Guest Commentary: Brad Wilson on fighting obesity

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Guest post by Brad Wilson

Hard times force difficult choices. That's particularly true in healthcare, where government, businesses and workers already struggle to fund growing healthcare needs. Yet, it is imperative that we invest in reversing certain health trends that will otherwise overwhelm the system.

Obesity is an epidemic that plagues the entire nation, and here in North Carolina, we're particularly affected. Nearly two-thirds of adults are overweight or obese. Even more alarming: nearly one-third of North Carolina children ages 2 to 4 are overweight or at risk of becoming so. Unless we change these trends, we can expect to fund expensive care for a future generation of citizens suffering at unprecedented levels from diabetes, heart disease, cancer and stroke, just to name a few of obesity's common co-morbidities.

Blue Cross and Blue Shield of North Carolina (BCBSNC) has long supported evidence-based care and healthcare initiatives built around solid research and documented return on investment. That's simply the most efficient and prudent way to manage limited resources.

The challenge in fighting obesity is that the benefits of intervention can be difficult to quantify in the short term. So, many insurers won't cover treatments or invest in incentives that could help patients get their weight under control. More than 10 years ago, BCBSNC made the decision that the imprecision of current ROI measures would not stop us from doing the right thing.

In the late 90s, we pioneered a lifestyle modification program called Healthy Lifestyle Choices that provided our customers with tools and support to help them achieve healthier weights. In 2005, we were the first insurer in the nation to cover obesity as a primary medical condition, including physician visits, nutritional counseling and toolkits to help families incorporate exercise and better nutrition into their daily lives.

Working with pediatricians and diabetes experts, BCBSNC and the Blue Cross and Blue Shield Association recently launched the Good Health Club Physician Toolkit, a package of materials, developed in consultation with the American Diabetes Association and American Academy of Pediatrics (AAP), that provides physicians with resources that support productive discussion about obesity. In addition to reference materials for physicians, the toolkit includes educational materials geared toward patients and parents that emphasize the "5-2-1-0" approach to good health: five daily servings of fruits and vegetables; two hours or less of screen time; one hour of physical activity; zero sweetened drinks. Physicians have had overwhelmingly positive feedback about these resources.

Most recently, the independent BCBSNC Foundation announced an initiative that focuses on helping children form lifestyle habits that will shape their adult health status. In collaboration with The North Carolina Partnership for Children (NCPC), the Foundation launched Shape NC. This initiative will target children in child care facilities, their families and child care professionals. It is built upon the foundation of solid, proven early childhood interventions developed by N.C. State University, the University of North Carolina at Chapel Hill and Be Active Kids®, an early childhood program supported by the BCBSNC Foundation. Changing early childhood habits is the key to reining in North Carolina's unsustainable rates of obesity and chronic disease.

We know from our own customers that intervention makes a difference: of the 100,000 participants in our obesity programs, 17 percent of obese customers achieved a 5 percent weight loss within six months of joining the program, while 6 percent of overweight customers reached a normal weight. The average loss was about seven pounds.

While these outcomes may initially seem modest, understand that the expected improvement in future health status from change of this level is considerable. These programs are important first steps toward changing perceptions about food, exercise and taking control of our own health. And when you consider the staggering cost of serious health conditions often associated with obesity, the importance of addressing it is evident. In the past 12 months, BCBSNC has spent approximately $396 million on type 2 diabetes, high cholesterol, hypertension, coronary artery disease and knee/hip replacements--all of which are common complications of being overweight or obese.

For years it seemed that despite growing evidence of the health risks of smoking, Americans would never put down their cigarettes. The work of a generation of health advocates--who like BCBSNC, targeted the youth of America--made rates of smoking among teens drop year after year. Early on, it wasn't clear what programs were the most effective, but passionate, committed people pushed on to find practical solutions.

That was the right thing to do then--and with obesity, it's the right thing to do now.

Editor's note: Brad Wilson is president and CEO of Blue Cross and Blue Shield of North Carolina.