This is a wonderful and yet frightening manuscript that summarizes why we must be so concerned about childhood obesity and overweight. Additionally worrisome is the high prevalence of severe obesity in very young children. More research is definitely warranted and needed, particularly regarding effective interventions, but with so many children already affected and suffering, we can't wait to act. However, currently the majority of pediatricians across the United States are unable to see a child for "only" having childhood obesity or overweight because these visits are rejected for payment by the majority of Medicaid and private insurance carriers in most states. There are some states and insurance carriers that reimburse an obesity or weight management visit, but for most pediatricians and other health professionals, we have to wait until the child develops a complication of their weight before we can see them to address their excess weight. This is very frustrating.
However, it also means that great untapped potential exists for pediatricians and other health professionals to play a much more impactful role in helping children and families make healthy changes. Making these changes early and avoiding severe obesity also will prevent the costly and often intractable complications that are certain to follow. The solution to the childhood obesity epidemic is not in the pediatrician's office alone, but if we are to be most successful at reversing the childhood obesity epidemic, our offices have to be part of the solution! How much progress would we have made in pediatric cancer or asthma if we were not reimbursed for the visits? No doubt we would have still cared for these children, as we do now, but progress certainly would have been slower.
In November 2011, Medicare approved intensive outpatient treatment for adults with obesity; however, the majority of insurance providers for children, both Medicaid and private payers, still do not recognize childhood obesity as a reimbursable reason for a child to visit their pediatrician - or other health care professional - to address their weight. If you are interested in working in this area of advocacy, the American Academy of Pediatrics section on obesity would love to work with you. Beyond the walls of our clinics, pediatricians and other health professionals must also work in our communities. We must advocate and lead healthy community change so that healthy choices are easier to make where our patients live. Then as we help empower our patients in our clinics, they can return to communities where the healthier choice is much easier to make.
Stephen Pont, M.D., M.P.H., is a pediatrician at Dell Children's Medical Center in Austin, Tex., and chair of the American Academy of Pediatrics section on obesity. (On Twitter @DrStephenPont). He said he had no relevant financial disclosures.
