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Weight loss

Weight loss, ROI, and systemic bias

Why is it ok to hold clinically proven weight-loss treatments to a more rigorous standard when it comes to reimbursement than most other medical conditions?

Dr. Tim Church, MD, MPH, PHD, Wondr Health Chief Medical Officer, dives deeper into weight loss, financial return on investment, and bias.

Finding the return on investment (ROI) of a benefit is like hunting a unicorn—elusive and difficult to prove its existence. With multiple peer-reviewed papers demonstrating its clinical efficacy and third-party validation, financial ROI for the Wondr Health program is an easy case to make. But even with Wondr Health’s demonstrated clinical impact and the ability to be billed as a medical claim, financial ROI is still called into question—the bigger question is why.

If our product was a medical device, new hypertension medication, or any number of elective surgeries, would the financial ROI even be questioned? For other medical procedures/medications, the cost or outcomes may be called into question, but never would a formal return on investment be part of the discussion for access to care or reimbursement.

The American Medical Association declared obesity a disease in 2013. Excess weight is a risk factor for diabetes, heart disease, cancer, and countless other medical conditions. With more than 70% of Americans meeting the clinical criteria of overweight or obesity, the emergent need for helping more Americans with their weight cannot be overstated, especially after 2020. We have made remarkable progress over the last few decades in behavioral, pharmaceutical, and surgical weight-loss options, as well as greatly improved clinical guidelines to support these different approaches; yet clinically proven weight-loss therapies are still held to a different standard than nearly any other medical treatment when it comes to reimbursement. As a society and even within medicine, excess weight is often treated as a personal failing or a lack of willpower. And these biases against weight become especially dangerous when they are institutionalized in the form of access to care. 

Why is it ok to hold clinically proven weight-loss treatments to a more rigorous standard when it comes to reimbursement than most other medical conditions? Obesity remains one of the last socially acceptable biases, which systemically impacts access to care. As we take on the much-needed discussions about bias and discrimination, it is critical to address the institutionalized bias against individuals in need of weight-loss treatment.

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