MDNews - Mid Hudson

sPecial clinical section: bARiATRiCS OBESE IN THE EXAM ROOM: Patient Perception and Physician Challenges By Jennifer Webster a Physician walKs into an eXam room where a longtime Patient is waiting For his annual checKuP. the Physician glances at the comPuter screen and notes the digits: Bmi = 36.7. does she do anything diFFerent From what she did last year? T HE AmERiCAN mEDiCAL Association's (AMA's) 276-181 vote to classify obesity as a disease does not present any particular instruction set to physicians, insurers or patients. Apart from scanning commentary in the blogosphere, will the average, busy primary care physician change how she spends 15 or fewer minutes with a patient who has obesity? And, will the physician's obligation to the patient change as institutions react to the AMA's classification? 14 | Mid Hudson MD News ■ mDNEWS.COm For instance, will accountable care organizations become responsible for not just screening patient body mass index (BMI), but also keeping it under a certain level? Presently, many large insurers, as well as Medicare and some state Medicaid plans, cover obesity screening and counseling. Many insurers' coverage for obesity treatment includes discounted or free membership for health clubs or programs such as Weight Watchers. Additionally, some forms of bariatric surgery may be covered for patients who are extremely obese or who have comorbid conditions. Following the AMA's decision, will insurance companies be more likely to cover counseling for weight loss, special meals, sessions with exercise therapists, or medications? Will bariatric surgery be covered for obesity without comorbidities? Many experts who work with obese patients hope this will be the case. As a positive sign, the Affordable Care Act preventive services benefit requires physicians of patients with obesity to offer guidance

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