Doshi said endocrinologists need to be aware that the barriers that the rest of the health care team are facing in terms of insurance are similar to their own. Having a discussion about insurance coverage for all services and out-of-pocket costs may need to become a part of their regular planning about weight management services, given that insurance coverage for these services remains variable from state-to-state. 

“We encourage further research that examines patient outcomes when insurance coverage for weight management services is improved and is no longer a major barrier to care for endocrinologists and other health care professionals alike,” said Doshi.

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Lack of Diagnoses

In the second study, Bartolome Burguera, MD, PhD, of the Cleveland Clinic’s Endocrinology and Bariatric Institutes and director of Obesity Programs, and  colleagues reviewed 324,199 active patients with a recorded BMI to see if patients with obesity or overweight as identified via BMI received a formal diagnosis using ICD-9 documentation.2 This cross-sectional summary from a large US integrated health system found that of all patients with a BMI greater than 30 kg/m2, only 48% had documentation of an ICD-9 code for obesity. In those patients with severe obesity (BMI greater than 40), only 75% had an ICD-9 code for obesity.2

“The most important message for endocrinologists is that obesity needs to be diagnosed and treated. The clinical significance is that we are not doing a good job of treating and diagnosing a very important disease,” Dr Burguera told Endocrinology Advisor. “I think the first message should be that obesity is a chronic disease and so endocrinologist need to establish a diagnosis and to start a treatment because in many cases we are treating the consequences of obesity and not the main problem.”

It is unclear why clinicians aren’t providing a formal diagnosis for obesity. However, Dr Kahan said this may go hand-in-hand with coverage. He added that if clinicians are not being paid to treat obesity, they may not see any benefit in making a formal diagnosis.


  1. Doshi R, Bleich S, Gudzune K. Health professionals’ perceptions of insurance coverage for weight loss services. Abstract T-OR-2087.
  2. Burguera B, Hobbs T, Chagin K, et al. The prevalence and recognition of obesity and its associated comorbidities in a large U.S. integrated health system. Abstract T-P-3135. Both presented at: ObesityWeek 2016; October 31-November 4, 2016; New Orleans, LA.