Everyone deserves access to effective obesity treatment, and we have the power to remove barriers to that treatment.
Since the 1980s, adult obesity rates have more than doubled to over 42% of Americans. Excess weight causes over 500,000 deaths in the U.S. each year. Obesity and related chronic illnesses led to more than $480 billion in direct health care costs and $1.24 trillion in indirect work-related costs due to absenteeism and disability from 2010-2017.
What’s more, obesity has a significant impact on communities of color and women. Nearly half of Black people and over 44% of Latinos have the disease. It is also associated with health complications that specifically affect women, such as breast and ovarian cancers.
No one can deny that obesity will continue to be a dire health need over the next four years. The incoming administration and Congress have a vital role to play in recognizing obesity as a chronic, treatable disease and supporting access to evidence based-obesity care for older adults.
What’s new in obesity treatment?
Fortunately, the past few years have ushered in remarkable developments in obesity treatment. Beyond nutrition, physical activity, behavior modification, and bariatric surgery, we now have obesity medications that have been approved by the U.S. Food and Drug Administration (FDA). Comprehensive obesity care includes all these treatments.
The efficacy and safety of obesity medications are well-documented, and a growing body of research points to their benefits. An analysis presented at the European Congress on Obesity and published in Nature Medicine in May showed an average weight loss of over 10% for people who used semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1). The drug won FDA approval for use in reducing the risk of serious cardiovascular complications in people with obesity and heart disease this past March.
Additionally, two recent studies show that GLP-1 medication tirzepatide was so effective at reducing sleep disruptions in persons with obesity and sleep apnea that 40-50% may no longer need to use a CPAP device. Tirzepatide also lowered systolic blood pressure and resulted in 18-20% weight loss.
Yet these potentially life-changing treatments are still not covered by Medicare. This puts about 18 million older adults living with obesity at risk—particularly those in underserved communities. The next administration—and the incoming members of the House and Senate—can help alleviate this burden by ensuring that those living with obesity have access to the comprehensive care they deserve.
How to expand obesity treatment access
One critical way to ensure access to obesity care is for Congress to pass the Treat and Reduce Obesity Act—recently amended and passed by the U.S. House Committee on Ways and Means. The amended legislation would allow Medicare to cover obesity medications for individuals who have been taking them for a year prior to enrolling. The bill also directs the Health and Human Services Secretary to review Medicare coverage of intensive behavioral therapy by highly skilled providers other than primary care physicians one year after it is enacted.
While this revised version has a much-reduced scope compared to the original bill, it is an important first step in the right direction. Once passed, the next administration must promptly sign this bill into law.
Older adults are counting on their elected officials to be a catalyst for coverage of comprehensive obesity care. University of Michigan polling shows that 76% of older adults want Medicare to cover obesity medications. A recent NCOA survey of women also found overwhelming bipartisan support for Medicare coverage of the full range of treatments for serious chronic diseases, including obesity.
Obesity medicine has advanced significantly since a 2008 Medicare Part D rule explicitly excluded the use of prescription drugs for weight loss. This lack of Medicare coverage leaves millions of older adults vulnerable to disability, disease, and premature death.
It’s a matter of equity—and the time to act is now. With the support of the next administration, Congress must begin to close this gap and enact TROA.
