Osteoarthritis Action Alliance Lunch & Learn Scott Kahan, MD, MPH Director STOP Obesity Alliance Faculty George Washington University School of Public Health and Health Services

Today’s Agenda  Introduction  Obesity & Osteoarthritis  About the STOP Obesity Alliance  What Interests Overlap in the Obesity and OA Communities?  Questions and Answers

Obesity Prevalence 3

Obesity & Osteoarthritis: What We Know  Excess weight has become one of the most pressing public health threats of the 21st century. ―Overweight and obesity affect 2/3 of Americans. ―Adults affected by obesity are most likely to report joint pain, according to a national survey.  The high prevalence of obesity, especially severe obesity, is fueling an epidemic of osteoarthritis. ―Osteoarthritis affects 1 in every 10 adults age 25 & older, and 1 in 3 adults age 65 & older – a total of 27 million Americans. ―OA is the 3 rd leading cause of years lived with a disability in the U.S. Source: Osteoarthritis Action Alliance, Background Facts on the Vicious Cycle of Obesity, Osteoarthritis (OA) and Disability

The Cycle of Obesity, Osteoarthritis and Disability  The risk of disability in people with OA increases with the degree of obesity. ―A 2004 study showed that persons with OA with obesity were 1.72 times more likely to be disabled than normal weight counterparts. ―The risk increases to 2.75 times higher among people with severe obesity. Source: Osteoarthritis Action Alliance, Background Facts on the Vicious Cycle of Obesity, Osteoarthritis (OA) and Disability

Benefits of Modest Weight Loss 6 Messier SP, et al. Exercise and Dietary Weight Loss in Overweight and Obese Older Adults with Knee Osteoarthritis. Arthr Rheum 2004.

STOP Obesity Alliance: Purpose and Goal Convene a diverse, prestigious group of consumer, provider, government, labor, business, health insurer and quality-of-care organizations to find ways to overcome and prevent obesity and weight-related health issues. – Now more than SEVENTY-MEMBER Coalition Move beyond awareness and consumer education to identify and address systemic and cultural barriers that are failing to adequately support individual successes – Conduct and assemble research that identifies any cultural and systemic biases – Develop and support research-based initiatives to improve treatment and prevention – Make recommendations and promote needed systems changes 7

Stakeholders Working Together to Advance Weight-Related Issues 15 Alliance Steering Committee Members and Government Liaisons including: – American Diabetes & Heart Associations – American Health Insurance Plans – National Business Group on Health ~50 Associate Member Organizations including chronic disease, consumer, minority health, provider and women’s groups 8 State-Level Members George Washington University, Department of Health Policy serves as Academic Home 17 th U.S. Surgeon General Richard Carmona, MD is Advisor Sanofi U.S. is founding sponsor – The Obesity Society – Service Employees International Union – U.S. Centers for Disease Control and Prevention

Core Policy Recommendations Underscore Alliance Objectives 9 Redefine Success Encourage Innovation Reduce Stigma Broaden the Research Agenda Encourage Physical Activity Explore the use of 5-10% percent sustained reduction of current weight as the measure of success for the purpose of determining whether treatment interventions and innovations are effective. Consider innovative approaches for obesity treatment, intervention and disease management for patients who have been unsuccessful with traditional nutrition and exercise only programs. Work with healthcare professionals, government and private entities to address obesity in ways that promotes open discussion rather than isolating those who are affected. Broaden the research agenda to examine all factors contributing to obesity and how they interact, as well as applied research to address the immediate needs of payers, providers and individuals. Encourage interventions and create environments that support physical activity to improve health, independent of weight or weight loss, resulting in a healthier population.

Initiatives Over the Years Brought Recommendations to Life for National Stakeholders Launch STOP - 11 Steering Committee Members, 17 th U.S. Surgeon General Release 1 st set of policy recommendations Release Employer/ Employee Survey Release Obesity GPS Publish Employer/Employee survey in Health Affairs and commentary in Women’s Health Issues Recruit first Associate Members - Initiate Funders Table - Host Primary Care Roundtable - Launch National Employee Wellness Month with Virgin HealthMiles Launch Task Force on Women Release Primary Care Survey - Launch Women, Weight and Media Discussion with NEDA - Release Media Guidelines Release Health Reform Recommendations 2011 Release Revised Policy Recommendations: Focus on Physical Activity Release EHB Recommendations Release Policy Maker Communications Guidelines Launch “Obesity and the States” Bulletin Series More than 40 Associate Members Followers; 860+ Friends CMS National Coverage Determination Address audience at inaugural CDC Weight of the Nation conference 2012 Obesity selected as a Great Challenge, STOP is the advocate Presented at CDC’s 2 nd Weight of the Nation Conference Launched State-Level Membership

Ways to Stay Connected With The STOP Obesity Alliance  Visit Sign up for monthly e-Newsletter Get updates about upcoming events and new research and resources  Request to receive future editions of “Weight and the States” research bulletin  Follow us on Twitter!  Like us on Facebook!

What Interests Overlap in the Obesity and OA Communities?  Studies show that even modest weight loss (especially when combined with exercise) in people who are classified as overweight or obese and have OA produces meaningful improvements in physical function, reductions in pain, improved mobility and independence, and increased quality of life.  In fact, a study in older adults with knee OA demonstrated that each pound of weight loss resulted in a four-pound reduction in knee joint forces.  Other research finds that a weight loss of only about 15 pounds can cut knee pain in half for individuals who are classified as overweight and have OA. 12 Source: Osteoarthritis Action Alliance, Background Facts on the Vicious Cycle of Obesity, Osteoarthritis (OA) and Disability

Questions? 13