Spider Web

Health Systems Rigged to Interrupt Obesity Treatment

It’s not easy. Getting access to good obesity care and maintaining it is a challenge that is especially frustrating as we see that the options for care are improving. But it seems that health systems right now are rigged to interrupt obesity treatment.

An illustration of this comes from a recent study published in Obesity. Rodolfo Galindo and colleagues analyzed data on drug utilization from 2010 to 2019 and found that people with obesity were more likely to receive prescription drugs that cause them to gain weight than to help them lose weight – almost five times more likely.

On top of that, with medications that might help a person lose weight, discontinuation of therapy was nearly twice as likely.

Trends Toward Improvement

These data come from Medical Expenditure Panel Surveys and the news is not entirely negative. A commentary by Jaime Almandoz and Ildiko Lingvay accompanies this research. They note of encouraging, but slow progress toward incorporating obesity care into diabetes care. He writes:

“This research shows a sluggish shift from weight gain-promoting to weight loss-promoting diabetes medications between 2010 and 2019. Furthermore, weight-reducing medication discontinuation rates were nearly double those for weight-gain medications and use was lower among lower socioeconomic and race/ethnicity minority groups. Factors contributing to discontinuation or low adoption of weight-reducing medications can include cost, insurance coverage, and health care provider documentation burden.

“We must overcome the existing inertia to treat obesity.”

Using Poor Access as a Reason to Deny Access

The inertia that Almandoz and Lingvay describe can be maddening. Especially frustrating is insurers that use data suggesting it’s not uncommon for people to stop taking anti-obesity medicines as an excuse to deny coverage. Health policy researcher Khrysta Baig describes this line of thinking:

“There can be a lot of spending on people that are not likely to reap any long-term health benefits.”

In other words, health systems will create systemic hurdles for ongoing obesity treatment and people may thus stop taking these medicines. So, insurers say, why bother?

Humans can rationalize just about anything.

Click here for the study by Galindo et al and here for the commentary by Almandoz and Lingvay.

Spider Web, photograph by Luc Viatour, licensed under CC BY-SA 3.0

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.


November 17, 2023