Obesity is becoming a worldwide problem

By Carmen Paun, Ben Leonard and Ruth Reader

BIG NEWS — Future Pulse will publish five days a week, at 2 p.m., starting Monday, Sept. 26. Our mission is expanding to cover all of the ideas reshaping health care. You’ll find analysis that takes you ahead of the curve, interviews with innovators and data-driven stories revealing what’s to come.

A TRILLION-DOLLAR WEIGHT — Obesity, typically seen as a problem of affluence, is starting to take a toll on poorer countries, according to a study published in BMJ Global Health today.

The study authors believe China, which is home to great wealth as well as poverty, will take a hit four times as large as the U.S.: $10 trillion in 2060. India, where a large swath of the population lives in poverty, will lose an estimated $839 billion.

“We have more commonalities with more people in the world than we used to have … in terms of the way we live our lives, in terms of the dietary habits and in terms of the need for policy responses,” said Rachel Nugent, one of the study authors.

Nugent is a vice president for global noncommunicable diseases at RTI International, a nonprofit institute providing research, development and technical services. It conducted the study with the World Obesity Federation, a professional society for scientists, researchers and doctors, supported by an educational grant from drugmaker Novo Nordisk.

Nearly two in five adults worldwide are either overweight or obese, according to the study. Those conditions put people at risk of developing heart disease, cancer and diabetes. And as the Covid-19 pandemic demonstrated, excess weight also makes people more susceptible to serious illness from infectious diseases.

South Korea and Indonesia were in the top five countries for projected economic costs, along with China, the U.S. and India. Germany, Brazil, Japan, Thailand and the United Arab Emirates followed.

The study took into account medical costs, the cost of seeking care and economic losses caused by premature deaths, missed work days and reduced productivity.

A counterintuitive trend? Not really. China and India’s economies are growing, as are people’s incomes, giving them the chance to afford fattening foods, like meat and dairy, and more food overall, Nugent said.

Ultraprocessed food, which tends to be cheaper, is also laden with sugar and plays a role, too, she said.

It may seem out of touch to fret about obesity in 2060 in developing countries while people are starving in the Horn of Africa today, but Nugent said the number of people who don’t have enough to eat or are facing famine is far lower than the number of people who are overweight or obese.

What can be done: First, stop blaming people for their weight and shift responsibility from the individual to society and policymakers, the authors said.

Then impose higher taxes on unhealthy food and drinks and toughen up marketing rules, make it easier for children and adults to be more active by improving school grounds and public spaces and help mothers breastfeed —– all measures linked to healthier weight, said Simón Barquera, president-elect of the World Obesity Federation and the director of the Nutrition and Health Research Center at Mexico’s National Institute of Public Health.

Welcome back to Future Pulse, where we explore the convergence of health care and technology. STDs are out of control, and more than 80 percent of maternal mortality is avoidable — what is tech gonna do about it? Send us your thoughts.

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DEMS PUSH BECERRA ON PRIVACY — Thirty Senate Democrats last week urged HHS Secretary Xavier Becerra to go further in using HIPAA, the privacy law covering health information, to bolster protections on records that could be used in abortion prosecutions, Ben reports.

HELP Chair Patty Murray (D-Wash.) led the group in calling on Becerra to begin a rulemaking to prevent HIPAA-covered entities like doctors and insurers from sharing reproductive health data without “explicit consent.”

After the Supreme Court’s June decision allowing states to ban abortion, HHS issued guidance explaining patients’ rights related to data under HIPAA, such as diagnoses and other health records, and data falling outside of it, like that collected by apps and websites. The HIPAA guidance said that in the case of a court order, abortion clinics would be allowed, but not required, to release records covered by HIPAA.

HOUSE CLEARS PRIOR AUTHORIZATION BILL — The House passed legislation on Sept. 14 aimed at accelerating the prior authorization process for Medicare Advantage plans, Ben reports.

Insurers now mandate providers get their approval for certain treatments to control costs, but resulting delays in care can harm patients.

The legislation — the Improving Seniors’ Timely Access to Care Act — aims to speed up prior authorization by mandating insurers do it electronically and asking HHS to roll out requirements encouraging plans to abide by evidence-based medical guidelines.

The legislation has broad support from industry like the American Medical Association and American Hospital Association. AHIP, a trade group representing health insurers, didn’t say whether it supported or opposed the bill in a statement to POLITICO.

