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Barriers remain for childhood obesity treatments
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Children with overweight or obesity in the United States are still not receiving evidence-based care for obesity despite the release of the U.S. Preventive Services Task Force recommendations 6 years ago, according to a consensus report published in Obesity.
“With nearly one in three children in the United States with overweight or obesity there is an urgent need to help these children get access to the evidence-based care they need to get healthy,” Denise E. Wilfley, PhD, Scott Rudolph University professor of psychiatry at Washington University School of Medicine, St. Louis, said in a press release. “The consensus group was successful in identifying several barriers to care that impede widespread implementation of the USPSTF recommendation, including lack of health insurance coverage for treatment.”
Earlier this year, a conference supported by the Agency for Healthcare Research and Quality, American Academy of Pediatrics Institute for Healthy Childhood Weight and The Obesity Society was attended by 43 multidisciplinary, cross-sector stakeholders, including clinical, scientific, policy and insurance experts, to identify barriers to implementations of the USPSTF recommendations and to make key recommendations for the next steps to address the childhood obesity epidemic.
According to the report, many insurers do not provide coverage for childhood obesity treatment despite evidence that the disease warrants early treatment and is mandated by the Affordable Care Act.
, it is often limited in scope and does not support treatments of adequate duration or breadth to effectively impact children with obesity,” Wilfley said in the release. “We cannot reach USPSTF-recommended care for children unless we advance efforts to secure payment for that care.”
Three key recommendations were highlighted at the conference:
Children with obesity should be offered family-based, multi-component behavioral therapy to help parents and children improve nutrition and dietary behaviors, promote physical activity and reduce sedentary behavior.
Obesity treatment should be framed in an integrated chronic care model calling for clinic to community linkages.
A multidisciplinary team approach should facilitate an integrated system of care.
“Childhood obesity is a serious public health issue with long-term ramifications,” Nancy Butte, PhD, spokeswoman for The Obesity Society and professor at Baylor College of Medicine, said in the release. “It’s crucial that we not just identify the best way to treat childhood obesity, but also how it will be paid for so that families can access the care. Payers should take a close look at these recommendations, as addressing obesity during childhood will reduce chronic diseases and associated costs in adulthood.”
In an accompanying editorial, Robert I. Berkowitz, MD, of the Perelman School of Medicine at the University of Pennsylvania, and Stephen R. Daniels, MD, PhD, chairman of the department of pediatrics at the University of Colorado School of Medicine, wrote that lack of funding may be part of the reason treatment programs have not been developed.
“Health care reform should include greater and sufficient funding for evidence-based lifestyle programs to treat childhood obesity,” Berkowitz and Daniels wrote. “It was heartening that insurers had considerable interest in supporting ways to improve funding at this conference.” – by Amber Cox
Disclosure: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Berkowitz reports receiving consultant fees from Eisai and Takeda, and research grants from Eisai and Novo Nordisk.
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