Navigating the Health Care System

Focus on Obesity

By Carolyn M. Clancy, M.D.

October 5, 2010

Obesity is literally a growing problem.

Today, 72 million Americans are obese. As you probably know, obese people are more likely to suffer from diabetes, heart disease and other chronic health problems. But did you also know obesity can be bad for your budget?

It can. On average, obese people spend $732 more each year on medical expenses than those with normal weight, according to a 2009 study sponsored by my agency, the U.S. Agency for Healthcare Research and Quality (AHRQ). The study also found that obese workers are paid less than other workers.

The terms "overweight" and "obese" refer to a person's overall body weight. People who are overweight carry the extra weight in muscle, bone, fat, and/or water. People who are obese have a high amount of extra body fat.

Obesity has become an epidemic, hurting people's health and costing as much as $147 billion each year in the United States, according to the Centers for Disease Control and Prevention (CDC). In 2009, nine States—Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee and West Virginia—counted nearly one of three residents as obese, according to the CDC. This is a serious development. In 2000, no State had such a high rate. In contrast, Colorado and Washington, D.C., have the lowest rates with fewer than one in five residents classified as obese.

Americans need more information.

A recent AHRQ report shows that many patients don't receive information from their clinicians about the risks of obesity or how to control or lose weight. This is true even for patients who already are overweight or obese:

• Only one in four overweight children and teens was told by a doctor or health professional that they were overweight between the years 2003 and 2006.
• During the same period, only 65 percent of overweight adults were told by a health professional that their weight was unhealthy—fewer than three years earlier.
• Only about one-third of uninsured adults received that advice in 2004.
• Obese people who are black, Hispanic, or do not have a high school diploma are less likely to receive advice about good food choices from their doctors. Only about one in four blacks and Hispanics received advice about eating lower-fat or low-cholesterol foods, for example.

As a nation, we're taking steps to get healthier. First Lady Michelle Obama is raising awareness of childhood obesity through her campaign Let's Move. Earlier this year, the U.S. Preventive Services Task Force recommended that clinicians screen children aged 6 years and older for obesity and offer or refer them to intensive weight loss programs.

The Patient Protection and Affordable Care Act, which was signed into law last March, comes with important new benefits. This Act will help more children get health coverage, end lifetime and most annual limits on care, and give patients access to free, recommended preventive services.

The act now requires private insurance plans to provide obesity screening for all adults and children at no cost. Height, weight and body-mass index (BMI) measurements for children also are covered as a preventive service. BMI is a number calculated from a person's weight and height, providing an indicator of body fat for many people.

Beginning in January 2011, patients covered by Medicare and patients enrolled in new health plans created by the law will receive more preventive services. This includes counseling from your health care provider on losing weight and eating healthfully.

Here are some steps you can take:

• Watch your weight. The CDC and healthfinder.gov provide basic tips to help.
• Know your BMI. The body mass index or BMI is the most common measure of overweight and obesity. BMI is based on height and weight and is used for adults, children, and teens. Calculate your BMI. For adults, a BMI of 30 or above means you are obese.
• Talk to your doctor or nurse. Even if your doctor doesn't talk about your weight, you can. Ask your doctor questions about how losing weight may help you. Also, ask about local programs and resources that can help you.

Just think: The steps you take to help your health will also help your wallet.

I'm Dr. Carolyn Clancy, and that's my advice on how to navigate the health care system.

More Information

AHRQ Podcast
Obesity in America (Transcript) Podcast Help

U.S. Preventive Services Task Force
Screening for Obesity in Children and Adolescents
http://www.uspreventiveservicestaskforce.org/uspstf/uspschobes.htm 

Centers for Disease Control and Prevention
Healthy Weight
http://www.cdc.gov/healthyweight/index.html

BMI Calculator
http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html

Healthfinder.gov
Watch Your Weight
http://www.healthfinder.gov/prevention/ViewTopic.aspx?topicID=25

Let's Move
http://www.letsmove.gov/about.php

Current as of October 2010

Internet Citation:

Focus on Obesity. Navigating the Health Care System: Advice Columns from Dr. Carolyn Clancy, October 5, 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/consumer/cc/cc100510.htm