GOAL

We understand the dynamics of the Health and Benefits market and recognize that we have a unique opportunity to provide obesity services that can have a positive impact on your benefits, work absenteeism, and health care expenditures. As the prevalence of being overweight reaches 70% of the US population, we believe that the benefits market has understood the importance of addressing their employee’s weight as part of their wellness programs. Large corporations are not waiting for regulatory action (obesity has been a medical diagnosis since 2013); they are, in fact taking the lead due to the realization of cost savings seen in multiple seminal studies on the direct and indirect health care costs of obesity. We are uniquely positioned to successfully help you address recruiting and retention needs with the value-added proposition to not only improve employee’s health and wellness and control obesity but improve the costly co-morbidities, absenteeism, presentism, and workmen’s compensation claims related to employees suffering from medical conditions related to obesity.

We are confident that our proposed services will effectively address your needs. Our goal is to provide evidenced based obesity medicine by board certified obesity providers. Your company will:

  • Decrease medical claims cost related to obesity
  • Decrease medical claims cost related to co-morbidities worsened by obesity
  • Decrease absenteeism, and presentism due to obesity
  • Decrease workmen’s comp claims related to obesity

Our unique ability to provide comprehensive treatment for obesity and our successful track record in working with MGM Resorts International, Nevada Public Employees’ Benefits Program (PEBP), Nevada Hand, and One Health makes us an invaluable partner in the treatment of obesity.

BACKGROUND

Premier Physicians Weight Loss & Wellness was founded in 2006 by Dana Trippi, DO and Erik
Evensen, DO (www.WellnessLasVegas.com) to offer medically supervised Obesity and Weight Management Services. Our Company is known for its unique comprehensive and individualized patient care designed to achieve measurable, sustainable weight loss and improve the health, wellness, and lifestyle of our patients-both individuals and corporate groups. The experience is personalized, supportive, comprehensive, and proven effective. Participants set realistic weight loss goals and then learn, through small tailored changes in diet, exercise, and behavior, to achieve and maintain a healthier lifetime weight. In addition to increased knowledge and confidence, participants can expect at least a five percent reduction in weight and significant improvement in nutrition, activity levels, and overall health.

Our program is uniquely different by offering a comprehensive and personalized set of treatment options most likely to yield individualized success. These include diet interventions, tailored exercise programs, behavior modification tools and pharmacotherapy. We believe that the treatment for being overweight and obese is like any chronic condition or disease, it must be consistently monitored and managed to achieve and maintain positive results.

In recognition of our accomplishments we have been named TOP DOCTORS in
Obesity/Bariatric Medicine by our peers in the Las Vegas Magazine/Healthcare Quarterly in 2011, 2013, 2014, 2015, 2016 and 2017

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NVHAND
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MARKS OF SUCCESS
There is a common misconception when an individual endeavors on a weight loss program, that if they do not reach their ideal body weight or lose dozens of pounds, there will be no health benefit. This misconception has consistently been disproven as more weight reduction studies continue to be released. The current evidence shows that a modest weight reduction of 5-10% can significantly improve co-morbid diseases. These include:

Cholesterol: A 5-10% weight loss can result in a 5 point increase in HDL cholesterol. Raising HDL can lower the risk of an individual developing heart disease.

Triglycerides: A 5-10% weight loss has been shown to decrease triglycerides by an average of 40mg/dl

Hypertension: Excess body weight accounts for approximately 25-30% of cases of hypertension. A 5-10% weight loss has been shown to decrease both the systolic and diastolic blood pressure by 5mmHg on average.

Diabetes: HgbA1c is a measurement of glucose control in the diabetic population. Normal is considered to be <6.5. A 5-10% weight loss has been shown to decrease this marker by 0.5 on average. This comes close to the effect that some diabetic pills have on HgbA1c.

