@article{57ae8baa13b049f2b78b1ec7a9595781,
title = "Cost and policy implications from the increasing prevalence of obesity and diabetes mellitus",
abstract = "Background: The increasing prevalence of obesity and type 2 diabetes mellitus (DM), among children and adults, has posed important policy and budgetary considerations to government, health insurance companies, employers, physicians, and health care delivery systems. Objective: This article examines issues that are common to obesity and DM, including cost, clinical research, and treatment barriers, and proposes health policies to address these issues. Method: A manual review was performed of authoritative literature from peer-reviewed medical publications and recently published medical textbooks. Results: Obesity has been disproportionately prevalent among women and minorities, accompanied by an increased risk for DM. Women have experienced an increased risk for the metabolic syndrome, DM, and cardiovascular disease after onset of menopause. Obesity has been related to an increased risk for breast cancer among women, and may be a barrier that prevents women from being screened for colon and breast cancers. Maternal obesity has been a risk factor for gestational DM. Conclusions: Obesity and DM represent crises for the health care system and the health of the public, incurring costs and disease burden for adults and children, with increasing costs and prevalence expected unless more coordinated efforts to address the causes of these conditions at the national level are implemented. An investment in infrastructure to promote increased physical activity and reward weight management may be budget neutral in the long term by reducing the costs of morbidity and mortality. About two thirds of the costs from DM complications could be averted with appropriate primary care.",
keywords = "behavior change, diabetes mellitus, health policy, metabolic syndrome, obesity, women's health",
author = "Ryan, {John G.}",
note = "Funding Information: CVD. We also have much to learn about the pathophysiology of obesity and OM, for example, with regard to the cannabinoid system for regulating food intake and the potential of a new class of drugs, the glucagen-like peptide-I-based pharmaceuticals, that may help to regulate glucose metabolism. New behavioral research should include the study of health ambivalence, a health psychology construct that describes the difficulty of resisting temptations of unhealthy choices, as well as other areas of study that will advance our understanding of effective doctor-patient communication.174 Translational research, the application of clinical research findings in community medical practice, is especially important, considering that the quality of medical care for people with diabetes is generally less than optimal.128,175 The federal government can provide external incentives for improvement of health care quality to organizations by assisting them to upgrade their clinical information technology capabilities.152The federal government, through the Guide to Community Preventive Services, offers informational resources to communities for the purpose of increasing physical activity in populations.176 Government may go beyond information resources by providing block grants to communities to foster weight reduction through physical activity competition in populations. Through the National Institute of Diabetes and Digestive and Kidney Diseases, the federal government supports a program of translational research grants designed to develop cost-effective and sustainable interventions for the prevention and control of obesity and OM. Increased resources to support real-world programs may be made accessible to populations at the highest risk for obesity and OM, along with evaluation guidance. Also, the federal Centers for Medicare and Medicaid Services should consider providing reimbursement to physicians and health care organizations for screening their high-risk patients for OM.",
year = "2009",
doi = "10.1016/j.genm.2009.01.002",
language = "English (US)",
volume = "6",
pages = "86--108",
journal = "Gender Medicine",
issn = "1550-8579",
publisher = "Excerpta Medica",
number = "SUPPL. 1",
}