So yesterday the American Medical Association made a bold announcement -they now officially recognize obesity as a disease. Their reason for doing so? To change the way physicians address obesity with their patients and to spur more insurers to pay for treatments.
Addressing obesity is of utmost importance especially in our current state where doctors openly admit they avoid talking about weight and insurers pay for treatment of obesity-related chronic disease but not healthy lifestyle incentives. Let’s face it though, calling obesity a disease doesn’t make talking about it with a patient any easier. These conversations can be uncomfortable, not just for the patient but the physician or dietitian as well. Also, insurance companies can’t foot the bill for everything, obesity treatment and prevention, all at once.
With the AMA’s decision not having any legal authority over physicians or insurers though, I guess I’m left wondering, will calling obesity a disease really change anything for the better? Perhaps, but my concern lies here.
Physicians and insurance companies treat disease with medication. That’s how it’s been for decades. While obesity drugs may help fight the disease, they won’t prevent it. It’s a losing battle. An expensive, losing battle. I imagine obesity drug manufacturers will be dancing their way to the bank more-so now than ever before -and that my friends, has me worried. It’s easier to prescribe a weight loss medication than to have that awkward obesity conversation and get the patient the weight loss counseling they may need.
Calling obesity a disease – Are you satisfied? I’m not. As medical professionals, there’s a lot we need to do to make sure this disease is not only treated but also prevented -preferably with as little reliance on drugs as possible.
Thought-provoking image by Melissa Gruntkosky
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I agree that I am not satisfied with calling obesity a disease. I also am scared about the impact that this classification will have on patients. I fully support your thoughts about drug manufacturers and am queasy at the thought.
I already am weary of our connotations with obesity and think there is a lot of false fat stigma in our country. I’m still not sure about the best way to approach it, but I think broad-sweaping generalizations are not helping. Especially when a lot of “obese people” are actually healthy (see Abigail Saguy’s Time Magazine article published today: http://ideas.time.com/2013/06/24/if-obesity-is-a-disease-why-are-so-many-obese-people-healthy/). I also highly recommend Dr. Saguy’s book, “What’s Wrong with Fat?” It’s very thought provoking and revealing about the way we view fat, including history of fat as well as the ways in which the media portrays research on the topic.
Thank you for sharing your weariness!
I’ve been thinking about this new classification since it happened and I’m still on the fence about it. It’s hard for me to relate to the insurance or healthcare system in America because I’m not from there and don’t like to comment on what I clearly have no experience with. I know that in Canada, treatments vary by province.
(I just went and googled to be sure)
In my province, obesity is considered a disease and is calculated using a variety of tools I don’t understand and divides adult patients into three classes of obesity. For patients in overweight or obesity class 1, lifestyle management is recommended.
For patients in obesity class 2 or 3, more extensive intervention is required in addition to lifestyle management.
Note that this is for adults only, they clearly state that only lifestyle management should be used for those under the age of 19. I like this approach as the classification of obesity as a disease has helped people get coverage for things like nutritionists and other regular lifestyle management counselling.
Ella- Working in the medical field and at a hospital I think this is something that physicians do overlook a lot, they tell patients to lose weight or I think that gastric bypass surgery would be an option for you but its the resources that these patients need. A lot of these individuals I see on a regular daily basis and this is a lifestyle change it cannot become a quick fix. It does scare me what this could turn out to be, because we are knowing putting a diagnosis of obesity on small children and when can we focus on teaching these patients how to live an everyday healthy lifestyle not just take this medication and your blood pressure will be fine. Its like we are saying don’t worry that you have high blood pressure or diabetes because there medication for that.
Thanks for a great post :)
Brooke
As a public health practitioner, I really ( really really) hope that we are moving to more prevention-based practice. So, I hope that the AMA’s decision will give providers more agency to educate themselves about diet and exercise strategies (because most don’t get any instruction about that), to make more referrals to dietitians, and to write “prescriptions” for fruits and vegetables, gym memberships, support groups, workshops, cooking classes, etc. In turn, maybe more insurance companies will start reimbursing for some of these things, I know some companies already have similar programs.
