The New York Times recently reported on the American Medical Association, the nation’s largest physician group, recently classifying obesity as a disease. The vote of the A.M.A. House of Delegates went against the conclusions of the association’s Council on Science and Public Health, which studied the issue over the last year.
Do you agree with the A.M.A.’s decision?
Obesity, particularly childhood obesity, is of great concern to us at Melt® Organic headquarters. We welcome opportunities that raise awareness of obesity so long as they emphasize the fundamental role diet plays in creating obesity and metabolic disorders.
Proponents of the A.M.A.s designation believe classifying obesity as a disease will:
- Induce physicians to pay more attention to the condition and spur more insurers to pay for treatments;
- Provide a new definition that helps in the fight against Type 2 diabetes and heart disease, which are linked to obesity;
- Bring more attention to obesity as a nationwide problem;
- Help improve reimbursement for obesity drugs, surgery and counseling;
- Encourage physicians to take obesity more seriously and counsel their patients about it;
- Reduce the stigma of obesity stemming from the widespread perception that it is simply the result of eating too much or exercising too little.
- Obesity should not be considered a disease primarily because the measure typically used to define obesity, the body mass index, is simplistic and flawed.
- Some people with a B.M.I. above the level that usually defines obesity are perfectly healthy while others below it can have dangerous levels of body fat and metabolic problems associated with obesity. Some people could be over-treated because their B.M.I. is above a line designating them as having a disease, even though they are healthy.
- Because of existing limitations with using B.M.I. to diagnose obesity in clinical practice, it is unclear whether recognizing obesity as a disease, as opposed to a ‘condition’ or ‘disorder,’ will result in improved health outcomes.
- No specific symptoms are associated with obesity; obesity is more a risk factor for other conditions than a disease in its own right. Proponents argue obesity fits some medical criteria of a disease, such as impairing body function and is a “multimetabolic and hormonal disease state” that leads to unfavorable outcomes like Type 2 diabetes and cardiovascular disease.
- “Medicalizing” obesity by declaring it a disease would define one-third of Americans as being ill and could lead to more reliance on costly drugs and surgery rather than lifestyle and dietary changes. For example, two new obesity drugs – Qsymia from Vivus, and Belviq from Arena Pharmaceuticals and Eisai – entered the market in the last year. Qsymia has not sold well in part because of poor reimbursement and concerns that the drug can cause birth defects, which resulted in restrictions placed on distribution. Those restrictions are now being relaxed. Belviq went on sale only about a week ago, so it is too early to assess its performance in the marketplace.