From the Front Lines: Investing in prevention, even when policy won't
- bostoncommunityped
- Aug 20
- 3 min read
Dear Friends,
At BCP, we talk a lot about what it means to invest differently–in healthcare, in prevention, in equity. At a time of federal divestment in medicine and science, BCP continues to be on the frontlines, investing differently in our children’s health and providing the highest quality healthcare to all. Usually, despite the external environment, inside the walls at BCP, we can still make that happen.
But sometimes government policies limit even BCP’s ability to invest differently–and the recent decision for MassHealth to stop covering GLP1s for weight loss is one of those times. Increasingly, these life-changing drugs are available only to the wealthy few. It is an equity issue, yes. But it is also a missed opportunity to invest in a healthier future for everyone.
Obesity affects a staggering 21% of children and teens in the U.S, and it is linked to serious and costly health outcomes.
Children with obesity are:
More likely to develop heart disease and lifelong diabetes,
Up to 9 times more likely to one day suffer a heart attack or stroke when other risk factors (e.g., high cholesterol) are present,
At greater risk for 13 different kinds of cancer, and
32% more likely to experience depression than their peers.
With millions of children at risk, GLP1s offer an amazing opportunity to invest in prevention, to stop a child from ever developing diabetes or heart disease or worse. Instead, insurers are refusing coverage until these chronic illnesses invariably appear...and cost billions of dollars annually to treat. It’s amazing to me that we still haven’t learned our lesson: prevention not only costs less in dollars, but its positive impact on mental health is priceless.
Of course, as with all medications, GLP1s have to be carefully considered and prescribed–particularly for young people. But for some children, GLP1s are a lifeline, one that has been pulled out of reach.
Before MassHealth dropped GLP1 coverage for weight loss, these drugs were helping several of our patients successfully lose weight–many for the first time in their lives. A male patient who just graduated high school had gained weight consistently over the past seven years (totalling 127 lbs of weight gain). Within just 3 months of taking a GLP1, he not only finally started to lose weight, but he was able to gain critical insight into his eating habits and hope for a better future. Being on this medication helped him realize that he always turned to food when he was anxious or stressed; he started to feel empowered to start changing those habits. He started feeling that losing weight and living a healthier life was possible for him–something he had essentially given up on. The impact was remarkable. Now, this invaluable tool has been pulled out from under him, just as he embarks on this next milestone in his life.
As a pediatrician, addressing weight loss with a child who is struggling with obesity has always been extremely hard. Weight loss is stigmatized. It is complicated. We now know that diet and exercise alone do not yield the same results for every body. And many individuals must also contend with the systemic challenges of living with low income. Poverty is not compatible with paying for a gym membership or buying expensive produce. And working multiple low-paying jobs is not compatible with having time to exercise or cook a healthy meal.
Now our conversations with these children are about to become even harder. Because we have to explain that a powerful weight loss tool that is transforming people’s lives is not available to them–because they are too poor. And they aren’t sick enough. Yet.
All children deserve equal access to the medicine and tools that can keep them healthy.
It is why BCP works tirelessly to address inequities that make weight loss so challenging for families with low income:
We help patients register for active summer camps, onsite running clubs, YMCA memberships, and more–at no cost to them;
We teach weekly cooking class that always centers a fruit or vegetable, with healthy ingredients delivered right to children’s homes so that kids can develop healthier habits from a very young age;
We make no-cost groceries available at every visit;
We partner with families to apply for SNAP and WIC and access food insecurity support.
And it is why BCP will continue to encourage our healthcare system to start investing differently–in healthcare, in prevention, in equity. Until then, we'll just have to show them how it is done.
Sincerely,
Dr. Robyn Riseberg
Founder, Boston Community Pediatrics
Stay tuned for further updates from the front lines, and do not hesitate to send us your questions, thoughts, and feedback.
