Why aren't seniors using Medicare's free obesity counseling?

Although Medicare now offers its obese members with free face-to-face obesity counseling, very few Medicare members have actually taken advantage of the benefit. In fact, just 50,000 seniors received obesity counseling in 2013, reported Kaiser Health News. As many as 13 million seniors in America are obese.

Medicare's decision to cover weight loss counseling made the government insurer a rarity in the industry, as 93 percent of all insurers don't cover weight loss programs. Counseling is less expensive than other obesity-related services like bariatric surgery, and it can lead to lower healthcare costs by slowing the rate of expensive chronic conditions.

The reason for the low uptake in the counseling services isn't clear yet.

"We think it's the perfect storm of several factors," Scott Kahan, an obesity medicine specialist at George Washington University, told KHN. Those factors include doctors and Medicare members not knowing about the benefit, he said, as well as some doctors being reluctant to bring up the subject of weight to patients.

"It used to be thought that older patients don't respond to treatment for obesity as well as younger patients," Kahan added. "People assume that they couldn't exercise as much or for whatever reason they couldn't stick to diets as well. But we've disproven that."

Weight-loss specialists believe the problem is that Medicare doesn't let dietitians or nutritionists provide the counseling. "The problem with using only primary care providers is that [Medicare] completely ruled out direct reimbursement for the population of providers who are uniquely qualified and experienced working with weight management. I think that was a big mistake," Bonnie Modugno, a registered dietician in Santa Monica, California, told KHN.

"Unless we change the nature of how…the counseling occurs, I don't see it being available to people in a meaningful way," she added.

Forcing weight-loss counseling to occur in a separate appointment has also contributed to the program's troubles, FierceHealthPayer previously reported.

To learn more:
- read the Kaiser Health News article