Top Ten in Healthcare Spending: Little for Obesity Care

You can look at healthcare spending in two different ways. One way is to ask, “What are we buying?” The alternative is to ask, “What are we paying for?”  A new study published this week in JAMA shows that we’re buying very little obesity care, but paying a lot for untreated obesity.

Of the top ten conditions for healthcare spending, all but one are linked to untreated obesity. Diabetes tops the list. Spending for diabetes and back pain – both closely linked to obesity – is growing faster than anything else in the top ten. In the top 20, only high cholesterol (also linked to obesity) is growing faster.

Even pregnancy, which obesity certainly does not cause, becomes more expensive for people who have obesity.

Joseph Dieleman and colleagues, who authored the study, point out the discrepancy in spending on obesity care:

Although a great deal of health burden is attributable to obesity and tobacco, the treatment of these 2 risk factors was not among the top 20 conditions of spending. 

Why are we spending so little on obesity care when the complications of obesity cost so much?

One factor is bias in the way these authors and most everyone thinks about obesity. They classify obesity care as “treatment of risk factors,” just like high blood pressure and high cholesterol. We’re still in a weird world where many otherwise smart people keep thinking obesity itself is not a disease. The American Medical Association got over that three years ago.

Anyone who actually has severe obesity or cares for those who do can tell you. It’s not silent risk factor. The suffering it causes is profound and often lifelong. Some people hide or ignore the suffering because it’s so highly stigmatized. Others are callous about it. They make false, harsh judgements about the character of people with obesity. They tell themselves obesity is voluntary and easily reversible. They’re terribly wrong.

Either way, the result is unmistakable. Obesity is becoming ever more common. People who need evidence-based obesity care often can’t get it. Most people report that their health insurance won’t pay for obesity care.

So, the disease progresses. Complications of untreated obesity destroy a person’s health. Then, and often only then, they receive medical care for diseases that could have been prevented by treating the primary disease, obesity.

Thus, we are buying very little obesity care but spending a fortune on untreated obesity.

Click here for the study and here for more perspective from HealthDay.

Pay Little, photograph © Todd Lappin / flickr

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December 29, 2016