Modern Healthcare

Pace of obesity growth slows

Federal efforts cited, but ‘lot more work to be done’

- Rich Daly

The Centers for Disease Control and Prevention hinted at promising news on the obesity front last week. The CDC’s annual survey of the health status of Americans revealed obesity rose in 2012 at its slowest pace in a decade and, statistica­lly speaking, may not have risen at all. Some experts said more slowly expanding waistlines may be a sign people are finally responding to a smattering of policy initiative­s and an outpouring of national concern about its long-term impact on the nation’s economy.

The adult obesity rate ticked up slightly to 28.9% in 2012. The 0.2% increase from the 2011 rate was the slowest rise in adult obesity since 2003.

“We’re getting close to being able to start turning back the obesity epidemic, but there’s still a lot of work to be done,” Richard Hamburg, deputy director of the Trust for America’s Health, said about the new CDC figures.

Americans now rank among the fattest people on earth after the national obesity rate rose from 19.4% in 1997 to 28.9% in 2012. The slower growth rate more recently may be an effect of the growing number of federal initiative­s aimed at decreasing calorie-intake and encouragin­g more active lifestyles. First lady Michelle Obama has made fighting childhood obesity a centerpiec­e of her time in the White House.

The Obama administra­tion is pouring about $70 million a year into local health promotion efforts through a Prevention and Public Health Fund, which included $10 million in fiscal 2012 to bolster state programs on “nutrition, physical activity and obesity,” according to HHS. Another $5 million was spent on child-focused obesity prevention programs.

However, the authorizat­ion has come under repeated assault on Capitol Hill, where last April the House of Representa­tives voted largely along party lines to eliminate the programs along with the rest of the Patient Protection and Affordable Care Act’s 10-year, $15 billion appropriat­ion for public health. Republican­s branded it a “slush fund” for HHS.

Yet there is rising support across the nation and on both sides of the aisle to continue doing something about the obesity problem. Last week, the American Medical Associatio­n voted to label obesity a disease, which supporters hope will spur payers to fund medical approaches to treatment. Medicare is also being pushed to expand its anti-obesity efforts for the elderly and disabled.

A bipartisan bill was introduced last week that would require Medicare to cover anti-obesity drugs and therapy. Previous legislatio­n sponsored by Sen. Tom Carper (D-Del.) went nowhere. “The obesity epidemic requires more than just diet and exercise and surgery; they need a full array of treatment options and that’s what this legislatio­n is meant to address,” said Rep. Ron Kind (D-Wis.), a sponsor of the House bill, which would require the agency to cover antiobesit­y drugs. Medicare already funds weightloss surgery, but not drugs.

A few anti-obesity medication­s have received Food and Drug Administra­tion approval in recent years, but industry analysts said their growth has been limited by insurers’ refusal to cover them. “It ought to be a part of the Part D plan,” Kind said.

Among the new legislatio­n’s supporters, according to a list from Carper’s office, is Johnson & Johnson. That company’s migraine and epilepsy drug, Topamax, is a key ingredient of one of the highest profile new anti-obesity drugs, Qsymia. The company contribute­d $3,500 to Carper and $4,000 to Kind in the last election cycle, according to the Center for Responsive Politics.

Other anti-obesity bills, meanwhile, continue to draw fierce opposition from the food and restaurant industries. A bill sponsored by Sen. Tom Coburn (R-Okla.) that would bar the use of food stamps to buy soda and other sugarladen junk food is given little chance of passage. The AMA endorsed such an approach for the first time last week. A 2012 study by the Yale Rudd Center for Food Policy & Obesity concluded the Supplement­al Nutrition Assistance Program spent more than $2 billion annually on beverages sweetened with sugar.

“SNAP may actually be exacerbati­ng the problem” of obesity, Coburn said. Senate leaders refused to allow a vote on an amendment to the massive farm bill now before Congress that would allow state pilot projects to test limits on junk food purchases under the food stamp program.

The bill drew the same industry opposition as New York City Mayor Michael Bloomberg’s effort to ban jumbo soft-drink containers, which was slapped down by the courts in March. Bloomberg threw his support behind the Coburn bill.

But Republican­s in the House remain staunchly opposed to regulatory approaches to curbing the obesity epidemic. “It becomes awfully tricky, as far as where you draw the line in what food choices and options are available,” Kind said. “So I’m not sure how receptive the overall Congress would be to that approach.” Kind said Republican­s would consider legislatio­n that gave people more food stamps if they used them to buy locally produced food.

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