AMA: Obesity is a disease

Drunk driving might not be a disease, but alcoholism is. And I haven't seen the statistics, but I'm willing to bet that the majority of drunk driving offenses are committed by alcoholics. And while it shouldn't require this extreme to bring about a change in our society, sadly, obesity is an epidemic, and actually, a greater issue plaguing our society than alcoholism. So in my opinion, the action is appropriate.

As far as your points about the negative impact on the healthcare community, I actually completely agree with you. This will cause insurance rates to go up, and there will be an influx of bariatric surgeries. The fight against the obesity epidemic will continue, but perhaps this will help to further preemptive initiatives and the benefits can be seen in the long term.

I'm willing to bet drunk driving is not alcoholics, but binge drinkers and weekenders.

Doctors want to be able to bill insurance companies for drugs and surgeries related to obesity. That's what this is all about. It's a money game. It's about making sure that people can get WLS for vanity's sake when there are no other indications.

It's just about billing. It's not a statement about the nature of obesity and it shouldn't be portrayed as such. This isn't about care. It's about payment.

All that being said, the OTHER reason people become obese, other than the "lifestyle" reason everyone is so focused on, is medication.

My friend is a social worker and she has a 12 year old client who just put on 60 pounds in a very short amount of time based on a change in medication; this girl looks like she is going to burst out of her skin. She has not changed her lifestyle. The medication is putting the weight on her. This happened once before, when her meds were changed. As soon as the meds were adjusted, the weight fell right off of her. It's not always "laziness." Perhaps now that her obesity will be considered a disease, the doctors will have to find another alternative for her treatment that does not induce it. Just a thought.

And I tend to think that a little bit of stigma is probably a good thing...

Why? Being fat is awful. Why do think it is necessary to further stigmatize fat people? I agree with whoever said we should pay our own way, & shouldn't have our health care subsidized by skinny people, but other people's fat shouldn't be any of your business.

Thank you, both of you. Being overweight is hard enough without dealing with other people's judgement. You don't know the details of how a person got to the weight they did, or whether they're genuinely trying to lose the weight. There are a ton of medications that are known to cause weight gain, and others that can disrupt the systems that control weight in such a way that weight loss is nearly impossible.

The stigma needs to be firmly planted on the behavior. Smoking is stigmatized. Drunk driving is stigmatized. What's wrong with stigmatizing other bad behavior?

Because it's not "bad behavior" for all of us. I've fought with two of my doctors for over a year (and am now awaiting my appointment at a third, who might actually listen to me) regarding my weight, because they've written me off as "just not exercising/eating right" despite the fact that I have three years of MFP logs that demonstrate otherwise. Thanks to the stigma, though, both of my current doctors have ignored my personal and family medical history of endocrinological problems that have directly interfered with my ability to lose weight (as evidenced by a positive response to certain medication a few years ago). All I've wanted are for one of them to run a couple of blood tests, but they're set in their judgement that I must just not be doing it right.

I don't necessarily agree that it's a disease. I agree with the person who said that it's better classified as a symptom of some kind of larger problem. However, I also don't agree with the idea that people who are overweight should be stigmatized by others, especially when they're trying to seek help.

My opinion on it being classified as a disease is that there isn't a way for the individual to treat it on their own, without medical intervention. (surgery, medication, treatments) Morbidly obsese people that are seeking weight loss surgery such as gastric bypass or lapband usually have to go through a diet period to ensure they can eat at normal, healthy levels after the surgery is complete. How is it that these individuals can lose 60 lbs for example, ON THEIR OWN, so they qualify for the surgery, but they can't continue down that path for successful weight loss?

Weight loss isn't required for gastric bypass. All that's generally required is a BMI over 40, or a BMI over about 35 plus some other severe medical issue.

