Severe Obesity: Hiding in Plain Sight

Severe obesity is hiding in plain sight as the Institute of Medicine (IOM) starts a three-year roundtable process on obesity solutions. Bill Dietz opened a workshop on the current state of obesity solutions in the U.S. He offered an optimistic assessment of overall obesity rates stabilizing in many segments of the population. But he offered a warning we need to heed.

Severe obesity is continuing to grow in children and adults and our current policies for obesity prevention will do nothing to reverse it.

Severe obesity affects only 8% of the population but accounts for 40% of the costs attributable to obesity, he said. And yet, health policy and mainstream healthcare in America is almost exclusively focused upon preventing mild obesity. People affected by obesity are left mainly to rely upon consumer oriented programs that are most effective for mild obesity and excess weight.

For folks who need more help than Weight Watchers can offer, but are not ready for obesity surgery, most people will have a tough time finding solutions from healthcare providers. Primary care physicians often can’t find the right words to offer help without implicitly or explicitly condemning their patient for his or her condition. Many are simply not equipped for the conversation, let alone for providing intensive treatment.

Obesity medicine physicians, few but growing in number, find payers fighting them over reimbursement for care. So the best care is often available only to cash-paying clients.

And when bariatric surgery is the best option remaining, patients must fight a bewildering array of obstacles to find good care and obtain coverage. Many become so frustrated with their health plans that they tap into home equity or retirement savings to pay for their treatment. Even under the Affordable Care Act, obesity treatment, especially surgery, is largely considered a non-essential health benefit.

Adolescents with severe obesity face an even tougher problem — with still fewer providers for the expert care they need.

So the real problem of severe obesity continues to hide in plain sight.

Click here to read more from ConscienHealth and click here and here to read more about the IOM Roundtable on Obesity Solutions.

Hide and Seek, photograph © Eric Leslie / flickr

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