Medicaid Payment for Diets - A Flawed Plan Based on Flawed DataObesity fears and inflated statistics have tipped the scales against sound judgment, leading the West Virginia Medicaid program to use tax dollars to pay Weight Watchers for weight-loss services. The methodology used by the state government to calculate the $100 million in annual costs linked to obesity is based on flawed methodology which leads to flawed data. Unfortunately, this unsound data has been used to justify paying Weight Watchers and to promote increasing the enrollment of health benefits group UniCare. West Virginia has started a trend which will be followed by other states, especially the states with higher obesity rates, such as Alabama. This move to classify a lifestyle-induced problem as a disease, if successful, could lead to higher insurance premiums, more prescription and over-the-counter weight-loss drugs, increased harassment of supplement and food manufacturers and marketers, and lawsuits against anything that contains calories. Obesity contributes to social problems and health complications, but it is not a disease. And as such, actions taken to reverse the effect of poor lifestyle habits should not be paid for with taxpayers’ money. Taxpayers already pay the cost of treating diseases, such as diabetes and heart disease that are aggravated by being obese; we should not have to pay for programs that are not medical treatments. There is no research that supports the assumption that obesity causes disease. It is a fact that losing weight is not a cure for disease. The “more than $100 million in annual costs linked to obesity” is misleading and intended to justify an increase in Medicaid spending. Since the method used by the government and adopted by the obesity industry to determine who is over weight or obese is illogical, it follows that the assertion that two-thirds of adult West Virginians are overweight or obese is also illogical. Therefore the $100 million in annual costs linked to obesity is deceptive. The Body Mass Index (BMI) is the measurement used to place people into overweight and obese categories using only a person’s height and weight. A person is considered over-weight if one has a BMI of 25 or greater; a BMI of 30 or more makes you obese, from which the statistic labeling over 65 percent of Americans as overweight is derived. The method does not differentiate weight from muscle mass and weight from fat, nor where the fat is located on the individual’s body. For example, using this method, the actor Tom Cruise who is 5 feet 7 inches and 201 pounds will have a BMI of 31, which will make him obese. And actors Will Smith who is 6-2 and 210 pounds with a BMI of 27 and Pierce Brosnan (6-2, 211 pounds, BMI 27) are overweight. Michael Jordan at 216 pounds and 6-6 with a BMI of 25 is also overweight. The Centers for Disease Control and Prevention (CDC) explains these counterintuitive results by stating: “Overweight may or may not be due to increase in body fat. It may also be due to increase in lean muscle.” The CDC changed the standard for measuring and defining overweight and obesity in 1998; it also abandoned the practice of distinguishing between men and women. Using the same flawed methodology, the government recently turned its attention to children, stating that “obesity is a concern because overweight rates have doubled among children and tripled among adolescents, and this greatly increases the number of years over which they are exposed to the health risks associated with obesity.” Another flawed statistic is the number of deaths caused by excess weight. The CDC recently lowered its estimate from 365,000 to 112, 000 deaths a year, citing “the general difficulty associated with attributing deaths to obesity, poor nutrition and physical inactivity and specific differences in methodologies.” The methodology used is based on the assumption that if a person dies while overweight, that person died because of excess weight. Using this logic, a motorcyclist who is “overweight” and gets hit by a truck will be included in the number of deaths caused by excess weight. The New England Journal of Medicine knows that the statistic is flawed and stated that the reported number of deaths caused by excess weight “is by no means well established. Not only is it derived from weak or incomplete data, but it is also called into question by the methodology difficulties of determining which of the many factors contribute to premature death.” The cost of obesity in the U.S., said to be $117 billion, was derived from a single study conducted in 1998. The authors acknowledged that their methodology resulted in the “double-counting of costs” which “would inflate the cost estimate.” But even if they were able to control for the double counting of costs, the conclusion would still be incorrect, because they used a flawed definition of obesity. Unfortunately, these are the statistics and methodology that the government, drug, food and supplements industries use in their marketing. Organizations such as the Center for Science in the Public Interest, the Physicians Committee for Responsible Medicine, and the American Obesity Association use these flawed statistics to promote classification of obesity as a disease. The West Virginia government is using this flawed “science” as a basis for its decision to use Medicaid funds to pay Weight Watchers through UniCare, a firm which would like to increase its share of the 300,000 to 370,000 West Virginia residents covered by Medicaid. There is definitive movement among a cross-section of Americans to classify obesity as a disease. If successful, we can expect the pharmaceutical industry to develop more diet drugs such as Xenical, Meridia, Acomplia, and Alli with their serious side effects. Health insurance providers would be made to pay for treatments for obesity which, based on the flawed statistics, would cause premiums to skyrocket. Medicaid and Medicare will be used to pay for questionable obesity treatments. There will be increased targeting of supplement and food manufacturers and marketers for making claims that certain foods can help to combat obesity. Gyms and other exercise programs will probably be banned from making claims that exercise can prevent and reverse obesity. And we can expect an increase in lawsuits against product makers and marketers for offering products that cause obesity. | 