Category Archives: Diet & Nutrition

Many insurers do not cover drugs approved weight-loss drugs

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ScaleBy Michelle Andrews
KNH

In December, the Food and Drug Administration approved a new anti-obesity drug, Saxenda, the fourth prescription drug the agency has given the green light to fight obesity since 2012.

But even though two-thirds of adults are overweight or obese — and many may need help sticking to New Year’s weight-loss resolutions — there’s a good chance their insurer won’t cover Saxenda or other anti-obesity drugs.

The health benefits of using anti-obesity drugs to lose weight—improvements in blood sugar and risk factors for heart disease, among other things—may not be immediately apparent.

“For things that are preventive in the long term, it makes plan sponsors think about their strategy,” says Dr. Steve Miller, the chief medical officer at Express Scripts, which manages the prescription drug benefits for thousands of companies. Companies with high turnover, for example, are less likely to cover the drugs, he says.

“Most health plans will cover things that have an immediate impact in that plan year,” Miller says.

Miller estimates that about a third of companies don’t cover anti-obesity drugs at all, a third cover all FDA-approved weight-loss drugs, and a third cover approved drugs, but with restrictions to limit their use. The Medicare prescription drug program specifically excludes coverage of anti-obesity drugs.

Part of the reluctance by Medicare and private insurers to cover weight-loss drugs stems from serious safety problems with diet drugs in the past, including the withdrawal in 1997 of fenfluramine, part of the fen-phen diet drug combination that was found to damage heart valves. Continue reading

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Beware of products promising miracle weight loss – FDA

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A Consumer Update from the US Food and Drug AdministrationScale

“This year, I’m going to lose some weight.”

If you find yourself making this common New Year’s resolution, know this: many so-called “miracle” weight loss supplements and foods (including teas and coffees) don’t live up to their claims.

Worse, they can cause serious harm, say FDA regulators.

The agency has found hundreds of products that are marketed as dietary supplements but actually contain hidden active ingredients (components that make a medicine effective against a specific illness) contained in prescription drugs, unsafe ingredients that were in drugs that have been removed from the market, or compounds that have not been adequately studied in humans.

“When the product contains a drug or other ingredient which is not listed as an ingredient we become especially concerned about the safety of the product,” says James P. Smith, M.D., an acting deputy director in FDA’s Office of Drug Evaluation.

Tainted products

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Obesity Costs Evident at the State Level | Brookings Institution

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Nearly 14 percent of Washington state’s Medicaid and nearly 8 percent of its Medicare spending goes to treat conditions caused by obesity.

At the state-level, a substantial share —between 6 percent and 20 percent—of Medicaid spending goes to adult obesity-related expenditures. In 2006, Oregon (18.8 percent), Arizona (17.0 percent) and Colorado (16.2 percent) saw the highest shares, while Kansas (6.5 percent), Virginia (6.8 percent) and North Dakota (7.5 percent) devoted the smallest shares of Medicaid spending to obesity-related expenditures.

Screen Shot 2015-01-03 at 8.19.49 PM

On a state-by-state basis, Medicare spending due to obesity was substantial, too, with shares varying from 5.2 percent to 10.2 percent in 2004.

The highest percent of obesity-attributable spending was found in Ohio (10.2 percent), Michigan (10.0 percent) and West Virginia (9.9 percent), while the lowest was in Hawaii (5.2 percent), Arizona (6.2 percent), and New Mexico (6.6 percent).

via Obesity Costs Evident at the State Level | Brookings Institution.

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Avoid raw milk, it’s just not worth the risk, says CDC

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Photo by Maciej Lewandowski

Photo by Maciej Lewandowski

From the US Centers for Disease Control and Prevention

Raw milk can carry harmful germs that can make you very sick or kill you. If you’re thinking about drinking raw milk because you believe it has health benefits, consider other options.

Developing a healthy lifestyle requires you to make many decisions. One step you might be thinking about is adding raw milk to your diet. Raw milk is milk that has not been pasteurized (heating to a specific temperature for a set amount of time to kill harmful germs). Germs include bacteria, viruses, and parasites.

Making milk safe
Milk and products made from milk need minimal processing, called pasteurization. This process includes:

  • Heating the milk briefly (for example, heating it to 161°F for about 15 seconds)
  • Rapidly cooling the milk
  • Practicing sanitary handling
  • Storing milk in clean, closed containers at 40°F or below

While it is possible to get foodborne illnesses from many different foods, raw milk is one of the riskiest of all.

