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How Improving Obesity Care Could Help End the Pandemic

With COVID-19 cases spiking across the country, public health experts are expressing concern about the disproportionate impact on people with obesity. Numerous studies have established that obesity significantly raised a person’s risk of hospitalization and death from COVID-19. The good news is we now know that losing weight can significantly lower that risk.

A new study published in the Journal of the American Medical Association covering more than 20,000 patients found that substantial weight loss achieved through surgery cut the risk of COVID-19 hospitalization by nearly half. This is welcome news for 70 million American adults living with obesity. And while surgery is only one way to lose weight, the message is clearly getting through.

In a recent interview with CNN, Dr. Fatima Cody-Stanford, a renowned obesity medicine and nutrition physician and scientist at Massachusetts General Hospital and Harvard Medical School, described the awesome demand at the obesity clinic where she works in Boston. “We are overwhelmed with the volume of patients that have really made that connection between obesity and Covid and the need for them to get appropriate care,” she said. The wait list has topped 1,000 people.

Dr. Cody-Stanford has been a leading light in the national effort to fight systemic bias against people with obesity and recognize the condition as a disease — not a choice. Writing in STAT News First Opinion, Dr. Cody-Stanford and her co-author, Kelly Copes-Anderson, Head of Diversity, Equity and Inclusion at Eli Lilly and Company, argued that outdated Federal health policies on obesity risk deepening racial inequities:

“When the American Medical Association recognized obesity as a disease in 2013, doctors and other health care workers began to pay greater attention to a condition that is a cause of death for nearly one out of five adults in America. Eight years on, U.S. policies have failed to catch up with medical understanding in addressing this public health crisis. Without the right kinds of policy interventions, nearly half of Americans will have obesity by 2030.

“Communities of color will be hit hardest. Already, nearly 50% of Black adults and 45% of Hispanic adults have obesity — a body-mass index (BMI) of 30 or higher. But this condition is not just a matter of carrying extra pounds. It puts individuals at greater risk for many other chronic diseases, including cardiovascular diseases, metabolic diseases like diabetes, and many cancers, all of which disproportionately affect communities of color and perpetuate health disparities.”

They highlighted a timely opportunity to reach millions of Americans with obesity. A bill moving through Congress, The Treat and Reduce Obesity Act of 2021 (TROA), would update Medicare’s outdated rules and establish two new provisions that empower people with obesity to take control of their health.

First, it would extend coverage for intensive behavioral therapy, a dynamic strategy that helps people modify their eating, exercise and environment to lose weight. Right now, Medicare only reimburses primary care physicians for this intervention. TROA would ensure other qualified health care professionals like dieticians are reimbursed, massively expanding the reach of this service.

Second, the bill would cover FDA-approved weight loss medications through Medicare Part D. This is a crucial step with new medicines coming to market that use the body’s hormones to control insulin and appetite.

The authors note the challenges in passing this piece of legislation while sounding hopeful notes that the time may finally be right:

“The Treat and Reduce Obesity Act has been introduced in every session of Congress since 2012 and gone nowhere, reflecting the profound systemic challenge of passing legislation to address this disease. But there is a palpable shift underway as more government leaders are adopting a mindset about obesity that is informed by science rather than by prejudice. Policymakers across the aisle are casting aside the old view that obesity is a matter of individual willpower and, like the American Medical Association and other leading health organizations, recognizing obesity as a disease. As a result, the act now has unprecedented bipartisan and bicameral support across the political spectrum.”

More than 100 obesity and health advocacy organizations representing diverse communities have endorsed the bill. And public support is behind it too. A Morning Consult poll showed that large majorities of American adults support Medicare recognizing obesity as a treatable medical condition and expanding coverage to prevent and treat the disease.

Ultimately passing TROA could help millions of people improve COVID-19 outcomes by losing weight. With cases spiking again and Americans eager to end the pandemic, let’s hope more policymakers get the message and take action.