As the incidence of diabetes and hypertension continues to grow worldwide – and increasing numbers of patients progressing to kidney disease and kidney failure place a financial strain on public health systems – the need for early patient education about kidney disease and treatment options, including home-based treatments, has become critical.

More than 240 million people have diabetes and this figure is projected to rise to 380 million by 2025¹. In the United States alone, 17.9 million have been diagnosed with diabetes resulting in medical and indirect costs (e.g., lost workdays, restricted activities and disability) of $174 billion or approximately one of every five health care dollars spent in US^2,3. About 40 percent of people with diabetes will develop chronic kidney disease, which also increases the risk of cardiovascular or other complications⁴. Today, 26 million American adults have chronic kidney disease and millions of others are at increased risk⁵.

“People with diabetes or hypertension, over the age of 60 or with a family history of kidney disease are at higher risk of progressing to chronic kidney disease. These patients should undergo screening and talk to their doctor about this disease regardless of if they display symptoms,” said Sarah Prichard, MD, vice president of global clinical affairs for Baxter’s Renal business. “Early detection of chronic kidney disease can dramatically affect how long you can preserve kidney function, what treatment options you will have and ultimately determine the quality of life you will experience while living with the disease.”

Baxter encourages patients with diabetes or hypertension around the world to learn about the symptoms and treatment options for chronic kidney disease on World Kidney Day, March 11. World Kidney Day is a global health campaign of The International Society of Nephrology (ISN) and the International Federation of Kidney Foundation (IFKF) that raises awareness about the importance of our kidneys and reducing the frequency and impact of kidney disease and its associated health problems.

According to two recent studies, chronic kidney disease patients who received early guidance from their nephrologist about their condition and dialysis treatment had a significantly lower risk of death within the first year of treatment^6,7. Studies have also demonstrated that people living with kidney disease who are informed about treatment options and are given a choice more often choose a home therapy.

Several studies report that patients on peritoneal dialysis, the most common type of home dialysis, are more satisfied with their care and experience a reduced impact of kidney disease on their lives compared to patients receiving in-center hemodialysis^8,9. In addition, home dialysis is cost-effective, associated with continued employment¹⁰ and can offer more flexibility and time for family and social activities. Recent studies also indicate that more than 75 percent of dialysis patients are eligible to choose either a home or center dialysis modality^11,12.

Recently, a new Medicare benefit went into effect that provides chronic kidney disease patients with six face-to-face kidney disease and treatment options education sessions, and provides physicians and certain physician extenders with reimbursement for educating patients. These classes are intended to educate patients about ways to slow the rate of kidney function loss, attenuate complications associated with kidney failure and provide them with information about treatment options (transplant, home dialysis, or in-center dialysis).

“It is important for people with diabetes and hypertension to learn as much as possible about the progression of kidney failure to prevent complications from chronic kidney disease,” said Prichard. “If kidney replacement treatment is necessary, patients should learn about all of their treatment options to select one that is best suited to their condition and lifestyle.”

The human kidney works to remove wastes and fluids from the body. When kidney disease progresses, the kidneys work less and less effectively. If the disease is detected early, lifestyle changes and selected medications can preserve kidney function for a longer period of time. If the disease progresses, people living with kidney disease must depend on renal replacement therapies, usually in the form of dialysis or transplantation, to make up for lost kidney function in order to survive. People may receive dialysis treatment at home (peritoneal or home hemodialysis), or in a dialysis center or hospital (in-center hemodialysis).

For more information on kidney disease screening and treatment options, visit www.renalinfo.com.

¹ The International Society of Nephrology and the International Federation of Kidney Foundations, World Kidney Day: Prevalence of Disease, http://www.worldkidneyday.org/page/prevalence-of-disease

² American Diabetes Association, Diabetes Statistics 2007, http://www.diabetes.org/diabetes-basics/diabetes-statistics/

³ The Centers for Disease Control and Prevention, Diabetes Statistics and Research: Frequently Asked Questions, http://www.cdc.gov/diabetes/faq/research.htm#4

⁴ The International Society of Nephrology and the International Federation of Kidney Foundations, World Kidney Day: Prevalence of Disease, http://www.worldkidneyday.org/page/prevalence-of-disease

⁵ National Kidney Foundation, Chronic Kidney Disease (CKD), http://www.kidney.org/kidneyDisease/ckd/index.cfm

⁶ Bradbury B., et.al., “Predictors of Early Mortality among Incident US Hemodialysis Patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS),” Clinical Journal of the American Society of Nephrology, no. 2 (2007), 89-99.

