August 11, 2013
John DiTragilia, MD
At the June meeting of the House of Delegates of the American Medical Association (AMA), obesity was declared a disease.(1) What does this mean? Is it a semantic thing like marriage between a man and a women? Does it mean that obesity is not caused by bad behavior? Other diseases can be caused by bad behavior like venereal disease and lung cancer and hypertension. Is it a tactic by organized medicine to get insurance and the government to pay for treatment? Maybe coincidentally, lawmakers introduced bipartisan bills in the Senate and House to lower health care costs and prevent chronic diseases by addressing the nation’s obesity epidemic. Introduced on June 19, The Treat and Reduce Obesity Act, would require Medicare to cover additional obesity treatments such as prescription drugs for chronic weight management and make it easier to receive weight-loss counseling. Although most insurers don’t cover primary care visits for obesity counseling Medicare already does. It would seem that whether or not obesity is a disease, insurers should cover only what works.
This debate is not new and it is not over. American Medical News had an article entitled “Is obesity a disease?” back in Feb. 6, 2006.(2) The National Institutes of Health declared obesity a disease in 1998. The AMA council on Science and Public Health, an advisory subcommittee of the AMA had recommended against classifying obesity as a disease. But the American Association of Clinical Endocrinologists got the resolution introduced and passed at the AMA meeting.
What do I think? I thought you’d never ask. If you say that obesity is caused by eating too much and not exercising then calling it a disease is not germane as I mentioned above. If you say that it is not the fault of the victim, as I believe, then calling it a disease means we should take obesity more seriously. Don’t we already obsess about obesity in this country despite the fact that we all keep getting fatter? What if there are no co-morbidities like hypertension or diabetes and you do eat right and exercise a lot? It’s silly.
1. Moyer CS. Delegates declare obesity a disease AMA News. 2013; 56(13):1.
2. Victoria E. Is obesity a disease? AMA News. 2006; 49(5):24-25.