Home Health and Health Care Should Obesity Officially Be Classified As a Disease?

Should Obesity Officially Be Classified As a Disease?

by Erika Nicole Kendall

The American Medical Association is considering making obesity an official disease, in what could be a landmark move not only for treatment, but in regards to studies that directly affect causes of said [potential] disease:

“More widespread recognition of obesity as a disease could result in greater investment by government and the private sector to develop and reimburse obesity treatments,” a 14-page report released by the AMA’s Council on Science and Public Health said.



While any action this week by AMA delegates has no legal authority, its policy stances in the past have been used by policymakers in Washington and in state capitols across the country when medical policy and health regulations are debated and made.

In a 14-page report, the AMA’s science and public health council offered its membership pros and cons of classifying obesity as a disease.  On the proponent side, the report said obesity is “similar to other diseases . . . (such as) hypertension, diabetes, lung cancer that result from a combination of genetics and environmental factors.”

On Sunday, several doctors who testified at an AMA panel on public health issues said doctors needed to be compensated for treating obesity and a disease classification would help in that regard.

Dr. Virginia Hall, an obstetrician from HersheyPa.,  said the AMA should endorse declaring obesity as a disease so “insurers can stop ducking their responsibility” in paying for treatment of the obese.

Yet opponents to classifying obesity as a disease reason “obesity results from personal choices to overeat or live a sedentary lifestyle,” the report states. Therefore, opponents say obesity is not an illness, the council on science and public health said.

Some, including AMA delegates testifying this week, worry that classifying obesity as a disease would lead unnecessarily to a spike in health care costs and not necessarily improve patient outcomes.

Employers and insurance companies say the current reimbursement structure for obesity as a condition is adequate and those who pay for health care have increasingly added new benefits to address the obesity epidemic.

“We understand obesity as a condition and a risk factor for other diseases,” said Susan Pisano, a spokeswoman for America’s Health Insurance Plans, which includes the nation’s largest health plans, UnitedHealth Group, Aetna, Cigna, Humana and many Blue Cross plans among its membership.

“The important thing is to get programs and supports in place to address it, as health plans have done and are doing,” Pisano added. [source]

The comments – ohh, boy – aren’t what you’d expect from a Forbes article, full of subtleties such as “KEEP THOSE FATTIES OFF MY HEALTH INSURANCE POOL.”

I, however, have a few thoughts I’d like to hear some insight on:

1) If the AMA is lobbying for obesity to be considered as a disease, does this mean that the government would funnel more public research dollars into studying what contributes to it? Potentially write policy to prevent it?

Does this mean that the food industry might have a vested interest in preventing obesity from being considered a disease? Should we be watching for the food industry and its controlling organizations to be making moves on this?

2) If obesity were classified as a disease by the government, does this mean that treatments to combat obesity, like health coaches, personal trainers, eating disorder therapy and the like would be covered, in some way, by health insurance? I mean, I know that bariatric surgeries and other similar services are often covered under certain circumstances, but what about people who don’t fit those requirements yet, who want assistance they may not be able to afford? Do we want people gaining weight to qualify for surgery? And, quite honestly, many people who do get surgery still need assistance after all the cutting and snipping has been done. Could insurance potentially cover that, as well?

The doctor in the article says it herself – doctors want to be able to charge patients for their insight and expertise when it comes to treating obesity, but since doctors aren’t the only ones who have expertise on treating obesity… then what?

3) If obesity is classified as a disease, how does this affect our daily interactions with people who may appear to be unhealthily obese? Is it going to change anything – make it better? Make it worse? – or is it going to be the same ol’ fat-shaming song?

What are other consequences or positives of this kind of decision? What am I leaving out? Fill me in!

Update, 9:20pm:  It’s a wrap, y’all:

The American Medical Association, the nation’s largest physician organization, decided Tuesday to recognize obesity as a disease that requires a range of medical interventions for treatment and prevention.

The decision was made at the group’s annual meeting in Chicago.

Experts in obesity have struggled for years to have obesity recognized as a disease that deserves medical attention and insurance coverage as do other diseases. Previously the AMA and others have referred to obesity as “a major public health problem.”

“The American Medical Association’s recognition that obesity is a disease carries a lot of clout,” says Samuel Klein, director of the Center for Human Nutrition at Washington University School of Medicine in St. Louis. “The most important aspect of the AMA decision is that the AMA is a respected representative of American medicine. Their opinion can influence policy makers who are in a position to do more to support interventions and research to prevent and treat obesity.” [source]

Really makes you wonder how this changes the lobbying landscape, now. Hmmm.

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Brooke June 18, 2013 - 2:32 PM

I hope if this does happen, something will be done to cause the people who manufacture our food to change what they do. Maybe the FDA would have wider range to regulate ingredients that are known to contribute to obesity. Not only that, but it only takes one generation for epigenetic changes to occur, so we could already be adapting to the changes in our food sources, which is bad for future generations.

SAR June 18, 2013 - 4:58 PM

Yes, I believe it should be. I have an inappropriate relationship with food which results in my being fat. As it stands, my insurance doesn’t cover anything directly related to obesity, like the weightloss surgeries and even something as simple as a nutritionist. My doctor wanted me to go see a nutritionsit and it was denied. To me, that’s insanity.

I believe the diagnosis, which really boils down to an acceptable insurance “code” would be approved for payment. It’s crazy that they’ll treat resulting diabetes, high blood pressure, high cholesterol, etc, but not actually pay for loss of weight directly.

LCE June 18, 2013 - 9:25 PM

I agree! I discovered my employer asked our healthcare provider to write things like weight lost surgery and nutritionist out of our policy.

