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PeaceHealth Medicare patients get help with weight loss

Program pairs patients, experts to set diet and exercise goals

By , Columbian Health Reporter
Published:
5 Photos
Roy Schneider of Vancouver steps on the scale during his appointment with registered dietitian Chris Collins at PeaceHealth Medical Group Family Medicine in Vancouver. Schneider is participating in the medical group's Intensive Behavioral Therapy for Obesity program, which is covered by Medicare.
Roy Schneider of Vancouver steps on the scale during his appointment with registered dietitian Chris Collins at PeaceHealth Medical Group Family Medicine in Vancouver. Schneider is participating in the medical group's Intensive Behavioral Therapy for Obesity program, which is covered by Medicare. (Amanda Cowan/The Columbian) Photo Gallery

Roy Schneider hasn’t always been overweight. In fact, he’s been thin most of his life.

But five years ago, after undergoing cancer treatment, his weight ballooned to 290 pounds. That weight gain was enough to scare the Vancouver man into action.

In the last eight months, the 71-year-old has lost nearly 35 pounds and brought his body-mass index — a measurement of body fat based on height and weight — down from 42.1 to 37.1. A BMI of 30 or greater is considered obese.

He’s accomplished the feat by setting — and reaching — diet and exercise goals and regularly meeting with dietitians.

And Medicare has paid for the program.

“This is a wonderful program,” Schneider said. “I can’t imagine getting on anything better.”

“It’s a godsend for me,” he added.

Schneider is one of 62 people who have participated in PeaceHealth Medical Group’s Intensive Behavioral Therapy for Obesity program — a Medicare-covered one-on-one counseling program with registered dietitians.

The program pairs eligible adults with dietitians who help them set goals, take steps to reach those goals and lose weight — all with the aim of bringing their BMI down low enough to no longer be considered obese.

“Medicare started this to not only help people lose weight, but also to help people improve their quality of life,” said Chris Collins, one of two PeaceHealth Medical Group registered dietitians participating in the program.

Medicare approved the benefit back in 2011, and PeaceHealth Medical Group began offering the program in 2013.

The program is open to adults who have Medicare Part A or Part B and a BMI of 30 or greater.

Medicare covers a maximum of 22 one-on-one sessions in a 12-month period. The 15-minute sessions are every week for the first month and every other week for months two through six.

During those sessions, the dietitian and patient work together to set diet, exercise and behavior goals. They also review the participant’s diet and exercise log and discuss obstacles to their success.

“It’s very individualized,” Collins said.

Participants need to lose 6.6 pounds in the first six months in order to remain in the program. If that requirement is met, the counseling sessions are once a month. Those who don’t meet that goal can re-enroll in the program after a six-month waiting period.

Participants can continue in the program as long as they meet the requirements. But once their BMI drops below 30, they are no longer eligible for the program.

“The minute they’re under 30, they’re no longer eligible,” Collins said. “And it’s a shame.”

Someone with a BMI of 25 to 29.9 is still considered overweight. Some program participants who drop below 30 could probably go on to get healthier and lose more weight, but they don’t get the support of the program, Collins said.

Karen Marcacci of Washougal enrolled in the program in May with a BMI of about 34. She phased out of the program at the end of September, but she enrolled in Weight Watchers in an effort to keep her weight-loss momentum rolling.

Since May, Marcacci has lost 25 pounds and brought her BMI down to 27. Her cholesterol has come down, her energy levels are up and her joints are no longer bothering her. Now, she’s a healthy 77-year-old, she said.

“I’m no longer obese,” Marcacci said. “I’m just fat. I can live with that.”

“I’m enjoying feeling well,” she added.

Marcacci isn’t the typical program participant, though. She’s one of only nine people who have phased out of the program because their BMI dropped below 30.

Like Marcacci, the majority of participants begin with a BMI above 32. But about 23 percent of the participants have been removed from the program because they gained weight and another 29 percent didn’t lose the required 6.6 pounds, Collins said.

For some patients, their progress was hampered by other medical issues — one patient needed knee surgery, for example, and couldn’t exercise. Others just weren’t in the right mindset for weight loss, Collins said.

But 16 percent of participants lost 6 to 10 pounds with the program, 13 percent lost 11 to 15 pounds, and another 13 percent lost 16 to 20 pounds. The remaining 6 percent lost more than 21 pounds.

Collins had to scale back her expectations when she started the program. She hoped to see big weight loss in her patients but soon realized that’s not always realistic. Many of the program participants have complex medical issues and are limited physically due to arthritis or other joint issues, she said.

“We may not have great weight losses,” Collins said. “But 10 pounds off someone, it improves their breathing. It improves their blood pressure. It helps them move better. It improves their quality of life.”

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