Posts Tagged ‘CMS’

Inventors, Investors, Regulators and Payors Struggle with New Technologies

December 20th, 2013

A two day meeting on the regulatory and reimbursement factors affecting medical devices for the treatment of obesity is now wrapping up in Washington, D.C. The workshop is jointly sponsored by the FDA Center for Devices and Radiological Health (CDRH)  and the American Gastroenterological Association. The meeting is one in a sequence bringing together young companies trying to develop new devices, researchers, venture capital investors, regulators and reimbursement experts from governmental and private payors. The challenges of getting a new device approved through the regulatory process and then getting it paid for.

The sponsors were kind to invite me to provide two short talks. One was on the reimbursement environment and I re-capped the changes brought about by the Affordable Care Act which is covered elsewhere. The other part I was asked to address was “What do Patients Want?” I indicated that the millions of patients with obesity did not fit any one pattern of what they wanted, nor did I have any particular data. But I did feel confident to offer that patients wanted their physicians to be respectful, competent and helpful in their weight management issues. I offered patients wanted health professionals to understand obesity as a disease, not a personality type and to recognize that stereotyping and stigmatizing persons with obesity is a defining characteristic of this condition.

I also indicated that the reasons why some patients undertake weight loss efforts, while some do not and while some take extreme risks while other do not, reflects the diversity of the population and the risks they are willing to undergo. And while health professionals often focus on weight loss for the prevention of type 2 diabetes or cardiovascular disease, patients may be just as motivated by more daily concerns, such as back or joint pain, mobility problems, incontinence, dealing with the shame and embarrassment, harassment and discrimination they experience or perceive. Finally, while the field has tried to minimize the ‘cosmetic’ goals of weight loss, we cannot avoid living in a culture in which personal appearance is so important.

It appears the AGA-FDA collaboration will continue with the goal of making the approval process more predictable and efficient and thereby facilitating getting new technologies to persons with obesity.

 

Downey Fact Sheet 2 – Quick Facts

September 27th, 2009
The Downey Obesity Report

The Downey Obesity Report

Printable PDF

ADULT OBESITY

The adult obesity rates have risen dramatically from 1960 to today; rates of overweight (BMI >30) have doubled, rates of obesity (BMI 30-39.9) have nearly tripled and rates of extreme or morbid obesity (BMI >40) have nearly increased seven fold.

ADULT (age 20-74) Prevalence 1

Overweight (BMI 25-30) Percentage

1960-1962 31.5%

2005-2006 33%

Obese (BMI>30)

1960-1962 13.4%

2005-2006 35.1%

Extreme or Morbid Obese( BMI>40)

1960-1962 0.9%

2005-2006 6.2%

The rates of obesity only tell half the story. During this period, the total US population has also increased. Therefore, the raw numbers of Americans affected have also increased. Looking at the numbers of people affected, the overweight population has doubled, the obese population has increased 5 fold and the population with extreme or morbid obesity as increased by a factor of nearly 12!

Number of Americans Overweight in 1960: 56.5 million

Number of Americans Overweight in 2006: 94.5 million

Number of Americans Obese in 1960: 24 million

Number of Americans Obese in 2006:
40 million

Number of American with extreme or morbid obesity in 1960:
1.6 million

Number of Americans with extreme or morbid obesity in 2006: 18.6 million

Since 1960-61 to 2006, the number of American adults who became obese or extremely obese*: 61.1 million

Average number per year: 1.3 million

Average number per month: 110,779

Average number per day: 3,693

Average number per hour: 153

Average increase per minute: 2.5

Since 1960-61 to 2006, the number of American adults who became  extremely obese*: 11 million

Average number per year: 240,217

Average number per month: 20,018

Average number per day: 667

Average number per hour: 27

Adolescents Obesity age 12-19 3

Percent overweight/obese 2005-2006 18%

Young adult Obesity
Ages 18-29

Percent obese 1971-1974 8%

Percent obese 2005 24%

Childhood 2

Ages 6-11 15%

Ages 2-5 11%

Year at which each group will reach 80% obesity 4

All 2072

Men 2077

Women
2058

African American Women 2035

African American Men 2079

Mexican American Women 2073

Mexican American Men 20 91

White Women 2082

White Men
2073

Adipose Tissue (Fat Cells) 5

Age at which typical body has acquired its full number of fat cells: 13

Number of fat cells in average American Adult: 23-65 billion

Number of fat cells in persons with morbid obesity: 37-237 billion

Number of fat cells lost in weight-loss efforts: 0

By Julie Snider for the Downey Obesity Report

By Julie Snider for the Downey Obesity Report

 