When milk is pasteurized, disease-causing germs are killed. Harmful germs usually don’t change the look, taste, or smell of milk, so you can only be confident that these germs are not present when milk has been pasteurized.

Remember, you cannot look at, smell, or taste a bottle of raw milk and tell if it’s safe to drink.

Risks of drinking raw milk

Raw milk can carry harmful bacteria and other germs that can make you very sick or even kill you. While it is possible to get foodborne illnesses from many different foods, raw milk is one of the riskiest of all. Getting sick from raw milk can mean many days of diarrhea, stomach cramping, and vomiting. Less commonly, it can mean kidney failure, paralysis, chronic disorders, and even death.

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Illnesses due to raw milk on the rise

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From the US Centers for Disease Control and Prevention 

Photo by Maciej Lewandowski

Photo by Maciej Lewandowski

The average annual number of outbreaks due to drinking raw (unpasteurized) milk have more than quadrupled – from an average of three outbreaks per year during 1993-2006 to 13 per year during 2007-2012. Overall, there were 81 outbreaks in 26 states from 2007 to 2012.

As more states have allowed the legal sale of raw milk, there has been a rapid increase in the number of raw milk-associated outbreaks.The outbreaks, which accounted for about 5 percent of all food-borne outbreaks with a known food source, sickened nearly 1,000 people and sent 73 to the hospital. More than 80 percent of the outbreaks occurred in states where selling raw milk was legal.

As more states have allowed the legal sale of raw milk, there has been a rapid increase in the number of raw milk-associated outbreaks.

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Wellness programs at work are popular – but do they work?

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yoga-office-570By Julie Rovner
KHN

If you get health insurance at work, chances are you have some sort of wellness plan, too.

But so far there’s no real evidence as to whether these plans work.

One thing we do know is that wellness is particularly popular with employers right now, as they seek ways to slow the rise of health spending. These initiatives can range from urging workers to use the stairs all the way to requiring comprehensive health screenings.

The 2014 survey of employers by the Kaiser Family Foundation found that 98 percent of large employers and 73 percent of smaller employers offer at least one wellness program. (Kaiser Health News is an editorially independent program of KFF.)

What makes wellness plans so popular?

It really is part of their strategy to help employees be healthy, productive, and engaged,” says Maria Ghazal, vice president and counsel at the Business Roundtable, whose members are CEOs of large firms. “And it’s really part of their strategy to be successful companies.”

And there’s another reason wellness has gotten so pervasive, said health consultant Al Lewis. It’s a big industry. Continue reading

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US takes aim at company ‘wellness’ programs

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ScaleBy Michelle Andrews
KHN

Do it or else. Increasingly, that’s the approach taken by employers who are offering financial incentives for workers to take part in wellness programs that incorporate screenings that measure blood pressure, cholesterol and body mass index, among other things.

The controversial programs are under fire from the Equal Employment Opportunity Commission, which filed suit against Honeywell International in October charging, among other things, that the company’s wellness program isn’t voluntary.

In the wellness program, employees and their spouses are asked to get blood drawn to test their cholesterol, glucose and nicotine use, as well as have their body mass index and blood pressure measured.

It’s the third lawsuit filed by the EEOC in 2014 that takes aim at wellness programs and it highlights a lack of clarity in the standards these programs must meet in order to comply with both the 2010 health law and the landmark Americans with Disabilities Act.

Honeywell, based in Morristown, N.J., recently got a reprieve when a federal district court judge declined to issue a temporary restraining order preventing the company from proceeding with its wellness program incentives next year.

But the issue is far from resolved, and the EEOC is continuing its investigations. Meanwhile, business leaders are criticizing the EEOC action, including a recent letter from the Business Roundtable to administration officials expressing “strong disappointment” in the agency’s actions.

In the Honeywell wellness program, employees and their spouses are asked to get blood drawn to test their cholesterol, glucose and nicotine use, as well as have their body mass index and blood pressure measured.

If an employee refuses, he’s subject to a $500 surcharge on health insurance and could lose up to $1,500 in Honeywell contributions to his health savings account.

He and his spouse are also each subject to a $1,000 tobacco surcharge. That means the worker and his spouse could face a combined $4,000 in potential financial penalties. Continue reading

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What’s on the menu? Calories.

