July 3, 2014

July 2014 NewsLetter, "Implications for Plan Sponsors of Obesity's Designation as a Disease"

Abstract

In June 2013, the American Medical Association (AMA) voted in favor of recognizing obesity as a disease that requires medical treatment. After noting how obesity treatments typically are covered today, this NewsLetter discusses the implications for plan sponsors of the AMA’s designation of obesity as a disease.

In response to the AMA’s designation of obesity as a disease, coverage for obesity treatment is likely to change. There are three potential treatments for obesity: clinical or non-clinical counseling with group or personal support services, prescription drug therapy, and surgical intervention.

To some extent, the designation of obesity as a disease will increase plans’ immediate costs. There are several strategies for dealing with the short-term cost increase associated with obesity’s designation as a disease.

Over the long term, covering obesity treatments is likely to save plans money by avoiding serious and costly chronic diseases and conditions for which obesity is a major risk factor, including, but not limited to, type 2 diabetes, hypertension, sleep apnea, gallstones, infertility, varicose veins, gout, osteoarthritis and deep vein thrombosis (DVT). The financial impact of obesity related diseases and treatments on medical plan budgets can be significant. Consequently, the potential long-term savings are substantial.

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