New York Times Examines Implications of New Medicare Obesity Policy
The New York Times on Sunday examined how a new Medicare policy on coverage for obesity treatments "may transform the weight-loss field by providing, for the first time, reliable data on methods for losing weight" (Kolata/Grady, New York Times, 7/18). HHS Secretary Tommy Thompson on Thursday announced at a hearing of the Senate Appropriations Subcommittee on Labor, Health and Human Services, and Education that the department will remove language from the Medicare coverage manual that states obesity is not an illness but will not classify obesity as a disease. The new policy will allow for expanded Medicare coverage of obesity treatments, such as stomach-reduction surgeries, diet programs, and psychological and behavioral counseling, but does not specify which the program will cover. In the past, Medicare only covered obesity treatments when beneficiaries also had related conditions such as diabetes. According to Thompson, Medicare will cover obesity treatments that "improve health outcomes for seniors and disabled Americans who are obese." CMS plans to review scientific evidence on obesity treatments at a meeting this fall and decide which Medicare will cover, according to agency Administrator Mark McClellan (California Healthline, 7/16).
CMS may fund large studies on the efficacy of obesity treatments to reach decisions on which Medicare will cover, but before agency officials can determine which obesity treatments are effective, they must decide "how to define success," the Times reports. Some obesity researchers consider obesity treatments effective when patients lose 5% to 10% of their weight, an adequate amount to improve blood pressure, blood glucose levels and cholesterol levels, according to Dr. Gary Foster, clinical director of the weight and eating disorder program at the University of Pennsylvania. Other researchers consider obesity treatments effective only when patients no longer have weight problems, according to Dr. Jules Hirsch, an obesity researcher at Rockefeller University. However, few obesity treatments are effective in the long term, obesity researchers say. Most diet programs conducted at academic research centers find that although patients lose about 5% of their weight in six months, 80% to 100% regain the weight within five years, according to Foster. Mortality rates would provide an improved measure of the effectiveness of obesity treatments, but CMS would have to conduct large, standardized studies to obtain such information, according to Dr. Jeffrey Flier, an obesity researcher at Beth Israel Deaconess Medical Center (New York Times, 7/18).
Several broadcast programs reported on the new Medicare policy on coverage for obesity treatments:
- ABCNews' "World News Tonight": The segment includes comments from Dr. Louis Aronne of Cornell University Medical College, Rick Berman of the Center for Consumer Freedom and Thompson (McKenzie, "World News Tonight," ABCNews, 7/16).
- CBS' "Evening News": The segment includes comments from Thompson (Cowan, "Evening News," CBS, 7/16). The complete segment is available online in RealPlayer.
- NBC's "Nightly News": The segment includes comments from Dr. Robert Kushner, director of the Wellness Institute at Northwestern Memorial Hospital and Thompson (Hager, "Nightly News," NBC, 7/16). The complete segment is available online in Windows Media.
- NPR's "All Things Considered": The segment includes comments from Berman, Dr. Sattar Hadi of the Vanderbilt University Center for Human Nutrition and Thompson (Siegel, "All Things Considered," NPR, 7/16). The complete segment is available online in RealPlayer.