Recognizing obesity as a disease is a major shift in our collective thinking. Most people consider obesity an aesthetic problem, not a chronic disease issue. Too often, we use the word “obese” as an adjective for how a person looks without recognizing that obesity is a disease the person is battling at a metabolic level.
The Battle Against Obesity
Many of us struggle to both lose weight and keep the weight off. Trying to talk to your doctor about effective ways to manage excess weight can be challenging because you might feel embarrassed or stigmatized as you try to get help. Most people don’t even realize they can ask their doctor specifically about weight loss, or that there are trained obesity specialists who can support your specific needs and help guide your weight loss journey.
Dietary modification and increased physical activity remain key concepts in the management of obesity, however, treatment options now include medications, as well as surgery for weight loss. There have been significant advancements in the science of anti-obesity medications (AOMs) offering new, safer, more effective medicines than ever before, but you need to examine your health insurance coverage to understand what anti-obesity action steps are covered by your health plan. Here are ways you can advocate for your own care.
Confront Your Weight Loss Challenge
The first step in the fight against obesity is recognizing and acknowledging the existence of the problem. Be bold in taking this first step. It can be frustrating to achieve weight loss and maintain your progress and there are several reasons why. Most people don’t know that obesity has been scientifically proven to be a disease. Obesity is diagnosed in four classes of body mass index or BMI:
Overweight: BMI is 25.0 to 29.9
Class 1 obesity: BMI is 30.0 to 34.9
Class 2 obesity: BMI is 35.0 to 39.9
Class 3 obesity: BMI is equal to or greater than 40.0.
(Waist circumference is also a factor in diagnosing obesity.)
What’s often misunderstood is how impactful heredity is on the prevalence of the disease in your family. If your mother and father battled obesity, you, your siblings, and your children are likely to have similar challenges with weight. The truth is that the longer you’ve lived with excess weight, the harder it can be to combat the disease.
Your brain has a “set point” for the weight it thinks you should maintain, so the brain sends signals that you’re hungry to get you to consume more food to maintain that weight. Consuming the wrong foods consistently — those high in sugars and saturated fats — and lack of exercise are also contributing factors in the severity of the disease.
Trying to lose weight is a journey, so beware of unrealistic expectations. Remember: weight is often gained gradually over a period so your weight loss will be gradual as well. Sometimes, part of taking the first step may include identifying one area of your journey that you can focus on and improve. This could be as simple as decreasing portion size, decreasing dietary consumption of sugary drinks, or increasing physical activity.
One of the keys to success is being consistent with the modifications. Often, this is more effective and practical than trying to make several changes at the same time. Once
you’ve made your first incremental change, you can build a supportive habit based on that success while on your journey.
Consulting your physician is crucial in combatting any disease and obesity is no exception. However, your health insurance might not cover anti-obesity specialist consultations or treatments, so it’s important to understand what your health insurance does cover.
Check Your Insurance Coverage
Before you make an appointment with your doctor or an obesity specialist, you should do your research and be prepared with information that verifies whether anti-obesity treatments are covered by your health insurance. Some insurance companies are beginning to cover anti-obesity treatments but not everyone’s insurance offers access to AOMs, dieticians, physical activity, or other supports.
Unfortunately, coverage for AOMs remains inconsistent. For example, the Veteran’s Administration covers FDA-approved weight loss medications. However, the Centers for Medicare and Medicaid Services (CMS) does not cover AOMs in the Medicare Part D program, affecting 60 million beneficiaries. Approximately 40 percent of people with employer-sponsored insurance, around 19 million people with obesity, have commercial coverage of AOMs.
The fact is pharmacotherapy is safer and more effective than ever before thanks to breakthrough science. Still, there are gaps in insurance coverage that may limit access to lifesaving therapies and trained specialists.
A trained specialist in obesity will complete a comprehensive evaluation and assess your medical history and will ultimately be able to discuss weight loss medications and choices that are best for you. Not everyone is a candidate for weight loss medications, especially if they have other medical conditions that may make the use of these medications unsafe.
Combining Interventions for Positive Impact
No single solution will win your battle against obesity. A combination of many factors in a continuum of obesity care may be just what you need to reach your goals. Once you’ve mapped out what your health insurance will cover and you’ve seen an obesity specialist, here are additional steps to implement in your life.
Explore Anti-Obesity Medications – In many cases, anti-obesity medications may be just what you need to manage your long-term battle against excess weight. However, not all physicians will bring this up as a treatment option during your visit. Ask questions about whether medications should be a part of the management of your weight.
If your physician agrees that you are a good candidate for AOMs, discuss which medications are available to you and why a medication might be appropriate for you. Don’t forget to ask about the possible side effects of the medications. AOMs, like most medications currently used to treat diseases, have potential side effects and there are times when stopping the medication and or switching to a different medication may be necessary. Discuss
our comfort level with how the medication can be taken. Some medications are pills while others are taken by injection.
Ask questions about realistic expectations concerning how much weight you could lose and how the medication works to affect your metabolism during your treatment program. These are important questions because some people quit their treatment programs when it seems ineffective based on their unrealistic expectations of how much weight they can lose in a given amount of time. Some medications will affect your appetite while others make you feel full for a longer period after a meal. Some AOMs affect your metabolism while others have a combination of effects. Ultimately, asking questions and being informed will help you and your physician make the best decision that’s right for you.
What You Eat Is Important! – Heredity is a major factor in your battle against excess weight, but another important factor is what you eat. We know we need to eat better and maintaining a healthy diet has long-term positive effects but doing this is a daily challenge for many people. Eating healthy can be more expensive than consuming fewer healthy options. One approach is to treat healthy eating as an investment in your health.
· When you consume sugary drinks and ingest unhealthy snacks, you’re making a withdrawal from your body’s health account.
· Consuming colorful vegetables, healthy proteins, and reducing sugar consumption is like depositing money in the bank, your body’s health account gets stronger with each deposit.
Ask your insurance provider if consulting a dietician is covered in your plan. Working with a diet specialist to chart a course for healthier food consumption can be foundational to impactful changes in your health.
Increase Physical Activity to Maintain Gains – With increased weight, we decrease our physical activity, which in turn decreases our resting metabolic rate. You’re burning fewer calories when your body is at rest, which contributes to weight retention. Although increased physical activity may not necessarily result in weight loss, there is evidence that it plays a key role in weight maintenance.
Find Your Community – An African proverb says “If you want to go fast, go alone. If you want to go far, go together.” Find other people who are on a similar weight management journey, who understand your challenges and will celebrate your triumphs. Find your tribe in exercise groups, culinary clubs, at your workplace, in your place of worship, or near your home who have similar goals and values as yours — you’ll achieve more. Working within a community that shares your goals will be very important for your long-term success while helping you believe in yourself. ●
