It’s a very lucrative time to operate a for-profit diet clinic overseen by doctors because of a provision in Obamacare requiring insurers to pay for nutrition and obesity screening.
Medical weight loss programs, including those run by hospitals and clinics, bring in an estimated $1 billion annually and are expected to grow by approximately 5 percent a year through 2019, according to John LaRosa, research director at Marketdata Enterprises, who has studied the weight loss industry for more than 20 years.
LaRosa says a get-rich-now mentality fed by insurance payments is fueling the temptation to offer ineffective quick fixes for treating obesity.
Ambition Versus Ethics
Dr. Gilbert Ross, executive director of the American Council on Science and Health, says there may be a lot more going on in many of these clinics than obesity screening and nutritional counseling, which are now covered by Obamacare.
“It doesn’t take much to screen for obesity,” said Ross. “Height, weight, and, if you’re ambitious, a fat-caliper to estimate adiposity is all that is needed. Nutritional counseling is complex when it’s done well.”
Ross says there may be too great of a temptation for doctors to exploit the system by selling useless vitamins and supplements and other quick fixes to vulnerable patients, but he remains optimistic about the profession as a whole.
“Well, it happens, and it can happen with any doctor and indeed with any professional who holds a position of trust,” Ross said. “To point out some examples of doctors who game the system is not the same as saying the whole field is rife with such behavior.”
Ross says it’s difficult to get obese patients to lose weight utilizing a long-term lifestyle approach, and there are some pharmaceuticals that do somewhat improve weight loss safely.
“If a responsible clinician wants to help long-term obese patients lose weight and keep it off, a combination of approaches is needed with regular follow-up,” Ross said. “Drugs included, even bariatric surgery when appropriate. [Simply] giving out phentermine and vitamins and supplements on sale in one’s office is unprofessional and unethical.”
Government Helped Cause Problem
The war on obesity will be complex and costly, and probably lost in the end, says Julie Kelly, a cooking writer, teacher, and policy advisor for The Heartland Institute, which publishes Health Care News.
“It’s hard not to make the connection between government’s overreach in how and what we eat during the last few decades and the rise in overweight and obesity rates,” Kelly said. “And now the health care law will incentivize the use of diet clinics that have little hope of making any progress against obesity.”
Since obesity is considered a disease, we are spending an enormous amount of resources to combat it, with little in the way of personal accountability, Kelly says.
“Some doctors acknowledge 90 percent of their patients who use diet clinics are unsuccessful,” Kelly said. “Why? Because people are looking for a quick fix, a crash diet, or products that do the hard work [for them]. This will be an even easier sell for people desperate to lose weight if taxpayers and insurers will pick up part of their tab at a diet clinic.”
There are many reasons for the obesity crisis, Kelly says, including cultural, socioeconomic, and heredity factors. But the government must also accept blame for promoting policies that have contributed to the problem.
“From giving bad advice such the high-carb, low-fat recommendations over the past few decades to supporting poor food choices for folks on [the Supplemental Nutrition Assistance Program], to now the misguided nutritional standards in the school lunch program, the federal government has largely been a failed messenger,” Kelly said.
Sean Parnell ([email protected]) is a policy advisor to The Heartland Institute and president of Impact Policy Management, LLC.
Internet Info
Steven Marks, “Obesity and New Pharmaceutical Approaches,” American Council on Science and Health, February 2009: https://heartland.org/policy-documents/obesity-and-new-pharmaceutical-approaches
Gilbert Ross, Ruth Kava, et al., “Obesity and Its Health Effects,” American Council on Science and Health, December 2008: https://heartland.org/policy-documents/obesity-and-its-health-effects
Sean Parnell ([email protected]) is a research fellow for health policy at The Heartland Institute.
