Disease Management Update
Volume IV, No. 44
February 28, 2008

Dear Healthcare Intelligence Network Client,

According to the American Heart Association, 9 million children and adolescents between 6 and 19 years old are considered overweight, and the prevalence of overweight among this age range has increased more than 10 percent between 1971 to 1974 and 2001 to 2004. If that isn't enough, nearly 14 percent of preschool children are overweight as well. These statistics paint a grim picture for many children, as overweight adolescents have a 70 percent to 80 percent chance of becoming overweight adults. As of 2006, 142 million American adults are overweight or obese.

This week's Disease Management Update looks at studies involving obesity in children as well as in adult males and the not-so-obvious side effects this condition can have.

Visit HIN's blog to read more about more about the obesity epidemic in America.

Your colleague in the business of healthcare,
Laura M. Greene
Editor, Disease Management Update

If this is a forwarded copy of Disease Management Update and you like what you see, you can register to receive your own copy of this complimentary service. Sign up at:

Table of Contents

  1. Childhood Obesity Leads to Higher Rate of Problems During Surgery
  2. Disease Management Q&A: Effective Interventions for Overweight Children
  3. HealthSounds Podcast: Get Coached to Your "Best Self"
  4. Overweight and Obese Men Have Lower PSA Values
  5. Survey of the Month: Health and Wellness Coaching
  6. Employer-sponsored Weight Management Programs

1. Childhood Obesity Leads to Higher Rate of Problems During Surgery

A new study from the University of Michigan Health System (U-M Health System) finds that obese children are more likely than normal-weight children to have airway obstruction and other breathing-related problems during surgery. Obese children were found to have a higher rate of difficult mask ventilation, airway obstruction, major oxygen desaturation and other airway problems.

Researchers studied the experiences of 2,025 children who were having elective surgery. Of those, 1,380 were normal weight, 351 were overweight and 294 were obese. Children ranged in age from 2 to 18 years old. Obese children also had a higher rate of illnesses and conditions including asthma, hypertension, sleep apnea and type II diabetes. These conditions all can contribute to problems during surgery, the study notes.

To learn more about this analysis, please visit:

2. Disease Management Q&A: Effective Interventions for Overweight Children

Each week, healthcare professionals respond to a reader's query on an industry issue. This week's expert is Eric Berman, D.O., M.S., medical director for Horizon Blue Cross Blue Shield of New Jersey.
Question: What initiatives have been enacted by health plans to furnish reimbursement or financial incentives to providers for investing the extra time and resources needed to implement and coordinate effective health interventions in overweight children?

Response: (Eric Berman) That is an area where most health plans are woefully inadequate. Our health plans do not reimburse pediatricians for addressing obesity as a primary diagnosis, which is a big problem. One way to address this is to develop regional programs in weight management. Horizon has developed a Health and Wellness Education program for our HMO members that is a self-referred program for members aged 12 or older.

Members can call and have a frank discussion with a nurse who will either direct them to a registered dietician or exercise physiologist or hear out their concerns and develop a weight-loss program for them to start exercising and eating right.

In Atlantic County, New Jersey, we are developing as an outgrowth of the Bariatric program at the AtlantiCare Health System an entire wellness program that includes children and adults. There are specialized classes for children on exercise and food selection, and they can also take cooking classes.

We’re also looking into rewards to our members who are able to lose weight and keep the weight off. WellPoint and possibly Blue Shield of California have embarked on similar programs where they are starting to either give people reductions in their premiums or cash bonuses. If they are able to lose 10 to 15 pounds, they receive a reduction of $200 to $500. If they keep the weight off for another six months, they get a second payment of an equal amount.

Many health plans are looking at this and over the course of the next few years, there will be more and more plans offering some kind of bonus for people who are starting to adapt these more healthy behaviors.

For more information on childhood obesity, please visit:

We want to hear from you! Submit your question for Disease Management Q&A to info@hin.com.

3. HealthSounds Podcast: Get Coached to Your "Best Self"

In this week's Disease Management podcast, "Coach Meg" (Wellcoaches CEO Margaret Moore) helps volunteer client Kathy Smith (not her real name) identify life issues that are keeping her from being her "best self" in managing her thyroid condition and weight issues. You'll hear how Coach Meg builds positive psychology into this real-life health coaching session, which was conducted as part of HIN's "Teaching Health Coaches to Integrate Positive Psychology with Physical Health to Improve Disease Management Outcomes" audio conference.

To listen to this complimentary HIN podcast, please visit:

4. Overweight and Obese Men Have Lower PSA Values

Men who are overweight or obese have lower concentrations of prostate-specific antigen (PSA) in their blood than their normal-weight counterparts, according to a new study led by Duke University Medical Center researchers.

The finding echoes earlier results on PSA concentrations found in obese and overweight men with prostate cancer and highlights the need to reconsider PSA threshold values for heavier patients and to encourage those patients to get serious about losing weight.

"A study released last year from our group showed that obese and overweight men with prostate cancer had deceptively low PSA scores compared to normal-weight men with prostate cancer, but we now have extended our findings to show that this trend holds true in the general screening population," said Marva Price, R.N., a family nurse practitioner and researcher in Duke's School of Nursing, the Duke Comprehensive Cancer Center and the Duke Prostate Center. "We found that mildly obese men's PSA scores were 14 percent lower than normal-weight men, and moderately and severely obese men had 29 percent lower PSA values," Price said.

To see more of this study's results, please visit:

5. Survey of the Month: Health and Wellness Coaching

Complete our online survey on health and wellness coaching by February 29, and you'll get a free executive summary of the compiled results.

To participate in this survey and receive its results, please visit:

6. Employer-sponsored Weight Management Programs

This white paper details the significant benefits to organizations that invest in proven weight control strategies at work. The paper cites more than a dozen studies highlighting the return on investment (ROI) in terms of health risks, costs and worker productivity and offers employers solutions to the growing crisis.

To download this complimentary white paper, please visit:
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