Division of Nephrology

Department of Medicine

Barre internal medicine specialist Priscilla Carr, M.D., clinical instructor of medicine

(DECEMBER 11, 2023) Barre internal medicine specialist Priscilla Carr, M.D., clinical instructor of medicine, wrote a commentary in VT Digger about Vermonters’ limited access to treatment for obesity.

Powerful new medications are being used for weight loss, and “they seem to have all of the makings of a modern-day miracle offering safe, effective therapy—and hope—to a group of people who have spent their lives struggling with a chronic condition that is often extraordinarily difficult to treat,” she wrote.

Despite the inarguable fact—known now thanks to extensive scientific research—that obesity is a disease associated with 200+ chronic medical conditions and implicated in the development of many forms of cancer, profoundly judgmental views of obesity continue to cloud people’s understanding that medications and surgery—interventions that change the brain’s regulation of energy balance—are often more effective at generating sustained weight loss than the old “eat less, move more” mantra.

Yet Medicare does not cover any weight loss medications; Medicaid programs from many states, including Vermont, exclude coverage for weight loss medications; and while many commercial insurance programs cover the medications, they have prior authorization requirements that are so complex that they prevent patients who clearly qualify for treatment from accessing medication, Carr noted.

“Never before have I had to look patients in the eye and tell them that there is a safe effective treatment available for the serious condition from which they suffer, and it’s not available to them,” she said. “These patients deserve better treatment.

“We can all try a little harder to … put equitable access to treatment for chronic disease ahead of judgment and blame,” she concluded.