Jayde June 18, 2013 - 4:59 PM

I don’t think we should label obesity as a disease because it’s just not…..a disease! If you do label it as one, people are going to think they are meant to be overweight and blame it on their “bad genes” instead of trying to turn their health around. This is just digging a deeper hole.

Karen June 19, 2013 - 2:58 PM

I think it will ultimately be a good thing. My insurance has begun to offer weight management programs that include access to nutritionists and classes to help us learn how to make better food choices. I think in the long run this will help the insurance companies out because they will have to spend less money paying for the illnesses associated with weight and maybe we’ll get lower premiums! (LOL on that last part!)

Annette June 19, 2013 - 7:27 PM

As I listen to how our food is doctored — Frankenwheat, GMO’s etc. I wonder sometimes if it is all engineered to create a health crisis.

Sad it’s come to this, most doctors aren’t equipped to give this type of advice. I wonder if this will create more stomach reducing surgery as a quick fix. Instead of looking at the foods. The animal proteins are injected with so many antibiotics and fed junk food which ends up in our bodies. I wonder how they will approach this.

Is this a ticket for doctors to get on the bandwagon and bill for more services or will patients actual get comprehensive treatment. Will the food industry clean up it’s act. Time will tell.

Shay Spearman June 22, 2013 - 4:39 PM

I believe it’s a good thing. I’ve been to doctors who have all looked at my history and said I need to lose weight. Then they refer me to a nutritionist. It’s not covered under my insurance. This will allow them to be covered. It will cause doctors to look at other underlying issues – mental, emotional, and physical – that are contributing to the problem. It will allow for a more interactive and proactive dialogue between patient and doctor to remedy the disease. Telling a fat person to stop eating so much is not enough. They need access to resources and support that will assist in their living a healthy lifestyle. This journey is not easy. It’s even harder with health issues. Treat the illness and the frequency of which one has to make a doctor’s visit, or get medications, goes down. But that wild cause issues for the pharmaceutical industry, now wouldn’t it?

Cathy November 15, 2013 - 2:49 AM

I think the move to classify obesity as a disease is disingenuous. It’s very much a money grab for expanding healthcare markets to open up new streams of revenue. Nutritionists, trainers, and various & sundry white-coated specialists can take their inflated share of the insurance pie driving health care costs even higher. I feel the move has VERY LITTLE to do with whether or not obesity is a disease (which I personally do not think it is), but much more to do with appropriating funds.

Remember the “Ebonics Debate” of the late 1990s. School districts were looking to define what they described as “Black English” as a second language in order to securing Federal grant money. Whatever happened to that money? School districts in California are STILL bankrupt 15 years later – and the needle hasn’t budged on African American student achievement. Just doing a quick Google search for “education trends for african american students in California” (the Ebonics debate centered on a school district in San Bernardino, CA — my old stomping grounds) – you’ll find graphs that relay pretty much a flat line in reading scores from 1986 – 2004, and a slight uptick in math scores during that same time. I can’t image teaching ebonics as a second language improves our children’s ability to solve for “x.” It was a money grab – and those who needed the most didn’t get any benefit from it. Well intended, maybe, but ineffective non-the-less.

The problem of obesity in this country is important enough all by itself to motivate concerned doctors & health care professionals to come up with strategies & solutions to share with their patients. The act of “disease-a-fying” it will serve to attract the least good-willed and good-intentioned folk to “fight” for the cause. Think about the FDA’s ban on transfat. Does ANYONE think this would have happened if food giants and their lobbyist (think Monsanto) hadn’t already figured out a way around it, and more than likely to PROFIT from it? Those lobbyist in congress didn’t get those lush salaries by fighting for the pubic good.

And NO ONE but your family and friends are truly vested enough in your health to DECLARE obesity a disease for your good benefit — certainly no one associated with the AMA and it’s enormous lobby in the halls of congress. Follow the money on this one. It stinks.

ObeseAmerican June 30, 2014 - 6:31 AM

Not sure why it would be a disease. Again government intervention/ interference. Childhood Obesity yes Adult Obesity no. I received mental health counseling for my issues after being referred from my doctor. I am now average weight because an issue in my life was addressed. Those who are not obese should not b deciding for all Obese people. Weight loss surgery is 50/50 and VERY expensive. We need to stop enabling Obese people (like myself). When will it end are any of those AMA professionals Obese? Put money into qualified mental health services an community programs for people with weight issues.

Erika Nicole Kendall June 30, 2014 - 1:03 PM

“Again government intervention/ interference. ”

The American Medical Association is not, in fact, a government organization.

“Those who are not obese should not b deciding for all Obese people. ”

A respectably-sized portion of the doctors in America are, in fact, overweight and obese.

“Weight loss surgery is 50/50 and VERY expensive.”

An increase in weight loss surgeries is not the single, only, or intended outcome of classifying obesity as a disease.

“Put money into qualified mental health services an community programs for people with weight issues.”

This is one of the potential outcomes of classifying obesity as a disease – investing funds into researching solutions like this for proven results.

Milaxx August 12, 2014 - 2:24 AM

I would like to see changes in terms of nutritionist. Allow insurance companies to cover one on one instead of these generic group classes many plans cover. They are so watered down it’s pathetic. I’ve had more than one not just make fun of my vegetarianism, but actually try to talk me out of it. More than one be surprised that I was versed in plant based proteins. Many will recommend diet soda, and one who tried to tell me there was little difference in white and wheat bread.

Let’s also talk about how classifying obesity as a disease changes the many food desserts in lower income neighborhoods.

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