2022 Atlanta Board of Trustees Meeting

7173 S. Havana St #600-130 Centennial, CO 80112 P: 303.770.2526 | F: 303.779.4834 obesitymedicine.org

3/2/2022

To:

Tracy Johnson, Colorado Medicaid Director

From:

Ethan Lazarus, MD Carolynn Francavilla, MD Rebecca Andrick, DO

Dear Ms. Johnson,

The Obesity Medicine Association (OMA) represents over 5,000 clinicians including physicians, nurse practitioners and physician assistants specializing in the care of patients with the chronic disease of obesity. Obesity is a multi-factorial disease and not adequately addressed with lifestyle changes alone. By the time patients with obesity seek our care, most have attempted weight loss multiple times and often with some success but then nearly always followed by weight regain due to the relapsing nature of the disease. One of the tools we have available to assist these patients with treating this disease are anti-obesity medications. These FDA-approved prescription medications enhance the amount of weight lost, and more importantly, double to triple the odds of sustaining the weight lost. Like medications used for diabetes or high blood pressure, they reduce the burden of the disease for the patient, improve co-morbidities, and improve quality of life. However, unlike medications for hypertension and diabetes, most insurance companies deny coverage for this important class of medications, because they inaccurately classify the disease of obesity as a lifestyle choice. This is not consistent with current views of this important disease. It is no more a lifestyle choice than diabetes, hypertension, or mental illness like depression. Obesity disproportionately affects persons with lower socioeconomic status such as those on Medicaid. Statistics from CDPHE (2014) show Colorado’s adult obesity rate to be 21.3% overall but 26.9% in the Medicaid population. Minority populations are also disproportionately affected with an obesity rate of 30.5% in blacks, 26.5% in Hispanics compared to 19.9% in whites. Obesity also affects women more than men. People with a body mass index above 35 are estimated to have a reduction in lifespan by as much as 8 years. Patients with obesity are a group that has been discriminated against because much bias exists in our health care system and having access to the full spectrum of treatment options for obesity is a matter of health equity. As you know, obesity is the root cause of as many as 236 other diseases such as diabetes, hypertension, hyperlipidemia, and cardiovascular disease. It also increases the risk for 13 types of cancer, is a major cause of degenerative arthritis in joints and obstructive sleep apnea. The pandemic