⁷ Hasegawa T., et. al., “Greater First-Year Survival on Hemodialysis in Facilities in Which Patients Are Provided Earlier and More Frequent Pre-nephrology Visits,” Clinical Journal of the American Society of Nephrology, no. 4 (2009), 595-602.

⁸ Carmichael P, et. al. “Assessment of quality of life in a single centre dialysis population using the KDQOL-SF questionnaire.” Qual Life Res, (2000), 9:195-205.

⁹ Kutner NG, et. al. “Health status and quality of life reported by incident patients after 1 year on haemodialysis or peritoneal dialysis.” Nephrol Dial Transplant, (2005), 20:2159-2167.

¹⁰ Paul M. Just, et.al., “Reimbursement and economic factors influencing dialysis modality choice around the world,” Nephrology, Dialysis, and Transplantation, January 30, 2008, no. 23, 2365-2373.

¹¹ Mendelssohn D., et. al., “A Prospective Evaluation of Renal Replacement Therapy Modality Eligibility,” Nephrology Dialysis Transplantation, (2009) 24: 555-561.

¹² Little J., et. al. “Predicting a Patient’s Choice of Dialysis Modality: Experience in a United Kingdom Renal Department. American Journal of Kidney Disease, 2001; 37: 981–986

So what does the public think of the healthcare insurance industry?  It appears that it’s confused.  DALBAR announced the release of its first-ever national evaluation of health insurance communications, the Explanation of Benefits (EOBs). This evaluation compared the usefulness of the communication from 34 leading insurers, including the federal government’s own Medicare program.

The evaluation found 68% of EOBs received failing grades. The Medicare communication was among the failures, scoring below the industry standard.

“This failure rate helps to explain why health care costs continue to rise with little resistance on the part of consumers — they just don’t know what they are buying,” said Kathleen Whalen, Managing Director at DALBAR. “An uninformed consumer is vulnerable to high prices, fraud and abuse,” she added.

A handful of innovative health insurers, Arkansas BlueCross BlueShield, CIGNA, and Humana, have recognized the importance of this communication to American consumers and have transformed them into understandable and, indeed, useful consumer tools.

The EOBs were evaluated using a method that has been developed and refined over the past two decades of evaluating print communication. Communications earned credit for including features that strongly impact a consumer’s ability to act prudently and make decisions. Features include the ability to understand the significance of the information, answer pertinent questions and utilize design elements that enhanced their overall effectiveness.

Key Findings include:

• Nearly seven out of ten firms failed to produce EOBs that provide a basic level of understandability.
• Just 9% of firms (3 out of 34) received a DALBAR Designation of “Excellent” for the Clarity, Content and Design of their EOBs.
• Less than a third of the EOBs evaluated received the minimum Designation of “Good” or higher.
• Only 3 firms include any charts and graphics on their EOBs to help consumers understand how their benefits work.
• Most messaging included in EOBs takes the form of supplemental notes that are often written in esoteric language and placed far away from the information to which they apply. These notes often contain the most important elements of the EOB – i.e., the “explanations.”
• The majority of EOBs failed to clearly answer the following most basic consumer questions:
  • How much, if anything, do I owe?
  • What action should I take now?
  • What do I do with this document?

When it comes to daily health activities such as diet and exercise, Americans and their doctors may not always see eye to eye. According to the new GE Better Health Study conducted with Cleveland Clinic and Ochsner Health System, 92 percent of healthcare professionals (HCPs) surprisingly give Americans far lower grades, “C” or lower, on managing their personal health than Americans give themselves. As the first in a series that will examine healthy living attitudes and behaviors, the study is part of GE’s healthymagination initiative, which seeks to provide better health for more people through technology and innovation.

The GE Better Health Study also asked Americans and HCPs about health and healthy living behaviors and the current state of patient-doctor relationships. The answers revealed that when it comes to daily health activities such as diet and exercise, Americans are not doing as much as they say they are to stay healthy.

For instance, 70 percent of Americans say they have at some point taken actions to avoid going to the doctor, including walking around in pain or asking a friend for medical advice, rather than addressing their health issues. When Americans do go for a checkup, 77 percent of HCPs say one-fourth or more of their patients omit facts or lie to them about their personal health.

