, not improve without evidence-based care. No care is available because few clinics are funded because health plans balk at paying for treatment intensive enough to have an effect.
The result? Untreated severe obesity progresses to type 2 diabetes, cardiovascular disease, obesity-related cancers, and a host of other diseases that those same health plans pay dearly to treat. These are the chronic diseases that are crushing the system with spiraling costs.
By the time those chronic conditions fully develop, these children are adults. The healthcare system that neglected them as children makes money from them as adults. Untreated obesity harms virtually every organ system in the human body. The rich resulting assortment of diseases generates lots of revenue for hospitals and healthcare providers.
We will never stop this madness without providing evidence-based care to children with obesity.
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December 7, 2016