Combating Obesity: Lack of Formal Diagnosis and Insurance Coverage Present Weight Loss Challenges

Lauren Santye, Assistant Editor
Published Online: Friday, November 18th, 2016
The lack of formal diagnoses of obesity and no insurance coverage for medical weight loss support are 2 of the greatest challenges in getting professional weight loss help.

These findings were presented at The Obesity Society (TOS) Annual meeting at ObesityWeek in New Orleans.

“These 2 barriers to care – no insurance for medical weight loss support and lack of initial diagnosis – can negatively impact people with obesity or overweight as they seek support from those most adept, trained weight-loss professionals,” said Scott Kahan, MD, MPH, spokesman for TOS and director at the National Center for Weight and Wellness.

Current obesity treatment guidelines strongly recommend counseling by health professionals in order to help individuals with physical activity, diet, and changing behavior. However, the studies found that there are few individuals who even have access to these services.

Prior studies of physicians have documented a lack of reimbursement as a barrier for weight loss services. Now, a new study adds the input of non-physician health providers who are part of weight loss services.

“More than half, 57%, of the 450 health professionals we surveyed believe that improved health insurance coverage for weight loss is a solution to greater access to care, and this finding cuts across all patient income levels,” said researcher Ruchi Doshi, MPH. “Furthermore, we found that a quarter of health professionals perceive current insurance coverage to be a weight-loss challenge.”

For the second study, researchers examined nearly 325,000 electronic health records (EHR) from the Cleveland Clinic to find whether patients with obesity or overweight received a formal diagnosis using ICD-9 documentation.

A cross-sectional summary from a large US integrated health system showed that out of all the patients with a BMI > 30, only 48% had documentation of an ICD-9 code for obesity, while in those with a BMI >40 – which is considered severe obesity – only 75% had an ICD-9 code for obesity.

“The disease of obesity is very prevalent yet too often underdiagnosed, which could be an important barrier to getting initial care,” Kahan said. “By providing a formal diagnosis, we may be able to help people get the treatment they need to lose weight and get healthy.”

Although it remains unknown why physicians are not giving formal diagnoses for obesity, Kahan said that it could go hand-in-hand with coverage.

“If doctors aren’t being paid to treat obesity, they may not see any benefit in making a formal diagnosis,” Kahan said. “Regardless, there is a clear need to advance the understanding of medical diagnosis and treatment of obesity across the spectrum, from providers to policymakers.”

In an effort to help advocate for a change in the way obesity is being handled and treated in a medical setting, TOS has joined with nearly 30 of its partners. Furthermore, during the second annual National Obesity Care Week, campaign partners asked physicians and other health care providers to “Take 5,” as in 5 minutes to have a productive conversation with their patients about weight.

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