The Effects Counseling Has On Treating Obesity

The Conversation by Edgar Degas

The Victorian treats clients struggling with anorexia,
bulimia and compulsive overeating. Compulsive Overeating can lead to obesity. People who are at a much
greater risk of developing a variety of serious medical conditions including
high blood pressure, stroke, high cholesterol, heart disease, diabetes, breast
cancer, gallbladder disease, upper respiratory problems, arthritis, skin
disorders, menstrual irregularities, ovarian abnormalities, and complications
of pregnancy. Obesity is one of our nation’s most critical health problems and
is directly responsible for as many as 300,000 deaths each year.

The U.S. Preventive Services Task Force urged doctors to
identify patients with a body mass index of 30% or more – The numbers are currently
1 in 3 Americans . The Task Force is asking that doctors provide counseling
themselves or refer the patient to a program designed to promote weight loss
and improve health.  Under the current
healthcare law, Medicare and most private insurers would be required to cover
the entire cost of weight-loss services and counseling that meet the task
force’s standards.

Few private health insurers now reimburse physicians for
weight-loss counseling or pay for programs that patients seek out on their own.
A growing number, in fact, charge obese patients more for coverage — a policy
that some public health officials have denounced as punitive and ineffective. The
task force concluded after a review of the medical literature that the most
successful programs in improving patients’ health were “intensive,
multicomponent behavioral interventions.” They involve 12 to 26 counseling
sessions a year with a physician or community-based program, the panel said. Successful
programs set weight-loss goals, improve knowledge about nutrition, teach
patients how to track their eating and set limits, identify barriers to change
and strategize on ways to maintain lifestyle changes.

Obesity and obesity-related diseases are already responsible
for an estimated $147 billion in annual healthcare spending. Widespread
adoption of the panel’s recommendation would increase that spending, at least
initially. The panel acknowledged that one problem with its recommendation was
that no studies have shown such intensive programs provide long-term health
benefits.

There appear to be short-term ones. Two studies cited by the
panel found that patients who received intensive counseling were 30% to 50%
less likely to have Type 2 diabetes two to three years later than those who
received lighter counseling, drug therapy or both. However, the counseling
subjects’ cholesterol numbers barely budged, and changes in blood pressure and
waist circumference were, on average, small. The subjects, who typically met
weekly for six months and monthly for the second half of the year, lost between
5% and 7% of their body weight and reduced their diabetes risk by 58%.