Gastric bypass is generally used as a last resort, when sustainable diet and exercise plans haven't worked for some reason. It's a highly invasive procedure with a rather high risk of complications (like "shred your stomach if you don't follow the recovery diet" type of complications). It's often chosen because the person's current condition is actually worse than the potential complications. (See here, for a good amount of information on gastric bypass and what it actually means for a person - http://www.mayoclinic.com/health/gastric-bypass/MY00825 )

The diet that they're on after the surgery, however, is generally quite a bit more extreme than most people do under most circumstances. They often don't (or can't) eat a lot of carbs and/or fat, and, depending on the surgery, they may only be able to eat an ounce at a time, because their stomach physically can't hold any more (compared to the average stomach capacity of 3 pints).

The people that don't have gastric bypass, but successfully lose weight under a doctor's supervision often can't continue down that particular path, because that path isn't sustainable. Many of the doctor supervised diets are designed specifically for rapid weight loss. The diets make the "Biggest Loser" diet look sustainable and reasonable, in many cases. Sustainable diets often don't work due to things like medications, and they have to resort to the extreme, even if they aren't sustainable.

Good I hope that's true now maybe we can start looking at preventative measures and actual solid treatment to treat a disease with such high recidivism and mortality.

"Preventative measures and solid treatments" like what? What can possibly be done to stop someone from opening their mouth and shoving food into it? Do you think you can force someone to exercise? Force them to eat healthy? The only thing this is going to do is make the excuses easier. "Oh yeah. I need the scooter to get around on because I have a disease. It's called obesity." Or allow the government to raise taxes on certain foods and/or eliminate foods like they tried to do in NY. It's ridiculous! Fast food isn't the problem. Big Gulps isn't the problem. Junk food isn't the problem! The problem is people not taking responsibility for their own issue. I have a friend who has started going to the gym with my husband and I this week. She is up early and meets us there at 5:30 in the morning to do a 90 minute workout that I came up with for her. Why is she doing this? Because she gained weight and is unhappy with herself and is TAKING RESPONSIBILITY and DOING SOMETHING ABOUT IT!

Yes obesity is preventative but calling it a "disease" isn't going to make any difference.

If it was as simple as will power and motivation then you wouldn't have a 95% failure rate and increased mortality rate. So what people are dying! Hey that's your own fault fatty for driving around in your scooter. These attitudes are archaic. It reminds me of our old attitudes toward alcoholism, depression, and female hysterics, and schizophrenia. I'm so glad that some of you are so much more knowledgeable than a professional association of physicians.

Preventative measures could mean more emphasis in the schools on nutrition and physical education. When a person reaches a certain BMI the government pays for either health education classes, gym membership, and/or WLS. More research on the causes of obesity, why the recidivism is so high, and more effective means of prevention and treatment. I dont have all the answers, but I think it's time we appropriate classify obesity as a disease because millions are dying.

"When a person reaches a certain BMI the government pays for either health education classes, gym membership, and/or WLS. More research on the causes of obesity, why the recidivism is so high, and more effective means of prevention and treatment. "

Why should I have to pay for education classes, gym memberships, etc just because a person doesn't know how to make good choices when it comes to food and exercise? People forget that "We the people" are the government, not the stupid politicians in office. We are the ones that pay for things, not them. People need to stop relying on the government and start taking responsibility for our own actions. Millions of people aren't dying because of obesity. People are dying because of the diseases that come with being overweight. Many of these "diseases" can be prevented just by losing weight. You can't make people do anything they don't want to do. It doesn't matter what the government does. Is the government gonna throw someone in jail because they're overweight and don't want to go to the gym? No, because that would be ridiculous. There are many, many programs and tools out there(for free) that can help you lose weight and keep it off and aren't government controlled. It's up to the person to make that decision, not the government. Calling it a disease is just another excuse for being fat and lazy.