Daily Calories Needed and Available 6

Recommended calories per day by typical American adult:

Men 2,400 to 2,800

Women 2,000 to 2,200

Mean (meaning half were above and half below) adult daily calorie intake per day 7 :

Men

1971 2,450

2001-2004 2,593

Women

1971 1,542

2001-2004 1,886

Percent increase in food available for consumption per person from
1970 to 2003: 16%

Amount of food available for each person increase from
1.67 pounds in 1970 to 1.95 pounds in 2003

Daily caloric intake has grown by 523 calories from 1970 to 2003. Leading the way were fats, oils, grains, vegetables and sugars and sweeteners.

U.S. Government Biomedical Research 8

2008 Budget of National Institutes of Health $29.6 billion

NIH Spending 2008 on selected diseases:

Cancer
$5.6 billion

HIV/AIDS funding $2.9 billion

Cardiovascular Disease
$2.0 billion

Heart Disease $1.2 billion

Obesity
$664 million

U. S. Government Infrastructure on Combating Obesity

Name of coordinator of U.S. global anti-obesity efforts:

(Trick question: no such position exists)

Name of White House coordinator of federal anti-obesity efforts:

(Another trick question: no such position exists)

Name of coordinator of Department of Health and Human Services***anti-obesity efforts:

(No such position exists)

*Calculations were made by taking the CDC prevalence figures for 1960-1962 and 2005-2006and multiplying them against US census data for 1960 and census data for 2006,respectively. See Census Bureau Home Page

**Available in this context means the total US calories available for consumption, less spoilage and waste. See ERS/USDA Data – Food Availability (Per Capita) Data System)

*** Department of Health and Human Services includes the National Institutes of Health, the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, the Food and Drug Administration, Office of the Surgeon General, the Agency for Healthcare Research and Quality among others.)

Notes

1. N C H S – Health E Stats – Prevalence of overweight, obesity and exreme obesity among adults: United States, trends 1960-62 through 2005-2006

2. FASTSTATS – Overweight Prevalence

3. http://www.cdc.gov/nchs/data/hus/hus08.pdf

4. Studies of human adipose tissue. Adipose cell size…[J Clin Invest. 1973] – PubMed Result

5. Will all Americans become overweight or obese? est…[Obesity (Silver Spring). 2008] – PubMed Result. In this estimate, by 2030, 86.3% of adults will be overweight or obese and 51% obese; black women at a level of 96.9% will be the most effected, followed by Mexican-American men (91.1%). By 2048, all American adults would be overweight or obese but black women would reach that milestone by 2034. In children, the authors estimate, rates will nearly double by 2030.

6. http://www.usdaplate.com/

7. http://www.ers.usda.gov/AmberWaves/November05/pdf/FindingsDHNovember2005.pdf

8. NIH Research Portfolio Online Reporting Tool (RePORT) – Estimates of Funding for Various Research, Condition, and Disease Categories (RCDC)

By Julie Snider for the Downey Obesity Report

By Julie Snider for the Downey Obesity Report

Health Care Reform and Obesity – The Issues

September 27th, 2009

The current health care reform debate has crucial implications for the prevention and treatment of obesity. This debate will be followed closely in the months, if not years, ahead. Here is my view of some of the critical issues in the current debate. MD

October 16, 2009

Senate Finance wellness loophole undercuts reform goals.  Wellness Incentives Could Create Health-Care Loophole – washingtonpost.com

————————— 

Has America Reached its Tipping Point on Obesity?

downey_youtube 

The two most recent surgeons general, Dr. David Satcher, left, and Richard H. Carmona, center, join Morgan Downey, right, at the STOP Obesity Alliance panel discussion at the Newseum in September. 

