Rebecca Andrick
Obesity is an epidemic affecting about 125 million people across the United States. Rates of overweight and obesity are rising in nearly all 50 states, including Colorado, which is typically known as a healthier state for people to live, work and play.
But the data shows otherwise: according to the state health department, nearly six in 10 adults in Colorado are classified as overweight or live with obesity. As of 2014, one in four of Colorado’s children are overweight or live with obesity. Sadly, these numbers continue to rise. Obesity disproportionately affects communities of color and our most vulnerable populations, including Medicaid enrollees.
Excess body weight that negatively impacts health is one of the main drivers of disease and early mortality. The chronic disease of obesity, specifically, is linked to 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, serious, relapsing and costly chronic disease. People need science-based interventions to treat and manage the chronic disease of obesity. These interventions can include intensive lifestyle modification and counseling, anti-obesity medications and bariatric/metabolic surgery as recommended by a health professional. The health benefits of effective weight management have been extensively and consistently documented.
In our employer-based private health insurance system, employers are able to choose whether they want to cover treatment for obesity or not, effectively creating a “carve out.” Obesity is still considered a lifestyle problem and not the chronic disease it is as defined by the American Medical Association in 2013. Treatments for obesity deserve coverage like any other chronic disease. Regarding Colorado Medicaid, the Department of Health Care Policy & Financing has been following the outdated rules Medicare has had in place since 2003 to not cover “drugs for weight loss or weight gain.” This can be changed as 15 other states have coverage for anti-obesity medications for their Medicaid beneficiaries. Treating obesity early can prevent debilitating and costly health problems related to obesity, and most importantly dramatically improve the health of those with obesity.
The estimated economic burden attributable to being overweight and obese in the U.S. was $480.7 billion in direct health care costs in 2016, and in 2022, the total annual cost of diabetes was $412.9 billion.
Health improvements can reduce the total annual health care costs of an individual, particularly for individuals with more than one chronic disease. One study found an individual with a sustained weight reduction of 5% or 12% for two years is estimated to result in direct medical savings of $15,800 or $26,400, respectively, per patient over 15 years.
We have an opportunity to improve the lives of people in Colorado, and we need to seize it. Senate Bill 24-054 introduced by state Sen. Michaelson Jenet and Reps. Kyle Brown and Javier Mabrey would allow for more equitable coverage of comprehensive obesity treatments including intensive behavioral therapy or lifestyle counseling, anti-obesity medications and bariatric surgery. This bill also emphasizes the need to treat prediabetes earlier to prevent the otherwise inevitable progression to type-2 diabetes.
As with diabetes, individuals with obesity deserve access to effective, Food and Drug Administration-approved, science-based treatment that can help them improve their health and ultimately drive down health care costs. Colorado needs to address and more effectively manage obesity to improve the lives and health of Coloradans.
The American Diabetes Association (ADA) is also addressing the obesity epidemic, recognizing the barriers and social determinants of health that many people face, and promoting health equity through advocacy and programs. Visit diabetes.org/Obesity to learn more.
Rebecca Andrick, DO, is certified by the American Board of Obesity Medicine & American Nutrition Association (CNS) and fellow of the Obesity Medicine Association.
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