COLUMBIA, S.C. » Poor, obese South Carolinians covered by Medicaid can get help slimming down through nutritional counseling sessions aimed at stemming chronic and costly health problems.

The Department of Health and Human Services added the weight-loss services this month for the estimated 184,000 Medicaid-covered adults with a body mass index of 30 or more, which is the definition of obese. That roughly translates to a 5-foot-8 adult weighing more than 200 pounds.

The goal is to reduce obesity rates in a state that consistently ranks among the fattest nationwide, saving both lives and money.

Nearly 32 percent of South Carolina adults are obese, up from 25 percent in 2004 and 12 percent in 1990. The state ranks among the worst nationwide in obesity-related diabetes and hypertension, according to the Trust for America’s Health.

Patients in counseling can learn how to prevent such chronic diseases with healthy habits they pass on to younger generations, hopefully improving the state’s overall health, said Jamie Kandora, a registered dietitian with Tidelands Health, which operates along the Grand Strand.

With a doctor’s referral, patients can receive individualized behavior and nutritional advice from doctors and licensed dietitians.

Medicaid will pay for up to 12 counseling visits that can include lessons on metabolism and exercise, cooking tips, and help planning healthy meals on a limited budget.

Some people don’t eat healthy because they think it’s too expensive, but it doesn’t have to be, Kandora said.

"Dietitians are particularly good at meeting patients where they’re at, not saying, ‘Only shop at Whole Foods and eat organic,’ but here’s how can we inch you closer" to a healthy weight based on your situation, said Nina Crowley, a registered dietitian at the Medical University of South Carolina. "It’s not a one-size-fits-all approach."

The program’s development began under former Medicaid director Tony Keck, who presented the idea to legislators last year.

Christian Soura, who took the agency’s helm last November, said the program is somewhat experimental and may need to be adjusted later. Evaluations over the next year will determine whether more office visits, for example, are needed to improve success rates.

It’s unclear how many people will participate, but the program’s estimated cost for this fiscal year is $5.6 million.

"Let’s see how it goes," Soura said Wednesday. "There’s an expectation there will be a gradual ramp up, and we’ll see if this version of the model works or not."

So far, 45 independent licensed dietitians have enrolled to be Medicaid providers. Others are employed through participating hospitals. The agency’s 43 dietitians can also assist with counseling services, according to the agency.