Breaking News: AMA Declares Obesity a Disease

Mamta Popat/Arizona Daily Star, via Associated Press

According the New York Times, and several news outlets, the American Medical Association has officially recognized obesity as a disease. For close to a decade now we have heard about the increasing issue of obesity and the problems it creates. Heck, it’s what this website is partially based on. There are varying opinions on whether or not obesity is a disease. Many feel it’s a simple equation…eat less + exercise more =lose weight. While the mechanics of that is correct, there are varying levels of complexity around shedding pounds. There’s the mental aspect, there’s the addiction aspect (one can be addicted to sugar, salt, fat), and there’s the body itself (chemical imbalance, thyroid issues, etc.). What does it mean to have the AMA say this is a disease.

Generally it could mean that insurers need to pay for treatments and doctors need to actively address and manage weight issues with their patients. It isn’t enough to simply say “lose weight”. Dr. Patrice Harris, a member of the AMA’s board stated ““Recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately one in three Americans.” While there is no universally accepted definition of disease and/or obesity, the goal of this first step is to help provide focus. One of the first things I learned in Interpersonal and Speech Communication is the human brain can focus on what is defined or has a name. This is why Eskimos have over 100 words for snow. If its amorphous the brain will either overlook it or try to fit it into its current understanding. The article goes on to draw the comparison saying relegating obesity to the result of a lifestyle choice is similar to saying lung cancer isn’t a disease because it’s brought on by the lifestyle choice of smoking.

What is our current understanding. That cancer is a disease. Malaria is a disease.Alzheimer’s is a disease. Obesity, to our brains, is the result of a lifestyle. It doesn’t fit into our current understanding of what constitutes a disease. There are drugs out there that are classified as obesity drugs, such as Qysmia and Belviq. However the success of these drugs may be limited due to lack of reimbursement. In 2004 Medicare removed obesity from its language saying that obesity is not a disease. Interestingly enough the AMA’s own Council on Science and Public Health advocated against classifying it as a disease primarily because it’s based on the flawed body mass index (BMI) system. (See my blog post on why BMI is flawed). Another reason the council was not in favor is that it would consider a third of the population ill increasing the reliance on drugs and surgery rather than lifestyle changes.

The debate rages on. At the end of the day I believe humans still have majority control over their weight. The simple equation is true. The additional complex factors are true. But if a person does nothing to help themselves such as exercise, eat right, and seek medical assistance when lifestyle changes alone aren’t enough – to a certain degree they are making a choice to remain obese. If you had lung cancer, would you seek medical attention or let the cancer grow?

I’m just keeping it new.

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