Are Smokers More Deserving of Treatment Than People Living With Obesity?Thursday, October 9, 2014
This certainly appears to be the opinion of the majority of people living in Denmark, as reported in a study by Thomas Lund and colleagues published in the European Journal of Clinical Nutrition.
The study examined public support for publicly funded treatment of obesity (weight-loss surgery and medical treatment) and two pulmonary diseases strongly associated with smoking (chronic obstructive pulmonary disease (COPD) and lung cancer) in Denmark.
While a large majority supported treatment for lung cancer (86.1%) and COPD 71.2% (even when described as ‘smoker’s lung’ 61.9%), only one in three supported publicly funded weight-loss surgery (30%) and medical treatment of obesity (34.4%).
Not surprisingly, respondents beliefs about the causes of lifestyle-related diseases (external environment, genetic disposition and lack of willpower) and agreement that ‘people lack responsibility for their life and welfare’ influenced support for these treatments, especially in the case of treatments for obesity.
My guess is that these finding will not be significantly different in other countries that have publicly funded health care systems, including the UK or Canada, where treatments for cigarette-related lung and heart disease (as well as treatments for smoking cessation) are by far more accepted and accessible than treatments for obesity.
While I am all for treating and perhaps even further improving the care of people with smoking-related health problems, not having the same degree of concern or accessibility to treatments for obesity should be unacceptable.
Lund TB, Nielsen ME, & Sandøe P (2014). In a class of their own: the Danish public considers obesity less deserving of treatment compared with smoking-related diseases. European journal of clinical nutrition PMID: 25248357
Tuesday, October 14, 2014
Lorcaserin (Belviq) has had slow uptake in the United States for obesity. Insurance coverage has been changing over time but it is slow. US insurers have exclusions for obesity medications probably because of the bias that is sighted in this article. As you state and I agree, it is unacceptable. To me it is discrimination against the obese.
Arena Pharmaceuticals is currently undergoing a clinical trial for Lorcaserin for smoking cessation. Trial results should be available before year end. If we really have one safe drug that help you lose weight and quit smoking at the same time it will really be something. At some point acceptance will come.