"When a person reaches a certain BMI the government pays for either health education classes, gym membership, and/or WLS. More research on the causes of obesity, why the recidivism is so high, and more effective means of prevention and treatment. "

Why should I have to pay for education classes, gym memberships, etc just because a person doesn't know how to make good choices when it comes to food and exercise? People forget that "We the people" are the government, not the stupid politicians in office. We are the ones that pay for things, not them. People need to stop relying on the government and start taking responsibility for our own actions. Millions of people aren't dying because of obesity. People are dying because of the diseases that come with being overweight. Many of these "diseases" can be prevented just by losing weight. You can't make people do anything they don't want to do. It doesn't matter what the government does. Is the government gonna throw someone in jail because they're overweight and don't want to go to the gym? No, because that would be ridiculous. There are many, many programs and tools out there(for free) that can help you lose weight and keep it off and aren't government controlled. It's up to the person to make that decision, not the government. Calling it a disease is just another excuse for being fat and lazy.

And what about those of us who have gone through the programs and still can't lose weight, likely due to an underlying medical condition, but the doctors refuse to test for it, because they've decided "you're fat because you're lazy and eat too much, and you're just not trying hard enough/doing the right things"?

While I agree that paying for gym memberships is questionable, calling obesity a disease isn't necessarily just another excuse for being fat and lazy.

Good I hope that's true now maybe we can start looking at preventative measures and actual solid treatment to treat a disease with such high recidivism and mortality.

"Preventative measures and solid treatments" like what? What can possibly be done to stop someone from opening their mouth and shoving food into it? Do you think you can force someone to exercise? Force them to eat healthy? The only thing this is going to do is make the excuses easier. "Oh yeah. I need the scooter to get around on because I have a disease. It's called obesity." Or allow the government to raise taxes on certain foods and/or eliminate foods like they tried to do in NY. It's ridiculous! Fast food isn't the problem. Big Gulps isn't the problem. Junk food isn't the problem! The problem is people not taking responsibility for their own issue. I have a friend who has started going to the gym with my husband and I this week. She is up early and meets us there at 5:30 in the morning to do a 90 minute workout that I came up with for her. Why is she doing this? Because she gained weight and is unhappy with herself and is TAKING RESPONSIBILITY and DOING SOMETHING ABOUT IT!

Yes obesity is preventative but calling it a "disease" isn't going to make any difference.

If it was as simple as will power and motivation then you wouldn't have a 95% failure rate and increased mortality rate. So what people are dying! Hey that's your own fault fatty for driving around in your scooter. These attitudes are archaic. It reminds me of our old attitudes toward alcoholism, depression, and female hysterics, and schizophrenia. I'm so glad that some of you are so much more knowledgeable than a professional association of physicians.

Preventative measures could mean more emphasis in the schools on nutrition and physical education. When a person reaches a certain BMI the government pays for either health education classes, gym membership, and/or WLS. More research on the causes of obesity, why the recidivism is so high, and more effective means of prevention and treatment. I dont have all the answers, but I think it's time we appropriate classify obesity as a disease because millions are dying.

"When a person reaches a certain BMI the government pays for either health education classes, gym membership, and/or WLS. More research on the causes of obesity, why the recidivism is so high, and more effective means of prevention and treatment. "

Why should I have to pay for education classes, gym memberships, etc just because a person doesn't know how to make good choices when it comes to food and exercise? People forget that "We the people" are the government, not the stupid politicians in office. We are the ones that pay for things, not them. People need to stop relying on the government and start taking responsibility for our own actions. Millions of people aren't dying because of obesity. People are dying because of the diseases that come with being overweight. Many of these "diseases" can be prevented just by losing weight. You can't make people do anything they don't want to do. It doesn't matter what the government does. Is the government gonna throw someone in jail because they're overweight and don't want to go to the gym? No, because that would be ridiculous. There are many, many programs and tools out there(for free) that can help you lose weight and keep it off and aren't government controlled. It's up to the person to make that decision, not the government. Calling it a disease is just another excuse for being fat and lazy.

Because you live in this society and you are building a future in this society for your children and grandchildren.

The definition of a disease is too lax, thus being easily manipulated you can make it cover any unsavory condition connected to humanity.

The Bible, philosophy, and other reference from ancient times called it like it is....gluttony. Today we feel we are entitled to whatever we want, right now, and in whatever quantities we think will fill our immediate want, ignoring our real need.

