The American Medical Association’s declaration yesterday that obesity is a disease is expected to increase medical interventions for Americans with high Body Mass Indexes -– including pills, surgery and counseling –- as insurance companies are more likely to reimburse consumers for treatment. And the numbers could be staggering.
It is “a move that effectively defines 78 million American adults and 12 million children as having a medical condition requiring treatment,” as Melissa Healy and Anna Gorman point out in their lede in Los Angeles Times.
“In making the decision, delegates at the association’s annual meeting in Chicago overrode a recommendation against doing so by a committee that had studied the matter,” the New York Times’ Andrew Pollack reports.
The Council on Science and Public Health committee, which had listed the pros and cons of elevating obesity from its designation of “condition” or “disorder,” wrote that “given the existing limitations of BMI to diagnose obesity in clinical practice, it is unclear that recognizing obesity as a disease … will result in improved health outcomes.”
Indeed, BMI has been widely criticized as a way to determine if a person’s weight is healthy or not. Going by the formula, for example, the Miami Heat’s ripped superstar LeBron James is “overweight” at 6-feet-8 and 240 pounds because the index does not distinguish between fat and lean muscle mass. But the AMA felt that the perception of obesity as a disease trumped any objections.
"Recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately 1 in 3 Americans," according to Dr. Patrice Harris, an AMA board member who supported the designation.
“I think you will probably see from this physicians taking obesity more seriously, counseling their patients about it,” obesity expert Morgan Downey tells Pollack. “Companies marketing the products will be able to take this to physicians and point to it and say, ‘Look, the mother ship has now recognized obesity as a disease.’”
Samuel Klein, director of the Center for Human Nutrition at Washington University School of Medicine in St. Louis, tellsUSA Today’s Nanci Hellmich that the AMA’s “opinion can influence policy makers who are in a position to do more to support interventions and research to prevent and treat obesity.”
The insurance industry maintains that it was already moving in a positive direction. Forbes contributor Bruce Japsen writes that “employers and insurance companies say the current reimbursement structure for obesity as a condition is adequate ….”
Susan Pisano, a spokeswoman for America’s Health Insurance Plans, tells Japsen: “We understand obesity as a condition and a risk factor for other diseases. The important thing is to get programs and supports in place to address it, as health plans have done and are doing.”
Even if it helps to “destigmatize” obesity, as advocates hope, and helps consumers pay for treatment, the AMA’s designation won’t end the debate over its causes, if not the dilatory effects on both adults and children. A study published in the current issue of the Canadian journal Psychological Science finds, for example, “our everyday beliefs about obesity may actually influence our eating habits -- and our body mass,” according to a report in Science Daily.
“Data from participants in Korea, the United States, and France showed the same overall pattern: Not only did people tend to implicate diet or exercise as the leading cause of obesity, people who implicated diet as the primary cause of obesity actually had lower BMIs than those who implicated lack of exercise.” To the researchers surprise, genetics was “a far distant third.”
The findings suggest that “in order to be effective, public health campaigns may need to target people's beliefs just as much as they target their behaviors.”
Meanwhile, two new studies “offer some solace to those who can't control their weight despite diet and exercise by providing more evidence that genetics may play a role in obesity,” Web MD’s Randy Dotinga reports. "When the genetic variations do occur, they play a major role in a person's weight," says the co-author of one of the studies.
Should these folks just grin and bear the extra load? Not at all.
“The usual weight-loss strategies” -- diet, exercise and surgery -- still apply, we are informed. And the first two, of course, need not necessarily involve funding from anywhere -– although that’s admittedly easier to type than it is to execute.