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Classifying obesity as a disease might help Americans treat it with the seriousness it warrants.
Friday, June 21, 2013
Public health officials feed Americans a steady diet of warnings about how obesity increases the risk of serious health problems. But obesity itself as a serious medical condition? Physicians haven’t regarded it that way, till now.
The American Medical Association’s House of Delegates vote this week to classify obesity as a chronic disease means physicians will have a professional obligation to treat it.
In doing so, the larger body went against the advice of the AMA’s own Council on Science and Public Health, which offered some scientifically sound resistance.
For one thing, an individual’s body mass index, or BMI — a measure for determining if a person is overweight or obese — is far from perfect. For another, while high BMI is clearly associated with serious health problems like heart disease and diabetes, some people with a high BMI remain metabolically healthy.
Still, 60 percent of the AMA delegates voted to call obesity a disease, reflecting a solid consensus among physicians, and for good reason.
One-third of American adults — 78 million people — are obese. Add to their number 12 million children, a statistic that is bound to grow if Americans don’t change the way they eat and live. Given the link between obesity and illnesses that are expensive to treat and often debilitating, the societal impact is obvious.
Doctors hope that acknowledging a responsibility for treating obesity will prod more insurance companies to reimburse them for the time they should, but often don’t, spend counseling and monitoring patients whose BMIs exceed 30, the medical tipping point for obesity. Physicians hope it will pressure more companies to cover obesity treatments, too.
Skeptics have valid worries that such an outcome would increase surgeries and pressure regulators to approve new drugs as quick-fix alternatives to behavioral therapy to help people make lifestyle changes that would better serve their overall health.
But the public health council conceded “the greater sense of urgency a disease label confers” also can create momentum behind public policy changes, say, to support more physical education and healthier foods in schools.
Obesity is so disdained and yet so common in America, anything that will open a dignified conversation about it between reluctant doctors and embarrassed patients likely will do more good than harm.
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