“Lifestyle changes that include avoidance of tobacco, regular physical activity, food choices and portion size, and managing stress could decrease healthcare costs more than 40 percent,” said Michael F. Roizen, M.D. Chief Wellness Officer at Cleveland Clinic. As a starting point, get active!”

AMERICANS MORE GENEROUS THAN HCPs IN GRADING THEIR HEALTHY LIVING HABITS

A promising finding in the study is that eight of 10 respondents said eating healthy and exercising regularly are very important to healthy living, and 71 percent said they have a plan for living healthy. However, while one-third give themselves an “A” grade on daily health specifics including exercise (34 percent), eating healthy (33 percent) and managing stress (30 percent), more than 90 percent of HCPs give them a “C” or lower on these same health specifics.

“It’s crucial for people to take ownership of their health if they want to maintain it. This is not just a question of motivation; we’re seeing a significant doctor-patient communication gap,” said Dr. Joseph Bisordi, Chief Medical Officer, Ochsner Health System, New Orleans. “Health care professionals are eager to help people achieve better health.”

VITAL PERSONAL HEALTH INFORMATION NOT A TOP PRIORITY

Less than half of Americans know their current cholesterol levels, only one-third know their daily caloric intake, and just 29 percent know their blood glucose level. There is also uncertainty about preventive screenings that could prove life-saving down the road: Nearly half of men (42 percent) find it easier to answer how old residents need to be in their state for a driver’s license versus at what age they should get their first prostate exam, and 30 percent of women say the same about mammograms. In addition, respondents have an easier time answering non-health-related questions than facts about their own health:

• More people (49 percent) know when to change the oil in their car than their current cholesterol level (43 percent).
• More know how many vacation days they have left (47 percent) versus the number of calories they ate yesterday (43 percent).

Though Americans say time is their biggest challenge to living healthier (33 percent), they spend more time each year cleaning their house or thinking about living in a cleaner house (50 percent) than taking care of their personal health (44 percent).

HEALTHYMAGINATION.COM OFFERS CONSUMER INNOVATIONS

In response to the study findings, GE’s healthymagination.com now offers a suite of solutions to help patients partner with physicians to improve their health.

• The Better Health Conversation, developed with WebMD, works to ensure that patients have both the personal information and questions needed to get more out of physician visits. An online “chat” walks users through a series of questions to ask their doctor about their health and identifies information patients should have before they arrive at their doctor’s office.
• The free mobile application “Morsel” provides consumers with a manageable and rewarding program that lets them take a simple step toward better health each day. The application, available for iPhone and Android, suggests easy-to-do health activities and explains why taking these steps is good for your health.
• The Sharing Healthy Ideas platform encourages users to share health news, features and blogs on a variety of sites with others via email, Twitter or by sending to their phone.

“We know Americans want to live healthier, but they are looking for a path to follow,” says Mike Barber, Vice President, healthymagination “Healthymagination is about better health for more people. We’re bringing innovations to consumers so they can refocus on their health and make healthy living activities part of their daily routine. Our goal is for consumers and physicians to be more effective partners through better communication, and a system that encourages continuous learning and improvement.”

OLYMPIANS JOIN GE TO LAUNCH HEALTHYMAGINATION: THE YEAR OF BETTER HEALTH FOR MORE PEOPLE

To promote the use of these tools and build awareness about ways Americans can take charge of their health, two-time Olympic champion and five-time World Champion figure skater Michelle Kwan will kick off the campaign in New York on Feb. 16. A strong advocate for Americans playing an active role in their own healthy lifestyles, Kwan will bring the study findings to life for consumers and encourage Americans to think about their health in new ways in 2010. In addition, Kwan will join Olympic Gold Medalists Scott Hamilton, Angela Ruggiero (current defenseman for U.S. Olympic Women’s Ice Hockey Team) and Martin Brodeur (current goalie for Team Canada Ice Hockey) will be in Vancouver talking to consumers about the importance of healthy living.

According to Life University, Millennials (ages 15-27), are overly optimistic about their own health, despite admitting to the same unhealthy habits that have caused chronic illness in previous generations.

On a scale of 1-10, a vast majority (84%) rate their own health higher than a seven and more than a third (38%) rate their health as high as a nine or ten. Millennials also believe that they are healthier than other generations – one in four say they are healthier than their parents now and 61 percent think they will be healthier when they are their parents’ age than their parents are today.

