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Pro or Con: Is Obesity a Disease?

CLASSIFYING OBESITY AS A DISEASE IMPACTS WHETHER WE SHOULD FOCUS ON PREVENTING IT OR PAYING FOR THE TREATMENT OF OBESITY

HEALTH GOES STRONG
ROBYN FLIPSE

Members of the House of Delegates of the American Medical Association (AMA) passed a resolution at their annual meeting this week that could be as significant as anything being considered by the US House of Representatives.  The AMA Delegates voted in favor of classifying obesity as a disease, moving it up from its former designations as either a behavioral problem, chronic condition, health concern or complex disorder.

This vote was in direct opposition to the recommendations of their own Council on Science and Public Health.

The Council studied the issue and concluded obesity should not be considered a disease because there’s no good way to measure it. Body Mass Index is the measurement now used, but is considered too simplistic, especially since it cannot distinguish between excess weight from fat versus muscle.

As it turns out, obesity isn’t the only thing the AMA has a hard time defining. There is no universally agreed upon definition of what constitutes a disease, either.

This action by the world’s largest physician’s group is largely symbolic since the AMA has no legal authority over the insurance industry, which gets to decide which claims to pay. The resolution was, however, supported by other health groups including the American Association of Clinical Endocrinologists, American College of Cardiology, and American College of Surgeons.

After reviewing the widespread coverage of this decision, it was immediately evident that not everyone in the public health and policy arena agrees with the decision. To put it into perspective I’ve rounded up some of the Pros and Cons to help you decide whether this new designation will help or hurt our national problem with energy imbalance.

PROS: If obesity is a disease the benefits are it may

  • Reduce the stigma that it’s caused by poor personal habits
  • Result in expanded coverage by health insurance
  • Force physicians to raise the issue with their patients (more than half of obese patients have never been told by their doctor that they need to lose weight)
  • Encourage more obesity prevention programs in schools and the workplace
  • Support efforts to restrict the sale of certain foods and beverages to those receiving food assistance
  • Increase research to find a cure or more effective treatment for obesity
  • Qualify expensive treatments for IRS tax deductions

CONS: If obesity is a disease the disadvantages are it may

  • Increase stigma towards those who don’t seek treatment
  • Raise health insurance premiums paid by individuals and employers
  • Run up the cost of care for the 1/3 of Amercians who are obese and seek treatment
  • Increase the sales of ineffective and untested products
  • Support taxes and restrictions on certain foods and beverages  
  • Undermine personal responsibility to change one’s eating habits and activity level
  • Shift attention towards expensive drugs and surgery and away from programs aimed at preventing obesity

If you’d like to read more about this evergreen issue, here are some past posts worth revisiting:

Prejudice Against the Overweight and Obese

Obesity and What We Buy at the Supermarket

3 Anti-Obesity Drugs Now Available in U.S.

Reflections on Obesity and Weight of the Nation

Metabolic Syndrome is Worse than Obesity

Research on Mindless Eating Offers New Insight into Obesity

Update on Dieting and Weight Loss News