Disparities in obesity prevalence and treatment

Obesity is rampant in the United States – affecting more than 40 percent of American adults, with more than 9 percent of cases qualifying as severe.¹ However, the impact isn't evenly distributed. It disproportionately affects certain racial and ethnic groups, as well as individuals from low-income households.

Viewing obesity as merely a result of poor lifestyle choices overlooks the influence of social determinants of health and steps we can take to address these disparities to promote greater health equity and improve outcomes across patient populations.

Social determinants of metabolic health

For Americans living in lower income communities, even the standard advice to eat healthy and exercise more may be logistically harder to accomplish. Millions of Americans live beyond walking distance to a supermarket or large grocery store, and many lack access to reliable transportation to shopping centers that are even just a few miles away.²

Living in a “food desert” can make it hard to maintain a nutritious and balanced diet. Safe spaces for regular physical activity may also be scarce.

Inadequate health care resources in lower income communities can make it difficult to get even basic preventive care, but especially to connect with a specialist, such as a registered dietitian or other clinician trained in obesity care. As a result, many people do not have access to effective treatment.

Additionally, mental health issues, social stigma and fear of discrimination can be obstacles to seeking help, which can exacerbate a weight problem or other health conditions. Obesity is linked to numerous health conditions, including diabetes, cardiovascular disease and certain cancers. So, it’s not surprising that we see similar disparities in these disease categories.

The path to health equity

Given these disparities, there is a clear opportunity – and need – for weight management programs to proactively identify and address social determinants of health (SDoH). An equitable program should include:

• A “whole-person” approach that looks beyond numbers on a scale and the number of calories consumed to monitor other areas of health, including preventive health and condition management
• A virtual care model that expands reach to those who can’t see a weight management specialist in person, with notification to the member’s primary care provider to help ensure coordinated care
• Broader access to effective therapies, including weight management medication, with effective utilization management to help ensure appropriate coverage and clinical oversight to optimize dosing and support members who chose to discontinue medication
• Personalized lifestyle and nutrition coaching that takes into account individual and cultural preferences and accessible options, with flexibility to help navigate obstacles or changing preferences
• SDoH training for clinicians to help monitor patients for food insecurity, transportation issues, financial hardship and social connectedness
• Proactive screening for mental health and SDoH, with connections to support services, as appropriate, through benefit programs or community resources
• Easy-to-use self-service tools, including virtual chats, that members can access anytime from anywhere to help with meal-planning, mental health or daily support

These strategies can help level the playing field to engage those who are most are risk and help drive better health outcomes across patient populations – and ultimately reduce the high cost and strain that obesity puts on our health care system and payors.

As a pharmacy benefits management company, we’re already looking at the bigger picture of how weight management fits into our clients’ overall cost and coverage strategies, leveraging our deep understanding of their member populations and their business goals. Our CVS Weight Management™ program is backed by years of clinical experience, with proven results.

Together, we can make a meaningful difference in the lives of those affected by obesity. Let’s talk about what that could look like for you and your plan members.