Slower growth in obesity rate could be sign policies are working

by | Jun 21, 2013

Obesity is still rising, but at a slower pace, which some experts say may be a sign people are finally responding to a smattering of policy initiatives and an outpouring of national concern about its long-term impact on healthcare spending.

The Centers for Disease Control and Prevention reported Wednesday that the adult obesity rate ticked up slightly to 28.9% in 2012. The 0.2% increase from the 2011 rate was the slowest rise in adult obesity since 2003.

“We’re getting close to being able to start turning back the obesity epidemic but there’s still a lot of work to be done,” Richard Hamburg, deputy director of the Trust for America’s Health, said about the new CDC figures.

The adult rate of obesity has increased nearly every year over the last 15 years, according to the CDC data, rising from 19.4% in 1997 to 28.9% in 2012. First lady Michelle Obama has made fighting childhood obesity a centerpiece of her time in the White House.

The slower rate of growth could stem from effects of a growing number of federal efforts aimed at decreasing calories and encouraging more active lifestyles, Hamburg said. He specifically cited the CDC’s Community Transformation Grants program, which provided about $70 million in 2012 to local efforts aimed at improving healthcare access.

Additional ongoing anti-obesity support is provided by the Prevention and Public Health Fund, which was authorized by the Patient Protection and Affordable Care Act. That fund provided $10 million in fiscal 2012 to bolster state programs on “nutrition, physical activity and obesity,” according to HHS. Another $5 million was spent on child-focused obesity prevention programs.

The House of Representatives voting almost entirely along party lines voted in April to eliminate the 10-year $15 billion fund, which is meant to be used to fight obesity, reduce smoking and promote better nutrition. Republicans described it as a “slush fund” for HHS.

The latest obesity rate data came a day after the American Medical Association’s House of Delegates voted to call obesity a disease. Supporters of the move said they hoped it would underscore the seriousness of obesity and spur payers to address it.

One payer that may expand its funding for anti-obesity efforts is Medicare. Bipartisan legislation introduced Wednesday would require Medicare to cover anti-obesity drugs and therapy. The legislation is a reintroduction of a bill Sen. Tom Carper (D-Del.) first offered in the previous Congress. The earlier bill did not advance and drew no co-sponsors, but this time around it drew bipartisan support as well as a companion measure in the House of Representatives.

“The obesity epidemic requires more than just diet and exercise and surgery, they need a full array of treatment options and that’s what this legislation is meant to address,” Rep. Ron Kind (D-Wis.) said in an interview. Medicare already funds weight loss surgery but like many private insurers it does not cover the cost of anti-obesity drug treatments.

A growing number of anti-obesity medications have received Food and Drug Administration approval in recent years but industry analysts said their growth has always been limited by the refusal of many insurers to cover them. When Medicare Part D was enacted “there weren’t a lot of drugs on the market that were clinically proven and therefore it wasn’t an option,” Kind said. “Since then there has been, and it ought to be a part of the Part D plan.”

Among the new legislation’s supporters, according to a list from Carper’s office, is Johnson & Johnson. That company’s migraine and epilepsy drug, Topamax, is a key ingredient of one of the highest profile new anti-obesity drugs, Qsymia. The company contributed $3,500 to Carper and $4,000 to Kind in the last election cycle, according to the Center for Responsive Politics.

Kind said any concerns that the bill was intended to open new markets to drugmakers missed its aim of helping to control the obesity epidemic. “If there are some medications that are available to help with the weight loss, that’s going to prove to be a much more cost-effective form of treatment than not doing it and having to deal with the chronic disease management that is driving almost 80% of Medicare costs today,” Kind said.

Kind was optimistic about the Medicare bill’s prospects but he was dubious another anti-obesity legislative initiative had much chance to pass. Sen. Tom Coburn (R-Okla.) has led a push to bar the use of food stamp funds for soda and other junk food. The American Medical Association joined Coburn’s push Wednesday when its House of Delegates endorsed such an approach for the first time.

When offering the amendment, Coburn cited a September 2012 study by the Yale Rudd Center for Food Policy & Obesity that concluded the Supplemental Nutrition Assistance Program spent more than $2 billion annually on beverages sweetened with sugar and 58% of all refreshment beverages purchased by SNAP participants were for sugar-sweetened beverages.

As a result, Coburn said “SNAP may actually be exacerbating the problem” of obesity.

Senate leaders declined to allow a vote on a related Coburn amendment during consideration of the massive farm bill currently moving through Congress, according to a Coburn staffer. That measure would have authorized state pilot projects to study the feasibility and effects of limiting junk food purchases under the food stamp program.

The soda effort drew support from New York Mayor Michael Bloomberg, who said he hoped “our leaders in Congress and the USDA consider the medical community’s serious health concerns about the relationship between sugar-sweetened beverages and obesity.”

Members of Congress were not likely to heed the advice of the mayor, who is known for his own efforts to limit the public’s soda consumption. “It becomes awfully tricky, as far as where you draw the line in what food choices and options are available,” Kind said. “So I’m not sure how receptive the overall Congress would be to that approach.”

Instead, Kind urged food stamp incentives that provide more funds if people used the stamps to buy locally produced food.

From: Modern Healthcare

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