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Insurance Coverage for Weight Loss

Overweight Adults' Views

      Background

      Given the prevalence of obesity and associated chronic conditions among U.S. adults, wellness benefits are an increasingly popular approach to promoting weight loss.

      Purpose

      The goal of the study was to assess overweight and obese adults' beliefs about the helpfulness of insurance coverage of weight loss–related benefits, their willingness to pay for such benefits, and whether these opinions differ by individuals' weight or health insurance type.

      Methods

      A national survey was fielded in 2012 among non-pregnant, overweight, and obese adults who had seen a primary care provider in the past year (n=600). Descriptive statistics summarized beliefs about which weight loss–related benefits would be helpful, willingness to pay for such benefits, and agreement about whether health insurers should be able to charge more to obese individuals. Multivariable logistic regression was employed to determine whether beliefs differed by weight category or health insurance type. Analyses were conducted in July 2012.

      Results

      The majority (83%) of respondents cited a specific benefit as helpful. Those with private health insurance had a higher probability (89%, 95% CI=86%, 93%) of endorsing any benefit as helpful relative to those with other types of health insurance. Being obese relative to overweight was associated with greater support (57% vs 39%, p<0.05) for preventing health insurers from charging higher premiums to obese individuals.

      Conclusions

      In this sample of overweight adults, a large proportion endorsed the value of weight loss–related benefits offered by health plans. However, only about one third were willing to pay extra for them, and half disagreed with the notion that health plans should charge more to obese individuals. Given evidence of their effectiveness, wellness benefits should be offered to all individuals.
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      References

        • Flegal K.M.
        • Carroll M.D.
        • Ogden C.L.
        • Curtin L.R.
        Prevalence and trends in obesity among U.S. adults, 1999–2008.
        JAMA. 2010; 303: 235-241
        • Wang Y.C.
        • McPherson K.
        • Marsh T.
        • Gortmaker S.L.
        • Brown M.
        Health and economic burden of the projected obesity trends in the USA and the UK.
        Lancet. 2011; 378: 815-825
        • Thorpe K.E.
        • Philyaw M.
        The medicalization of chronic disease and costs.
        Ann Rev Public Health. 2012; 33: 409-423
        • Finkelstein E.A.
        • DiBonaventura M.
        • Burgess S.M.
        • Hale B.C.
        The costs of obesity in the workplace.
        J Occup Environ Med. 2010; 52: 971-976
        • Ricci J.A.
        • Chee E.
        Lost productive time associated with excess weight in the U.S. workforce.
        J Occup Environ Med. 2005; 47: 1227-1234
        • Gates D.M.
        • Succop P.
        • Brehm B.J.
        • Gillespie G.L.
        • Sommers B.D.
        Obesity and presenteeism: the impact of body mass index on workplace productivity.
        J Occup Environ Med. 2008; 50: 39-45
        • Finkelstein E.A.
        • Trogdon J.G.
        • Cohen J.W.
        • Dietz W.
        Annual medical spending attributable to obesity: payer-and service-specific estimates.
        Health Aff (Milwood). 2009; 28: w822-w831
        • Kaiser Family Foundation/Health Research and Educational Trust
        Employer health benefits, 2011 annual survey.
        ehbs.kff.org/
        Date: 2011
        • National Business Coalition on Health
        Opportunities and challenges for promoting obesity prevention and control among small- to mid-size employers.
        • Conn V.S.
        • Hafdahl A.R.
        • Cooper P.S.
        • Brown L.M.
        • Lusk S.L.
        Meta-analysis of workplace physical activity interventions.
        Am J Prev Med. 2009; 37: 330-339
        • Heinen L.
        • Darling H.
        Addressing obesity in the workplace: the role of employers.
        Milbank Q. 2009; 87: 101-122
        • Baicker K.
        • Cutler D.
        • Song Z.
        Workplace wellness programs can generate savings.
        Health Aff (Milwood). 2010; 29: 304-311
        • Mitchell N.S.
        • Ellison M.C.
        • Hill J.O.
        • Tsai A.G.
        Evaluation of the effectiveness of making weight watchers available to Tennessee Medicaid (TennCare) recipients.
        J Gen Intern Med. 2013; 28: 12-17
        • Thorpe K.E.
        • Yang Z.
        Enrolling people with prediabetes ages 60-64 in a proven weight loss program could save Medicare $7 billion or more.
        Health Aff (Milwood). 2011; 30: 1673-1679
        • Mello M.M.
        • Rosenthal M.B.
        Wellness programs and lifestyle discrimination—the legal limits.
        N Engl J Med. 2008; 359: 192-199
        • Lee J.S.
        • Sheer J.L.
        • Lopez N.
        • Rosenbaum S.
        Coverage of obesity treatment: a state-by-state analysis of Medicaid and state insurance laws.
        Public Health Rep. 2010; 125: 596-604
      1. Sec. 1001. Patient Protection and Affordable Care Act (Pub.L. 111–148) and Health Care and Education Reconciliation Act (Pub.L. 111–152, 124 Stat. 1029). 2010.

