OBESITY As An Example

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OBESITY As An Example
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Obesity Presence in Americans(30 kg/M2)
Age Prevalence 2-5 10
6-19 15 20 male 22.6 20 female
22.8

Lowest in African Americans Highest in Hispanics
both female male
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Obesity, Television and Soft Drinks385 (185,
199) grade 6,7 students

• TV Hours/School NightVariable
  2 P
• BMI Z Score 0.34 0.82
• Body Fat 18.5 23.1

Soft Drinks/DayVariable
2 P BMI Z Score 0.51 1.02 Body Fat 20.3 24.6
ARCH Ped Adolesc Med Sept 2003
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• About 45 of women and 25 of men are trying to
  lose weight at any one time. Only one-fifth are
  using the recommended combination of fewer
  calories and increased exercise.
• 15 of youngsters ages 6 to 19 and 10 of
  children 2 through 5 are seriously overweight.
• Americans spend more than 33 billion a year on
  weight-loss products and services. However, the
  economic cost of obesity in the United States was
  about 117 billion in 2000.
• Sources AHA, NIH, CDC, NHNES

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The Correlative Factors in CMR Are Getting Worse
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Obesity Trends Among U.S. AdultsBRFSS, 1986
Source Mokdad A H, et al. J Am Med Assoc
199928216, 200128610.
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Obesity Trends Among U.S. AdultsBRFSS, 1990
Source Mokdad A H, et al. J Am Med Assoc
199928216, 200128610.
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Obesity Trends Among U.S. AdultsBRFSS, 1994
Source Mokdad A H, et al. J Am Med Assoc
199928216, 200128610.
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Obesity Trends Among U.S. AdultsBRFSS, 1998
Source Mokdad A H, et al. J Am Med Assoc
199928216, 200128610.
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Obesity Trends Among U.S. AdultsBRFSS, 2001
Source Mokdad A H, et al. J Am Med Assoc
199928216, 200128610.
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Obesity Trends Among U.S. AdultsBRFSS, 2004
Source Mokdad A H, et al. J Am Med Assoc
199928216, 200128610.
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We Are Not Alone
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But We Are At The Head Of The Pack!!
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DIABETES
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Diabetes
which is
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WHY ALL THIS MATTERS
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The Problem
Metabolic Syndrome
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Employers Slow to Address 'Metabolic Syndrome'
Despite Sharp Impact on Health CostsAwareness of
the health condition, which is largely
preventable through diet and exercise, remains
low. By Leslie Gross Klaff

• prevalence of metabolic syndrome in Americans
  over age 40 has increased by more than 60 percent
  in the past decade, according to a report from
  the Mayo Clinic.
• The average yearly pharmacy cost of treating
  adult patients with metabolic syndrome exceeds
  4,000.
• The syndrome is largely preventable through diet
  and exercise, and that's what employers need to
  focus on when tackling the health care costs.

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Res Ipsa Loquitur
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Treating CMR
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CP1068633-48
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Developing a Treatment Plan for Obesity

• Use a combination of weight loss strategies
• Reduce calories by 500-1,000 calories/day
• Increase physical activity
• Behavior modification
• patient diaries and assessment
• Pharmacotherapy
• Surgery
• Overcome patient and physician treatment barriers
• incentives Obesity and Metabolic Syndrome Work
  Group

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Obesity Management

• The ounce of prevention is worth more than the
  pound of cure.

• A single bariatric surgery 30,000-41,000

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Principles Guiding Prevention of Obesity and
Metabolic Syndrome

• Education, Incentives (ownership)
• Compliance and commitment
• Start in childhood
• parents, children, school
• dietary instruction, school lunches
• physical education programs
• organized sports
• more emphasis on participation, fun
• less emphasis on competition, winning
• Intervention
• children 25kg/M2 BMI
• Enlist skilled professionals in this challenge

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Opportunities
Program design awareness, ownership, compliance,
commitment, school, industry
Health and Exercise Psychology Professionals
Factors influencing motivation, compliance
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Some CMR References
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http//www.medscape.com/viewprogram/4324 http//ww
w.postgradmed.com/issues/2004/07_04/doelle.htm htt
p//www.postgradmed.com/issues/2004/01_04/metaboli
c_resources.htm http//www.postgradmed.com/issues/
2005/11_05/comm_cooppan.htm http//www.americanhea
rt.org/presenter.jhtml?identifier4756
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WHAT WE WANT TO DO
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Our Value Proposition

• AIAG Member Companies Need Better Health Care
  Value. Nowhere is this more true than with
  Cardio-Metabolic Risk.
• AIAG Member Companies Recognize Physicians as
  Lynchpins to Achieving Better Value in Health
• AIAG Member Companies Believe that
  Employer/Provider Relationships are Broken
• Us vs. Them
• Misunderstood and Misaligned Incentives
• Lack of Trust
• Too Many Intermediaries