Insulin resistance: Insulin resistance results in high levels of circulating insulin throughout the body. These high insulin levels results in an increase in fat, especially around the waist, elevated cholesterol levels, and has other detrimental effects. Modest weight loss has been shown to significantly reduce insulin levels.

Obstructive Sleep Apnea: A 5-10% weight loss has been shown to improve sleep apnea, and in less severe cases patients may discontinue CPAP at night.

Inflammation: Fat cells are known to produce numerous inflammatory substances. These substances increase the risk of heart attacks and strokes. A 10% drop in weight have been shown to substantially reduce these markers.

Summary: A weight loss of 5-10% can statistically improve obesity related diseases, lowering morbidity and mortality. It should be noted that implementation of a program such as ours can also further improve the outcomes by:

  • Modifying medications and avoiding weight positive drugs
  • Implementing exercise programs
  • Making modifications in diet including diets low in concentrated sugars, and fats
  • Providing accountability
  • Utilizing psychological, nutritional support and provide diabetic education.

COSTS OF OBESITY IN THE WORKPLACE

Obese Employees with co-morbidities such as high blood pressure, diabetes, and high cholesterol incur more costs than obese workers without these conditions.

Normal weight employees cost on average $3,838 per year in health care costs, overweight to morbidly obese employees cost between $4,252 and $8,067. Each additional body mass index (BMI) point above normal weight costs $194-$222 per year per employee.

Obesity can lead to more missed work days and less productivity while at work, research has tabulated that obesity related absenteeism and presenteeism cost U.S. employers $73 billion annually.

Obese employees are also more likely to be absent, averaging ten times more days off for a work injury or illness.

Work related injuries of obese employees are 25% higher, and compensation claims are filed twice as much. The cost of these medical claims are also seven times higher than employees at a healthy weight.

Weight loss significantly reduced diabetes-related costs. The 1-year total health care cost following 1% weight loss was $213 cost decrease.

Losses of 6% to 10% of initial body weight reduced pharmacy costs $122.64 /month for insulin treated diabetes, $42.92/month for sulfonylurea-treated diabetes, and $61.07/month for hyperlipidemia treated with medication.

The savings from a given percent reduction in BMI are greater the heavier the obese individual, and are greater for those with diabetes than for those without diabetes. These results provide health insurers, and employers with accurate estimates of the change in medical care expenditures resulting from weight loss, which is important information for calculating the cost effectiveness of interventions to prevent and treat obesity.

Employer Group #1 (EG1) POPULATION OUTCOMES

EG1 with close to 50,000 lives has used our services for the past two years. Following are our own in-house review and analysis of the outcomes of EG1 members participating in their unique obesity services program.

Basic Demographics: 83 % of the EG1 participants are female, average age is 47, they are 65” tall, and weight about 220 lbs at the start of the program. 77% of the participants from the EG1 qualify with a BMI ≥ 30. The average BMI is 36, and their average waist measurement is 44“ in circumference.

EG1 chose a unique approach to their program. They selected a program designed to award their members for reaching challenging weight loss goals. The milestones are by their nature difficult but achievable and if met result in significant benefits to the participant’s health and wellness.

The challenge: At the members first visit their body composition is measured and their entry BMI is compared against the standard of reaching a BMI of 25. The number of pounds from their entry BMI is subtracted from the BMI of 25 and that is excess weight that is used to establish each member’s personal goals of 20%, 40%, 60%, and 80% of excess weight loss. Example: A patient starts her program and weights 220lbs and is 66” tall. Her calculated weight at a BMI of 25 would be 154.9lbs. Subtract this value from 220lbs and her excess weight loss goal is 65.1lbs.

The science: We can correlate medically significant weight loss of 5% and 10% to the milestones that EG1 selected. Given the same patient described above the calculation would yield the results in the table below. If we put the two scales one on top of the other the correlation is easy to see. 

