New research shows that 140 million American adults - about 65 percent - are recommended for behavioral weight-loss treatment, with 83% of those (or 116 million) considered for pharmacotherapy. Thirty-two million adults recommended for both pharmacotherapy and behavioral treatment are also potential candidates for bariatric surgery. Researchers used data from the 2007 - 2012 National Health and Nutrition Examination Survey (NHANES) to estimate the proportion of adults in the United States recommended for treatment based on The Obesity Society (TOS), The American Heart Association (AHA) and The American College of Cardiology Guidelines (2013) for Managing Overweight and Obesity in Adults, released just one year ago in November 2013. The findings will be presented by lead researcher June Stevens, PhD, AICR distinguished professor of Nutrition and Epidemiology at the University of North Carolina, Chapel Hill and TOS member, during a poster session on Thursday, Nov. 6 at The Obesity Society Annual Meeting at ObesityWeek 2014 in Boston, Mass.
This research comes at a time when the American obesity epidemic is one of the worst in the world. The development and release of the Obesity Guidelines are intended to offer healthcare providers empirically based and effective weight-loss treatments for those affected by obesity.
"These guidelines address critical questions in obesity treatment, and provide evidence-based recommendations on topics such as: Who needs to lose weight? How much weight loss is needed to improve health? And what are the best and most appropriate methods for losing weight?" says Dr. Stevens. "Our team was eager to apply these recommendations to the population of the United States, and unfortunately, we were not surprised to see that a massive number of Americans are recommended for weight-loss treatment."
Nationally representative data were used to estimate the number recommended to lose weight among adults 20 years or older who were not pregnant. The recommendation to lose weight was based on an algorithm that included weight, height, waist circumference and risk factors like diabetes, hypertension and blood lipid levels. Researchers also compared various demographics and found that individuals were more likely to be recommended for treatment if they were over 45, male, African American or Mexican American, did not have a college degree and were insured by either Medicaid or Medicare rather than another type of health insurance.
"These findings remind healthcare providers, policymakers and the public that obesity is a disease that needs to be taken seriously," says Donna Ryan, MD, Obesity Journal associate editor-in-chief and professor emeritus at Louisiana State University's Pennington Biomedical Research Center, speaking on behalf of TOS. "With more than half of U.S. adults recommended for weight-loss treatment, we call on all health practitioners from primary care physicians to registered dietitians to review the guidelines and take steps to put them into practice. This huge number of Americans recommended for weight-loss therapy reinforces the need for broad, sweeping transformations in obesity management in the primary care setting. The good news is that there are evidence-based treatments readily available for most adults recommended for weight-loss treatment."
Today, millions of Americans continue to be denied health insurance coverage for legitimate and proven obesity treatments. TOS and its partners in the Obesity Care Continuum are advocating for change, and the organization recently launched an Advocacy Action Center to enable others to sign onto its efforts.
In addition to the Obesity Guidelines, healthcare providers can soon look forward to reviewing the first pharmacotherapy guidelines for the medical treatment of obesity, which are expected to be released by The Endocrine Society and The European Society of Endocrinology and TOS in January. These guidelines will expand upon the current Obesity Guidelines, and combined, both resources will fill a gap in the treatment of obesity, a disease that puts individuals at risk for more than 30 other health conditions.
"Seeking the support of a healthcare practitioner for weight loss can make all the difference for people affected by obesity," continues Dr. Ryan. "As an adjunct to diet and exercise, medications approved by the FDA for treatment of obesity can help people with obesity lose weight, specifically if they have not found prior success with diet and exercise alone. However, the decision to add medical treatment or surgery for any disease should be one made by the physician and the patient. The guidelines are intended to provide an evidence-based tool to help physicians identify and treat patients that may need the additional support."
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