Considering the Obesity Epidemic
There is no question that the pandemic has had serious effects on people’s mental health and, at the same time, it has made significant differences to their waistlines. An estimated 28% of Washington residents consider themselves obese, according to a recent CDC survey, using the Behavioral Risk Factor Surveillance Systems (BRFSS), while the national prevalence rate is 42.4%. In addition, race and ethnicity can be important factors for those with obesity, as the rate is:
- 8% for Hispanic adults;
- 2% for Non-Hispanic Black adults;
- 3% for Non-Hispanic White adults; and
- 9% for Non-Hispanic Asian adults.
Age also plays a role, as young adults were half as likely to have obesity as middle-aged adults. Adults between 18 and 24 had the lowest self-reported obesity rate at 19.5% compared to adults aged 45 to 54, who had the highest prevalence at 38.1%. Like other health issues such as smoking and exercise habits, there is a correlation between obesity and level of education. The BRFSS data show adults without a high school degree or equivalent had the highest self-reported obesity rate at 38.8%, followed by adults with some college at 34.1%, high school graduates follow at 34%, and then college graduates at 25%.
One of the most troubling aspects of obesity is its prevalence in children and the long-term implications of childhood obesity. In 2020, with a rate of 13.2%, Washington state was ranked 40th in the nation for the rate of obesity in children for 10 to 17 year-olds. But looking at the trend over five years, that is a 50% increase compared to 2016, when the rate was 8.7%. Studies show children with obesity are more likely to have obesity as adults. That results in serious health implications, as heart disease, stroke, type 2 diabetes, and certain types of cancer which are among the leading causes of preventable, premature death.
The Washington Health Alliance’s (Alliance) Community Checkup uses National Committee for Quality Assurance (NCQA) data to track the percentage of children (ages 3 to 17) and adults (ages 18 to 74) whose body mass index (BMI) was documented in the current or preceding year. Only one health plan exceeded the state average for the commercially insured population for calendar year 2019, Kaiser Permanente NW, with a rate of 94% for both. Aetna had the lowest rate for tracking BMI at 50% for children and 61% for adults.
Obesity poses significant challenges not just for patients, but for employers, as it is a contributing factor in absenteeism, lost productivity, and increased health care costs. Direct and indirect medical costs for obesity and its related conditions total an estimated $1.4 trillion in spending annually, or 6.76% of GDP for the United States. Health spending is an estimated 36% higher for adults with obesity compared to normal-weight adults, and most of the higher spending is attributable to treatment for high cholesterol, diabetes, and heart disease.
For employers looking for guidance, the National Alliance of Healthcare Purchaser Coalitions (National Alliance) provides an Obesity Action Brief with these recommendations:
- understand the importance of early diagnosis and prevention;
- recognize the science behind obesity and the challenges for people who have it;
- identify your population’s obesity rate and how your plan’s physicians treat and code for the disease;
- work with your plan and pharmacy benefit manager to ensure coverage and treatment are adequate; and
- reduce stigma and encourage employees to get the care they need.
The National Alliance recently released a video, The New Science of Obesity and is offering a complimentary webinar, Rethinking How Employers Support the Obesity Patient Journey on December 9th from noon to 1 pm PT. The webinar covers evidence-based information on the latest science regarding effective treatments that should be included in a comprehensive benefits strategy. Register here.
As we enter this holiday season, it is important to appreciate what it means to be healthy and to exert our leadership in ways to make that possible for everyone. I wish you and yours a safe and healthy holiday season.
All the best,