However, even though Millennials think they are healthy, their actual habits predict otherwise. More than half (58%) say they eat junk food several times a week, 50 percent drink soda regularly, 50 percent do not get enough sleep, 44 percent do not exercise on a regular basis, 17 percent smoke cigarettes frequently, 13 percent have unhealthy relationships and six percent drink too much alcohol several times a week.

“The national healthcare debate has triggered endless discussions about cost and access, but very little dialogue about whether the system promotes sustainable health,” said Dr. Guy Riekeman, co-author of the Millennial survey and President of Life University. “Millennials believe they are the healthiest generation, but the reality is that they are no different from their parents. Both age groups have a quick-fix mentality towards health that’s been reinforced by our country’s policies. If Millennials want to avoid the same diseases that are beginning to harm their parents, they must adopt habits that support prevention and wellness. Perhaps then their children will understand what it really means to be healthy.”

These findings are from the first annual edition of Millennial Myopia: What Young Americans Don’t Know About Healthcare, a survey examining the opinions of 1,000 Millennials, defined as ages 15-27, spread evenly across the country, on health, wellness and healthcare reform.

Below are some of the major findings from Millennial Myopia: What Young Americans Don’t Know About Healthcare:

• The Depressed Generation? Nearly one third (28%) of Millennials take medication on a regular basis and 23 percent of those that take medication regularly are on anti-depressants, which was the third most popular drug behind allergy medications and birth control. Twenty percent of Millennials, and 40 percent of Millennials taking medication regularly, think that their life is moving in the wrong direction.
• Millennials Accountable on Healthcare. Thirty-nine percent of Millennials blame insurance companies for the problems with the U.S. healthcare system, while 32 percent blame the federal government. Regardless, 50 percent believe that it is the government’s responsibility to fix the system and only 20 percent look to the insurance industry. The vast majority (85%) of Millennials agree that individual U.S. citizens have a responsibility to improve healthcare by practicing healthier habits. Half (50%) agree strongly with this statement.
• Bad Relationships Coincide with Poor Health. Thirteen percent of Millennials regularly spend time in unhealthy relationships. Those that do are more likely to rate their health below a seven, have a higher incidence of unhealthy behaviors and are more likely to take medication. More than half (57%) of Millennials who are in unhealthy relationships and who take medication on a regular basis, believe that they are overmedicated.
• Women Are Hard on Themselves. Women place a higher level of importance on factors for good health than men do: nutrition (84% v. 74%), regular exercise (71% v. 67%), positive personal relationships (68% v. 57%), and preventative care (65% v. 51% percent). Despite knowing what it takes to be healthy, fewer women rate their health a 9 or 10 and they are more likely to let outside factors, such as financial pressure, family commitments and time restraints impact their decisions.
• Primary Care Doctors, Parents Greatly Influence Millennial Health. Most (64%) say primary care doctors have the most influence on their heath decisions, followed closely by their parents (60%).
• Prevalence of Chiropractic. Twelve percent of Millennials say that they have visited a chiropractor within the last year. Older respondents, those who rate their health a 9-10 and women are more likely to see a chiropractor. Of those who see a chiropractor, most (75%) do so for back pain, but a sizable group (40%) see a chiropractor for preventative care. Sixty percent say that alternative care practitioners have some influence over their health decisions, 18% of which say that impact is a major one.

A new Harris Interactive/HealthDay poll finds that reducing unemployment and creating new jobs are clearly considered the top immediate priorities for President Obama and Congress, but healthcare reform is still important. Half of U.S. adults say it will be a “bad thing” if there is no major reform of the healthcare system in the next two years.

These are some of the results a Harris Interactive/HealthDay poll of 2,075 adults surveyed online February 3-5, 2010 by Harris Interactive.

This survey was conducted on the heels of Scott Brown’s election into the Massachusetts Senate –which some say sent a loud message against the current healthcare reform efforts, followed by the President’s State of the Union address, where he reiterated the importance of this initiative.

Although a substantial 50% to 27% plurality want to see health reform in the next two years, the public is split on whether the reform proposed by the President and the Democrats should be passed.