I had this exact discussion with my boss the other day. (We work for ACP, AMA is actually a floor below us here in DC. Haha.) Obesity in my mind isn’t a disease. It’s preventable and as a nation we should focus more on a nutrition and exercise than handing out these magic pills (that most likely aren’t going to help with the weight issue, it’s to deal with other issues that stem from obesity (diabetes, heart issues, etc.)) As a half-glass full kinda-gal I do feel we’ve made improvements with obesity being a hotter topic. Better nutrition in schools, more programs to get kids active (and off all their tech gear), obesity rates stabilizing since 2010, and with last year’s Marine Corps Marathon…32% of those registered were new marathoners! (I’m thinking higher % of people who have slowly picked up running?) Baby steps…
Normally, I wouldn’t have given AMA’s announcement too much thought. Not to say that I don’t care (that’s not it at all), but I might have been satisfied with their calling it a disease.
But after reading your view on it, I couldn’t agree more with you. It really scares me how medicine is being so easily handed out now, when sometimes issues are best changed with a natural, healthy lifestyle. I think you’re right about the fact that to avoid an awkward conversation, medicines might be prescribed more now than they should be.
I’m really glad that you brought this up. It made me think about the whole situation – the positives and the not so positives.
Thanks for bringing this up. There are just SO MANY issues wrapped up in this decision. For one, the way we currently measure obesity using BMI is pretty flawed to begin with, so it seems strange to take the somewhat drastic step of labeling obesity a disease when physicians can’t even agree on a fool-proof way to measure it. Also, I know this might be an unpopular opinion on a healthy living blog, but some people who are medically considered obese *are* healthy and don’t experience the health problems we often (if not, always) associate with obesity. It seems, I don’t know, disingenuous? insensitive? to insist these people have a disease when they’re otherwise healthy. Lots of things to think about…
That’s not unpopular at all and I completely agree – healthy comes in all shapes and sizes. Our medical definition of obese is certainly lacking some important factors.
I’m so glad you’re bringing light to this topic. I agree that labelling obesity as a disease will turn the focus more on the “treatment” with drugs rather than all of the changes we as a society need to make. It’s not just about treating the individual but rather changing this unhealthy lifestyle that society seems to be promoting. We need to change the norms in order to prevent obesity rather than slapping a bandaid on a much bigger issue.
Thanks for sharing your thoughts on this. When I heard the news that obesity was officially a “disease” I wasn’t sure what to think. I agree we have a long way to go in terms of preventing obesity not just treating it, so I do wonder what will happen in terms of how it is treated. My concern is that labeling obesity a disease will only reinforce the “quick-fix” mentality a lot of people have by using medicine to try to fix the problem.
Replied on Facebook, but I don’t think it will make any difference for most obese people. As someone who is on her way to NOT being obese (84lbs down and counting), I knew, prior to the weight loss, that I was obese and I knew the health problems that could arise with being so overweight. I didn’t need a doctor to tell me I had a disease or that I was overweight. I already knew it. That being said, any doctor I have been to has always said I needed to lose weight. Until the person makes the decision it’s time, nothing anyone says or does will help. The obese person needs to commit to the journey–and it is a journey. You have to commit yourself to eating better, watching your portions and exercising. Lap band and bypass surgeries only do so much. If you don’t change your habits, you will still fail in the long run. I have a friend who had lap band almost 2 years ago and she has lost no more than 50 lbs and continues to fluctuate. She does not exercise and does not eat as well as she should on a regular basis. There is no magic pill, no easy way. You have to commit, accept you’re going to have those days where you are not eating properly and you don’t want to workout, but never let it deter you from the end goal. I’m shooting for another 20 or so pounds myself.
Thanks for your thoughtful comment. Karen! I agree completely and feel physicians need to start having conversations with patients to at least see where they’re at and get them help if they’re ready for it.
So wonderful to hear about your success with making healthier lifestyle choices. Keep up the great work!
Thank you! :)