Kevin Eberly's Blog | Confronting America's Obesity Epidemic

A recent Danish study found routine annual physicals have little benefit for healthy people. Researchers went as far to conclude routine physicals are meaningless and a waste of money and resources.

The study breakdown: Study participants were randomly assigned either to receive a physical or not receive a physical. Participants were given a routine exam, which included screening tests, advice about lifestyle changes, and a physical exam. The results showed both groups were just as likely to die over a nine-year period.

However, I think the study fails to look at the bigger picture. We have recurring expenses for being in poor health, and if we don’t go to the doctor, how will we know where we stand?

The first step is a checkup. It allows a doctor to diagnose emerging issues early, so you don’t become one of those people who need to be subsidized by other people for avoiding care. Ideally, obesity screenings would be done with an annual physical.

Now, the study did point out that going to the doctor for a specific screening or a vaccine is beneficial for everyone, but researchers do not believe it is necessary to have screenings done every year, stating it costs a lot of money and overuses resources.

Here is where I stand: Prevention does cost money—there’s no denying it. But if you look at the costs of the conditions these annual physicals prevent—obesity, heart disease, diabetes—the cost of prevention comes out significantly lower; millions of dollars lower. The cost of diabetes in the United States, for example, has risen to $245 billion in 2012 from $174 billion in 2007, according to the American Diabetes Association. The number is a 41 percent increase over a five-year period for diabetes alone.

These conditions, which are often caused by obesity, are largely preventable. Annual physicals give doctors a platform to easily monitor and predict conditions over time. When patients come in regularly, meaning they keep up with their annual physicals, doctors can recognize health trends and see when a patient’s health took a bad turn, making it easier to pinpoint why and determine the best course of action.

The U.S. Preventative Services Task Force recommends all adults be screened for obesity annually. As Americans become larger, studies show we eat less healthy than we think. An annual checkup, under the care of a physician, is the most accurate way to monitor your health, and it’s essential these screenings are covered under insurance.

What do you think? Are annual physicals worth the cost?

Your primary care physician is the first person you turn to if you have a health-related concern. You put trust in your physician to guide you in the direction to better health and trust he or she has confidence to do so.

One chronic condition many primary care physicians are not confident in treating: obesity.

A recent survey, published in BMJ Open, found only 44 percent of primary care physicians reported success in helping obese patients lose weight. This low percentage may come as a shock to you, but it doesn’t surprise CMWL’s chief medical officer Dr. Michael Kaplan. He tells me it’s training you just don’t get in medical school, and you learn more about malaria than obesity. Ironically, he’s never had to treat malaria, but he has seen countless obesity cases.

Why is this a problem? Think of primary care physicians as defensive linemen—the first line of defense. They’re the first people to see the play unfold and determine the actions necessary to stop the offense from advancing and reduce the number of yards gained. Primary care physicians are usually the first people exposed to a patient at risk for obesity, and the sooner it is acknowledged, the sooner steps are taken to treat it, resulting in fewer long-term health issues.

When it comes to treating obesity, many doctors feel underequipped, unprepared, uncomfortable, or a combination of three. However, I was surprised to find, as the survey indicated, that the majority of physicians believe obesity screening should be a routine part of a visit, and BMI should be included as a fifth vital sign.

This attitude, which 93 percent of primary care physicians surveyed supported, is promising. Doctors are starting to hear the noise that says they should be on the forefront of treating obesity. It’s a chronic condition that needs to be treated over time, and physicians are most qualified to do so.

Physicians recognize obesity as a problem and support regular screenings, but how do we boost their confidence? They need a toolbox.

CMWL equips physicians to be on the front line of preventative obesity medicine. I wouldn’t be here if I didn’t believe it works. It’s not just my speculation, but science backs it up. A study published in the American Journal of Medicine found people enrolled in a 12-week, physician-led weight loss program lost an average of 28 pounds. It proves the positive effect physicians can have on a patient battling with weight issues.