The recommendations of the group will provide policymakers guidelines in dealing with obesity in forthcoming reform bills. STOP Obesity Alliance 

Richard H. Carmona, M.D., M.P.H., STOP Obesity Alliance Health & Wellness Chairperson, 17th Surgeon General of the United States (2002-2006) Richard H. Carmona, M.D., M.P.H., STOP Obesity Alliance Health & Wellness Chairperson, 17th Surgeon General of the United States (2002-2006) 

David Satcher, M.D., M.P.H., The Satcher Leadership Institute Director, 16th Surgeon General of the United States (1998-2002) David Satcher, M.D., M.P.H., The Satcher Leadership Institute Director, 16th Surgeon General of the United States (1998-2002) 

Jeff Levi, Ph.D., Trust for America’s Health Jeff Levi, Ph.D., Trust for America’s Health 

Christine Ferguson, J.D., STOP Obesity Alliance. Christine Ferguson, J.D., STOP Obesity Alliance Director. 

 

 

 

August 11, 2009

President Obama calls for health insurance reform to cover obesity treatments, stating, “All I’m saying is let’s take the example of something like diabetes, one of — a disease that’s skyrocketing, partly because of obesity, partly because it’s not treated as effectively as it could be. Right now if we paid a family — if a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they’re taking their medications in a timely fashion, they might get reimbursed a pittance. But if that same diabetic ends up getting their foot amputated, that’s $30,000, $40,000, $50,000 — immediately the surgeon is reimbursed. Well, why not make sure that we’re also reimbursing the care that prevents the amputation, right? That will save us money. Text – Obama’s Health Care Town Hall in Portsmouth – NYTimes.com

July 27-29

Centers for Disease Control and Prevention hold Weight of the Nation Conference in Washington, D.C. Speakers include former President Bill Clinton and HHS Secretary, Katherine Sebelius. For full conference information go to CDC Features – Weight of the Nation

July 12, 2009

From Morgan Downey: The ways in which health care reform can address obesity

  1. Prevalence of Obesity in Uninsured Population

There appears to be a high prevalence of overweight and obesity in the uninsured population. A study published in 2000, indicated that, “Smokers, obese individuals, and binge drinkers, were more often uninsured than adults without these risk factors. In contrast, people with self-reported hypertension, diabetes mellitus, and elevated cholesterol were less likely to be uninsured than adults without these conditions.” Ayanian, JZ, Weissman, JS, Schneider EC, Unmet Health Needs of Uninsured Adults in the United States, JAMA, 2000;284:2061-2069. Free full text at Unmet Health Needs of Uninsured Adults in the United States — Ayanian et al. 284 (16): 2061 — JAMA

Likewise, it is estimated that nearly half of all uninsured, non-elderly adults report having a chronic condition. Common reported chronic conditions are diabetes, hypertension, arthritis-related conditions, high cholesterol, asthma and heart disease, all of which are either caused by or highly associated with, overweight and obesity. “Uninsured American with Chronic Health Conditions: Key Findings from the National Health Interview Survey, Uninsured Americans With Chronic Health Conditions: Key Findings from the National Health Interview Survey – RWJF

2. Limiting Use of Pre-Existing Conditions

When individuals, outside of group plans, with obesity try to purchase health insurance policies on an individual basis, they find they are unwelcome. Many private health insurance programs exclude individuals with certain Body Mass Index from accessing individual policies. According to F as in Fat report by the Trust for America, many companies will charge additional premiums for persons with a BMI between 30 and 39. Over a BMI of 39, a person may find no company willing to provide individual coverage. Other plans may classify persons as “unhealthy” or “uninsurable” due to obesity. Companies are free to make their own definitions of these terms. Few states restrict these practices. 14-14 (See F as in Fat: How Obesity Policies Are Failing in America 2008 – RWJF)

Even if the person with obesity can overcome the weight hurdle, their coverage may be limited by the use of the common ‘pre-existing condition’ requirements which restrict a person for a period of time from accessing their plan’s benefits. As indicated above, many chronic diseases are associated with obesity and these can form additional hurdles to obtaining needed care.

Some health insurance plans have started to take very small steps to deal with obesity. For the most part, these efforts include bariatric surgery for additional premiums or offering employer’s a worksite wellness program, also for an additional payment.

Finally, few states have any kind of mandated benefits related to obesity treatment or prevention. In such cases, the insurance industry typically fights such proposals extremely vigorously. (See statement of Bob Clegg former Republican majority Senate leader, New Hampshire at The Challenge of Obesity for Policy Makers: Recommendations for the Next Administration: Republican Convention Forum – health08.org)

  1. Coverage of Obesity Interventions

Once insured the question arises, “Will offered health plans address obesity prevention and treatment?” If the uninsured health plan does not address the, or one of the, root cause of an individual’s health concerns, will any progress be made in using this entire health reform effort to improve individual and public health? The current situation of health insurance, in its avoidance of obesity prevention and treatment, perpetuates a focus on the conditions caused by obesity. Millions spent on heart disease or type 2 diabetes (not to mention the other ill effects, see above) will only continue. Only by addressing the root problem will Americans and America’s health see improvement.

