Local battle on obesity underway

LEWISTOWN – Almost two months after obesity was declared a disease by the American Medical Association, local healthcare providers have begun taking steps to limit the disease’s reach in area communities.

“Declaring obesity a disease encourages medical professional to pay more attention to obesity and certainly calls for insurance to cover more types of treatment,” said Dr. Virginia Wray, director of the Center for Weight Management and Nutrition at Lewistown Hospital.

Most people, doctors included, view obesity as a host of poor choices or a personal weakness in patients, Wray said. People don’t understand just how complicated obesity is or how difficult it is to recover from, she said.

“For an obese person to fully recover and get healthy, it requires a team of medical professionals consisting of a dietitian, behavior therapist and bariatrician to address all aspects of the condition,” Wray said. “Now that it’s a disease, I hope to see more physicians specializing in this area.”

Over the next two months, Lewistown Hospital plans to form a number of action teams devoted to improving health in Mifflin and Juniata counties, said Phyllis Mitchell, vice president of marketing and community affairs at the hospital. One of the teams will focus specifically on reducing obesity and the co-morbid conditions associated with it, she said. “Obesity is such a widespread concern and the local statistics are just shocking,” Mitchell said. “We’d really like people to get engaged and for the community work together to address this issue.”

According to the 2013 Community Needs Health Assessment, 31 percent of adults in Juniata and Mifflin counties are obese, in addition to the 22 percent of children in Juniata County and the 18 percent of children in Mifflin County that are obese.

The assessment also reports that roughly 50 percent of restaurants in Mifflin and Juniata counties are fast food.

“I’d like to see the obesity action team working with fast food restaurants to promote the more healthy choices that are offered,” Mitchell said. “Clearly we can’t stop people from going, but hopefully we can make them more conscious of what they’re eating when they do.”

The hospital is also looking at possibly expanding the Center for Weight Management and Nutrition, as well as adding a nurse navigator position specifically for obesity, Mitchell said.

The Health Implementation Plan also suggests increasing educational physician visits for obese patients and increasing the proportion of physicians that regularly assess body mass index.

“You can’t treat obesity without addressing lifestyle changes, but without insurance coverage, this process can be expensive,” Wray said. “For example, a new patient visit with a nutritionist averages at $100 and $50 for a follow-up.”

While most insurances cover bariatric surgery, there’s usually no additional coverage beyond that, Wray said.

However, a recently introduced bill may change all that. The Treat and Reduce Obesity Act of 2013, introduced only days after obesity was declared a disease, would amend the Social Security Act to include information on the coverage of intensive behavioral therapy for obesity in the “Medicare and You Handbook.”

The bill would allow physicians, registered dietitians and certified diabetes educators to provide, and be independently reimbursed for, intensive behavioral therapy for obesity outside of the primary care setting, as long as they discuss treatment plans with the primary care physician.

Additionally, the act would authorize the coverage of medication to treat obesity or assist with weight loss management for an overweight individual with one or more co-morbidities.

“Generally, when a change that big occurs in Medicare, it rolls through to public insurance,” said Amy Bowen, public relations specialist at Geisinger Health Plan. “Obesity is expensive and contributes to a number of other conditions that are also expensive. It makes sense for insurance providers to get involved.”

Geisinger Health Plan has offered a variety of obesity coverage for years, Bowen said, including coverage for bariatric surgery, fitness center memberships, Weight Watchers discounts and weight management programs.

“Because obesity is such an underlying factor for other chronic diseases, we began implementing weight loss programs as part of disease management,” Bowen said. “We saw, moving forward, that there was a strong need for these programs.”

Hopefully, there will be a noticeable change in the way the healthcare community addresses and handles obesity and people will start coming forward for help, Wray said.

“There’s still a lot of discrimination and embarrassment when it comes to obesity,” Wray said. “I think these changes in healthcare will encourage providers to look at obesity more seriously and treat it as the complicated disease that it is.”

For more information, contact Wray at 242-7099. Additional information on the Treat and Reduce Obesity Act of 2013 is available at www.govtrack.us/congress/bills/113/hr2415.