Disease Management Update
Volume V, No. 17
August 21, 2008

Dear Healthcare Intelligence Network Client,

It is a well-known fact that obesity can lead to other health problems — diabetes, CVD, hypertension and stroke, to name a few. But a link between obesity and ear infections? New research suggests children who are chronic earache sufferers could face a greater risk of obesity as they age. And another study says that sleep apnea — often triggered by obesity — is not always cured after surgical weight loss.

Visit HIN's blog to find out more about obesity management and prevention.

Your colleague in the business of healthcare,
Laura 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: http://www.hin.com/dmdesktop/diseasemanagement.html

Table of Contents

  1. Chronic Ear Infections Linked to Increased Obesity Risk
  2. Disease Management Q&A: Health Coaching & CDHPs
  3. HealthSounds Podcast: Keys to CDHP Success
  4. OSA Not Eliminated by Bariatric Surgery
  5. Survey of the Month: Obesity Management and Prevention
  6. Encouraging Independence: Promoting CDHPs and Decision Support Tools in the Workplace

1. Chronic Ear Infections Linked to Increased Obesity Risk

New research suggests damage caused by chronic ear infections could be linked to people's preference for fatty foods, which increases their risk of being overweight as they age.

“Middle ear infection is a common childhood disease and obesity is a growing problem worldwide,” said Linda Bartoshuk, Ph.D., of the University of Florida College of Dentistry. “Any potential association between these two public health issues is of considerable interest.” Bartoshuk presented some preliminary findings at the American Psychological Association's 116th annual convention that suggest a strong link between localized taste damage from chronic middle ear infections, or otitis media, and an increased preference for high-fat foods.

John Hayes, Ph.D., of Brown University and his collaborators at the University of Connecticut, found associations between otitis media exposure, taste, food choice and obesity. Among middle-aged women, those with taste functioning consistent with taste nerve damage preferred sweet and high fat foods more and were more likely to have larger waists. In another study, they found preschoolers with a severe history of ear infections ate fewer vegetables and more sweets and tended to be heavier, suggesting that taste damage from ear infections may alter food choice and thus obesity risk.

Another study examined 6,584 people who attended a lecture series and responded to a series of health questions. The study determined their history of middle ear infections and their BMI. The participants, mostly academics, were between 16 and 92 years old. The findings showed that those with a moderate to severe history of otitis media were 62 percent more likely to be obese. Bartoshuk noted that the overall rate of obesity in this sample was less than the general population.

To learn more about this research, please visit:

2. Disease Management Q&A: Health Coaching & CDHPs

Each week, a healthcare professional responds to a reader's query on an industry issue. This week's expert is Roger Reed, executive vice president and chief health officer at Gordian Health Solutions.

Question:What is the role of health coaching in CDHPs?

Response: (Roger Reed) When CDHPs were first offered, only about 10 percent of employees enrolled in them. Today, about 56 percent of employees will enroll, with participation sometimes as high as 90 percent. The individual is being asked to take more responsibility, to set their own goals and to make informed decisions about their healthcare.

A recent Hewitt survey found that 93 percent of employees were comfortable with taking greater responsibility for their healthcare decisions and would be comfortable modifying their health plan. However, most of them had no idea how to accomplish it. These employees are asking how to become a better healthcare consumer and how to take responsibility and improve their own healthcare to avoid dipping into their HSAs to pay these bills.

Health coaching supports employers as they move toward consumer-driven healthcare. Health coaching also supports employees as they try to become more judicious users of healthcare and more active consumers so that they can reach their own health potential.

For more details on health coaching in DM, please visit:

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

3. HealthSounds Podcast: Keys to CDHP Success

In tracking members' experiences with Aetna's CDHPs, Kathleen Campbell, head of the insurer's CDHPs, notes that more employers are now offering CDHPS and explains why enrollment within these organizations has increased. Campbell also discusses Aetna's suite of CDHP products and Aetna's focus on simplicity within their CDHPs.

To listen to this complimentary HIN podcast, please visit:

4. OSA Not Eliminated by Bariatric Surgery

According to a new study, while surgical weight loss results in an improvement of obstructive sleep apnea (OSA), most patients continue to have moderate to severe OSA one year after undergoing bariatric surgery. Results of this study suggest that it is the severity of the condition, rather than a patient’s pre-surgical weight, that determines if OSA will be resolved.

Results show that bariatric surgery reduced BMI from an average of 51 to 32 in 24 adults with OSA. At the one-year follow-up, however, only one participant (4 percent) experienced a resolution of OSA, and the majority of the study group (71 percent) still had moderate to severe OSA. Patients who have residual OSA after surgery are encouraged to maintain ongoing treatment with continuous positive airway pressure (CPAP) therapy.

“We were surprised by the severity of the residual sleep apnea in postoperative patients. The majority of individuals still had moderate to severe OSA,” said principal investigator Christopher J. Lettieri, M.D., chief of sleep medicine at Walter Reed Army Medical Center. “The second surprising finding of this study was that despite the persistence and severity of the disease, most people thought their sleep apnea was resolved after their weight loss and only a few still used CPAP,” he said.

To learn more about this research, please visit:

5. Survey of the Month: Obesity Management and Prevention

In 2004, HHS reclassified obesity from a lifestyle behavior to a medical condition. And for the last decade, many healthcare organizations have directed initiatives at the estimated 67 million obese Americans, 75 million overweight citizens and 10 million overweight children and adolescents. The obesity epidemic triggers upward of $117 billion in healthcare costs annually and is implicated in a host of related health conditions.

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

6. Encouraging Independence: Promoting CDHPs and Decision Support Tools in the Workplace

Rising costs, shifts in employment and ever-changing benefits plans are driving a cross-industry move to alternative HR services that give employees clear information, more relevant choices and greater autonomy. The problem is this: No matter how good a new service is, it won’t be successful if employees don’t use it. Luckily, a strategic communications program can encourage employee adoption of new services such as CDHPs and decision support tools at a cost that quickly pays for itself. Discover the elements of such a communication strategy in this white paper.

To download this complimentary white paper, please visit:
Please forward this news announcement to your colleagues who might find it useful.
Contact HIN:
Editor: Laura M. Greene, lgreene@hin.com;
Sales & Marketing Coordinator: Deirdre McGuinness, dmcguinness@hin.com;
Publisher: Melanie Matthews, mmatthews@hin.com

For more information on the products and services available through the Healthcare Intelligence Network, contact us at (888) 446-3530 / (732) 528-4468, fax (732) 292-3073 or email us at info@hin.com.
All contents of this message Copyright 2008