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Why Weight? An Analytic Review of Obesity Management, Diabetes Prevention, and Cardiovascular Risk Reduction

  • Evidence-Based Medicine (L. Roever, Section Editor)
  • Published:
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Abstract

Purpose of Review

In this review, we examine one of the ironies of American health care—that we pay more for disease management than disease prevention. Instead of preventing type 2 diabetes (T2DM) by treating its precursor, obesity, we fail to provide sufficient insurance coverage for weight management only to fund the more costly burden of overt T2DM.

Recent Findings

There is a vital need for expanded insurance coverage to help foster a weight-centric approach to T2DM management. This includes broader coverage of anti-diabetic medications with evidence of cardiovascular risk reduction and mortality benefit, anti-obesity pharmacotherapy, bariatric surgery, weight loss devices, endoscopic bariatric therapies, and lifestyle interventions for the treatment of obesity.

Summary

The fundamental question to ask is why weight? Why wait to go after obesity until its end-stage sequelae cause intractable conditions? Instead of managing the complications of T2DM, consider preventing them by tackling obesity.

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Authors and Affiliations

  1. Division of Endocrinology, Diabetes and Metabolism, Comprehensive Weight Control Center, Weill Cornell Medical College, 1165 York Avenue, New York, NY, 10065, USA

    L. I. Igel & K. H. Saunders

  2. The E. William Davis, Jr., M.D. Professor of Medical Ethics, Professor of Medicine Chief, Division of Medical Ethics, Weill Cornell Medical College, New York, NY, USA

    J. J. Fins

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  1. L. I. Igel
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Leon I. Igel, Katherine H. Saunders, and Joseph J. Fins declare no conflict of interest.

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Igel, L.I., Saunders, K.H. & Fins, J.J. Why Weight? An Analytic Review of Obesity Management, Diabetes Prevention, and Cardiovascular Risk Reduction. Curr Atheroscler Rep 20, 39 (2018). https://doi.org/10.1007/s11883-018-0740-z

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