Saturday, October 02, 2004


My post of 28th about Hot Cross Buns got more responses than usual. One reader questioned the veracity of the story. It is true that the local councils concerned did deny that it was their "official policy" to ban the buns but there is no denial of what some council employees said and did. See here for full details. The original story is here. Note that it is still up -- despite huffing and puffing by the councils. Their threats of lawsuits over the matter seem not to have been followed up by any action -- which rather suggests that the councils knew that the original report was justified.


Apparently the good old generous taxpayer now wants to provide people with a substitute for self-control

At a meeting in November, Medicare's advisers will assess the safety, efficacy and cost of one increasingly popular method of weight loss - surgery - as a first step in a new policy that could lead to the use of federal money to cover a range of other obesity treatments.

Yet, at a time when coverage by Medicare and other insurers may increase, the evidence suggests that few obese people can lose significant amounts of weight in the long term. And some obesity researchers are also questioning the fundamental idea that losing weight improves health. Are weight loss programs, they ask, unnecessary medicine? "No one wants to hear this," Dr. Jules Hirsch, an obesity researcher at Rockefeller University, said, "but I would ask where the data are." None of the experts, however, are suggesting that people should abandon healthy eating habits and exercise, which have clear benefits.

At the moment, Medicare will pay for surgery for obesity when patients suffer other problems associated the condition, like diabetes. Now, Medicare says it may decide to cover treatment for those who are simply obese, meaning their body mass index, a measure of body fat, is at least 30. The agency said that it would need to determine if obesity treatments help people lose weight and improve their health, adding that as yet it has no estimate on costs.

The immediate question is whether to cover so-called bariatric surgery, which costs $30,000 to $40,000 if there are no complications, and greatly reduces how much food can be consumed and the calories that can be absorbed. But commercial diet programs as well as many obesity doctors, including members of the American Obesity Association, whose sponsors include makers of weight loss drugs as well as companies like Weight Watchers and Jenny Craig, say they want coverage for other programs, too. The obesity association said that it planned to use Medicare as a wedge to open the door for broader coverage for the obese and then, possibly, for overweight Americans.

More here.

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