The question has been raised of using the Medicare and Medicaid coverage criteria as the model for the legislation’s covered services. In terms of obesity, these programs cover obesity treatment and prevention inconsistently and inadequately. Regarding Medicare,

  1. In 2004, Medicare eliminated language in its coverage manual to the effect that obesity was not a disease. This opened the door to treat obesity in its own right as a disease.
  2. In February 2006, CMS significantly expanded its national coverage policies to cover more bariatric surgery procedures when performed in designated centers of excellence.
  3. Medicare Part D does not cover drugs for the treatment of obesity.
  4. Medicare does not cover physician or dietetic counseling for weight loss.

Regarding Medicaid,

  1. Most Medicaid plans have no to limited coverage of drugs for the treatment of obesity. The Medicaid statute actually bans states from including such pharmaceutical products but allows a waiver on request of the state. Few states have sought or received such a waiver.
  2. Bariatric surgery, while nominally covered in many states, is subject to such low reimbursement rates that few surgeons want to provide it. Other limitations on is provision further limit its ability to help individuals who meet the NIH recommendations from receiving the surgery.

The Internal Revenue Service, through a change in a revenue ruling in 2000, allows individuals to deduct the costs of weight loss programs upon recommendation of a physician. Of course, taxpayers must meet the threshold of 7.5% of adjusted gross income to qualify for the medical deduction at all. Therefore, Congress should use the expert, evidence-based recommendations of the NIH to decide covered services. (See, http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf)

Similar recommendations adopted by the American Academy of Pediatrics and 15 national medical societies should be adopted by children and adolescents as indicated. (See, Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report — Barlow and and the Expert Committee 120 (4): S164 — Pediatrics)

The Baucus Plan (Call to Action Health Reform 2009, November 12, 2008, Senate Finance Committee) would leave coverage decisions to a new independent health coverage council. This is probably insufficient and Congress should make this decision on coverage of obesity interventions, both prevention and treatment, itself. This would be consistent with the Baucus Plan’s goal, “Prevention must become a cornerstone of the health care system rather than an afterthought. This shift requires a fundamental change in the way individuals perceive and access the system and community-based wellness approaches at the Federal, state, and local levels. With a national culture of wellness, chronic disease and obesity will be better managed and, more importantly, reduced.” (See, http://finance.senate.gov/healthreform2009/finalwhitepaper.pdf (at p. 28)

5. Eliminating the Itemized Deduction

As mentioned earlier, in 2000, the Internal Revenue Service issued a revenue ruling allowing the expenses for weight control which were recommended by a physician to be deductible as a medical expense. While the scope of this ruling is constrained by the limitation that such expenses must exceed 7.5% of adjusted gross income, it is nevertheless the only federal financial support for treatments for obesity outside of the Medicare coverage of bariatric surgery (which is limited to Medicare elderly and non-elderly disabled populations). As such, it should not be modified or repealed unless Congress mandates the benefit package described above.

6. Taxing Sugar-sweetened beverages

The role of sugar sweetened beverages in the increase of obesity, particularly childhood obesity, has been well documented. The evidence from epidemiological and experimental studies indicates that a greater consumption of sugar sweetened beverages is associated with weight gain and obesity.( See, Malik VS, Schulze MB, Hu FB, Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr 2006;84:274-88. Intake of sugar-sweetened beverages and weight gai…[Am J Clin Nutr. 2006] – PubMed Result) Replacing sugar sweetened beverages with water could result in an average reduction of 235 calories per day. ( See, Wang YC, Ludwig DS, Sonneville K, Gortmaker SL, Impact of changes in sweetened caloric beverage consumption on energy intake among children and adolescents. Arch Pediatr Adolesc Med 2009 Apr; 163(4):336-43.Impact of change in sweetened caloric beverage con…[Arch Pediatr Adolesc Med. 2009] – PubMed Result)

The Senate Finance Committee options, however, do not indicate the level of taxation under consideration. Only a significant tax level is likely to affect consumption and its effect on obesity is predicated on the sugar sweetened beverage not being replaced by foods or beverages of similar caloric value. A significant tax, however, is likely to presage decline in consumption over time with an accompanying decline in tax revenue over that time. Therefore, its contribution to financing tax reform would be offset by its value in reducing obesity. As no state or jurisdiction has undertaken this policy option, there is no way of knowing with some certainty whether obesity levels would fall. This may not be a reason not to impose such a tax.

