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Arizona’s Medicaid program may start charging fees to smokers and to diabetics who don’t lose weight. The proposal comes from the state’s Health Care Cost Containment system. Smokers on Medicaid would be charged $50 a year. The same fee would apply to people with diabetes who don’t follow their doctors’ orders to lose weight. There’s a dual purpose, officials said. It would bring revenue into the state’s cash-strapped Medicaid program. And it could encourage people to take better care of themselves. The state will ask the federal government to approve these two proposals and others that are aimed at cutting costs. The New York Times and the Associated Press wrote about the proposals April 1.

Diet plus exercise help obese older adults more than either one alone, a new study finds. Though that may seem like conventional wisdom, some doctors would disagree, the author told HealthDay News. Some worry that diet changes and exercise may reduce bone and muscle and make older adults more frail. But the study found the opposite was true. The study included 93 obese adults. All were older than age 65. They were randomly divided into four groups. One group did supervised exercise 3 times a week. It included aerobic exercise, weight training and stretching. Another group was given a reduced-calorie diet and support from a dietician. The third group did both things — exercise and diet changes. The fourth group received general advice on diet. The study lasted a year. People who dieted and exercised had the best results. They lost 9% of their weight on average.