The Republicans in Congress and the healthcare industry are seen as mainly to blame for failure to pass a healthcare reform bill now – not President Obama. Obviously, this is less true for Republicans, who blame the Democrats in Congress. There are very large differences between Republicans and Democrats on all these issues, with Democrats much more strongly in favor of pushing hard for major reforms.

“The public is clearly split, with Republicans on one side and Democrats on the other, as to how hard the president should push for health care reform,” said Humphrey Taylor, chairman of The Harris Poll. “The president’s stated intention to push ahead is likely to be popular with most Democrats, but will probably remain so only if he and Congress can deliver significant legislation. Failure to do so could be very damaging.”

Overall, and specifically for Independents, controlling the out-of-pocket costs of healthcare and health insurance is now seen as the most important aspect of healthcare reform. Results vary for Democrats and Republicans individually:

For Democrats, the most important is to ensure more people have health insurance.

For Republicans, the most important is not increasing taxes to pay for health reform.

Independents have become the swing votes in America, and how they feel could be an important indicator of where things will go. “But, if the debate drags on without a clear outcome,” said Taylor, “the more ‘health reform fatigue’ will increase, which is likely to help Republican candidates in the November elections.”

A significant majority of U.S. employers believe health care reform, if enacted, would lead to higher costs for both employer-sponsored benefit programs and health care services overall, according to initial results from an employer survey conducted by Towers Watson and the National Business Group on Health. A separate Towers Watson survey of U.S. employees found that a majority of workers think health reform will not only lead to higher costs, but decrease the quality of care and reduce the benefits available to them.

“Although the status of legislative health care reform is currently in limbo, it’s clear that employers and employees alike are concerned over the potential impact reform could have on health costs and their benefit programs,” said Ron Fontanetta, Towers Watson Health and Group Benefits practice leader for Intellectual Capital Development. “While health reform could ultimately provide greater access to health care to more Americans, there is a fair amount of skepticism over whether health reform will be able to curb rising health costs.”

The Towers Watson – National Business Group on Health survey found that nearly three-fourths (71%) of employers believe health reform will increase the overall cost of health care services in the United States, while 69% believe it will increase the cost of their benefit programs. Additionally, more than one-third (35%) say health reform will lead to fewer employers offering subsidized benefits. Nearly half (46%) of employers believe it will decrease employer-sponsored offering of retiree medical benefits, while very few — only 5% — say it will increase, and just 27% of employers say it will cause no change.

“These survey data confirm quantitatively what many people — employers, employees and policy pundits — have been talking about for the past four months. That is, whatever else a health care reform plan might do, it is unlikely to control health care costs, which has everyone worried,” said Helen Darling, President of the National Business Group on Health.

On balance, there are some pluses and some minuses in employers’ views and expectations from health care reform. On the one hand, roughly one-fourth (27%) believe it will lower health care quality and decrease the value of benefits that employers offer, but 39% and 40%, respectively, say it will have no change in these areas. On the other hand, a majority (71%) believe health care reform will increase access to health benefit coverage. In other encouraging outcomes, 34% believe it will increase transparency of provider prices, and 30% say it will increase the transparency of provider quality. Additionally, just over one-third (34%) believe health care reform will increase adoption of total replacement consumer-driven health plans (CDHP) by large employers, while only 9% believe adoption will decrease, and 27% believe there will be no change.

The separate Towers Watson survey of approximately 1,000 workers at midsize and large U.S. companies found similar concerns over health reform. Two-thirds (67%) believe health reform would result in higher benefit costs, while more than one-half (54%) believe it would reduce their available benefits and lower the quality of health care (53%).

This survey also found that 40% of employees would not be comfortable purchasing their own insurance in the reformed markets as an alternative to getting coverage through their employer. The current legislation proposals include a mandate for all individuals to have health insurance coverage, which ultimately could impact employees who currently receive insurance from their employer — if the employer decides to terminate the company plan and pay into the system instead.

“All eyes remain on Congress, and there will likely be trade-offs in whatever final legislation emerges from their negotiation process,” said Steve Raetzman, senior consultant for Towers Watson. “However, with or without health care reform, employers will continue to look for ways to control rising health care costs and provide high-quality health care for their workers and families.”

Hospitals rated in the top 5% in the nation by HealthGrades have a 29% lower risk-adjusted mortality rate and are improving their clinical quality at a faster pace than other hospitals, according to a new study issued today by HealthGrades, the leading independent healthcare ratings organization. Hospitals rated in the top 5% can be found at www.healthgrades.com.

