Rebecca Andrik
Obesity is an epidemic, affecting approximately 125 million people across the United States. Rates of overweight and obesity are rising in nearly all 50 states, including Colorado, which is generally known as a relatively healthy state for people to live, work, and play.
But the data shows otherwise. Nearly six in 10 Colorado adults are classified as overweight or live with obesity, according to the state health department. As of 2014, one in four Colorado children are overweight or living with obesity. Unfortunately, these numbers continue to increase. Obesity disproportionately impacts communities of color and the most vulnerable populations, including those on Medicaid.
Excess weight, which has a negative impact on health, is one of the main causes of disease and early death. Specifically, the chronic disease of obesity is associated with more than 200 health conditions, including prediabetes, type 2 diabetes, cancer, heart disease, stroke, and premature death.
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Obesity is a complex, multifactorial, common, severe, recurrent, and costly chronic disease. People need science-based interventions to treat and manage the chronic disease of obesity. These interventions include intensive lifestyle modifications and counseling recommended by medical professionals, anti-obesity medications, and bariatric/metabolic surgery. The health benefits of effective weight management have been extensively and consistently documented.
In employer-based private health insurance plans, employers can choose whether or not to cover obesity treatment, effectively creating a “carve-out.” Obesity remains a lifestyle issue and is not considered a chronic disease as defined by the American Medical Association in 2013. Obesity treatment, like other chronic diseases, deserves insurance coverage. Regarding Medicaid in Colorado, the Department of Health Policy and Finance is following an outdated rule that Medicare has had in place since 2003 that excludes “medications for weight loss or weight gain.” This is subject to change, as 15 other states cover anti-obesity drugs for Medicaid recipients. Treating obesity early can prevent the debilitating and costly health problems associated with obesity and, most importantly, can dramatically improve the health of obese people.
The estimated economic burden of overweight and obesity in the United States was $480.7 billion in direct medical costs in 2016, and the total annual cost of diabetes in 2022 was $412.9 billion.
Improved health status can reduce total annual health care costs for individuals, especially those with multiple chronic conditions. One study estimated that sustained weight loss of 5% or 12% over 2 years would result in direct medical cost savings of $15,800 or $26,400 per patient, respectively, over 15 years.
We have an opportunity to improve the lives of Coloradans, and we need to seize it. Senate Bill 24-054, introduced by State Sen. Michaelson Jennette and Reps. Kyle Brown and Javier Mabry, is a comprehensive bill that includes intensive behavioral therapy, lifestyle counseling, anti-obesity medications, bariatric surgery, and more. This will enable more equitable coverage of obesity treatment. The bill also emphasizes the need to treat prediabetes early to prevent the inevitable progression to type 2 diabetes.
As with diabetes, people with obesity are entitled to effective, Food and Drug Administration-approved, science-based treatments that can help improve health outcomes and ultimately reduce health care costs. Colorado must address and more effectively manage obesity to improve the lives and health of Coloradans.
The American Diabetes Association (ADA) also addresses the obesity epidemic, recognizes the health barriers and social determinants facing many people, and promotes health equity through advocacy and programs. For more information, visit diameter.org/Obesity.
Dr. Rebecca Andrick is board certified by the American Board of Obesity Medicine and the American Nutrition Society (CNS), and is a Fellow of the Obesity Medicine Society.