Hunger is temporal. What is insatiable is our appetite. We don't differentiate, and we fail.

"A reason often given for making the declaration is that it would help remove the stigma that obesity is a result of eating too much or exercising too little."

Um....isn't it in many cases? I'm not sure I agree with this.

It's been said before, but here's the Miriam Webste definition of a disease.

"a condition of the living animal or plant body or of one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms "

From a purely descriptive and analytical perspective it's fairly easy to see how that definition can apply to obesity.
The actual cause of the " disease " is irrelevant.

But, is there an underlying condition that makes it difficult to lose weight, maintain, and easy to gain weight? Are there biochemical abnormalities that go beyond willpower?

If there is, then it is a different disease. Hypothyroidism, PCOS, are already recognized as diseases. Illness-related obesity isn't a disease unto itself. It is a symptom.

Yeah. There are. We call it leptin resistance. It's just not classified as a disease.

This may sound harsh...but is it neccesarily wrong that obese people be charged more for health care? Just like alcoholism, smoking, drug abuse, most of the time obesity is the result of a choice to be excessive in eating and ignoring healthy habits. If you make the choice to eat too much, maybe its acceptable that you be charged more for health care.

I can't say I don't agree.

Please tell me why then are the majority of obese people of lower socio-economic status? Hooray for charging poor people more for health care! *eyeroll*

Because poor people buy cheap food, which coincidentally is highly processed, high in calories, and full of hydrogenated oils, fat, sugar, and sodium.

Head of lettuce- $.98
Doritios- $3.00

Your argument is null.

The problem lies in education. Lower income classes tend to have less education- directly linked to poor choices (think drug addiction, alcoholism, etc.....)

For real?! How about you compare the price to an actual vegetable....ya know....one with calories? Eggplant, squash, broccoli? All more expensive and harder to prep than doritos. Add it the fact that doritos are easy to get at any corner store and vegetables need to come from a supermarket, which is not always accessable in low-income neighborhoods. Plus the fact that some grocery stores don't actually carry much of a produce section. When I lived in Buffalo, the grocery store of the neighborhood I was doing volunteer work in had 10 kinds of vegetables with none of the 3 I mentioned. The grocery store near the upper middle class neighborhood where I was living had 30 kinds of vegetables. They call it "serving their customers".

Search the term food desert and educate yourself.

This may sound harsh...but is it neccesarily wrong that obese people be charged more for health care? Just like alcoholism, smoking, drug abuse, most of the time obesity is the result of a choice to be excessive in eating and ignoring healthy habits. If you make the choice to eat too much, maybe its acceptable that you be charged more for health care.

I can't say I don't agree.

Please tell me why then are the majority of obese people of lower socio-economic status? Hooray for charging poor people more for health care! *eyeroll*

Because poor people buy cheap food, which coincidentally is highly processed, high in calories, and full of hydrogenated oils, fat, sugar, and sodium.

Head of lettuce- $.98
Doritios- $3.00

Your argument is null.

The problem lies in education. Lower income classes tend to have less education- directly linked to poor choices (think drug addiction, alcoholism, etc.....)

For real?! How about you compare the price to an actual vegetable....ya know....one with calories? Eggplant, squash, broccoli? All more expensive and harder to prep than doritos. Add it the fact that doritos are easy to get at any corner store and vegetables need to come from a supermarket, which is not always accessable in low-income neighborhoods. Plus the fact that some grocery stores don't actually carry much of a produce section. When I lived in Buffalo, the grocery store of the neighborhood I was doing volunteer work in had 10 kinds of vegetables with none of the 3 I mentioned. The grocery store near the upper middle class neighborhood where I was living had 30 kinds of vegetables. They call it "serving their customers".

Search the term food desert and educate yourself.

