As a second part to the discussion of obesity now being classified as a disease by the A.M.A., I’d like to weigh in on the discussion from a few different angles.
As a Physician Assistant
With statistics suggesting that almost two thirds of the population is overweight or obese, it is unlikely that a day will pass in the life of a health professional without encountering patients who weigh too much. They may present with other health concerns and ignore their obvious weight issues, which may be complicating their health, or refuse to discuss weight even if the doctor gently suggests the merits of a discussion. Will the designation of obesity as a disease really make these patients now more willing to talk about their weight struggles or the fact that their child is already overweight or obese? I just don’t think so, but time will tell.
As a Health Coach/Nutritionist
Under this professional title you would think that if someone seeks my help, the obesity chat would go so much more easily. Think again….Just the other day, a fellow gym member who has struggled with his weight, reached out to me to discuss (again) the merits of the Paleo diet. He had already had double knee surgery a few years ago, gained and lost 25 pounds (he probably needs to lose 60 or 70 pounds), and was now recovering from spine surgery. He felt I should hear the whole surgical saga before we discussed a possible professional collaboration on his weight. He told the entire story without once mentioning how his weight was complicating his health, his recovery and his quality of life. When I asked him if any of these surgeons had suggested the need to lose weight before or after surgery, he replied, “Sure.” When I pointed out that he never mentioned his weight during the surgical story telling – he just looked at me quizzically. I wonder - am I really going to be able to help this guy???
As a person who shed fifty plus pounds over 30 years ago
I am part of the “one percent.” Actually the dismal numbers of individuals who were classified as obese and successfully lost and kept weight off for decades, may be higher, but not by a whole lot. Despite the fact that several generation of women in my family were obese, despite the reality that my home environment was fraught with constant food temptation, despite the fact that my mom taught me to treat emotions with food therapy, despite the fact that I lived in a neighborhood that was not safe for outdoor play (and this was in the 1960s and 1970s in Brooklyn, N.Y.), and despite the fact that there was no doctor intervention, I was able to use a commercial diet plan and lose more than fifty pounds at age sixteen and stay within a five pound range of that weight for over three decades. Why was I successful despite my limited nutrition education and very limited financial resources?
Obesity is a unique disease
If you’ve read some of my previous blogs, you know that (a) dating and (b) wanting to prove to my mother that I could accomplish what she could not, inspired me to persevere through initial hunger, deprivation, awful exercise, weeks of weight plateaus at the ripe old age of sixteen, to finally hit my goal weight in about 5 months’ time. Keeping the weight off was helped by further nutrition and fitness education in college, creating a home and away from home environment that minimized temptation as much as possible, recognizing that some form of exercise had to happen daily and that it had to be challenging and last at least an hour, and constantly reinforcing habits that averted the use of food to treat my emotions. I learned to pre-think restaurant or buffet or party choices beforehand; I learned to organize and only shop for food with a list. I decided to specialize in nutrition to help myself – but it turned into a professional passion. I became a fitness instructor and personal trainer to help myself stay in shape and it turned into a component of my Health Coaching practice. You don’t have to become a professional to battle obesity but you do need to care enough to obtain education, set up a support system, and to think of your weight loss as disease treatment and the maintenance phase as disease remission – which means that it is not resolved but merely in a healthy holding pattern. And you have to contend with your genetic predisposition to easy weight gain, the possibility of a slightly slower metabolism, your ingrained unhealthy habits that you will be battling for years, and despite your best efforts to control your environment, temptations galore that will pop up thanks to work events, friends and family who love you with food gifts, illness which can limit exercise, and the list goes on. Obesity is a unique disease because you have to learn to co-exist with food daily, despite the reality that it may be your risk factor for weight gain.
There is a treatment plan
Diet, exercise, and support, as well as behavioral therapy are the cornerstones of treating obesity. For some, there may need to be drugs, surgery and additional therapies. This reality was true before the A.M.A. decided to unite and call it a formal disease, and it continues to hold true with this new call for a specific medical designation. Just like any other disease, there are the core treatments that seem to help most people, plus the personalized treatments that are uniquely appropriate for your specific physical and behavioral template. Hopefully calling obesity a disease will help you to proactively address your weight issues. Maybe doctors will be more willing to try to open a discussion regarding weight and its implications despite a patient’s resistance. Certainly it appears that the A.M.A. position will nudge the government, the healthcare industry, the insurance industry and health professionals to meet you halfway. The question is will you do the same?
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. For more information check out www.healthgal.com.