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      The physical and mental burden of obesity

      Effective weight management should address member needs holistically

       

      Daniel Knecht, MD, MBA, Vice President & Chief Clinical Innovation Officer, CVS Caremark

      Briefing

      Mental health and obesity are interconnected. People with depression are more likely to experience obesity and people with obesity are more likely to have depression.1 While these conditions often coexist, we can’t say which comes first. We do know the best treatment approach is one that considers the full spectrum of health needs for a person with multiple conditions.

       

      Understanding the impact of weight on body and mind

      Obesity increases the risk for physical problems like heart disease, high blood pressure, diabetes, joint problems such as osteoarthritis, and various cancers.2

      It’s important we don’t overlook its impact on mental and emotional health as well. Obesity is associated with multiple mental health diagnoses.3 Between 20 and 60 percent of people with obesity and extreme obesity suffer from a mental health issue.4

       

      People with extreme obesity are 5x more likely to have a major depressive episode in the previous year compared with those of average weight5

      43% of adults with depression have obesity6

       

      Research has also looked at the link between weight and mood and anxiety disorders from the other direction. People with mental health problems are at an increased risk for obesity compared with the general population.7

       

      A look at payor considerations

      Obesity and mental health disorders cost the United States $173 billion and $280 billion, respectively.8,9 While GLP-1s come with a high price tag, used appropriately, they could potentially help offset some of the health care costs associated with the conditions. Early studies may show a role for GLP 1s in the treatment of mental illness.10,11,12

       

      41%
      Plan members taking an anti-obesity medication who also were prescribed medication for depression and/or anxiety13

       

      Integrated strategies for promoting mental health and weight management

      While many treatment approaches are effective at treating obesity and mental health conditions independently, the prevalence of the conditions co-occurring shows we should address them together. Fragmented obesity and mental health care involves separate treatment plans addressing different goals and objectives, across multiple clinicians, dietitians, wellness coaches, and mental health counselors. With an integrated approach, members have a dedicated care team to help them address their weight and behavioral health needs – which can drive optimal outcomes and lower costs.

      At CVS Health, our weight management solutions consider comorbidities like mental health and social determinants that can affect health and well-being. And they include clinical and nutrition support for members to meet them wherever they are in their journey. With a complete view of a member’s care, powered by advanced analytics, we can surround them with personalized support, such as:

      • Screening questions about weight goals, health history, general well-being, and behavioral health — with referrals for other services, if appropriate
      • Lifestyle support including registered dieticians with additional credentialing, such as Certified Diabetes Care & Education Specialist and training related to social determinants of health
      • Education and personalized content on nutrition and behavioral health through the Health Optimizer app
      • Clinical dosing and oversight from board-certified providers
      • Notification of the member’s primary care provider, so progress can be discussed during regular visits


      Because our program integrates with their other benefits, members will be connected to additional resources to provide support for mental health concerns. Guiding members to appropriate mental health care can help keep them engaged with other health care priorities, better manage co-occurring conditions, and maintain medication adherence.

      Plan sponsors can provide valuable resources for members living with obesity and mental health problems. An effective treatment approach should address member needs holistically. As payors consider GLP-1s for weight management, it’s important to remember this class of drugs is most effective when paired with lifestyle support. It’s imperative to offer appropriate care – and for some that might include interventions for mental well-being.

      That’s where a collaborative, customizable strategy comes in to set members up for success, helping control costs and ensuring that weight loss is sustainable.

       

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