Obesity in the United States now carries the hefty price tag of $147 billion per year in direct medical costs, just over 9 percent of all medical spending, experts report.
In fact, people who are obese spend about 41 percent more than an average-weight person. One of the reasons for this hefty price tag is that obesity is linked to other costly comorbidities such as Type 2 diabetes, cancer, coronary heart disease and stroke, hypertension, gallbladder disease, osteoarthritis, arthritis and chronic back pain.
Most of these health conditions can be controlled, treated and in many cases prevented with medical nutrition therapy. Medical nutrition therapy (MNT) is the use of specific nutrition services to treat an illness, injury or condition, and it involves two phases: 1) assessment of the nutritional status of the client and 2) treatment, which includes nutrition therapy, counseling, and the use of specialized nutrition supplements.
As Idaho begins defining our health insurance marketplace under the Affordable Care Act, let’s not forget how we address the obesity and diabetes epidemic. We think of our healthy Idaho lifestyles as above the norm, but when it comes to obesity and diabetes, Idaho ranks as average. According to the CDC, the number of Idahoans who are overweight or obese is around 62 percent. This compares to 63 percent of the population of the United States. The number of Idahoans with diabetes is 9.4 percent, as compared to the U.S. population of 9.5 percent. Diabetes rates have doubled in the past 15 years and are projected to increase to 50 percent in the year 2030.
Policymakers and taxpayers need to pay attention to these numbers because they are crippling our ability to have a healthy American workforce. We need to increase our efforts to reverse this debilitating and costly epidemic. Insuring wellness and preventive services and creating healthy environments are key to reversing the obesity and diabetes epidemic, particularly for Idaho children.
As policy makers determine the essential benefits package under Idaho’s health exchanges, medical nutrition therapy (MNT) provided by registered dietitians should be included as a necessity.
It is well documented by the Lewin Study Group that MNT is associated with a reduction in utilization of hospital services of 9.5 percent for patients with diabetes and 8.6 percent for patients with cardiovascular disease. Also, utilization of physician services declines by 23.5 percent for MNT users with diabetes and 16.9 percent for MNT users with cardiovascular disease.
Also noteworthy is that participation in community-based programs that focus on improving nutrition and increasing physical activity had a 58 percent reduction in incidents of type 2 diabetes compared with drug therapy, which had a 31 percent reduction.
You don’t have to be a rocket scientist to see the return on investment here. Nutrition therapy pays for itself and then some with a net reduction in health services utilization and costs for much of the population. In the case of people 55 or older, the savings in utilization of hospital and other services will actually exceed the cost of providing the MNT benefit.
The Robert Wood Johnson Foundation estimates that in Idaho, for every dollar spent in wellness programs, companies could save $3.27 in medical costs and $2.73 in absenteeism costs. Some interventions have been shown to help improve nutrition and activity habits in just one year and had a return of $1.17 for every dollar spent.
Reducing the average body mass index in the state of Idaho by 5 percent could lead to health care savings of more than $1 billion in 10 years and $3 billion in 20 years.
In summary, please consider the impact of preventative services, including coverage for nutrition services as Idaho defines its insurance packages that are provided in the state exchange. There are more than 500 licensed dietitians located throughout rural Idaho who can help make a difference.
SeAnne Safaii, PhD, RD, LD, is the president-elect of the Idaho Academy of Nutrition and Dietetics and an assistant professor at the University of Idaho.
