The Map of the World

Obesity Care: A Roadmap for Employers

One of the big trends for this year will be increasing access to obesity care. That means more and more employers will be adding obesity care to the their health benefit plans. Yes, there will be much squawking about the list price for advanced obesity medicines. That’s perfectly normal and good. But the fact is that a health plan that doesn’t provide for real, effective obesity care is not an honest health plan at a time when obesity is the most prevalent chronic disease in America. When the complications of untreated obesity are overwhelming health systems everywhere.

So we are very much in debt to the American College of Occupational and Environmental Medicine (ACOEM) and the STOP Obesity Alliance for publishing a new guide to the core components of obesity care for employers.

A Thoughtful Process

It’s no surprise that ACOEM and STOP went through a thoughtful process to develop this roadmap. They convened corporate medical directors from aerospace, defense, and energy industries to reflect on the clinical science of obesity in the context of their workforces and business operations. These directors reviewed all of the elements of effective obesity care and compared them with present benefit plan designs.

They found significant gaps in information and engagement. But from this process came a description of the core elements for a comprehensive obesity care benefit design. It should provide for prevention and screening, intensive behavioral therapy, pharmacotherapy, surgery, and ongoing weight maintenance to provide for good long-term outcomes.

Steering Away from Excessive Focus on GLP-1s

Christine Gallagher, project director for STOP, cautioned that the current interest in GLP-1 therapies should not overshadow the need for a more complete approach:

“Many employers are interested in finding ways to increase access to and utilization of comprehensive obesity care for their employees. This is particularly important in light of the remarkable success and growing interest in anti-obesity medications, such as Wegovy and Zepbound, which largely remain unaffordable for most workers unless they’re covered by insurance.

“It’s important for employers to make sure they are providing comprehensive obesity care benefits and to remember that these medications remain merely one tool of many in treating and managing the chronic and relapsing disease of obesity.”

This is a complex chronic disease. Sound health benefit designs will facilitate the application of a balanced chronic care model. So this roadmap is an important starting point for developing better designs. Because “if you don’t know where you’re going, you might wind up someplace else.”

Click here for the publication in JOEM and here for the STOP Obesity Alliance guide to developing a comprehensive benefit for outcomes-based obesity treatment in adults.

The Map of the World, illustration c.975 by Ende / WikiArt

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January 2, 2024