EG1 Excess Weight Loss Milestones Vs. Medically Significant total weight loss %

EG1 Milestones starting at 220lbs:

Percentage 20% 40% 60% 80%
Pounds lost to reach milestone -13lbs -26lbs -39lbs -52lbs
Weight at milestone 207lbs 194lbs 181lbs 168lbs

Medically significant for 220lbs:

Percentage 5% 10% 15% 20%
Pounds lost to reach significance -11lbs -22lbs -33lbs -44lbs
Weight at medical significance 209lbs 198lbs 187lbs 176lbs

The point being that whether you use EG1 milestones as a total weight loss goal to a BMI of 25, or if you use the medically significant standard of 5%, 10% you are getting a significant improvement in body composition that results in health and wellness benefits. 

Summary of Results: EG1 members achieved the following results. Average results of members who completed the following number of days of active participation:

59 days of active participation lost 16lbs, and 3 inches off their waist.

99 days of active participation lost 29lbs, and 5 inches off their waist.

168 days of active participation lost 39lbs, and 7 inches off their waist.

223 days of active participation lost 48lbs, and 8 inches off their waist.

So, the average EG1 member who started the program at 220lbs, with a waist of 44 inches at 223 days was 172lbs, and a waist of 36 inches, and has a BMI of 28. Any way you look at this result, whether from EG1 milestones, or from the medically significant change. Members who were actively engaged during the program demonstrated measurable improvements related to comorbidities, thus improving quality of life; resulting in a healthier and happier employee.

EG1 COST ANALYSIS and COMPARISON

EG1’s benefit: There are any number of studies, some we have cited above that discuss the direct and indirect benefits of a weight loss programs. The direct benefit is of course the weight loss. Some of the indirect benefits of weight loss programs are improved employee retention, and decreases in the following: co-morbid medications, medical complications, workmen’s comp claims, medical expenditures, and presentism.

Comparison of costs of weight loss programs and medications: In 2014, an article by Finkelstein and Kruger looked into the cost per kilogram of weight loss of several effective weight loss programs. These are their results:

Costs ($) Mean (95% CI) per kg of weight loss

Weight Loss Methods Medications
Weight Watchers $377/kg Qsymia 7.5/46 $1,366/kg
Vtrim $682/kg Orlistat 3 3 120 mg $1,518/kg
Jenny Craig average income $3,152/kg
Jenny Craig high income $2,512/kg
Lorcaserin 2 3 10 mg $1,743/kg

Let us compare our cost per kg with the summary of programs identified above using our EG1 patient population.

Cost of treatment (2 visits x $189, and additional visits at $89, with average medication cost of $2/day). Average visits for actively engaged members are every 14 days.

20% EG1 Milestone
16lbs lost in 59 days (2 visits x $189, and 2 visits x $89, meds $118 = $674)

16lbs = 7kg, $674/7kg = $96/kg

40% EG1 Milestone
29lbs lost in 99 days (2 visit x $189, and 5 visit x $89, meds $198 = $1,021)

29lbs = 13kg, $1,021/13kg = $79/kg

60% EG1 Milestone
39lbs lost in 168 days (2 visits x $189, and 10 visits x $89, meds $168 = $1,604)

39lbs = 18kg, $1,604/18kg = $89/kg

80% EG1 Milestone
48lbs lost in 223days ( 2 visit x $189, and 16 visits x $89, meds $223 = $2,248)

48lbs = 22kgm, $2,248/22kg = $102/kg

The result is clear. The weight loss methods and medications range from $377/kg to $3,152/kg. Premier Physicians Weight Loss and Wellness ranges from $79/kg to $102/Kg.

CONCLUSION

We believe by minimizing risk and maximizing health, we can make positive changes in long term health care costs and optimize employee’s health and wellness. Overweight/Obesity is a modifiable risk factor in the workplace. Premier Physicians Weight Loss & Wellness is confident that our robust comprehensive health weight management program will benefit the Businesses of Las Vegas and their employees.

Please call us, 702-822-7400, to set up a tour of our medical clinic at your convenience.