Medicare Is Missing The Obesity Target

On July 16, 2004 the headline posted all over America was
“WASHINGTON (AP) — Medicare now recognizes obesity as an
illness, a change in policy that may allow millions of
overweight Americans to make medical claims for treatments such
as stomach surgery and diet programs.” (cnn.com)

It was almost impossible to miss this story, since it was
plastered on virtually every front page in the nation and
received heavy rotation on all the major news networks.

The government representative in front of the cameras said all
the right things about the dangers of excess body fat: Health
and Human Services Secretary Tommy Thompson said, “Obesity is a
critical public health problem in our country that causes
millions of Americans to suffer unnecessary health problems and
to die prematurely.”

Treating obesity-related illnesses results in billions of
dollars in health care costs, Thompson said.

“With this new policy, Medicare will be able to review
scientific evidence in order to determine which interventions
improve health outcomes for seniors and disabled Americans who
are obese,” Thompson told a Senate panel on Thursday. (end quote
from cnn.com)

That is all 100% true and accurate; obesity DOES cause a
multitude of health problems in the United States and around the
world. Fitness professionals around the nation have joined
together in congratulating the Department of Health & Human
Services in finally taking a much more pro-active role in
obesity prevention.

However, we must take issue with what appears to be the main
focus of this new initiative: fat loss results through surgery.
On July 21, 2004 the Idaho Press Tribune (idahopress.com) ran a
much more in-depth story on this issue (written by Mark Sherman
of The Associated Press). In part, this story stated that “Now
willing to pay for a treatment that works, Medicare is shunning
fad diets to focus on one of the more radical solutions, stomach
bypass surgery. Despite the claims of various diets and surgical
procedures, most researchers agree that no approach to weight
reduction has been proven to be effective over the long
haul…..officials said they would consider paying for
something, but only something that can be shown to work.”

We are shocked and dismayed that anyone at the Department of
Health & Human Services would not automatically endorse and
promote exercise as the number one proven remedy for obesity!

Please understand that we are not discounting the effectiveness
of stomach bypass surgery. On the contrary, it is perhaps the
best solution for some people. However, for the vast majority of
Americans, regular cardiovascular and resistance exercise is
will provide much better and long-lasting results.

Further along in the article from The Associated Press we find
this quote: “Some health plans subsidize gym memberships, but it
is unlikely that Medicare would, despite the undeniable benefits
of exercise.” The folks at Medicare just don’t seem to get it.
They’re missing the obvious solution to obesity.

The plain and simple fact of the matter is that liposuction,
stomach bypass surgery, and other surgical forms of obesity
control do not convey the same benefits as exercise. That is an
undisputed fact. Yes, fat-loss surgical procedures work for some
people and have even saved lives. If you think you may be a
candidate, then by all means please talk it over with your
physician. Odds are good that your doctor will discuss it with
you and then recommend (prescribe?) a healthier diet and regular
exercise.

There are two basic reasons why exercise is superior to fat-loss
surgery. First, the simple act of removing fat from your body
does not make your heart healther (as exercise does). Surgically
taking fat off your body (via liposuction) will also not prevent
diabetes or hypertension (as exercise does). In short, although
surgical procedures will make you healther they will not convey
the same benefits as regular exercise.

The second reason that exercise is superior to surgical
solutions is that we must change our behavior if we are to make
life-long changes in our body composition. Think about it. What
if we could magically take 20 lbs. of fat off our body today?
Poof! It’s gone. Now doesn’t that feel (and look) good? What
will happen if we don’t change our diet or activity
level….will that 20 lbs. come back? Of course! Similar to the
yo-yo diets many of us have experienced, without permanent
changes to our lifestyle and/or dietary habits, permanent change
is next to impossible.

So, while we applaud the folks at Medicare for their added
emphasis on obesity, we are alarmed that exercise will not (for
the time being, at least) play a role in their new initiative.
In the meantime, let’s continue to work out regularly and try to
keep our diets ‘clean’. Let’s talk to our doctors about our
goals…..the odds are good that they’ll continue to recommend
regular exercise and a healthy diet.

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