Guest Essays, Letters to the Editor, Opinion

Guest essay: It’s time for Medicare to cover anti-obesity medications

by Sabrina Weekley

For many West Virginians, food means family. We grew up with our grandmothers fixing big meals as an expression of their love. And in turn, the memories created and associated with eating bring us comfort and provide a sense of security to many of us during difficult and stressful times.

Unfortunately, the well-intentioned bond created between families, food and love along with the state’s other health and socio-economic demographics has had an unintended consequence. The Centers for Disease Control recently ranked the Mountain State’s obesity rate the highest in the nation, trumping both Alabama and neighboring Kentucky.

People living with obesity are at a higher risk for heart disease, diabetes and other chronic health issues. It can also affect mental health and physical mobility.

Obesity is recognized as a chronic disease that stems from biological, genetic and environmental influences, not just one’s lifestyle choices. Exercise and dieting may work for some, but not everyone has the same results or the same causes of obesity.

The good news is there are growing options available for the treatment of obesity through FDA-approved anti-obesity medications (AOMs) that can improve wellness. But currently, the 300,000 West Virginians who have Medicare are being denied access to these treatments due to restrictions placed in law on their health insurance.

The Treat and Reduce Obesity Act (TROA) would allow Medicare Part D to add AOMs to its coverage, allowing thousands of West Virginians and millions of Americans new treatment options for weight management. Health care providers would be able to treat obesity as a disease, just like the other chronic illnesses they manage every day.

Family is important to us in West Virginia. TROA would help our seniors be healthier and improve the quality of time spent with their children and grandchildren.

TROA was first cosponsored by Sen. Shelley Moore Capito in 2021 and, in addition to expanding Part D’s coverage of AOMs, would allow health care professionals to offer intensive behavior therapy for weight management, among other treatments. Despite bipartisan support, the legislation did not pass last Congress. I urge our entire West Virginia delegation to cosponsor the legislation this year in Congress.

Medicare spends an estimated $50 billion per year on obesity-related diseases and, on average, a Medicare beneficiary with obesity costs thousands of dollars more than a beneficiary in a healthy weight range. It makes sense to allow Part D to cover obesity treatment options, because it could generate substantial offsets due to decreased risk of obesity-related disease.

More than half of current Medicare beneficiaries are treated for at least five chronic conditions per year. Now that obesity is rightfully recognized by the medical community to be a chronic condition, Medicare needs to update its coverage to include obesity treatments.

Now is the time for Congress to pass the TROA and update Medicare Part D to reflect medical advances in the noninvasive treatment of obesity. Medicare recipients deserve to have access to the treatments they need without having to worry about steep financial costs.

Sabrina Weekley is a licensed medical assistant with Monongahela Valley Association of Health Centers, where she sees firsthand the effects of obesity on patients. Weekley’s opinions are her own and are not intended to represent those of her affiliated institution.