8. Tax on ‘Cadillac Plans’

Also, proposals have been made to treat as income to employee the costs of “Cadillac” health insurance plans, i.e. those that have extensive benefit packages, very low co-payments or deductibles or both. In regard to obesity, probably most of the health insurance plans which now cover surgery, drugs and behavioral modification for persons with obesity would be regarded as such a plan. To tax the employee for these benefits may undo the goals of obesity prevention and reduction. The time has come for employers and payors to provide comprehensive coverage of obesity treatments. Enactment of a tax on the extra costs of such plans is likely to have a negative effect. (See, Swallowing the Cost of Obesity Treatment | workforce.com)

April 21, 2009

Somerville MA tagged as model for health care reform Mass. town takes steps to trim fat (really), health care costs – USATODAY.com

March 5, 2009

Obama addresses obesity at close of national health care forum The White House – Press Office – Closing Remarks by the President at White House Forum on Health Reform, followed by Q&A, 3/5/09

Feb 4, 2009

President Obama Signs SCHIP Bill, Includes Childhood Obesity Demonstration Project.

The new SCHIP legislation contains a requirement for the Secretary of HHS in consultation with the Centers for Medicare and Medicaid Services to conduct a “systematic model for reducing childhood obesity.” The model is intended to identify behavioral risk factors for obesity through self-assessment, identify, through self-assessment, needed clinical preventive and screening benefits among children identified as target individuals on the basis or such risk factors and provide ongoing support to such individuals to reduce risk factors and promote use of preventive and screening benefits and “be designed to improve health outcomes, satisfaction, quality of life, and appropriate use of items and services available under Title 19 (Medicaid) or Title 21.

November 30, 2008

CEO’s Talk Up Obesity CEOs’ Healthcare-Reform Priorities: Obesity and Tort Reform, But Not Universal Coverage | BNET Healthcare Blog | BNET

August, 2008

For the first time in history, the two major political parties in the United States recognized the importance of obesity in their respective party platforms

Democratic Party Platform addresses obesity

The Democratic Platform, adopted in Denver, Colorado on 25 August 2008, refers to obesity three times:

“Our nation faces epidemics of obesity and chronic diseases as well as new threats like pandemic flu and bioterrorism. Yet despite all of this, less than four cents of every health care dollar is spent on prevention and public health.” (p 8)

An Emphasis on Prevention and Wellness. Chronic diseases account for 70 percent of the nation’s overall health care spending. We need to promote healthy lifestyles and disease prevention and management especially with health promotion programs at work and physical education in schools. All Americans should be empowered to promote wellness and have access to preventive services to impede the development of costly chronic conditions, such as obesity, diabetes, heart disease, and hypertension.” (p 9)

Public Health and Research. Health and wellness is a shared responsibility among individuals and families, school systems, employers, the medical and public health workforce and government at all levels. We will ensure that Americans can benefit from healthy environments that allow them to pursue healthy choices. Additionally, as childhood obesity rates have more than doubled in the last 30 years, we will work to ensure healthy environments in our schools.” (p 10)

A forum on obesity was held by the Obesity Society. The forum at the Democratic National Convention, held on 25 August 2008 at the Denver Art Museum, featured Gary Foster, president, James Hill and Robert Eckel of the University of Colorado, past presidents, and Caroline Apovian with Melody Barnes, Director of Policy for the Obama for President Campaign, and Karen Kornbluh, principal author of the 2008 Democratic Party Platform. Also presenting were Congressman and chairman of the Congressional Black Caucus John Conyers (D-MI-14), Jim Rex, Superintendent of Education in South Carolina and R.T. Rybak, Mayor of Minneapolis, Minnesota. Sally Squires, former columnist for the Washington Post and founder of the Lean Plate Club, moderated the event. Discussions ranged far and wide about expanding treatment and improving prevention of obesity, especially the role of schools in childhood obesity.

