Reimbursement for obesity is an “anomalie”  Obesity is a serious disease that is often associated with increased mortality rates, hypertension, type-2 diabetes, coronary artery disease, degenerative joint disease and several types o cancer.

Due to the lack of coverage that obese people receive, they choose not to seek treatment for it.  The market for treatments are “cheap and plentiful,” and effective treatments are time intensive and costly.  

Medicare and Medicaid do not cover obesity as they do not recognize it as a disease.

Lack of coverage can be attributed to lack of understanding of obesity as a disease.  However, there is a decrease in the development of new therapies as people feel these treatments will be no reimbursements.

There is also a perception that responsibility to treat obesity is on the individual themselves.  The public perceives that these diseases are based on personal behavior. 

There is evidence that things are beginning to change.  The IRS is now allowing weight loss expenses to be deducted, when there were previous instructions not allowing this. 

Future:  Many health conditions can be treated by weight loss. 

Results from National Health and Nutrtion Examination Survey showed that 17% of children ages 2-19 years old are overweight. Children between the ages of 6-11 have increased from 11 to 19% from 1988-94 to 2003-2004.

Based on data, overweight in children and adolescents was stable from the 1960s to 1980. However, since 1994, overweight in youths has increased ever since 1994.

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            In 2003-2004, NHANES estimated that 66% of U.S. adults are either overweight or obese.  Over the last 25 years there has been an increase in the prevalence of individuals who are either overweight or obese.

            Click on graphs to enlarge.

Costs of obesity are divided into three categories: direct costs of health care, indirect costs such as loss of economic activity due to illness, and intangible costs which are social and personal losses.

Genes- a small percentage of obese cases can be attributed to genetic factors.  This include mutations in the leptin gene and its receptor, or the melanocortin system. The onset of obesity in these cases usually occurs at an early age.  In these cases, obesity can be attributed to over-eating instead of defects in energy expenditure.

One third of the variance in BMI may be due to genetic factors. 

Metabolism- Studies have been shown that obese people have higher metabolic rates than their non-obese people. 

Behaviour- obesity is a result of energy intake exceeding energy needed.  Many overweight people eat in response to boredom, loneliness or stress. 

Physical Activity- physical activity brings important health benefits.  Obesity can be attributed to failure of the homeostatic mechanisms to match energy intake to the body’s energy needs.

Environment- increase in obesity is linked to “economic development suggests that we have a latent susceptibility to obesity.”  Cultures around the world, when introduced to western cultures rapidly gain weight and develop diabetes.  Overweight tends to run in the family, which results from genes and shared lifestyles.

Programs are being implemented to address the issue of obesity.  The Nutrition and Physical Activity Program to prevent obesity and other chronic diseases is designed to address poor nutrition and inadequate physical activity.  From 2005-2006, states were being funded for the use of said program.

Look at picture to show states.