Imagine how much smaller our healthcare costs would be if 100 percent of doctors felt confident in treating obesity; if 100 percent of doctors had the proper treatment platform and tools to help patients lose weight and manage weight loss over time. The dollars obesity is costing America warrants its own post. But what do you think? Should primary care physicians be more active in treating obesity?

A recent report projected 44 percent of Americans will be obese by 2030.

F for Fat: Obesity Threatens America's Future 2012

Think it couldn't possibly be that bad? Look at data from 1991; in almost every state less than 10 percent were obese. Now look at the data from 2011; in all 50 states more than 20 percent are obese. 

Here's how the predicted rates of obesity threaten our future:

• there will be 7.9 million new cases of diabetes, compared to 1.9 million new cases in recent years. 
• There could be 6.8 million new cases of chronic heart disease and stroke every year, compared with 1.3 million new cases per year now. 
• Today, obesity-related medical costs are $147 billion to $210 billion (out of total healthcare spending of $2.7 trillion). In the future, add $66 billion more in annual obesity costs.  

The projected rates support a study published earlier this year in the American Journal of Preventive Medicine that found that by 2030, 42 percent of U.S. adults could be obese, adding $550 billion to healthcare costs over that period.

This is a real problem, what can we do today to start fighting it? 

I’m the kind of manager who likes to solve problems. And not just any problems, but those that have significant impact on people’s lives and wellbeing.  It may be why I’ve spent half of my professional life addressing one of the biggest problems facing the country for the last quarter century: obesity.

Why obesity? Obesity has proven to be a problem that is the root cause of so many other problems that are putting the health of the United States (literally) in jeopardy. Here are some facts that we’ve probably all read at one point or another, but they bear repeating because we have reached a point where none of us can afford (literally) to ignore them:

PROBLEM: Healthcare costs make up close to 20 percent of the national GDP, and 75 percent of healthcare costs are related to the diagnosis and treatment of preventable diseases such as diabetes, heart disease, and hypertension. The underlying cause of these diseases: obesity.

PROBLEM: Companies in the U.S. have faced staggering increases in healthcare costs, experiencing on average 12 percent in insurance premium rate hikes per year. The cost increases create severe challenges for companies to stay competitive in the global economy. What is cited as the reason for an estimated annual $73 billion in medical and lost productivity costs? Obesity.

PROBLEM: More than one-third of Americans can’t go a day without taking a medication to control a chronic condition, can’t walk without pain, can’t sleep without risking apnea, and can’t perform some of the most basic activities that enrich life’s experiences. What’s the cause? Obesity. And that number amounts to more than two-thirds of the population if we include people who are categorized as overweight.

In light of these statistics, which seem to keep going in the wrong direction, there must be a clear-cut solution, right? If only! But, being a problem solver at heart, I rely on hard data and facts to point me in the right direction. The statistics tell me that physicians hold the key to reversing these alarming trends. It’s the reason I am confident the physician-directed, non-surgical weight loss approach based on evidence will be the proven method for effectively managing long-term health and preventing obesity in those who currently are not affected.

The Center for Medical Weight Loss has been ahead of its time, with its participating physicians having successfully treated thousands of patients for the better part of the last decade. But it’s only recently that third parties have started to subscribe to its approach. These include:

• In January 2012 The Centers for Medicare and Medicaid Services (CMS) announced coverage for physician-directed behavioral counselling for obese patients (those with a BMI of 30 or higher). Private insurers quickly followed suit.
• In May 2012 the US Preventive Service Task Force endorsed physician behavioral counselling for obesity.
• In June 2012, The American Journal of Medicine published a major study of Center for Medical Weight Loss physician-directed results, reporting clinical outcomes of an average 26 pounds lost, or 11.1 percent of total body weight lost, in 12 weeks among obese and overweight patients. 

And this is just the beginning. While we don’t purport to have all of the answers, we are confident we are onto something. But there are still much work to do and many complex issues to explore. That is why I invite you to join in the conversation and lend your voice to what you believe are sustainable solutions to effectively addressing the clinical condition of obesity. Starting today, I’ll be posting new research and commentary. I look forward to hearing from you!