Call to Arms

Dear Naughty Nutrition Reader,

This a plea that you will help the nation in the fight against obesity by allowing Medicare and Medicaid recipients to be covered to see medical professionals who are truly qualified and focused on treating their condition rather than their primary care giver alone. Recently, Centers for Medicare and Medicaid Services decided that Intensive Behavioral Therapy for Obesity could only be furnished by primary-care providers in the primary-care setting. Meaning medical professionals, such as registered dietitians and clinical psychologists, can no longer be reimbursed by Medicaid or Medicare for providing these services to obese Medicare/ Medicaid recipients. Primary-care providers, who have significantly less training on obesity counseling, are now being asked to show positive outcomes in treatment of obesity. Interestingly, a recent survey of primary-care physicians showed that 78 percent said they had no prior training on weight-related issues. Of those, 72 percent said no one in their office had weight-loss training. This hardly justifies what Centers for Medicare and Medicaid Services has done.

Many states in this nation are afflicted by the obesity epidemic and the numbers are continuing to rise. According to the CDC one-third of U.S. adults are considered obese. An even gloomier outlook, 12.5 million children and teens (or 17 percent) from age 2 to 19 are considered obese. This is a large number of people whose options for treatment are down to one person who may have little to no training in that area.

Obesity can lead to numerous chronic conditions including type 2 diabetes, hypertension, coronary heart disease, and cancer. The results of these conditions are not pretty, nor are they inexpensive. Take type 2 diabetes for example, in 2003 researchers performed a study to find out how much it will cost to treat an obese person with type 2 diabetes. In 2003 it cost $1,700 dollars for white men and $2,100 dollars for white women. This amount is minus the cost of what it would be to treat complications of diabetes. Obviously, not all patients with type 2 diabetes are white, but for the sake of this example and the lack of research concerning the cost of type 2 diabetes, I'll assume that treatment for blacks, hispanics, and asians would cost about the same. Coincidentally, most people with type 2 diabetes are not white but are black, hispanic or asian.

Now for a little math, shall we? According to the American Diabetes Association there are 25.8 million people in the US with some form of diabetes. Of that, 5 percent have type 1 diabetes. That knocks us down to 24.51 million people with type 2 diabetes. For the sake of trying to guess how many of each sex has diabetes, I'll average the costs to $1,900 a person to treat type 2 diabetes without any complications.

I failed to mention something, the $1,900 cost I used was just using diet therapy. Not many primary-care givers automatically recommend diet alone. I say this because someone near and dear to me was recently diagnosed with type 2 diabetes. He was told, "No white bread, no regular soda, and take this pill before every meal. I'll see you 3 months." Not what I wanted to hear. I wonder what advice that primary care doctor will give an obese patient. I am fairly certain it will include "take this pill."

Multiplying $1,900 by 24.51 million patients we get $46.569 billion to treat type 2 diabetes. These costs and patient numbers are from 2003 and 2007. Inflation since 2003 has likely increased how much it costs to treat diabetes. The number of people with type 2 diabetes has also increased. In actuality this number is a little low. The cost of treatment per person increased 10-90% depending on if drugs or other diseases related to diabetes occurred. If their diabetes lead to kidney failure and they required dialysis the cost increased 11-fold. Those are some big jumps in cost and these costs are passed on us, the tax payers, for Medicare and Medicaid recipients.

Type 2 diabetes is just one example of a chronic condition that can stem from obesity. Keep in the mind there are ten health conditions related to obesity. All of them requiring different types of treatments and therapies. All of these conditions can cost an astronomical amount of money, whether it be for the treatment or the economic loss of an individual being unable to work and needing assistance. All of these chronic health conditions may be prevented if proper and adequate action is taken to treat obesity.


This is the first year there are no blue states on the map. Welcome to the club Colorado.

We can have an impact on these chronic conditions by stomping out obesity. Tell Centers for Medicare and Medicaid Services that medical professionals such as RDs and clinical psychologists can help people with obesity in conjunction with (and maybe even better than) their primary care giver. If you or someone you know has been diagnosed as being obese and has benefited from the help of a RD you owe to yourself, that family member/friend, and that RD. You can sign the petition here: http://wh.gov/DWX.

Thank you and good night.