This past week the American Medical Association declared that obesity was a disease. Previously the AMA used strong terms to describe obesity such as “”urgent chronic condition,” a “major health concern” and a “complex disorder,” but stopped short of declaring it a disease, according to an article in the Los Angeles Times.
Apparently declaring obesity as a disease serves two purposes. One, to allow doctors to be reimbursed for time spent discussing the implications of obesity with their patients and two, to encourage doctors to talk to patients about their weight and send patients to programs designed to help the obese patient lose weight and monitor their progress.
Dr. Keith Ablow, in an article on Fox News, says this about the declaration:
[the declaration is] “another step towards eroding people’s autonomy and making them passive participants in their health. It is also an example of how the medical establishment is laying the groundwork to bill Medicare and Medicaid for every bad choice anyone makes, ever.”
Dr. Ablow likens the declaration of obesity as a disease to the declaration that alcoholism is a disease. He says there is “no no known gene that would make people veer off into the McDonald’s drive-through lane or direct them to choose whole milk over 1 percent milk.”
I tend to agree with Dr. Ablow that in the vast majority of cases, obesity really is a choice rather than a disease. I say that as a formerly 300+ pound woman whose obesity was absolutely a choice. I alone chose to drink a chocolate milkshake at 2:00 in the afternoon, eat a panful of biscuits during my children’s nap time, and order the highest calorie dish at the restaurant. That was me. It wasn’t a particular gene unique to me, but rather choices I made.
Now, I acknowledge that our standard American diet does not make it easy to manage our weight. The added sugars in foods make it hard for us, the abundance of cheap fast food make it difficult for us to say no, and our sedentary lifestyle makes it challenging to maintain a healthy weight. In fact, just this weekend someone asked me if my lifestyle was second nature after 15 years of weight maintenance. I hesitated and said, “In some ways, yes. But on the other hand, I still have to be very careful to make good choices day in and day out or else I could end up gaining pound upon pound again.”
While I do think that health insurance should help pay for weight loss treatment programs, I also believe that declaring obesity a disease may make some people feel as though their obesity is not their personal responsibility, but rather something that just “happened” to them. I often tried to blame genetics, an enlarged thyroid, or some mysterious ailment on my obesity, but in the end, I had to come to the point where I could acknowledge my role, take responsibility for it, and do something about it.
If obesity was classified as a disease back when I was 300 pounds, I believe I would have felt it validated the fact that I could not seem to lose weight. It would have likely left me feeling justified and a little defeated. After all, if my obesity was a disease, then there was little I could do about it so why try very hard?
While this may not seem like a big deal in the scheme of things, this declaration could have far reaching effects on health insurance costs and health insurance coverage in the future. After all, with about a third of Americans falling into the obese category, this declaration affects millions of people.
What do you think? Is obesity a medical disease? Diane