Obesity is no longer a disorder, it’s a disease.
This week, the American Medical Association voted to reclassify obesity—a $150 billion annual health care headache—from a chronic health condition to a disease. According to the CDC, 35 percent of adult Americans are obese. To be considered obese, you must have a Body Mass Index of 30 or higher. A healthy BMI is is between 18 and 25, and the CDC has a handy BMI calculator on their website.
Dr. Richard Besser, Chief Health and Medical Editor for ABC News, couldn’t care less about the formalities. “I think it matters little whether we call obesity a disease, a condition, or a disorder,” he told us. “It matters less what we call it than what we do to prevent it.”
The question is, how will medical treatment change in response to this new decision? Labeling obesity a disease quickly left those in the medical establishment with uncertainty about the future of obesity treatment. There are a slew of surgical procedures that combat obesity, none of which cure it completely. The onus is on the patient to follow through with the treatment and reach a healthy weight. Obesity is a unique disease because nutritional education, fitness awareness, and simple willpower are the most effective remedies. “We need to get physical activity back into everyone’s lives, starting with our kids,” said Dr. Besser.
As with all health care concerns, obesity treatment has to be paid for. Our resident nutrition expert, Mary Hartley RD said, “Obesity’s status and acceptance as a disease has more to do with reimbursement for treatment. When obesity was not a ‘disease,’ it was not accepted as a billable diagnosis, therefore a health insurance company would not pay for treatment.”
Exactly what that treatment will be is unclear, since obesity is a direct result of personal responsibility, environmental surroundings, and other psychological variables. “I believe obesity is a disease because it is a physiological dysfunction of the human body in response to environmental and genetic stimuli,” said Hartley. “All obesity is not the same; some has a clear genetic basis while others are primarily environmental.”
With so many factors and inconsistencies, it could take years to see widespread and defined treatment become available. The AMA council wrote that medical treatment for obesity could “detract from creative social solutions” in the development of healthy diet and exercise behaviors. In other words, just because obesity is now a disease covered by insurance, it doesn’t mean we can all let ourselves go and rely on health care to fix the problem.
The new decision by the AMA to classify obesity as a disease isn’t intended to be a bandage for our obese nation. Going forward, the medical establishment will be scrambling for solutions on how to go about treating this fickle disease of excess tissue. But before the first tummy tuck funded by government cheese commences, the AMA should roll out a campaign of preventable maintenance instruction, one that encourages healthy behaviors and holds people accountable. According to Dr. Besser, “That is where the conversation should be focused, not on whether this is a disease.”
June 19th, 2013