what is obesity?

A.M.A. Now Calls Obesity a Disease…So What Was it Before?

The HealthGal Health Guide June 21, 2013
  • It’s official – The group of doctors who belong to the American Medical Association has now decided to sign off on obesity as a disease, which means that…..well what does it mean exactly?

     

    Definition of disease

    If you turn to the Miriam-Webster online dictionary, you will find that a disease is: “a condition of the living animal or plant body or of one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms : sickness, malady.”  Not everyone agrees with that particular definition.

     

    Does the A.M.A. position have any legal authority?

    It does not, and frankly many health professionals still do not agree on what constitutes a disease.  It’s also important to point out that only between 15% and 29% of doctors (sources offer different statistics) practicing in the U.S., belong to the A.M.A., due to disagreements with its position on Medicare, lack of progress on malpractice reform, position on the Affordable Care Act, and other key physician and healthcare issues.  So to be clear, the A.M.A. perspective on obesity as a disease was by no means a position taken by most doctors in the U.S., though, if asked, they may agree that it is time to classify it as such.

     

    What does this decision represent?

    First of all, the A.M.A. overrode a recommendation by a committee. The Council on Science and Public Health, that had studied the issue for more than a year, and had decided not to support this new disease distinction.  The new definition may help to improve insurance coverage for treatments that range from group exercise and personal training, to visits with dieticians and nutritionists or licensed health and lifestyle coaches.  It may also provide the opportunity for more government funds to be spent on associated conditions like diabetes and heart disease.  It could also help to provide more coverage for drugs, surgery and other supportive and preventive therapies   Certainly doctors should now be compelled to proactively engage patients in conversation about weight, even if the patient appears reluctant.  It should also be noted that back in 2008, The Obesity Society had officially recommended that obesity be classified as a disease.  The IRS has, in recent years, allowed more obesity treatments to qualify for tax credits.  this may push that trend even further.

     

    Why did the Council on Science and Public Health vote against the new classification?

    Members of the group objected to the current use of B.M.I. (body mass index) as an indicator of obesity, because many health experts have suggested that the B.M.I. is a flawed system for diagnosing obesity.  The council felt that using the term disease would not result in improved health outcomes.  Some members also felt that obesity is better classified as a risk factor, rather than a disease.  On the other hand, some members did see the benefits of using a disease distinction.  Perhaps it help would help to reduce the stigma associated with obesity, and the notion that weight is simply a matter of willpower.  Another concern for the council was the possibility that with a disease classification, more patients would now be “clinically diagnosed,” and there would be a bigger reliance on drugs and surgery. This might reduce the effort to push patients to engage in the more challenging treatment called lifestyle change, that places a bigger burden on the patient’s willingness to commit to exercise, diet, and support therapies. 

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    Specifically how did the A.M.A. position its final determination?

    They declared obesity  “a multimetabolic and hormonal disease state” with the strong possible outcomes of diabetes type 2 and heart disease.   members further declared that "to suggest that it is simply associated with overeating and lack of exercise is to underestimate its complicated and pervasive nature as a disease."

     

    Coming up next: What do I think

     

    Amy Hendel is a health professional, journalist and host of Food Rescue, Simple Smoothies and What’s for Lunch?  Author of Fat Families, Thin Families and The 4 Habits of Healthy Families, she tweets health headlines daily @HealthGal1103.  Catch her guest appearances on Marie! on Hallmark and other local and national news and talk shows.