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

  • L. I. IgelEmail author
  • K. H. Saunders
  • J. J. Fins
Evidence-Based Medicine (L. Roever, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Evidence Based Medicine


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.


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.


Obesity treatment Type 2 diabetes mellitus Diabetes prevention Evidence-based medicine Insurance coverage Access to care 


Compliance with Ethical Standards

Conflict of Interest

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

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Authors and Affiliations

  1. 1.Division of Endocrinology, Diabetes and Metabolism, Comprehensive Weight Control CenterWeill Cornell Medical CollegeNew YorkUSA
  2. 2.The E. William Davis, Jr., M.D. Professor of Medical Ethics, Professor of Medicine Chief, Division of Medical EthicsWeill Cornell Medical CollegeNew YorkUSA

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