The Health Care Cure Must Include Prevention

It seems incongruous that obesity — which costs our nation an estimated $147 billion or more each year — is barely covered in medical school.

A recent study found that medical students receive hardly any training in obesity. And the exams they take to be licensed as doctors include very few questions about obesity prevention and treatment.


It’s like we’re approaching health care reform in a vacuum.

The cost of health care isn’t just about fixing high premiums and deductibles so the average American worker and small business employer can afford them.

Many, many things are driving these costs. And a big one is the plague of obesity that has infected the lives of our citizens and the stability of our health care delivery system. Obesity is behind many of the preventable chronic diseases that are dragging us down.

Frankly, much of the waste in our health care spending is tied to how we — and the medical community that cares for us — think about prevention. And it’s tied to how our lawmakers value and prioritize prevention in our health and tax policies.

When I say prevention, I’m really talking primary prevention. I don’t mean screenings for early diagnosis, although these can be important for good health. I’m talking about healthy habits — what some in the medical field call lifestyle medicine — that help keep people well in the first place. I mean things like regular exercise, good nutrition and dietary habits, avoidance of tobacco and other controlled substances, limiting alcohol, and engaging in stress management.

Obesity is closely tied to many illnesses:  Type 2 diabetes, heart disease, cancer, arthritis, non-alcoholic fatty liver disease, Alzheimer’s and dementia, kidney disease, and anxiety, depression and other mental health conditions. And chronic illnesses are projected to cost our country $42 trillion between 2016 and 2030, according to estimates from the Partnership to Fight Chronic Disease.

Obesity isn’t just a health care issue, either. It’s a very serious business issue as well.

Consider these numbers when you apply them to the real world: 57 workers at a small business of 150 employees are obese. That’s what it means when nearly 38 percent of U.S. adults have a BMI of 30 or more.


That’s a significant financial strain for a small company — and for the individuals themselves. Overweight and obese workers are 25 to 68 percent more likely to be injured, and obese adults spend 42 percent more on direct health care costs. Obesity also drains U.S. companies in terms of absenteeism ($4.3 billion) and lower productivity ($506 per obese worker) each year.

If we’re going to make any sustainable impact on driving down these costs, we need our doctors to be trained in primary prevention and how to counsel their patients on preventing obesity. We need them to regularly update that training through continuing medical education (CME) requirements. And we need them to routinely talk to their patients about healthy everyday living habits.

We need our doctors to team with affiliated wellness professionals — like dieticians, stress management specialists, and local community health clubs with group classes and personal trainers — so the underlying causes of obesity and chronic diseases actually get addressed.

Finally, as health care cost-sharing and decision-making continues to shift toward the patient-consumer, we need to give Americans more flexibility in how they can spend their health care dollars.

Workers need to have the autonomy to use their Health Savings and Flexible Spending Accounts for primary prevention — that is, for things like paying for nutrition counseling, health club memberships, and stress management classes.

Out-of-control health care spending and waste in America really must be brought under control. But until we fully address the problem of obesity — and the lifestyle factors that fuel it and other chronic diseases — no health care reform proposal will ever be able to adequately relieve the financial pressures pervasive in America today.


Helen Durkin is executive vice president of public policy for the International Health, Racquet & Sportsclub Association.

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