The Republican Party Platform, adopted a week later in St Paul, Minnesota, provides:

“Prevent Disease and End the ‘Sick Care’ System. Chronic diseases—in many cases, preventable conditions—are driving health care costs, consuming three of every four health care dollars. We can reduce demand for medical care by fostering personal responsibility within a culture of wellness, while increasing access to preventive services, including improved nutrition and breakthrough medications that keep people healthy and out of the hospital. To reduce the incidence of diabetes, cancer, heart disease and stroke we call for a national grassroots campaign against obesity, especially among children.”

On 2 September 2008, The James L. Hill Research Library in St Paul, Minnesota, was the scene of the Republican forum. Speakers included Caroline Apovian, Eric Finkelstein, and Michael Jensen, also a past president of the Society. Allen Levine and Charles Billington (another past president) presented welcoming statements from the University of Minnesota. Lesley Stahl, correspondent on CBS News’ 60 Minutes, moderated a panel consisting of former Secretary of Health and Human Services, Tommy Thompson, representing the campaign of Senator John McCain, former Presidential candidate and Arkansas Governor, Mike Huckabee and State Senator Bob Clegg of New Hampshire. Huckabee enthralled the audience with accounts of trying to get attention to health care issues and obesity in the presidential debates and within his own party. Bob Clegg told his personal story of his fight with obesity and subsequent bariatric surgery. Clegg was the Republican majority leader in the New Hampshire State Senate, and push through the legislature, a bill mandating insurance companies cover bariatric surgery. His personal story combined with the legislative maneuvering was compelling.

Video and transcript of Republican National Convention Forum is available at: http://www.kaisernetwork.org/
health_cast/health2008hc.cfm?hc=2970

Video and transcript of Democratic National Convention Forum is available at: http://www.kaisernetwork.org/
health_cast/health2008hc.cfm?hc=2962

The video and transcript of the 19 September 2007 forum on what the next administration should do can be found at: http://www.kaisernetwork.org/
health_cast/hcast_index.cfm?display=detail&hc=2353

Archives

September 27th, 2009

APRIL 2009

April 24, 2009

After planting garden, Michelle Obama skips out to Five Guys for a burger.

First lady says she sneaks off to fun restaurants – washingtonpost.com

MARCH 2009

March 31, 2009

Kansas Governor Kathleen Sebelius lead off her testimony to the Senate Health, Education, Labor, and Pensions Committee stating, “Yet, at the beginning of the 21st century, we face new and equally daunting challenges.

We face an obesity epidemic that threatens to make our children the first generation of Americanchildren to face life expectancies shorter than our own.”

March 30, 2009

Review of new drugs for obesity Obesity Drug by Arena Has an Effect, but a Limited One – NYTimes.com

March 27, 2009

New York Times reports on walking school buses in Italy fighting obesity and climate change

Students Give Up Wheels for Their Own Two Feet – NYTimes.com

March 18, 2009

Another study shows obesity increases risk of death

Obesity Takes Years Off Your Life – Forbes.com

March 13, 2009

Mississippi to cover state workers’ bariatric surgery

Surgery: Long-term care is more expensive | clarionledger.com | The Clarion-Ledger

March 9, 2009

Obama sets out Administration policy on use of science The White House – Press Office – Memorandum for the Heads of Executive Departments and Agencies 3-9-09

March 6, 2009

Abdominal obesity adversely affects lung function Belly Fat Bad for Your Lungs?

March 6, 2009

New study finds dietician students prejudiced against persons with obesity Bias Against Obesity Is Found Among Future Dietitians – Forbes.com

March 1, 2009

Obesity increases worker’s comp. Obesity supersizing workers comp costs – Financial Week

March 1, 2009

South Carolina Senator criticized for trying to dump bicycle paths from stimulus bill. DC Bicycle Transportation Examiner: Sen. DeMint’s pro-obesity legislation was the real pork in the stimulus debate

FEBRUARY 2009

February 27, 2009

Obama budget to cut farm subsidies; improve child nutrition Obama wants to cut subsidies to farmers | DesMoinesRegister.com | The Des Moines Register

February 27, 2009

Drug maker buries data on diabetes drug causing weight gain AstraZeneca Documents Released in Seroquel Suit – NYTimes.com

February 20, 2009

North Carolina looks to penalize persons with obesity: Smoking, obesity may cost state employees | CharlotteObserver.com

February 19, 2009

Robert Wood Johnson Foundation announces national effort on childhood obesity Leading Research Funders Launch Collaborative To Accelerate Nation’s Progress in Reducing Childhood Obesity – RWJF

