Monday, October 25, 2021

Medicare restrictions on obesity care perpetuate harmful stigmas

By Tammy Boyd and
Dr. Michael Knight

Congress may soon enact a historic expansion of Medicare benefits to include services like dental, vision, and hearing. For millions of seniors, access to these services will be life changing.

But a critical issue is missing from the conversation around Medicare expansion, with serious consequences for millions of Americans nation’s health. Congress must also prioritize care for obesity, a national epidemic, dire health equity issue, and leading comorbidity for serious cases of COVID-19.

Not only does obesity impact 1-in-3 Americans, it also takes a disproportionate toll on communities of color since almost half of Black Americans are living with obesity. Obesity is also a leading risk factor for COVID-19; 78% of people who were hospitalized, placed on a ventilator, or died from the pandemic were overweight or living with obesity. And we know that COVID-19 disproportionately impacts Black and Latino communities, who are nearly three times as likely to be hospitalized for severe cases of COVID-19 than whites.

In short, obesity is a life-or-death issue, but Medicare restrictions on obesity care perpetuate outdated, dangerous, and, frankly, discriminatory laws that disenfranchise millions of Americans and block access to safe and effective treatment options.
Many people don’t know that when Medicare Part D was first passed in 2003, the nation wrongly viewed obesity as a chosen lifestyle. In the intervening years, the medical community caught up with the science and in 2013, the American Medical Association took the historic step of designating obesity as a disease requiring treatment and medical attention.

As part of a new nationwide Obesity Care Now campaign, an effort by 25+ obesity care advocacy groups, including the Black Women’s Health Imperative, the YMCA, and others, we are leading the fight to modernize policies and actively working with Congress to provide obesity care, save lives, and pass TROA now. (Photo via NNPA)

Despite this decision, Medicare rules remain dangerously out of step. Today, obesity care is on a short list of excluded drug categories, including hair loss drugs, erectile dysfunction medication, and cold and flu treatments. These categories were meant to exclude cosmetic or traditionally over-the-counter treatments when Part D was passed, yet instead they deny people life-saving obesity care, with far-reaching health implications on Black and Latinx communities.

Along with intensive behavioral therapy, studies show that anti-obesity medications lead to clinically meaningful weight loss of up to 15%. Without action from policymakers, patients will not have access to these new therapies, since weight loss medications are rarely prescribed to eligible patients. As COVID-19 worsens, this lack of access to the full continuum of care for obesity puts our entire community at increased risk from the pandemic, especially communities of color.

Congress must, and can, take action to right this injustice. Obesity care must be part of the conversation around Medicare expansion, including in the ongoing negotiations around budget reconciliation.

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The solution is simple, since legislation already exists to fix this problem: The Treat and Reduce Obesity Act, bipartisan legislation that would provide the full continuum of care and relief for the many seniors living with obesity, making their lives safer and healthier. As part of a new nationwide Obesity Care Now campaign, an effort by 25+ obesity care advocacy groups, including the Black Women’s Health Imperative, the YMCA, and others, we are leading the fight to modernize policies and actively working with Congress to provide obesity care, save lives, and pass TROA now.

As lifelong advocates for healthy Black communities, this issue is personal. Over the past 18 months, we have seen friends, family, and community members impacted by obesity and the pandemic. Now, with the rising Delta variant, the threat is only getting worse. We cannot address all of the pandemic related issues affecting the Black community, but we can take action to provide obesity care now to those in need.

Tammy Boyd is the Chief Policy Officer & Senior Counsel for Black Women’s Health Imperative. She leads the strategic policy and government affairs direction for the organization.

Dr. Michael Knight is board certified in internal medicine and obesity medicine, and practices clinically at the GW Medical Faculty Associates in Washington, D.C.

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