You can still find things cheaper than junk food... a pound of bananas is still cheaper than even a 50 cent bag of chips... at least it is here and you can feed more people off that one pound of bananas than that bag of chips. And EVERYTHING is harder to prep than a bag of doritos or cookies or whatever... because it takes more than the 2 seconds it takes to open the package. While I get that there are fewer fresh options in some places, that doesn't mean that it is totally unreasonable to eat relatively healthier. Hell, even at Mcdonald's you can choose to drink water rather than soda... you can choose apple slices rather than french fries (at least here you can)... The bigger problem is people don't want to do the work that comes with eating a better diet... and people don't want to realize that the long term costs are much cheaper even when the short term costs may be slightly higher.

I wonder if anyone has replicated the Twinkie Diet yet.

Good I hope that's true now maybe we can start looking at preventative measures and actual solid treatment to treat a disease with such high recidivism and mortality.

you mean like making a choice not to eat fast food 3+ times a week, drinking soda like its going out of style, staying on the couch instead of going outside and doing something or checking your house for ghosts that are preventing you from doing pushups, situps and other sorted exercises that you can do that you need not belong to a gym?

i think its a bad idea, now people will use it even more as a crutch. yes, i caught the fat from some guy in brazil. i think he got it having sex with a hippo.

This is a WIN for providers such as myself who work in a "medical center" who's focus is treating the dis-ease of living created by the symptom of obesity.

Too many times I come across someone who would greatly benefit from my services and that of my team to discover the root of the issues that have resulted in the dis-ease of living but can not afford our services.

I am not a fan of labels and codes and diagnosis's as they follow us throughout our lives in our medical charts and therefore insurance. However, if giving it the diagnosis allows me to reach, touch, teach and affect more people's lives then I'm all for it.

As with a lot of classifications of dis-ease including addictions it has allowed insurance carriers to pay for treatment of many kinds.

Why would we shun someone seeking treatment and help to turn their lives around in regards to obesity when we support someone who goes into treatment centers seeking help to turn around their lives for alcholosim or another form of addiction when insurance pays for that?

The lack of EASE in living should be treated in any form possible when the person is ready for change and if my insurance that I pay premium dollar for helps me in that treatment, I'd take full advantage of that offer.

A lot of great thoughts in the previous posts, the above are mine.

The financial implications of this boggle my mind.

If obesity in and of itself is a disease, everything that is currently being sold to fight obesity (effective or not,) is going to be covered under health insurance.

So my health insurance is now going to be used to buy my gym membership, my "it works!" wraps, my HCG, my Jenny Craig, my Nutrisystem, my Thighmaster, my Weight Watchers, my raspberry ketones, my green tea extract......the list is long.

How much are we prepared to pay for health insurance? The insurance companies are sure to pass along their increased costs in the form of higher premiums.

It doesn't even work that way now. Health insurance has the choice to cover or not to cover something, and when they do cover it, they have a choice on what to charge for it.

My stepdad has COPD, and the medication he needs for it, if bought through his insurance, in the US, would cost $400 a month - nearly half of my parents' monthly net income. It's technically covered by insurance, but because of various politics, it costs an outrageous amount of money. So, they get it from a Canadian seller and don't go through insurance, where they can get a 3-month supply of the exact same thing (kid you not, same manufacturer, same brand, everything) for under $100.

Many insurance companies don't cover things like certain birth controls, while other medications - yes, even ones that people depend on just to live - are either not covered at all, or require what's known as "pre-authorization," where you have to get a form, take it to your doctor to fill out part of it, maybe take it to your pharmacy to fill out part, then send it to your insurance, where they'll decide whether they'll cover it for your particular circumstance, and for how long.

Oh yeah, and insurance doesn't generally cover over the counter medications (flexible spending accounts might, but those are generally paid for by the person and their employer).

So no, this ruling won't make every insurance cover every weight loss thing. Yes, some might choose to help cover the cost of a gym or Weight Watchers membership (likely under provisions similar to handling group counseling sessions and drug addiction treatment), or might cover the cost of surgery, but most of the other things you list will likely not be covered, if for no other reason than being over the counter.

nope. You cant pop pills and make obesity go away. Its not a disease.

Tell that to Dr Oz and his millions of followers.