Addressing obesity requires bold leadership and long-term thinking

Obesity is a vexing problem plaguing millions of Texans, health care professionals, employers and policymakers.

About 10 million Texans have obesity, or 34% of the adult population, and the number is growing at an alarming pace. In fact, researchers predict that by 2030, more than half of all adults in Texas will have obesity.

Obesity is costly, taking a toll on individuals and families, the health care system and the economy. Annual U.S. obesity-related medical costs are estimated at nearly $173 billion and rising; not surprising since obesity is linked to more than 200 conditions, including cardiovascular, liver and kidney diseases, as well as Type 2 diabetes, cancer, sleep apnea, infertility, dementia and mental health issues. The trends even have national security implications, with military leaders pointing to weight-related disqualification as a significant factor in why they are missing recruitment goals.

In Texas, obesity diminishes our productivity, costing the economy a staggering $39.8 billion in 2022 alone. Obesity also saddles Texas employers with $9 billion annually due to higher health care costs, absenteeism and disability. Out-of-pocket medical costs also have increased for people with obesity, rising an average of 37% over the last decade for people with large employer coverage. Texas taxpayers are paying the price, too, with excess weight costing Texas Medicaid more than $928 million annually.

What are we going to do about obesity?

For decades, most solutions have focused on lifestyle-based interventions, like reducing caloric intake and increasing exercise. Unfortunately, these approaches have failed to slow the growth of obesity. It’s time for policymakers to join the scientific and medical community to pursue a more comprehensive approach if we are going to begin to reverse the trend.

Obesity prevention should remain the cornerstone, with policymakers and community-based organizations continuing to prioritize access to healthy affordable food, safe spaces for exercise, and nutrition education through thoughtful planning, investment and policies that intersect agriculture, food systems, health care, community infrastructure, transportation, cultural differences and more.

However, obesity treatment must also be part of the solution. We know that genetic, social, and environmental factors contribute to obesity, and treatments such as intensive behavioral therapy, obesity medications and metabolic and bariatric surgery are having a profound impact on outcomes. In fact, new data published in December found that the prevalence of U.S. obesity declined slightly in 2023 for the first time in many years, concurrent with the increased uptake of obesity treatments.

Unfortunately, many people cannot access these innovative interventions because they are not covered by insurance. Though insurance plans pay for medications to treat diabetes and cardiovascular disease, for example, they often do not cover the same FDA-approved medications to treat obesity, which may prevent diabetes or heart disease from ever developing.

To do something about obesity, policymakers should collaborate with public health leaders and take a balanced approach that not only focuses on prevention but also improves access to treatment for millions already living with obesity. House Bill 2677 by Rep. Senfronia Thompson and Senate Bill 2729 by Sen. Molly Cook would provide Medicaid coverage for comprehensive treatment for adults with obesity, including intensive behavioral therapy, obesity medications and surgery. The American Diabetes Association (ADA) estimates that tackling obesity among adult Texans in Medicaid would cost the State of Texas $36.6 million through 2027 – a small fraction of the state’s Medicaid budget. The state’s investment would reap $6 million in indirect economic benefits during that same time period, according to the ADA, due to increased workforce participation, reduced absenteeism and fewer worker’s compensation claims, as well as the longer-term benefits of having those 6,300 Texans become healthier, preventing future costly chronic health conditions that often stem from obesity.

Given the personal, financial and economic implications of obesity, Texas policymakers should look beyond short-term budgets and make bold, long-term decisions to disrupt the rising prevalence of obesity and chart a course for better health and a more productive future for all Texans.

(The opinions expressed here are purely mine and not those of The University of Texas at Austin.)