Payment System Thwarts Efforts to Treat Obesity : Many physicians try to get counseling paid for by coding for a related comorbidity, such as diabetes.

Some physicians have realized that they are limited in what they can accomplish in an office visit so they have started their own weight management programs that incorporate good nutrition and physical activity.

One such physician is David Geller, M.D., a pediatrician in Bedford, Mass., who launched the Early Start program a little over a year ago. The program includes several weeks of medical sessions, nutrition counseling, and structured physical activity.

Dr. Geller said that he had grown frustrated with his inability to fully address overweight and obesity issues in his practice. “I just felt there was a better way to address it,” he said.

His medical visits with patients are generally well covered by insurance, Dr. Geller said, and they have seen improved coverage since the program began for the nutrition counseling.

Families generally pay out of pocket for the remainder of the costs.

“The insurance companies are realizing now that obesity is an issue,” Dr. Geller said.