No matter how you spin it, the rising rates of obesity in America are alarming. Over 42% of Americans are clinically obese — up from 30% just 20 years ago. Estimates show nearly half of Americans will be obese by 2030, and one in four be severely obese. When you consider that the U.S. shells out over a trillion dollars on obesity-related healthcare costs each year, what does this mean for employers who foot nearly half that bill?
Employers must be proactive in reaching out and engaging those employees who need obesity care. Ensuring these individuals receive the care they need will not only improve their overall wellbeing and reduce the risk of many obesity-related conditions, it will also stop the flood of downstream costs.
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Myth: “Obesity is a choice”
There’s a common misconception that people choose to be fat or thin and that anyone can lose weight, they just have to try. Nothing could be further from the truth and it’s past time we erase the stigma and stop dismissing obesity as a reversible consequence of a lack of willpower. As America’s obesity crisis has worsened, it has become increasingly clear that obesity is a disease. More than 10 years ago, the American Medical Association (AMA) designated it as a “disease state with multiple pathophysiological aspects requiring a range of interventions to advance obesity treatment and prevention.” This marked a key milestone toward accepting obesity as a disease and advancing evidence-based approaches for its prevention and treatment.
Obesity is far more than a matter of appearance or ill-fitting clothing. It’s a major risk factor for some of the most common — and expensive — chronic conditions, including diabetes, hypertension, heart disease, stroke, back pain and cancer. But not all Americans face those risks equally.
Fact: Obesity trends reveal stark inequities
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Accessing care and achieving one’s highest level of health is easier for some people than others.
Social determinants of health (SDOH), the nonmedical factors that influence health outcomes, are the circumstances in which people are born, grow, work, live and age, along with the wider set of forces and systems that shape their daily lives.
SDOH have a major impact on someone’s ability to live a healthy and fulfilling life, accounting for 80 to 90 percent of the modifiable contributors that are linked to health and risk outcomes. Examples of SDOH include:
- Access to nutritious foods and opportunities for physical activity
- Education, job opportunities and income
- Safe housing, transportation and neighborhoods
- Economic policies and systems
- Racism, discrimination and violence
- Language and literacy skills
Obesity trends reveal the hard truths of health inequities across the country. Black and Hispanic adults are most likely to suffer from obesity. In fact, four out of five Black women are obese or overweight. Factors like education compound the issue, as those without college degrees report higher rates of obesity than those with a college education.
Black, Native or Latino members of a workforce are two to three times more likely to suffer from food insecurity than their White counterparts. They may live in a so-called “food desert” where they lack access to lean meat, fresh fruits and vegetables, and their primary options are processed foods.
This is especially concerning as the medical community increasingly embraces the “food as medicine” movement, which maintains that healthy choices – specifically, increased consumption of a variety of whole, minimally-processed plant-based foods and limited intake of highly processed foods rich in added sugar, fat and salt – may prevent, reduce symptoms of or even reverse a disease state.
When someone doesn’t have easy access to healthy options – and they may be low on money – the dollar menu at the nearby fast-food restaurant becomes a way of life. They don’t even have to get out of their car to procure an inexpensive meal comprised of artery-clogging, blood pressure-raising, obesity-inducing foods that are going to shorten their life and increase their need for medical services.
What’s the prescription? Right treatment, right person, right time
The easier we can make it for people to access the care and support they need, the better outcomes we’ll see across the board. That’s a big reason why more employers are partnering with care navigation solutions to point employees to high-quality, low-cost interventions within their benefits ecosystem. One such intervention is a virtual obesity management program.
These increasingly popular programs tailor care to a person’s specific needs — whether that’s personalized medical nutrition therapy, behavioral coaching, and/or medication — all while keeping costs in check. In other words, they focus on delivering the right treatment to the right person at the right time.
Targeted outreach to deliver better outcomes and advance health equity
Employers can partner with these obesity solutions to analyze the socioeconomic factors in their own workforce — from neighborhood income levels and housing costs to healthy food access. Using data analytics, those solutions can then target the segments of their population who need the most care. This personalized outreach meets people where they are, incorporating culturally sensitive messaging and bilingual support for a smooth onboarding process.
Instead of relying on traditional fee-for-service and brick-and-mortar models where so many fall through the cracks, employers deliver truly equitable and convenient care for diverse populations with digital solutions as well as strategies that center on improving healthcare literacy and getting the right information to the right populations in a culturally sensitive way.
Engaging people in their health pays dividends
The most equitable care is personalized care. One-size-fits-all approaches rarely work for the most vulnerable in a population. Obesity management solutions focus on building deep relationships between providers and patients. They provide bilingual registered dietitians who can offer culturally sensitive eating plans and medical nutrition therapy on an individual level, so people can enjoy the foods they’re accustomed to while improving their health and weight.
These programs are successful because they treat obesity like other diseases, prescribing pharmacotherapy when appropriate. Most people don’t need the new GLP-1 medications, but those drugs should be available for the select few who require intensive treatment.
While obesity is not merely a matter of willpower, fundamental to any successful treatment is an emphasis on behavior change. As healthcare costs continue to rise and inequities become increasingly apparent, the more we can engage people in their own health through easy care navigation, daily habit reminders, and self-directed cognitive behavioral therapy principles, the better outcomes we’ll see. Digital solutions are paving the way for a future in which healthcare is accessible and fair – and patients receive the personalized care they need.
Photo: undefined, Getty Images
Bipin Mistry, MD is Chief Medical Officer at Alight Solutions. He is board-certified in Internal Medicine and obtained his medical degree at Kings College School of Medicine and Dentistry, University of London and an MBA from Babson College. He is passionate about value-based care and issues connected to the advancement of health equity.
Dr. Richard Frank, CMO at Vida Health, is an experienced physician executive with demonstrated success in product development and strategy, managing high-risk Medicare and Medicaid populations, developing new business for established and VC-backed companies, engaging providers in value-based contracts, controlling healthcare utilization, and implementing clinical programs within not-for-profit and publicly traded companies.
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