| Popis: |
Sixty-eight percent of Americans are overweight or obese, making more than 190 million people candidates for weight management services in the United States. Obesity is a risk factor for a variety of serious chronic conditions, such as type 2 diabetes, cardiovascular disease, and some cancers. Obesity-related conditions are also major causes of death. Additionally, many of these conditions are preventable through lifestyle changes that promote weight loss. Not only does obesity cause many deaths in the US, but obesity also increases healthcare costs dramatically. Overweight and obesity cost roughly $147 billion per year currently and these increased expenditures are unsustainable in the long-term. The standard of care for treatment of adult overweight and obesity, as found in the National Guideline Clearinghouse, consists of evidence-based clinical practice guidelines for registered dietitians (RDs) to provide effective weight management programs. Modest weight loss and long-term maintenance of loss are the goals of adult weight management programs. A weight loss of 5-10% of initial body weight has been shown to improve patient outcomes, such as decreased hemoglobin A1C, decreased blood pressure, and improved HDL and triglycerides. In 2002, the Diabetes Prevention Program provided compelling evidence for delay or prevention of type 2 diabetes through modest weight loss, which was achieved through changes in eating habits and physical activity. Registered dietitians played a key role in this study, coaching participants in lifestyle change and ultimately results of the study demonstrated that modest weight loss can reduce incidence of diabetes by 58%. This policy brief offers an evaluation of existing policy on reimbursement to registered dietitians (RDs) for adult weight management services. Private insurance plans are described and compared to the standard of care. Additionally, barriers that exist in increasing the role of the dietitian in these services are uncovered. Ideally, registered dietitians would facilitate weight management programs in communities to help adults lose weight, but currently, numbers of adult weight management programs are low and few dietitians are being reimbursed. After uncovering the barriers that exist upstream of reimbursement, key recommendations will be described for RDs to take action to eliminate these barriers. |
