FEHB Program Carrier Letter 2023-01
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provided detailed guidance on bariatric surgery and in 2014, OPM issued
Carrier Letter 2014-04 clarifying that it is not permissible to exclude weight
loss drugs from FEHB coverage on the basis that obesity is a “lifestyle”
condition and not a medical one or that obesity treatment is “cosmetic.”
Screening and Prevention
Recognizing that obesity continues to be a significant public health problem,
the United States Preventive Services Task Force (USPSTF) published
updated recommendations that all adults, children and adolescents, and
pregnant women be screened for risk factors associated with obesity. These
recommendations are referenced in:
• Healthy Weight and Weight Gain In Pregnancy: Behavioral Counseling
Interventions (2021)
• Healthy Diet and Physical Activity for Cardiovascular Disease
Prevention in Adults With Cardiovascular Disease Risk Factors:
Behavioral Counseling Interventions (2020)
• Weight Loss to Prevent Obesity-Related Morbidity and Mortality in
Adults: Behavioral Interventions (2018).
The USPSTF reaffirmed their recommendation that adults with a body mass
index of 30 kg/m
2
or higher be referred for intensive, multicomponent
behavioral interventions such as behavior-based weight loss and weight loss
maintenance interventions. The purpose of this recommendation is to
prevent or mitigate the health conditions associated with obesity. USPSTF
rated this recommendation as Grade B.
The USPSTF recommendation, Obesity in Children and Adolescents:
Screening (2017), is currently under review and expected to be updated by
Weight Management in Children and Adolescents: Interventions. The USPSTF
recommends that clinicians screen for obesity in children and adolescents 6
years and older and offer or refer them to comprehensive, intensive
behavioral interventions to promote improvements in weight status. As
stated in Carrier Letter 2022-03 adolescents experienced sharp increases in
their rates of weight gain during the COVID-19 pandemic, particularly