Wed June 12, 2013
Is Obesity a Disease?
UPDATE: The AMA voted yes on calling obesity a disease, despite a committee's recommendations against it.
Next week is the American Medical Association's annual meeting in Chicago. It's the big deal event for the nation's physicians, residents, and medical students, where, in addition to the speeches and educational sessions, delegates from every state and specialty organizations consider new health policies to adopt. The result is a kind of physician consensus on emerging health issues, and people tend to pay attention.
One resolution under consideration this year: whether or not obesity should be classified as a disease. You can read the resolution, including background and discussion of the pros and cons, here.
It's a timely discussion for Rhode Island, where obesity rates are about 25% of the population, and obesity-related conditions, like diabetes, are climbing steadily, according to the CDC.
Why should it matter how we classify obesity, if we already know it's generally pretty bad for your health? Could it actually help improve health outcomes for obese people?
Well, some of the arguments in favor of calling it a disease go like this: If you call it a disease, you might get more serious government and private sector investment in treatments and better chances those treatments will be reimbursed. Insurers like codes for specific diseases and conditions. Check the box for one of those codes and it's easier to reimburse. Also, calling obesity a disease might lend the growing health problem it's become for our nation some more urgency.
But some arguments against say this: If you start calling something a disease, you run the risk of "medicalizing" it, making it more appealing to treat it with drugs and surgeries--rather than preventing it. You might also stigmatize a huge segment of the population--a third of which is considered obese--in one fell swoop. And if you have a disease, treatable with drugs and surgeries and recognized as a great burden to you, what's your motivation for self-treatment, for managing your disease through the most accepted means (diet, exercise)?
A couple of other interesting considerations in the debate: how exactly do we define disease? And can we really define obesity in the first place? The current standard is BMI (Body Mass Index), which national and international health organizations say is a pretty imperfect measure and a not-so-great indicator of health.
The AMA is considering many other resolutions. This is one to watch because it could impact so many people.