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From the US Food and Drug Administration

How Many Calories? Look at the Menu!

HamburgerWhen you eat in a restaurant, do you generally know how many calories you’re consuming? The answer is most likely, “no,” according to research findings examined by the Food and Drug Administration (FDA).

The good news is that FDA is now taking an important step to provide consumers with more information to help them make more informed choices about the food they eat away from home.

FDA has issued two final rules requiring that calories be listed on certain menus in chain restaurants and other places selling restaurant-type food and on certain vending machines.

“Americans eat and drink about one-third of their calories away from home,” says FDA Commissioner Margaret A. Hamburg, M.D. “These final rules will give consumers more information when they are dining out and help them lead healthier lives.”

The goal is to provide consumers with more information in a consistent, easy-to-understand way.  Continue reading

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Campaign targets health threats posed by sugar

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SugarScience_Web_Ads_300x250By Lisa Aliferis
KHN and the Washington Post

Dean Schillinger is a primary-care physician at San Francisco General Hospital. He first came to the city in 1990 at the peak of the AIDS epidemic. “At that point, one out of every two patients we admitted was a young man dying of AIDS,” he says.

Today, that same ward is filled with diabetes patients.

“I feel like we are with diabetes where we were in 1990 with the AIDS epidemic,” Schillinger said. “The ward is overwhelmed with diabetes — they’re getting their limbs amputated, they’re on dialysis. And these are young people. They are suffering the ravages of diabetes in the prime of their lives. We’re at the point where we need a public health response to it.”

Schillinger and other researchers at the University of California at San Francisco are setting up a project called Sugar Science, to spell out the health dangers of too much added sugar in our diets.

The project aimed at consumers includes a user-friendly Web site and materials such as television commercials that public health officials can use for outreach. Health departments from San Francisco to New York City have agreed to participate.

Photo: Courtesy of Lauri Andler, Phantom under Creative Commons License.
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Seniors’ obesity-counseling benefit goes largely unused

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ScaleBy Phil Galewitz
KHN

Three years ago, the Obama administration offered hope to millions of overweight seniors when it announced Medicare would offer free weight-loss counseling.

Officials estimated that about 30 percent of seniors are obese and therefore eligible for counseling services, which studies have shown improve the odds of significant weight loss.

But less than 1 percent of Medicare’s 50 million beneficiaries have used the benefit so far. Experts blame the government’s failure to promote the program, rules that limit where and when patients can go for counseling as well as the low fees for providers.

Since November 2011, about 120,000 seniors have participated, including about 50,000 last year, according to federal data.

“It’s very disappointing,” said Dr. Scott Kahan, an obesity medicine specialist at George Washington University.

“It’s a huge lost opportunity,” said Bonnie Modugno, a registered dietician in Santa Monica, Calif., who advises doctors how to provide weight loss counseling.

By  comparison, about 250,000 seniors last year used Medicare’s tobacco cessation counseling benefit, which started in 2005 and offers greater flexibility about how providers can offer it. Nationally, 9 percent of seniors smoke, while 30 percent are obese. Continue reading

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For those who were once obese, stigma often remains

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Carlos Romero and girlfriend Kate Rowe sit down for a meal that they cooked together at Romero's apartment in Seattle (Photo by Mike Kane/NPR).

Carlos Romero and girlfriend Kate Rowe sit down for a meal that they cooked together at Romero’s apartment in Seattle (Photo by Mike Kane/NPR).

This KHN story also ran on NPR

SEATTLE — Carlos Romero’s apartment is marked with remnants from his former life: a giant television from his days playing World of Warcraft and a pair of jeans the width of an easy chair. The remnants of that time—when he weighed 437 pounds—mark his body too: loose, hanging skin and stretch marks.

“I lift weights and work out and work hard, but there’s lasting damage,” said Romero.

Yet for all the troubles he had dating when he was obese—all those unanswered requests on dating web sites—shedding weight left him uneasy about how much to reveal.

Carlos Romero 1 176

Romero once weighed 437 pounds. (Photo by Sarah Varney/KHN).

“If you were to say to someone on the first date, ‘I lost 220 pounds,’ you’re indicating that you had a very serious issue at one point and that you may still have that issue,” he said. “So it’s not something I put on a dating profile because I don’t want people to judge me for it.”