February 19, 2009

Clinton Foundation announces alliance on childhood obesity Alliance for a Healthier Generation Expands Efforts to Combat Childhood Obesity with Launch of Landmark Healthcare Initiative

February 18, 2009

Court of Appeals upholds NYC Calorie Disclosure Ordinance

http://www.citizen.org/documents/NYSRAOpinion.pdf

Court Upholds the City’s Rule Requiring Some Restaurants to Post Calorie Counts – NYTimes.com

CDC: Young Invincibles are obese CDC: ‘Young invincibles’ have significant health concerns – CNN.com

February 16, 2009:

Home recipes increase in calories: ‘Joy of Cooking’ or ‘Joy of Obesity’? – Los Angeles Times

February 12, 2009

CMS Issues decision on using bariatric surgery to treat Type 2 Diabetes; notes effectiveness of bariatric surgery in resolving Type 2 Diabetes. Centers for Medicare & Medicaid Services

Obesity linked to Birth Defects

Obesity During Pregnancy Linked to Infant Birth Defects – NYTimes.com

JAMA paper on birth defect risks with mothers with obesity. JAMA — Maternal Overweight and Obesity and the Risk of Congenital Anomalies: A Systematic Review and Meta-analysis, February 11, 2009, Stothard et al. 301 (6): 636

February 19, 2009

Fast food restaurants predict strokes

More Fast-Food Joints in Neighborhoods Mean More Strokes – US News and World Report

February 12, 2009

How evolution lead to modern obesity

AAAS: Modern obesity epidemic can be traced back two million years – Telegraph

NEJM — Expanding Coverage for Children — The Democrats’ Power and SCHIP Reauthorization

JANUARY 2009

January 24, 2009

Childhood obesity influenced by genetic variations

Science Centric | News | Childhood obesity risk increased by newly-discovered genetic mutations

January 21, 2009

Obesity imperils health care reform

FEATURE-U.S. obesity epidemic shows perils to health reform – Forbes.com

January 20, 2009

Employers try incentives for healthier workforce Firms offer bigger incentives for healthy living – USATODAY.com

January 13, 2009

NIH launches study of how genes and environment affect children’s development National Children’s Study Begins Recruiting Volunteers, January 13, 2009 News Release – National Institutes of Health (NIH)

January 9, 2009

Physical Activity May not be Key to Obesity After All

Physical Activity May Not Be Key To Obesity Epidemic

January 6, 2009

Obesity and Ovarian Cancer Linked

Obesity Linked To Elevated Risk Of Ovarian Cancer

DECEMBER 2008

December 22, 2008

A little overweight and inactive hurts too

Even a Little Overweight, Inactivity Hurts the Heart – washingtonpost.com

December 19, 2008

Limiting snacks in schools can increase fruit, veggie consumption

Limiting School Snacks Boosts Fruit, Veggie Consumption – US News and World Report

December 18, 2008

Childhood Obesity may affect thyroid

Childhood Obesity May Cause Thyroid Problems – washingtonpost.com

December 16, 2008

New York Debates Tax on Soft Drinks

A Tax on Many Soft Drinks Sets Off a Spirited Debate – NYTimes.com

December 12, 2008

Study looks at relationship between obesity, breast cancer and frequency of mammography

Daily Cancer News – CancerConsultants.com

December 3, 2008

Visceral obesity linked to depression in elderly

Depression Linked to Increase in Abdominal Fat – US News and World Report

Federal Government

September 27th, 2009

Federal Programs on Obesity

For an excellent overview, see http://www.stopobesityalliance.org/research-and-policy/research-center/gw-research/ and F as in Fat: How Obesity Policies Are Failing in America 2008 – RWJF

National Institutes of Health

NIH is the preeminent research organization in the United States and the world and have a number of research programs related to obesity.

