A New England Journal of Medicine study shows, rather unsurprisingly that fat folks who get more interventions to help them shed weight did better over a period of 2 years. But the thing is: cost effectiveness was not proved and who knows what will happen when the plug is pulled and less interventions like lifestyle coaches are given.

The time has come to make the fatties pay. If you have packed on the pounds it is great that you get the help you need to shed those pounds but the cost must be borne not by those who have good lifestyle habits. That is, factor body weight into cost of health insurance. And those on Medicaid who pay nothing, get no taxpayer funds to help them drop weight.
That doesn’t mean leaving them high and dry. Medicaid folks can get access to inner city gyms that should be built with taxes on sugar-filled sodas sold IN THEIR Neighborhoods. Tax the Hood and use the funds to provide free gym access for 30 minutes per day in their Hood.
For those on private pay insurance, use extra funds collected to pay for their care and give reduced fee gym memberships or put treadmills in the workplace with rotating schedules of 15 minutes per use.

Give them 2 breaks a day if they agree to do the steps 12 or more floors twice a day or treadmill each break. This will mean less lbs over time and help them lower cost of their health insurance by shedding lbs.

And because…..
Overweight or obese children who lose the excess weight by adulthood have a similar cardiovascular risk profile as adults who were never obese, according to a study in the New England Journal of Medicine.
Gyms in the HOOD where childhood obesity is a grave problem should have kid access after school as well daytime schools should have mandatory 30 per day exercises periods that require treadmill walking on incline. Or rather than letting kids out at 2:30 in the afternoon, keep them there until 3 for mandatory gym programs for obese kids. It really is that simple. Similar programs should be instituted for low-income whites, especially in the South where obesity rates are very high.