GOP EYES TELEMEDICINE EXPANSION — Rep. Kevin McCarthy is set to roll out Republicans’ “Commitment to America” agenda Friday, a spokesperson for the House minority leader told Future Pulse.

The agenda — aimed at laying the groundwork for the 2024 election — includes expanding telemedicine access as part of a broad plan covering issues such as the economy, immigration and health care, Axios reported earlier this month.

UNITEDHEALTH PROCEEDS WITH CHANGE ACQUISITION — The Department of Justice’s attempt to block UnitedHealth Group’s purchase of payment optimization company Change Healthcare was thwarted on Monday.

Federal District Court Judge Carl Nichols ruled that the $13 billion deal could proceed as long as UnitedHealthcare divests Change’s payment software, ClaimsXten, to TPG Capital.

The DOJ had argued at trial that Change Healthcare has insight into how competing insurers reimburse health care providers and gain efficiencies — information that could give UnitedHealth an anti-competitive advantage. UnitedHealth’s lawyers argued that the company would lose clients if it misused the data.

FTC TARGET HAS TRACKERS IN PERIOD APPS — Data broker Kochava, recently sued by the FTC for selling data that can identify people visiting abortion clinics, also collects data from period tracking apps, reports POLITICO’s Alfred Ng.

Outside researchers have identified thousands of apps embedded with Kochava’s data trackers. Among them are apps for tracking menstrual cycles, staying fit during a pregnancy and creating digital pregnancy announcements. Womens Health & Period Tracker alone has been downloaded more than 100,000 times, according to Google’s app store.

Kochava said it doesn’t sell access to data collected from apps. But no federal regulations restrict the kinds of location information data brokers can sell.

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TELEHEALTH USE BROKEN DOWN —  The Centers for Medicare and Medicaid Services unveiled new data chronicling how telehealth use has risen and fallen amid the Covid-19 pandemic at both the state and national levels, POLITICO’s Tucker Doherty reports. There are significant differences by state:

A CLOSER LOOK AT TELEHEALTH ACROSS STATE LINES — Medicare patients taking advantage of pandemic policies that allow them to see doctors virtually in other states used the flexibilities mainly for primary care or mental health appointments, a study published Friday in JAMA Health Forum found.

“There’s this perception that out-of-state telemedicine is this phenomena used primarily for uberspecialized care, the patient with cancer or rare disease who needs to go across state lines to get care,” said lead author Ateev Mehrotra, a health care policy professor at Harvard, told Ben. “The majority of out-of-state telemedicine is for bread and butter stuff.”

The researchers found that rural patients, those living near state lines or people seeking cancer treatment were likely to access care across state lines.

But now that many state waivers have expired, some patients have to travel for in-person appointments if they want to meet their out-of-state doctors.

USAID HEALTH BOSS PLEADS FOR GLOBAL FUND MONEY — “My grandmother died of malaria,” said Atul Gawande, the U.S. Agency for International Development’s top global health official in pleading with countries and companies on Monday to finance the Global Fund to Fight AIDS, Tuberculosis and Malaria.

“She had lived at a time when the knowledge of how to save her life existed. It wasn’t even expected that we can bring that knowledge to a rural village in India,” he said, arguing that the Global Fund can spread that information now.

Putting $18 billion into the Global Fund for the next three years will help save the lives of people living with AIDS, tuberculosis and malaria, Gawande said.

President Joe Biden hosts the Global Fund fundraising event in New York City today.

‘This is pharma’s dream’: How drugmakers are turning telehealth into a marketing gold mine — STAT

A revised Hippocratic Oath for the era of digital health — Journal of Medical Internet Research

Walgreens to buy the rest of Shields specialty pharmacy for $1.37 billion — Forbes

A message from the Commonwealth Fund:

Did you know state health policies and practices lead to vastly different health care experiences depending on where you live? The Commonwealth Fund’s State Health Data Center is an all-in-one resource where you can explore health system performance and policy data through custom tables, graphs, and maps. From maternal and mental health to racial equity, insurance costs, and more, you can access state-level data at a glance or take an expansive view into over 100 hundred performance indicators. Visit www.statehealthdata.org to see how your state ranks when it comes to the most pressing health care issues.

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