Weight Information Network has many fact sheets, also available in Spanish Welcome to WIN – The Weight-control Information Network

What is NIH spending on obesity? A projected $664 million. NIH Research Portfolio Online Reporting Tool (RePORT) – Estimates of Funding for Various Research, Condition, and Disease Categories (RCDC)

What are the specific grants now in process? NIH Research Portfolio Online Reporting Tool (RePORT) – RCDC Project Listing by Category

What is their plan to address obesity? Obesity Research at the National Institutes of Health (NIH)

Information on applying for grants. http://grants.nih.gov/favicon.ico

Clinical trials Home – ClinicalTrials.gov

Some particular projects:

Longitudinal Assessment of Bariatric Surgery Longitudinal Assessment of Bariatric Surgery

Clinical Nutrition Research Units WIN – Research – ONRCs and CNRUs

Research Opportunities Obesity Research at NIDDK : NIDDK

Advisory Groups Clinical Obesity Research Panel (CORP) : NIDDK

NIDDK Office on Obesity Research Office of Obesity Research : NIDDK

Look Ahead Trial Action For Health in Diabetes (Look AHEAD) : NIDDK

Food and Drug Administration (FDA)

The FDA has several responsibilities when it comes to obesity, including nutrition labeling and approval of drugs and devices

Calories Count: The 2004 plan of FDA to address obesity FDA/CFSAN – Calories Count: Report of the Working Group on Obesity Q&A Questions and Answers – The FDA’s Obesity Working Group Report

The Keystone Report on Away from Home Foods Calories Count and Keystone Report

Consumer information on reading the nutrition label. Make Your Calories Count

Department of Agriculture

Women Infants Children program of the USDA is a program of providing grants to states for nutrition education and support for low income pregnant, breastfeeding or post partum women WIC

Food and Nutrition Information Center Food and Nutrition Information Center

General Information on obesity General Information and Resources : Weight and Obesity : Food and Nutrition Information Center

Consumer Nutrition Information Weight Management : Nutrition.gov

Internal Revenue Service (IRS)

While the IRS is not considered a health agency, it does provide that taxpayers may use the medical deduction for expenses related to weight loss when a physician makes a recommendation of weight loss. Publication 502 (2008), Medical and Dental Expenses

Surgeon General

Surgeon General Richard Carmona on Obesity The Obesity Crisis in America

Surgeon General’s Report to Prevent and Decrease ObesityThe Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity

Transcript of meeting where Surgeon General David Satcher decided to issue Surgeon General’s Report on Preventing and Overcoming Obesity: http://www.health.gov/hpcomments/council4-23-99/focus.htm

Earlier Surgeon General Reports on Nutrition and Health The Surgeon General’s Report on Nutrition and Health (1988) and Physical Activity Physical Activity and Health Executive Summary

Center for Medicare and Medicaid Services (CMS)

In 2004, CMS dropped language from its policies that obesity was not considered a disease. 2004.07.15: HHS Announces Revised Medicare Obesity Coverage Policy. A Deletion Opens Medicare To Coverage for Obesity – The New York Times

Subsequently, it convened an advisory panel to consider expanding or restricting medicare coverage of bariatric surgery which considered a summary of the evidence on the surgery’s safety and effectiveness. http://www.cms.hhs.gov/FACA/downloads/id26c.pdf

The outcome of the advisory panel was very favorable and, in 2006, official coverage policy was changed and expanded. Centers for Medicare & Medicaid Services

Disability

EEOC Policy on obesity EEOC Informal Discussion Letter

EEOC definition of “disability” Section 902 Definition of the Term Disability

6th Circuit Court of Appeals denies ADA claim based on morbid obesity. Read the full decision in EEOC v. Watkins Motors. http://www.ca6.uscourts.gov/opinions.pdf/06a0351p-06.pdf

Through the Social Security Administration, individuals who are morbidly obese and have cardiovascular, respiratory or musculoskeletal problems may quality for disability.

See: Disability Doc – Examining Social Security Disability – Obesity and Disability

Centers for Disease Control and Prevention (CDC)

The CDC has numerous fact sheets and guides. Where appropriate, they are incorporated into more specific sections of the site.

To see all the CDC resources available, go to Obesity and Overweight: Topics | DNPAO | CDC

Agency for Healthcare Research and Quality (AHRQ)

AHRQ funds research, especially on the translation of basic research into clinical practice, improvements to clinical care and a number of evidence-based guidelines. Relevant guidelines are included in the treatment or health effects sections. AHRQ is a leader in Comparative Effectiveness Research and obesity is one of their major conditions of interest.

See Agency for Healthcare Research and Quality (AHRQ) Home Page

Medicaid

Morbidly obese patients often return to work after gastric bypass surgery Return to work after gastric bypass in Medicaid-fu…[Arch Surg. 2007] – PubMed Result

Veterans Administration

Learn about the VA programs in weight management at MOVE! Home

Department of Defense

Information on the military’s Tricare program and weight management can be found at The TRICARE Blog