In addition to having lower risk-adjusted mortality rates, hospitals in the top 5% – designated Distinguished Hospitals for Clinical Excellence by HealthGrades – also had risk-adjusted complication rates that were 9% lower than all other hospitals.

Now in its eighth year, the HealthGrades Annual Hospital Quality and Clinical Excellence study examines patient outcomes at all 5,000 nonfederal hospitals in the country based on 40 million hospitalization records from 2006, 2007 and 2008 obtained from the Centers for Medicare and Medicaid Services. Participation is not voluntary, and no hospital can opt out of being rated. For each hospital, risk-adjusted mortality and complication rates are evaluated across 26 procedures and diagnoses, from heart attack treatment to valve-replacement surgery to total knee replacement.

“This independent study of mortality and complication rates identifies an elite group of hospitals that are setting the benchmark for outstanding patient outcomes,” said Rick May, M.D., HealthGrades Vice President of Clinical Excellence Research and Consulting and an author of the study. “And what’s extraordinary is that these hospitals are not standing still. In fact, the data show that they are continuing to improve their patient outcomes at a faster rate, reflecting a commitment to quality that stands as a model for all other hospitals.”

The 2010 study of Medicare patients also found:

• Thirty-six states have one or more hospitals in the top 5%. Delaware has the highest percentage of Distinguished Hospitals for Clinical Excellence at 50% of eligible hospitals, followed by Maryland, Minnesota, Florida and Connecticut.
• 150,132 patient deaths among Medicare patients may have been prevented and 13,104 inhospital complications among Medicare patients may have been avoided if all hospitals performed at the level of the top 5% of hospitals.
• The top 5% of hospitals showed greater overall improvement in risk-adjusted mortality from 2006 through 2008, with an average of 13.91% improvement versus 10.41% improvement for all other hospitals.

How could a little-known Republican possibly have won a competitive U.S. Senate race in Massachusetts, the bluest of blue states? A new study by a team of Hoover researchers indicates that the culprit is the unpopularity of health care reform, and it likely means that Democrats will face even greater challenges later this year in less liberal states than Massachusetts.

“While the majority party historically loses seats in midterm elections, the stunning Democratic loss of Ted Kennedy’s Senate seat in Massachusetts signals a midterm Republican rebound of striking proportions,” says Hoover deputy director David W. Brady.

The recent study polled voters in the eleven states most likely to have competitive Senate races in November on their opinions about health care reform and how they might vote in November. The interviews were conducted from January 6 to 11 with 500 registered voters in Arkansas, Colorado, Connecticut, Delaware, Florida, Louisiana, Missouri, Nevada, North Dakota, Ohio, and Pennsylvania. The respondents were selected from a nonpartisan YouGov PollingPoint panel to be representative of the registered voters in each state.

Health care reform is significantly more popular in some of these states than in others, the study shows; where it is unpopular—which includes most states—the Democratic Senate candidates will face uphill battles. Calculated by the relationship between voters’ support for health care reform and the spread between the Democrat and Republican candidates’ vote share, the state-by-state findings indicate that support for health reform varies from a low of 33 percent in North Dakota to a high of 48 percent in Nevada. Democrats trail Republicans in six of the states; three are toss-ups; in two, Democrats have a solid lead.

How is it possible to conclude that the health reform bill itself is to blame and not just that these are more conservative states? First, the study asked voters if they knew how their incumbent senators had voted on the bill passed on Christmas Eve; about two-thirds answered correctly. Even now, long before the Senate campaigns have intensified, voters know where the candidates stand on health care. Second, voters were asked about their preference for Democrat versus Republican candidates in a generic House race. The results indicated that the higher the level of opposition to health reform, the greater the likelihood that the state’s voters supported Republicans.

So you or your patient needs to lose weight, however it seems like working out and dieting do nothing to improve their health.  Maybe the problem could be medical.

The American Society of Bariatric Physicians (ASBP) works with physicians so they’re better prepared to deal with society’s obesity epidemic. Even though people focus on weight loss more in January than any other month, successful weight loss is a year-round long-term initiative that goes far beyond just diet and exercise. The ASBP has highlighted five questions everyone who needs to lose weight should ask their physician.

1. Do I have other conditions that may be keeping me from losing weight?

It is important when you begin any weight loss program that you visit with a bariatric physician who can identify any weight-related conditions that can slow or stop successful weight loss. A bariatric physician will do a complete medical work-up to assess your overall health and metabolic state.

