Session: Rising obesity, chronic conditions and costs: What to do next
Speaker: Abinue Fortingo, MPH, CPH, Principal, Population Health & Well-Being Consultant Brown & Brown
Speaker: Kelly Polinski, MPH, National Population Health Consultant, Brown & Brown
Moderator: Dr. Tejaswi Kompala, Clinical Strategy Director, Teladoc Health
Rising cases of obesity and new approaches to care, such as GLP-1s, have many employers considering innovative strategies to better support their members. At Forum 2023, Dr. Tejaswi Kompala, Clinical Strategy Director for Cardiometabolic Conditions, led a panel to discuss steps employers can take to address unique challenges related to obesity, such as access to experienced clinicians and stigma.
“There’s propensity to prescribe certain characteristics about people with obesity,” said Kelly Polinski, MPH, National Population Health Consultant at Brown & Brown. “Those tend to be characteristics like they must be lazy, or they must be weak-willed,”
She said the stigma around obesity ignores other factors like access to appropriate resources. This includes a shortage of clinicians with experience managing the complexities of obesity.
With new approaches to weight loss, such as medications like GLP-1s, this has created a troublesome scenario.
“For many physicians in general practice, now is the first time they’re being asked to prescribe medications for weight loss because their patients are coming to them for that,” Polinski said. “A lot of them don’t have the background to understand all the underlying aspects that should go into a treatment plan.”
This situation is happening more often too with the increase in popularity of GLP-1s. According to Abinue Fortingo, MPH, CPH, Principal, Population Health & Well-Being Consultant at Brown & Brown, employer spend tripled from 2021 to 2022 on the drug.
As employers look to manage costs, Fortingo said they should think holistically. A comprehensive approach is especially important with recent studies indicating that some weight loss due to GLP-1s may not be sustainable without lifestyle changes.
“We have to treat the whole person. The comorbidities when it comes to physical health and mental health should also be addressed in an innovative manner.”
Abinue Fortingo, MPH, CPH
Principal, Population Health & Well-Being Consultant, Brown & Brown
Fortingo listed supporting employees with mental health and promoting engagement in a lifestyle modification program as options to consider for managing costs.
Besides looking at costs, Polinski said, “value on investment” is also important. She said when employees are healthier, they are more likely to engage and be productive in their work. Coverage of GLP-1s has also become an important differentiator in benefit packages with some employees changing employers to seek coverage.
“Unlike an infertility benefit where there’s appreciation (from employees) that it’s there whether or not you need to use it,” Polinski said.
“I think with GLP-1 coverage, people that are seeking it out are more likely to take advantage of it.”
“We are nudging our clients to think creatively about some of these solutions before just immediately pulling coverage,” Fortingo said. This includes offering programs that provide coaching and other tools to encourage employees and help them maintain healthy lifestyle changes.
Simultaneously supporting people with lifestyle changes, Kompala said, while also providing access to critical treatment for those who need it is the key at Teladoc Health. Members engage in a chronic care solution, such as a weight management program, with access to digital tools and coaching. Then, members in need of extra support are invited to meet with a Teladoc Health provider who can prescribe.
“It’s important for those who need support to have access to providers with the right area of expertise,” Kompala said. “Not all providers are comfortable with weight loss medications, and that is a reflection that we haven’t been thinking of obesity as a disease.”
Kompala said obesity needs to be framed as part of the cardiometabolic spectrum—the same as diabetes or hypertension.
With the increased focus on obesity as a disease and improving how obesity is treated, Polinski thinks there’s a silver lining.
“Similar to the revolution of mental health in recent years, obesity and other conditions like that are being approached as a health condition,” she said. “We’re being pushed to consider it from that perspective, so let’s continue to treat and think of obesity as a cardiometabolic condition.”
