Lifestyle vs. Drugs & Education for Overweight with Diabetes

Healthcare costs are the United States' largest drag on competitiveness for jobs with Europe and Asia, costing companies 2 to 3 times more in good ol’ USA. And that hurts our job market mightily. So along comes a big cost reducer, but is it covered by insurance or the government in USA's system? You guessed it, nope!

Posted on | Mike Roizen, MD | Comments ()

Healthcare costs are the United States' largest drag on competitiveness for jobs with Europe and Asia, costing companies 2 to 3 times more in good ol’ USA. And that hurts our job market mightily. So along comes a big cost reducer, but is it covered by insurance or the government in USA's system? You guessed it, nope!

Here's what we're talking about Obama, Boener, Pelosi, and Reid: (and it will save the USA dollars it now spends) Three prior studies and our own Lifestyle180 data have shown that for 1 year Lifestyle changes (exercise, food choices, and stress control) trump drugs and education as cheaper and more beneficial for diabetics. Today we know that's true for longer – lifestyle interventions can make a huge difference for 3 years. How many years do we have to study it and how many papers published before the insurance companies and HHS decide to get off their duffs and save money and jobs?

Maybe it’s the Docs fault. Lifestyle interventions are a simple and extremely logical (not to mention cost-effective) approach to disease management that teach, coach and guide patients to learn how to do the appropriate exercise, how to shop and cook appropriately and even manage stress, yet it is least common prescription doctors write or patients follow for obesity and diabetes.

Nope, if not paid for and the patient isn't one of those rich folks, we can't prescribe it, but can only tell patients about it – go and learn on your own doesn't work, and doesn't save money. Maybe the politicians and government regulators would rather spend your money.  In the study just published (for the wonks: Arch Intern Med. 2010;170:1470-1479), lifestyle interventions involved diet modification and physical activity. The results?  This group lost a significantly larger percentage of their weight, experienced greater improvements in fitness, blood glucose levels, blood pressure, and levels of good cholesterol, HDL. Good markers for living younger, longer, not to mention fewer absentee days and more productivity.

We’re hoping these results will grab attention and even supplement the pic of Drew Carey for the politicians to see (they do look at more than polls don't they) on the cover of this week’s Parade Magazine.  After only 10 weeks of diet modification and physical activity, he reversed his Type 2 Diabetes symptoms and no longer needs to take medication for it. Think about where he will be 3 to 4 years from now! No, not what show, but how vigorous he'll be if he keeps these Lifestyle changes that anyone can do.

The data are available, and there are more to come. Researchers are excited (just like us) by the health benefits and cost effectiveness of these types of lifestyle interventions.  A Swedish study examining lifestyle interventions found that after three years, patients saved almost $500 just by reducing doctors’ visits, and another $2500 on drug costs per year, not to mention test costs and time missed from work. And institutions like the Cleveland Clinic have developed inexpensive lifestyle intervention programs to teach these behaviors. Stress management and behavioral health are crucial in ensuring that these lifestyle changes stick like gum to the bottom of your shoe.

Believe it or not, even a few self insured companies are jumping on the bandwagon.  They’re sponsoring their employees to participate in programs to decrease health care costs. Our hope is that lifestyle interventions like the Ornish program for heart disease will be extended to obesity and diabetes by the insurance and Medicare gate keepers to help others the way Drew Carey got help. We know it works, so why wait? Choose lifestyle and the country will win, Obama, Boener, Pelosi, and Reid. Yes, that way the USA will save money and get healthier, and be more competitive for jobs. Can you break away from campaigning long enough to vote for something that saves dollars and helps create jobs for the USA?  

Blog written by Mike Roizen, MD
Dr. Roizen is a past chair of a Food and Drug Administration advisory committee and a former editor for 6 medical journals with...