SAN DIEGO — The recent merger of two obesity associations to create the Obesity Society is expected to consolidate efforts to influence government programs and funding for the obesity epidemic, Richard M. Downey, J.D., said at a symposium on obesity sponsored by the American Society of Bariatric Physicians.
Mr. Downey is a staff member for the North American Association for the Study of Obesity, which has been renamed the Obesity Society. In December 2006, the association completed a merger with the American Obesity Association, where Mr. Downey previously was executive director.
He highlighted some of the successes and continuing struggles in the effort to increase government attention to obesity.
Although the Department of Health and Human Services (DHHS) Healthy People 2010 report prominently listed obesity as a leading health indicator, little has been done on the DHHS level to address the problem, he said. Although the stated goal was to decrease the prevalence of obesity in adults and adolescents by 10% by 2010, the prevalence is on track to increase 10% by then—the only leading health indicator moving in the opposite direction of the goal. Today, about 60% of U.S. adults are overweight or obese.
The new Obesity Society will push for creation of a National Institute of Obesity Research, he said. The National Institutes of Health (NIH) spends around $450 million per year on obesity research, but spends 6 times that amount on diabetes, 10 times that amount on cardiovascular disease, and 15 times that amount on HIV and AIDS research, he added.
“A few years ago, obesity got the same amount of research funding as anthrax, which was responsible for five deaths,” he noted.
The NIH did develop a 4-year plan for research on obesity, but NIH research funding for obesity is grant driven, without an initial commitment of government funding as applied to other problems such as HIV or bioterrorism, he added.
In activities by other federal agencies, the Food and Drug Administration posts links to resources for tackling obesity (www.fda.gov/loseweight/obesity_info.htm
On the positive side, 18 states receive funding from the Centers for Disease Control and Prevention to address pediatric obesity. In addition, the Centers for Medicare and Medicaid Services in 2004 deleted language from its policies that said obesity is not a disease, and in 2005 expanded coverage for bariatric surgery for obesity at Centers of Excellence. Prior to those actions, insurers were abandoning coverage of bariatric surgery, Mr. Downey said.
His and others' efforts to get obesity medications included in Medicare drug benefits have been unsuccessful, and Medicare still does not cover physician counseling for weight loss. “We will continue to lobby for these,” he said. Mr. Downey has been an adviser to Eli Lilly & Co. and to Amylin Pharmaceuticals Inc., which make obesity drugs.
Actions by other federal agencies sometimes conflict with efforts to decrease obesity, he noted. Some of the $35 million allocated to agricultural subsidies go to programs to increase food consumption. In 2006, Congress appropriated $1.3 billion to subsidize the cost of high-definition television converter boxes. The amount of TV viewing correlates with excess weight, studies have shown.
The Obesity Society is likely to demand better evaluation of obesity prevention programs, Mr. Downey said. The lack of coordination and evaluation of programs to prevent childhood obesity makes it impossible to learn from experience and difficult to replicate successes, a recent Institute of Medicine report suggests.