Obesity: A chronic disease that Ohio cannot ignore

Editor's note: Hackenburg and her family reside in Clyde. Jessica and her son, Nicholas, are part of the Obesity Action Coalition's Thrive Together Youth and Families Program. My youngest son, Nicholas, was born about four and a half weeks early and weighed just under six pounds. He needed to have his tonsils and adenoids removed when he was two and a half because they were so large that they touched at the back of his throat, which made him feel sick to his stomach all the time. Not long after that procedure, Nicholas gained 30 pounds in a month. As a nurse, I thought I knew what to look for. We ran several tests, and all the results came back normal. I was feeding him the same way as our older two children, so it didn't make sense to me why he kept gaining this weight. Doctors dismissed my concern, saying Nicholas was going through a 'chubby phase,' but I knew there was something more going on. This marked the beginning of a long journey to find answers. A dietitian provided great guidance. Still, Nicholas continued to gain weight, reaching nearly 400 pounds by the age of 13. A physician assistant familiar with our struggle helped us find a great endocrinologist, who finally answered our questions: Nicholas has a genetic abnormality so rare that while it is not officially linked to obesity, it is known in the medical community to cause obesity in children. With Nicholas approaching pre-diabetes, he was prescribed Ozempic. The results were nearly immediate: Nicholas lost 15 pounds while on the GLP-1 medication covered by our insurance for three months. Then the policy changed, making the medication unaffordable. At 16, despite sticking to a strict diet and maintaining an active lifestyle that included tennis, Nicholas still gained weight when he couldn't access a GLP-1. Recently, we successfully restored coverage. Access to the GLP-1 has been a crucial part of his weight loss, along with dedication to healthy eating and regular physical activity. We are particularly thankful for the medication coverage because we have been in a lengthy struggle to access bariatric surgery coverage for Nicholas. Amazingly, our policy administrators have repeatedly denied our appeals to the point where we literally exhausted all options. This has been a heartbreaking battle for our family. For Nicholas and many others across Ohio, obesity is a chronic disease. It is not a choice. We do literally everything in our power and still cannot stop it. That is why I was thrilled to hear that the DeWine Administration and the Ohio Department of Administrative Services announced a new weight management program for state employees that started Oct. 7. It includes partial reimbursement for Food and Drug Administration (FDA)-approved GLP-1 medications for those who medically qualify. The pilot program is a good first step – but only a beginning. HB 388, introduced by Rep. Josh Williams in late June and recently assigned to the Ohio House General Government Committee, would lower out-of-pocket costs more than the Administration's new program and allow employees to see their preferred provider. The current pilot program requires patients to use the state's vendor, Virta Health, instead of their own healthcare provider. Hopefully, the committee will act quickly to advance the legislation. I have seen how comprehensive obesity coverage can change lives and have experienced with Nicholas how important it is for those with obesity to have the full range of approved treatment options, potentially including bariatric surgery. Rep. Williams has stated that HB 388 is crucial for improving access to obesity care for all Ohioans. With this in mind, the DeWine Administration and the Ohio Department of Medicaid must remove the prohibition against Medicaid coverage for obesity treatments from the state's Administrative Code. It is the only way Ohio can begin a meaningful discussion to address the fact that 36% of Ohio's adult population has obesity. I only have one question for Governor DeWine: What would you do if Nicholas were your child? I have no doubt you would do everything possible to help him be healthy and avoid the serious health risks associated with obesity, including heart disease, stroke, type 2 diabetes, certain cancers, and kidney disease. Ohio must continue evolving its public policy on obesity, acknowledging it as a serious public health concern that is incredibly costly, reduces workforce productivity, and contributes to a host of comorbidities. Obesity is an epidemic in Ohio, but comprehensive coverage works – and the potential benefits of a healthier Ohio are too significant to ignore.