Indeed, the stigma of obesity is so strong that it can remain even after the weight is lost. Holly Fee, a sociologist at Bowling Green State University, has conducted some of the only research on dating attitudes toward the formerly obese. In 2012, Fee published her findings in the journal Sociological Inquiry.

She found that potential suitors said they would hesitate to form a romantic relationship with someone who used to be heavy. “The big dragging factor in why they had this hesitation in forming this romantic relationship was that they believed these formerly obese individuals would regain their weight,” Fee said. Continue reading

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Only half of US adults being screened for diabetes

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GlucometerBy Sharyn Alden
Health Behavior News Service

A study in American Journal of Preventive Medicine finds that only half of adults in the U.S. were screened for diabetes within the last three years, less than what is recommended by the American Diabetes Association (ADA).

As the rates of obesity have increased, so does the incidence of type 2 diabetes, which also increases the risk for cardiovascular disease.

Up to one-third of people with diabetes are undiagnosed, note the researchers. Continue reading

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Rise in US diabetes rates slow – CDC

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From the US Centers for Disease Control and Prevention

Glucometer showing a blood sugar of 105New CDC data published in the Journal of the American Medical Association, JAMA, suggest that after decades of continued growth in cases of diagnosed diabetes, the rate of increase may be slowing from year to year.

The study, “Prevalence and Incidence in Trends for Diagnosed Diabetes Among Adults Aged 20 to 79 Years, United States, 1980–2012,” was published today.

“Our findings suggest that, after decades of continued growth in the prevalence and incidence of diagnosed diabetes, the diabetes epidemic may be beginning to slow for the first time,” said Linda Geiss, a chief epidemiologist in CDC’s Division of Diabetes Translation and lead author of the study.

What This Means:

  • About 1.7 million new cases are diagnosed each year. For the first time, this study shows that number is not getting bigger every year, as in years past, but the numbers are still alarmingly high.
  • These data suggest a change in momentum, a turning of the tides. Now is not the time to let up. Although this news inspires hope, there is still much work to be done.
  • The rate of increase may be slowing from year to year, but diabetes is an urgent public health epidemic, affecting more than 29 million Americans.
  • Although overall growth rates of diagnosed diabetes seem to be slowing, the rate of increase of new cases continues to rise among some groups including:
    • Non-Hispanic blacks.
    • Hispanic men and women, and
    •  People with less than a high school education.

“While this news is encouraging, our work is more important now than ever,” says Ann Albright, PhD, RD, director of CDC’s Division of Diabetes Translation. “These evolving trends show we’re moving in the right direction, but millions of people are still diagnosed with diabetes yearly. We need to fortify our efforts to see a real, sustained decrease in new cases of diagnosed diabetes.”

What You Can Do:

Reducing new cases of diabetes is unlikely without continuing to reduce obesity, improve diet, and reduce sedentary lifestyle in the U.S. population, and particularly in those at high risk of developing diabetes. Long-term lifestyle change programs—like the CDC-managed National Diabetes Prevention Program—can help those at high risk of developing the disease.

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27% of Washington state residents are obese

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Twenty-seven percent of Washington state residents are obese, the US Centers for Disease Control and Prevention reports.

You are considered obese if your body mass index, or BMI, is 30 or more.

To find out your BMI go here

Obesity prevalence in 2013 varies across states and regions

  • No state had a prevalence of obesity less than 20%.
  • 7 states and the District of Columbia had a prevalence of obesity between 20% and <25%.
  • 23 states had a prevalence of obesity between 25% and <30%.
  • 18 states had a prevalence of obesity between 30% and <35%.
  • 2 states (Mississippi and West Virginia) had a prevalence of obesity of 35% or greater.
  • The South had the highest prevalence of obesity (30.2%), followed by the Midwest (30.1%), the Northeast (26.5%), and the West (24.9%).

Prevalence* of Self-Reported Obesity Among U.S. Adults by State, BRFSS, 20132013-state-obesity-prevalence-map

 

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Always Hungry? Here’s the Real Reason Why | RAND

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French FriesMost Americans recognize the difference between “empty-stomach” hunger and urges caused by the smell of popcorn at the movies or the sight of candy in the checkout line. Nonetheless, it’s hard to resist. America is a food swamp, says Deborah A. Cohen, where cheap, convenient food is everywhere, and marketing exploits human tendencies.

Always Hungry? Here’s the Real Reason Why | RAND.

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