UnitedHealthcare joins fight against childhood obesity

EATING WELL: Eleven-year-old Ryan Morel makes a salad while his mother, Dana, looks on. Ryan dropped from size 16 to size 12 through diet. / PBN PHOTO/DAVID LEVESQUE
EATING WELL: Eleven-year-old Ryan Morel makes a salad while his mother, Dana, looks on. Ryan dropped from size 16 to size 12 through diet. / PBN PHOTO/DAVID LEVESQUE

Rhode Island – like the nation as a whole – is facing an epidemic in childhood obesity, with severe long-term health and economic consequences.
The overweight child is going to be in the work force down the road, with a tremendous potential impact on health costs, warns Rena R. Wing, director of the Weight Control and Diabetes Research Center within the Centers for Behavioral and Preventive Medicine in Providence.
The United Health Foundation last month released a national report that found that no state had an obesity prevalence of less than 20 percent.
Identifying the problem is the first step, but the larger question remains: What are the most effective strategies to combat obesity in children and families?
Toward that end, UnitedHealthcare launched its “beta” version of a family based, pilot workplace-wellness program, JOIN, in October 2011, in partnership with Raytheon Corp., one of the region’s largest private employers, working with groups of employees in Portsmouth and in Massachusetts.
The JOIN program extends fully reimbursed wellness programs to children of employees, helping kids and teens achieve a healthy weight to combat the national epidemic in obesity. About 75 families are expected to participate in the 12-month pilot program that, if successful, will serve as a rollout for a national program in 2012, according to Tom Beauregard, executive vice president at UnitedHealthcare.
The evidence-based program builds upon an initial clinical study conducted in Rhode Island in a partnership between the YMCA of Greater Providence, UnitedHealthcare and Gary Foster, director of Temple University’s Center for Obesity Research and Education.
That clinical study, begun in January 2011, targeted children between the ages of 6 and 17 who are above the 85th percentile for body-mass index, or BMI, a measure of body fat based on height and weight. The study looked to fill a void for families who are struggling with the effects of excess weight and its consequences, according to Karen Leslie, CEO of the YMCA of Greater Providence. The results have been dramatic for participants in the clinical study such as Ryan Morel, 11. The JOIN program literally changed his life, according his mother, Dana Morel. “I try not to gush too much,” she said, describing how Ryan’s clothing sizes went from a size 14-16, husky, to a size 12, slim, in the last year. “He feels so good about himself, he’s more confident.”
In a written statement about his experience, Ryan said: “I lost my weight through a combination of strategies. I tracked everything I ate and drank in a journal at least five out of seven days a week for six months. My calorie target was 1,200 a day and I made sure I stayed right around there.”
Weighing and measuring all his food helped him to learn portion control, he continued. Ryan also swapped out high-calorie foods for smarter choices, switching to turkey burgers, turkey bacon, grilled chicken, egg substitute, and pitas instead of buns.
Ryan credited the support and encouragement he got from his JOIN coordinator, his fellow participants and his family, who cheered him on every step of the way.
“I’ve learned life skills that will stay with me forever,” he said. “I feel so much better about myself and proud that I’ve transformed myself on the inside and out. It feels great when people walk up to me and can’t believe all the weight I’ve lost.”
What made the JOIN clinical study different from other efforts was its family-based approach, according to Elissa Jelalian, an assistant professor of psychiatry and human behavior at Brown University’s Warren Alpert Medical School, who assisted in the study. “It was an open trial, with no comparison conditions, no control groups and children were not randomized and conditioned,” Jelalian said. “It was not a hospital-based or agency-based study.” Jelalian praised the collaborative and complementary role played by UnitedHealthcare. “United was involved in setting things up, providing the infrastructure; my involvement was in providing directions on how to interact with families,” she said.
There is no specific data or evaluations yet available from the ongoing JOIN program now under way with Raytheon employees, but according to UnitedHealthcare’s Beauregard, his expectations are that the results will mirror the very solid results of the clinical trial with the general population in Providence. “We expect to see meaningful weight loss for the kids,” he said.
For UnitedHealthcare, the origins of the JOIN program began with the recognition that there was a huge gap, according to Beauregard. “We saw that there were no effective treatment programs in the childhood-obesity space,” he explained. “Our plan is to expand JOIN nationally to other companies such as Raytheon, through private payers, and through Medicaid.”
The secret sauce, Beauregard continued, is the family’s involvement. “Childhood obesity is a family problem. Bringing the family together for the intervention, and doing it as part of a group session, has proven really effective,” he said.
The participation of an employee’s family members in JOIN is fully reimbursable, Beauregard stressed.
“There is a significant economic return for employers and a significant economic return for payers,” Beauregard said. “And it’s the right thing to do from a clinical perspective.
“More than 30 percent of our kids are overweight; there is a path from obesity to diabetes, to diabetes with complications, and then to heart disease,” he said. •

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