Is Obesity Really a Disease?

Written by Bill Paquin

This past week delegates of the American Medical Association voted to recognize obesity as a disease, despite the recommendation of a panel assigned to study the issue. The panel voted that way because they felt BMI was not a good measure of obesity.  But according to AMA board member Patrice Harris, the broader AMA physician community overruled the recommendation because “recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately one in three Americans.”    

Gauging by the reaction of opinion pieces and comments from readers, it would appear this action is quite controversial.

While I would vote "Yes" on the question, I am not sure the answer really matters.  The decision by the AMA to name obesity a disease is already accomplishing its goal: sparking greater awareness and action around the impact of obesity on America and Americans.

Having spent the last week reading a surprising amount of negative responses from both experts and everyday Americans, it seems like we are missing the broader point.

The responses seem to fall into two categories:

  1. Obese people are lazy. Therefore calling this a disease absolves them from any personal responsibility 
  2. This decision will promote the "medicalization" of obesity

The first characterization belies a lack of understanding about obesity, its causes, and implications for this country, while the second is a cynical response to the AMA's attempt to address what is a global pandemic - whether technically accurate or not.

First let's look at some of the facts: (source CDC.gov)

 

The number of states with obesity rates greater than 30% (the darkest color) increased by 33% in one year! And it is not slowing down.  Most statistics indicate by next year one out of every three Americans will be obese.  According to the American Heart Association, obesity costs this country $254 billion and is on the way to $850 billion over the next 15 years.  We are literally drowning under the weight of this epidemic.

More alarming, according the the American Academy of Pediatrics, 1 out of every 3 new cases of type 2 diabetes, lifestyle related diabetes, are children.  Yes, children.  If you think our healthcare cost challenge is a problem now, just wait.  In fact, we are finding that the incidence of complications is higher in children with type 2 diabetes than adults, so the velocity of the problem will increase over time.

We need to change the way we think about this problem.

Which brings me back to the backlash against the AMA's decision to label obesity a disease.

Here are some quotes I found from the comment section of reputable news sites that wrote about this story:

Even the editorial pages of many major papers and websites echoed variations of these two arguments, admittedly with more care than the commenters above.

Once you get past the emotion and hyperbole, you realize that the AMA's action, regardless of the merit of the decision, accomplished exactly what we needed.  It started a national dialog about obesity and its impact on society. Regardless of cause, the effect of obesity harms all of us in the form of a greater percentage of GDP going to treat chronic lifestyle disease. 

Slamming physicians, the pharma industry and entrepreneurs for seeking cost-effective solutions to the problem is NOT the answer.  Screaming about personal responsibility will not get us out of this mess.  We need to embrace a variety of behavioral, psychological, pharmacological and surgical interventions in combination to have an impact.  It will cost money, but the costs of intervening now are significantly lower than the costs of treating the complications of obesity tomorrow.

I could care less if you call it a disease or an addiction, but I am 100% behind the AMA's decision to do so because its an important first step in a national solution to a national problem.

For a more in depth look at both sides of this issue, Travis Saunders at Obesity Panacea has a great post and video debate

Do you agree with the AMA's decision to define obesity as a disease?