WEDNESDAY, June 19, 2013 — Millions of Americans woke up diseased today after the American Medical Association (AMA) officially reclassified obesity as a disease. Until now, the AMA considered obesity to be a major public health issue, but after a vote on Tuesday, the organization overwhelmingly voted to define it as a disease, which experts say should help doctors better treat the 1 in 3 Americans who are obese.
“Obesity rates have doubled among adults in the last twenty years and tripled among children in a single generation,” the AMA said in a report. “Evidence suggests that by 2040 roughly half the adult population may be obese.”
The vote goes against the advice of the AMA’s Council on Science and Public Health, which last week advised against calling obesity a disease.
"Without a single, clear, authoritative, and widely accepted definition of disease, it is difficult to determine conclusively whether or not obesity is a medical disease state," the council told the AMA's House of Delegates, which makes policy. "Similarly, a sensitive and clinically practical diagnostic indicator of obesity remains elusive."
But AMA committee on public health member Douglas Martin, MD, told MedPage Today that the organization felt declaring obesity a disease was the right move.
"We felt it's time to take a stance and say we're going to identify this as a disease," he said. "We think that's going to send a message not only to the public but to the physician community that we really need to make it a priority and put it in our cross hairs."
Reclassifying obesity as a disease means that millions of people who were previously unable to receive treatment will now be able to, said Christopher Ochner, PhD, assistant professor, departments of pediatrics and psychiatry at the Icahn School of Medicine at Mount Sinai in New York City.
“This is a major step forward in the fight against obesity and win for obese people in general,” Dr. Ochner said. “Until the American Medical Association classifies something as a disease very few insurance companies will reimburse for its treatment.”
Esa Davis, MD, MPH, assistant professor of medicine and obesity researcher at the University of Pittsburgh said that the AMA’s decision will allow doctors to counsel their patients on their weight in a way that they were previously unable to.
“Physicians weren’t doing a good job counseling patients because they couldn’t bill people or refer them to specialists because it’s wasn’t covered,” Dr. Davis said. “We’ve tried to address it different ways, such as referring them for hypertension or heart disease, but for obese patients who do not yet have other conditions, it’s been difficult to get them treated.”
By referring patients before other health conditions set in, it will be easier for patients to get healthy, she added.
“This will help physicians engage people more and direct patients to the proper resources, which can have major implications down the line,” Davis said.
Weight-loss resources are typically expensive, Ochner said, but now, he expects many of them to be covered by insurance.
“These include commercial behavioral weight-loss programs, meal replacement programs, and weight-loss counseling from qualified individuals practicing validated lifestyle change treatments,” he said. “Further, we would expect more of these programs to be offered now that hospitals and treatment centers know that the people who really need them can actually afford them.”
Is Obesity a Disease or a Choice?
While the AMA views obesity as a disease, the public doesn’t always share the same sentiment.
“I disagree that it's a disease,” Rachel McDonald said on the Everyday Health Facebook page.“Own up to the fact that we do this to ourselves. I CHOOSE to eat healthy and exercise. Some choose not to. I CHOOSE not to eat fast food.”
But the AMA says that line of thinking isn’t correct.
“The suggestion that obesity is not a disease but rather a consequence of a chosen lifestyle exemplified by overeating and/or inactivity is equivalent to suggesting that lung cancer is not a disease because it was brought about by individual choice to smoke cigarettes,” the AMA says in the report.
Ochner agreed that obesity is not simply due to overeating.
“That is not to say that individual choice is not important or that people are not responsible for what they put into their bodies,” he said. “However, it is much easier for some people than others to stay thin, based on both genetics and prior lifestyle.”
And when one-third of Americans are obese, said Dr. Davis, it’s clear that obesity is more than a choice.
“There is a behavioral component to obesity,” she said. “There are some people who take in too many calories, but over time is where obesity becomes a problem. We’re not talking about people who are overweight, we’re talking about obesity.”
America’s health care costs related to obesity top $65 billion every year, and Davis said obesity is the reason. Reclassifying obesity as a disease will help America save lives and money, and is a move that should be applauded for bringing the problem to the public eye.
“We’re paying the highest amount of money for health care costs, and we’re not living any longer,” she said. “We have to start looking at why.”
Last Updated: 6/19/2013