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Our analysis of population-representative data indicates that in 2013, severe obesity cost the nation approximately $69 billion, which accounted for 60 percent of total obesity-related costs. Approximately 11 percent of the cost of severe obesity was paid for by Medicaid, 30 percent by Medicare and other federal health programs, 27 percent by private health plans, and 30 percent out of pocket. Overall, severe obesity cost state Medicaid programs almost $8 billion a year, ranging from $5 million in Wyoming to $1.3 billion in California. These costs are likely to increase following Medicaid expansion and enhanced coverage of weight loss therapies in the form of nutrition consultation, drug therapy, and bariatric surgery. (Wang et al., 11/2)

As part of a 2009 revision to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program, the Department of Agriculture required WIC-authorized stores to stock additional varieties of healthy food. ... Using surveys conducted in 118 Baltimore City, Maryland, food stores in 2006 and 2012, we examined associations of the change in healthy food availability with store type, neighborhood demographics, and the 2009 WIC policy change. Overall, healthy food availability improved significantly between 2006 and 2012 .... On an 11-point scale measuring availability of fruit (3 points), vegetables (4 points), bread (2 points), and milk (2 points), the WIC policy change was associated with a 0.72-point increase in WIC-relevant healthy food availability, while joining WIC was associated with a 0.99-point increase. (Cobb et al., 11/2)

Using nationally representative data from the Medical Expenditure Panel Survey (MEPS) from 2008 to 2011, we determined whether children and youth aged 2 to 21 years with outpatient visits for mental health problems in the past year saw [primary care providers] PCPs, psychiatrists, and/or psychologists/social workers for these conditions. ... One-third (34.8%) of children receiving outpatient care for mental health conditions saw PCPs only, 26.2% saw psychiatrists only, and 15.2% saw psychologists/social workers only. Nearly a quarter (23.8%) of children saw multiple providers. ... PCPs prescribed medications to a higher percentage of children than did psychiatrists. Children seeing a PCP for ADHD were more likely to receive stimulants or α-agonists than children with ADHD seeing psychiatrists (73.7% vs 61.4%). (Anderson et al., November 2015)

Previous studies show that the vast majority of physicians accept Medicare, but the proportion taking new Medicare patients is smaller, particularly among primary care physicians compared with specialists. ... This Data Note presents findings on reported acceptance of Medicare patients among non-pediatric primary care physicians, based on data from the Kaiser Family Foundation/Commonwealth Fund 2015 National Survey of Primary Care Providers. ... The vast majority of non-pediatric primary care physicians (93 percent) say they accept Medicare—comparable to the share accepting private insurance (94 percent). A majority of primary care physicians also say they are also taking new Medicare patients (72 percent), but this share is somewhat lower than the share of primary care physicians accepting new privately insured patients (80 percent). (Boccuti et al., 10/30)

Tracking calories at chain restaurants is supposed to become easier next year, but new studies raise questions about whether the counts actually make a difference for diners and eateries. ... New York University researchers used receipts and surveys at McDonald's, Burger King, KFC and Wendy's to track customer purchases. In New York City where menus were labeled, calories averaged between 804 and 839 per meal, essentially the same as the 802 to 857 calories at fast-food locations in New Jersey that didn't post calorie content. (Neergaard, 11/2)

More than 20 percent of pediatricians “always” or “often” turn away families who decline to get their babies vaccinated, according to a survey released Monday by the American Academy of Pediatrics. Even so, dismissing families from a practice doesn’t happen all that frequently. Most pediatricians said just a small sliver of their patients refused to vaccinate babies. (Samuel, 11/2)

Women in surgical training programs who feel that those around them endorse negative stereotypes about female doctors have poorer psychological health than others who do not feel a “stereotype threat,” a new study found. Not all women perceived a stereotype threat. And such perceptions did not affect the mental health of young women in non-surgical specialties, the researchers found. (Doyle, 10/30)

Being married may improve the odds of a good recovery after surgery, according to a new report. The study, in JAMA Surgery, included 1,567 people 50 and older who underwent cardiac operations — 1,026 married, 184 divorced or separated, 331 widowed and 35 never married. ... About 20 percent of married patients had either died or developed a new dependency within two years of their operations. But 28.8 percent of divorced or separated people and 33.8 percent of the widowed had these negative outcomes. Even after controlling for age, sex, smoking and other factors, compared with people who were married, the divorced, separated or widowed were at least 40 percent more likely to have died or acquired a new disability. (Bakalar, 11/2)

Hundreds of patients with mental illness are signing up to test an unusual experimental treatment: video games.It’s part of a bold push by several companies, led by two Boston startups, to secure permission from federal regulators to market their video games as medical therapies, to be prescribed by physicians for conditions ranging from depression to autism to even, perhaps, Alzheimer’s disease. (Robbins, 11/5)

Preliminary testing of two long-acting injectable drugs indicates it might be possible to keep HIV at bay indefinitely with injections every month or two. Johnson & Johnson and partner ViiV Healthcare, which specializes in HIV drugs, on Tuesday announced results from the first 32 weeks of the planned 96-week study, which combines one drug from each company. Significant additional testing is needed, but the combination treatment would be a first if approved and could eventually be a huge advance over a disease once almost universally fatal. (Johnson, 11/3)

Three years ago, Allison Turner noticed her vision was getting a little blurry. "I knew I had to see a doctor," she said. "But I was scared and didn't deal with it." The result was that when Turner, a professor of public policy and administration at West Chester University, awoke one morning, she couldn't see out of her left eye. A trip to a retina specialist confirmed she had suffered a detached retina caused by diabetic retinopathy. (Rush, 11/2)

A new study adds to the evidence that a technique that uses a catheter to physically grab a blood clot leads to better results than drugs that break clots up. ... researchers at McMaster University used data from eight randomized clinical trials that involved 2,423 stroke patients. Of those, 1,313 received what’s called endovascular thrombectomy, or physical removal of the clots. That is often done with a device known as a stent retriever. The remaining patients received the current standard of care, which is treatment with the drug tissue plasminogen activator or tPA. (Burling, 11/3)