Fixing the Mistake of Health Systems Closed to Obesity Care

Since forever, health systems have been closed to the need for obesity care. While obesity prevalence tripled, care providers, health plans, and even government policy doubled down on a simple response. “Your obesity is not our problem. It’s yours. Go away, eat less, move more, and come back when you’ve lost 25, 50, or 100 pounds. Or when you’re sick with the complications of untreated obesity.”

So it really should not be a surprise that one in four American adults would tell researchers at Ohio State University that they would prefer to get the new GLP-1 medicines for obesity without a prescription from their doctor. They are simply proving that they listened when providers and insurers told them to forget about getting any help from clinicians or health insurance plans.

Cost, Insurance, and Providers

Ohio State’s Wexner Medical Center worked with the SRSS opinion research organization to survey 1,006 U.S. adults online and by phone. The reasons for preferring to get their medicine without a traditional prescription were cost (18%), no insurance coverage (15%), reluctance of prescribers (9%), and unavailability in pharmacies (6%). In other words, every part of the health system is failing these people – drug makers, pharmacies, health insurers, and clinicians.

Better Is Possible

But clearly, health systems can do better to meet the need for obesity care. Wexner’s Shengyi Mao said that dialogue with a trusted primary care provider is the obvious place to start:

“Weight loss medications are not one size fits all and patients should always discuss options with a trusted medical professional first to avoid being exposed to potential health risks.

“I would ask permission to discuss weight and listen. This may allow for an open dialogue to start a partnership in reaching their goals in a safer way.”

Demonstrating that primary care can rise to the challenge of obesity care, researchers at the University of Michigan studied a cohort of 132 patients in a primary care weight navigation program. The control group was matched patients getting usual care. Patients in the weight navigation program had the opportunity for visits with obesity medicine specialists and support from their primary care providers. Compared to the control group, they were seven times more likely to achieve a ten percent or greater weight loss.

So, yes, we can do better. Drug makers can do their part with an adequate supply and more reasonable drug pricing. Health plans can stop pretending that obesity is not a real medical problem. And primary care providers can do their job, providing care for this complex chronic disease. It should be easy. Health systems must open up to providing real obesity care. But old habits die hard.

Click here for the study from the University of Michigan and here for more on the survey research from Ohio State. For further perspective, click here.

Closed Eyes, painting by Odilon Redon / WikiArt

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September 28, 2024