HEALTH CARE

Due to their popularity and effectiveness, anti-obesity medications (AOMs) have recently seen increased visibility in the media and public discourse. The presence and popularity of these medications reflect a more accurate and evidence-based understanding of why so many struggle with excess weight and obesity-related health conditions.

As the medical community makes advances in treatment for those living with obesity, we must ensure that those who need treatment have access to these medications. Patients are often limited in the care they can receive due to biased and nonevidence-based insurance policies restricting coverage. Denying coverage for antiobesity medications ignores the estimated millions of dollars in medical costs associated with obesity that could be saved with preventative treatment.

While private insurers also have a responsibility to improve their coverage for this chronic illness, I strongly encourage Congress to expand Medicare coverage to include AOMs through the Treat and Reduce Obesity Act (TROA). This legislation will improve the quality of life for millions of Americans while reducing the strain that obesity-related medical costs have on our healthcare system.

For years, the prevailing view in the medical field and the general public has been that obesity is the result of poor lifestyle choices. However, there is now undeniable evidence that obesity, like all chronic diseases, is caused by a combination of genetic, biological, and environmental factors. There are multiple biological processes in place that promote weight regain and make sustained and significant weight loss an uncommon outcome of lifestyle interventions alone. Medical treatments for weight management are not an “easy” fix. Rather, they are a way to help those with a predisposition to obesity maintain a healthier weight long-term without the unrealistic expectation to constantly work against their biological resistance.

As a physician specializing in obesity treatment, I’ve seen firsthand the benefits these medications have in the health and well-being of my patients. Not only does treatment improve the mechanical complications of excess weight such as impaired mobility and joint pain, it also directly impacts the myriad health conditions directly related to complications of obesity. These include chronic diseases affecting millions of people such as high blood pressure, heart disease, multiple forms of cancer, stroke, and type II diabetes. On average, over $2,000 more is spent annually on treatment for Medicare recipients living with obesity than those who are not. These costs are seen in the coverage of associated chronic diseases, which can be reduced if these patients have access to treatment. Treating obesity is treating the root cause of a patient’s complex medical picture, helping them to prevent future disease and to improve current health conditions, sometimes to the point of full remission. By expanding coverage, the overall improvement in the health conditions of those suffering from obesity would lead to lower expenditures in inpatient stays, prescriptions, and emergency room care, resulting in net savings between $6,700 and $7,100 over 10 years per person receiving Medicare. For the medical system at large, it is estimated billions of dollars would be saved by the reduction in additional treatments for patients in the decades to come.

Leading medical associations fully support AOM coverage because they have reviewed the data, understand the causes of obesity, and recognize the potential positive impact of treatment. The American Diabetes Association (ADA) cites the downstream benefits of treating obesity, such as improving diabetes, sometimes to the point of remission. This is especially impactful given that a third of Medicare beneficiaries already have type II diabetes, and millions more suffer from pre-diabetes. The Endocrine Society and the American Association of Clinical Endocrinologists have also come out in support 1of AOM coverage and include AOMs under their recommended treatment guidelines for patients with obesity.

Helping my patients improve their current health, prevent future diseases, and have a better quality of life is why I love working in this field. Providing Medicare recipients access to AOMs will reduce the strain that obesity-related costs put on financial and healthcare systems by increasing our options for treatment. The Treat and Reduce Obesity Act (TROA), would permit the coverage of AOMs, and many members of my field have been vocal in our support. This bipartisan legislation has support from members of the New Hampshire delegation, and their efforts on this issue have been admirable. Congress has the opportunity to implement this vital legislation now, to expand access to these medications for millions of Americans. I am hopeful that our leaders in Washington will act now to make AOM coverage under Medicare a reality.

Melissa Scull, M.D., specializes in internal medicine and obesity medicine with New England Weight Management Institute at Catholic Medical Center in Manchester.