        • Madison K.M.
        • Volpp K.G.
        • Halpern S.D.
        The law, policy, and ethics of employers' use of financial incentives to improve health.
        J Law Med Ethics. 2011; 39: 450-468
        • Gabel J.R.
        • Whitmore H.
        • Pickreign J.
        • et al.
        Obesity and the workplace: current programs and attitudes among employers and employees.
        Health Aff (Milwood). 2009; 28: 46-56
        • Fuemmeler B.F.
        • Baffi C.
        • Masse L.C.
        • Atienza A.A.
        • Evans W.D.
        Employer and healthcare policy interventions aimed at adult obesity.
        Am J Prev Med. 2007; 32: 44-51
        • Rivara F.P.
        • Koepsell T.D.
        • Wang J.
        • et al.
        Comparison of telephone with World Wide Web-based responses by parents and teens to a follow-up survey after injury.
        Health Serv Res. 2011; 46: 964-981
        • McMorris B.J.
        • Petrie R.S.
        • Catalano R.F.
        • Fleming C.B.
        • Haggerty K.P.
        • Abbott R.D.
        Use of web and in-person survey modes to gather data from young adults on sex and drug use: an evaluation of cost, time, and survey error based on a randomized mixed-mode design.
        Eval Rev. 2009; 33: 138-158
        • Fricker S.
        • Galesic M.
        • Tourangeau R.
        • Yan T.
        An experimental comparison of web and telephone surveys.
        Public Opin Q. 2005; 69: 370-392
      2. Gallup Poll. 2011.
        • Altman D.G.
        • Deeks J.J.
        • Sackett D.L.
        Odds ratios should be avoided when events are common.
        BMJ. 1998; 317: 1318
        • Kleinman L.C.
        • Norton E.C.
        What's the risk?.
        Health Serv Res. 2009; 44: 288-302
        • Trogdon J.G.
        • Finkelstein E.A.
        • Feagan C.W.
        • Cohen J.W.
        State- and payer-specific estimates of annual medical expenditures attributable to obesity.
        Obesity. 2012; 20: 214-220
        • U.S. Preventive Services Task Force
        Screening for and management of obesity in adults: U.S. Preventive Services Task Force Recommendation Statement.
        (June 2012)
      3. Section 4108. Patient Protection and Affordable Care Act and Health Care and Education Reconciliaton Act. USA; 2010

        • LaVeist T.
        • Thorpe Jr, R.
        • Bowen-Reid T.
        • et al.
        Exploring health disparities in integrated communities: overview of the EHDIC study.
        J Urban Health. 2008; 85: 11-21
        • Bleich S.N.
        • Thorpe Jr, R.J.
        • Sharif-Harris H.
        • Fesahazion R.
        • Laveist T.A.
        Social context explains race disparities in obesity among women.
        J Epidemiol Community Health. 2010; 64: 465-469
        • Merrill R.M.
        • Richardson J.S.
        Validity of self-reported height, weight, and body mass index: findings from the National Health and Nutrition Examination Survey, 2001-2006.
        Prev Chronic Dis. 2009; 6: A121
        • Stommel M.
        • Osier N.
        Temporal changes in bias of body mass index scores based on self-reported height and weight.
        Int J Obes. 2012;