2. Do I have hypothyroidism?

Hypothyroidism is a condition in which the body lacks sufficient thyroid hormone. Since the main purpose of thyroid hormone is to “run the body’s metabolism,” it is understandable that people with this condition usually have a slow metabolism and thus, difficulty losing weight. A bariatric physician can identify a thyroid problem and provide a treatment plan that addresses hormonal and metabolic problems.

3. How are my Vitamin D levels?

Vitamin D levels are almost always low in patients who are overweight. Low Vitamin D levels can cause fatigue, muscle pain, bone pain and an overall feeling of lethargy, making it hard to lose weight.

4. Am I insulin resistant?

Insulin resistance turns off fullness signals to the brain. Typically, the heavier a person is, the more insulin resistant they may be, making them feel less full, causing them to continue to overeat. It is a complex condition that can be treated with the use of medications, exercise and dietary changes. Once it is treated, patients can feel more satiated, leading to more effective weight loss.

5. Am I ready for exercise?

This question may seem obvious, but exercise can be dangerous cardiovascularly in patients who are severely overweight. The heavier a person is, the more prone they are to injury. Often, it makes more sense medically for a patient to lose weight first and implement an exercise program when it is safe to do so, using exercise to maintain weight.

According to Dr. Wendy Scinta, a board certified family physician, a board certified Diplomate of the American Board of Bariatric Medicine (ABBM) and a member of the Board of Trustees of the ASBP, there is a skill set to managing obesity.

“If it were as simple as just eating less, we wouldn’t have an obesity epidemic in this country,” said Dr. Scinta. “Obesity is a medical condition, and it should be treated as such.”

Physician supervision is necessary to detect and treat weight-related medical conditions. A program supervised by a physician who is a member of the ASBP and who has completed specialized training in bariatric medicine, offers a comprehensive and effective approach to maximizing overall health and reversing co-morbidities.

To find a bariatric medical practice near you, visit www.asbp.org and click on the “Find a Physician” link.

How important are wellness programs to companies?  Well, 45% of Americans working at small to medium-sized companies said that they would stay at their jobs longer because of employer-sponsored wellness programs, according to the latest Principal Financial Well-Being Index.

The survey also found that as a result of workplace wellness programs, 40 percent of workers say they are encouraged to work harder and perform better and 26 percent miss fewer days of work by participating in such programs. As in previous years, 51 percent of workers believe wellness programs are very or somewhat successful in reducing health care costs.

The index, which surveys American workers at growing businesses with 10-1,000 employees, is released by the Principal Financial Group and conducted by Harris Interactive. These findings focusing specifically on wellness attitudes and behaviors among American workers were taken from the fourth quarter 2009 Index.

“Wellness programs are clearly a win-win, especially at a time when employers and their employees are more budget conscious,” said Lee Dukes, president of Principal Wellness Company, a subsidiary of the Principal Financial Group. “Employers benefit by retaining top talent, energizing their employees and reducing the number of sick days. Employees benefit from improved physical health, reduced stress in the workplace and the financial benefits of a healthy lifestyle.”

While not all employers offer wellness programs, the survey found nearly half (47 percent) of workers surveyed would participate or do participate in wellness programs to achieve better overall physical health. Other top reasons for participation include:

• Reduced personal health care costs (30 percent)
• Greater chance of living longer and healthier lives (30 percent)
• Receiving employer incentives for participation (28 percent)
• Reduced stress (28 percent).

Fitness Tops Workers’ Wish List as Worries about Changing Health Plans Mount

The survey found most workers are interested in wellness programs that improve their physical fitness, with 27 percent saying they would like in-office fitness facilities, 23 percent citing fitness center discounts and 19 percent expressing interest in weight management programs. For some, these wishes came true last year, as significantly more workers (15 percent) have access to fitness facilities in fourth quarter 2009 compared to 11 percent in fourth quarter 2008.

As workers seek ways to improve their health, they are concerned about potential changes in their health insurance. Significantly more workers, 34 percent, expect their medical plan options to change in 2010 compared with only 23 percent in 2009, the survey found.

“While uncertainty over the future health care system mounts, more Americans are taking charge of their own health by focusing on preventive care and living a healthy lifestyle now to lead a longer, more quality life,” said Dukes.