Medicare Is Missing The Obesity Target

On July 16, 2004 the headline posted all overPlease understand that we are not discounting the
America was "WASHINGTON (AP) -- Medicareeffectiveness of stomach bypass surgery. On the
now recognizes obesity as an illness, a change incontrary, it is perhaps the best solution for some
policy that may allow millions of overweightpeople. However, for the vast majority of
Americans to make medical claims for treatmentsAmericans, regular cardiovascular and resistance
such as stomach surgery and diet programs."exercise is will provide much better and
(cnn.com)long-lasting results.
It was almost impossible to miss this story, sinceFurther along in the article from The Associated
it was plastered on virtually every front page inPress we find this quote: "Some health plans
the nation and received heavy rotation on all thesubsidize gym memberships, but it is unlikely that
major news networks.Medicare would, despite the undeniable benefits of
The government representative in front of theexercise." The folks at Medicare just don't seem
cameras said all the right things about the dangersto get it. They're missing the obvious solution to
of excess body fat: Health and Human Servicesobesity.
Secretary Tommy Thompson said, "Obesity is aThe plain and simple fact of the matter is that
critical public health problem in our country thatliposuction, stomach bypass surgery, and other
causes millions of Americans to suffersurgical forms of obesity control do not convey
unnecessary health problems and to diethe same benefits as exercise. That is an
prematurely."undisputed fact. Yes, fat-loss surgical procedures
Treating obesity-related illnesses results in billionswork for some people and have even saved lives.
of dollars in health care costs, Thompson said.If you think you may be a candidate, then by all
"With this new policy, Medicare will be able tomeans please talk it over with your physician.
review scientific evidence in order to determineOdds are good that your doctor will discuss it with
which interventions improve health outcomes foryou and then recommend (prescribe?) a healthier
seniors and disabled Americans who are obese,"diet and regular exercise.
Thompson told a Senate panel on Thursday. (endThere are two basic reasons why exercise is
quote from cnn.com)superior to fat-loss surgery. First, the simple act
That is all 100% true and accurate; obesity DOESof removing fat from your body does not make
cause a multitude of health problems in the Unitedyour heart healther (as exercise does). Surgically
States and around the world. Fitness professionalstaking fat off your body (via liposuction) will also
around the nation have joined together innot prevent diabetes or hypertension (as exercise
congratulating the Department of Health & Humandoes). In short, although surgical procedures will
Services in finally taking a much more pro-activemake you healther they will not convey the same
role in obesity prevention.benefits as regular exercise.
However, we must take issue with what appearsThe second reason that exercise is superior to
to be the main focus of this new initiative: fat losssurgical solutions is that we must change our
results through surgery. On July 21, 2004 thebehavior if we are to make life-long changes in
Idaho Press Tribune (idahopress.com) ran a muchour body composition. Think about it. What if we
more in-depth story on this issue (written bycould magically take 20 lbs. of fat off our body
Mark Sherman of The Associated Press). In part,today? Poof! It's gone. Now doesn't that feel (and
this story stated that "Now willing to pay for alook) good? What will happen if we don't change
treatment that works, Medicare is shunning fadour diet or activity level....will that 20 lbs. come
diets to focus on one of the more radicalback? Of course! Similar to the yo-yo diets many
solutions, stomach bypass surgery. Despite theof us have experienced, without permanent
claims of various diets and surgical procedures,changes to our lifestyle and/or dietary habits,
most researchers agree that no approach topermanent change is next to impossible.
weight reduction has been proven to be effectiveSo, while we applaud the folks at Medicare for
over the long haul.....officials said they wouldtheir added emphasis on obesity, we are alarmed
consider paying for something, but only somethingthat exercise will not (for the time being, at least)
that can be shown to work."play a role in their new initiative. In the meantime,
We are shocked and dismayed that anyone atlet's continue to work out regularly and try to
the Department of Health & Human Serviceskeep our diets 'clean'. Let's talk to our doctors
would not automatically endorse and promoteabout our goals.....the odds are good that they'll
exercise as the number one proven remedy forcontinue to recommend regular exercise and a
obesity!healthy diet.