AMA: It’s Official, Obesity Is A Disease
By Dr. James Palermo // June 19, 2013
LIFESTYLE CHOICE OR MEDICAL CONDITION?
ABOVE VIDEO: Medical specialist for Canadian CBCNews, Dr. Karl Kabasele, discusses the importance of addressing and managing obesity as a disease. With the AMA’s recent designation of obesity as a disease, physicians may be more aggressive at medically, or in appropriate cases surgically managing obesity.
Determining whether or not obesity should be defined as a disease was a primary focus of the American Medical Association’s (AMA) House of Delegates at their annual meeting in Chicago last week.
OBESITY DESIGNATED ‘DISEASE’ AFTER SPIRITED DEBATE
After an earlier report by the AMA’s Council on Science and Public Health outlining the benefits and drawbacks of classifying obesity as a disease and ultimately concluding that it could not “determine conclusively” whether obesity is a medical disease or not, the governing House of Delegates voted overwhelmingly to “recognize obesity as a disease state with multiple pathophysiology aspects requiring a range of interventions.
The AMA’s official recognition of obesity as a disease came at the urging by several medical societies, including the American College of Cardiology, the American Urologic Association and the American Society of Bariatric Physicians, for the association to reconsider the Council on Science and Public Health’s previous inconclusive stance on the disease designation.
DESIGNATION IMPACTS HEALTHCARE POLICY AND REGULATIONS
The AMA had previously considered obesity a major public health issue, but did not designate it as a “disease.” This decision has no legal standing, however it is common for federal and state policymakers to adopt the association’s positions when drafting medical and public health regulations.
LIFESTYLE CHOICE OR MEDICAL DISEASE?
The debate among the members was spirited, with advocates for disease designation arguing that the treatment and prevention of the myriad of obesity associated complications and conditions would improve and physician reimbursements for obesity-related care would be better defined and more consistent.
However, some physicians at the meeting said that obesity does not meet the definition of a “disease” because overweight patients can still be in good health. It was also argued that obesity is a result of lifestyle choice, not medical illness, and the disease designation would “medicalize a condition” that affects over one-third of the nation.
DISEASE DESIGNATION MAY IMPACT INSURANCE PREMIUMS
An impact on insurance premiums and even on employment for the obese was brought up as a reason to be very careful in officially endorsing obesity as a disease.
Obesity management is a focus of the Patient Protection and Affordable Care Act (PPACA), allowing employers to charge obese workers 30% to 50% more for health insurance if they decline to participate in a qualified wellness program. The law also includes provisions that incentivize Medicare and Medicaid beneficiaries to see a primary care physician about losing weight, and funds community demonstration programs for weight loss.
SEMANTICS ASIDE, OBESITY CONTRIBUTES TO DISEASE AND COSTS
Whether obesity is a designated disease or not it is a costly condition that can reduce quality of life and increases the risk for many serious chronic diseases including heart disease, stroke, type 2 diabetes, and certain types of cancer, all of which are leading causes of premature and preventable death.
More focus and resources must be devoted to striving for a less obese, healthier and more active America if we are to move away from a “reactive” disease-based model of health to a “proactive” wellness-based model to reduce the risk of chronic disease, improve overall health and wellbeing and minimize medical costs.