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Is Obesity a Disease? Yes, Says Doctors’ Group

June 19, 2013

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The obesity epidemic is dire. Nearly 36% of American adults and 17% of children are obese, putting them at risk for heart disease, stroke, type 2 diabetes, and other preventable chronic illnesses. While the contributing factors to the epidemic are complex, obesity is generally caused by poor diet and a sedentary lifestyle.

But when it comes to discussing and defining obesity, should it be called a disease? Yes, says the American Medical Association, the United States’ largest physician group. On Tuesday, it announced that it officially recognizes the condition as a disease – one that requires medical treatment and prevention.

While the designation is largely a question of semantics – there isn’t even a universally accepted definition of what constitutes a disease – the declaration could have far-reaching and long-lasting implications.

There is considerable stigma surrounding obesity, fueled by the widespread perception that it is a result of overeating and laziness and can be easily reversed by people who have enough willpower to change their lifestyle. If obesity is recognized as a disease, doctors, insurance companies, and society at large may take it more seriously and provide increased counseling and support for people who cannot control their weight.

The resolution argued, “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.” From this perspective, obesity is a “multimetabolic and hormonal disease state” that leads to serious life-threatening illnesses.

Yet many people fear that “medicalizing” obesity may increasingly lead people towards weight-loss drugs and surgery. Medicare currently does not cover weight-loss drugs, classifying them in the same category as medications for hair growth or erectile dysfunction. This could change if obesity is officially considered a disease, and many obese people may seek a pill to “cure” their illness.

An additional caveat is that obesity is diagnosed through body mass index (BMI), a measurement that has come under fire for being simplistic and flawed. By comparing weight to height, a BMI result is said to give an indicator for total body fatness. Yet it fails to consider the actual proportions of bone, muscle, and fat and ignores important obesity indicators such as waist size.

A perfectly healthy athlete whose muscle mass is heavy may qualify as overweight, while someone with dangerous levels of body fat and metabolic problems may still fall within the healthy weight range. Because of the problems inherent in the BMI measurement, the Council on Science and Public Health last year concluded that obesity should not be considered a disease.

The AMA’s hope is that the new designation will increase awareness and public funding: “More widespread recognition of obesity as a disease could result in greater investments by government and the private sector to develop and reimburse obesity treatments,” it said in a statement.

If that’s the case, hopefully the emphasis will shift not towards drugs and medications but instead towards health coaching and preventive care. Studies show that Health Coaches help people lose weight and reach their health goals; it would be an incredible victory if insurance companies covered or reimbursed health coaching sessions.

Do you think that obesity should be called a disease?