Obesity, a Fledgling Disease, Needs Physician Support

Joe Cantlupe, for HealthLeaders Media , August 1, 2013

If physicians don't start having serious dialogues with their overweight patients, the American Medical Association's recent classification of obesity as a disease won't mean much at all.

So, America is heavyset. It's husky, unslender, and thin-challenged.

What's in a name? As more Americans are tipping the scales toward obesity, the American Medical Association says that another name is linked to obesity and that name is: disease.

Delegates at the AMA's annual meeting last month voted to recognize obesity as a disease, elevating it from its previous status as just another health concern. Proponents hope the move will prompt reimbursement changes that may allow physicians to take more time to discuss obesity with patients and advise them to change their diets.

But not everyone agrees with the shift, and some are wondering whether the AMA is missing the point because of the complexities of obesity. Critics also note that one of the AMA's key committees even recommended against declaring obesity a disease because of different definitions being used for body mass.

Michael Nusbaum, MD, medical director of the Obesity Treatment Centers of New Jersey, doesn't think so. How ironic, he says, that the Patient Protection and Affordable Care Act doesn't treat obesity as a disease. By omitting it from essential benefits, tens of millions of Americans "are disenfranchised from the healthcare system," he told me.

He says the Centers for Medicare & Medicaid Services and insurance plans should "wake up and admit it's a disease; it needs to be treated like a disease and covered like a disease."

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4 comments on "Obesity, a Fledgling Disease, Needs Physician Support"

Ben D (8/2/2013 at 12:11 PM)
Doctors, please refer your patients to Overeaters Anonymous. It is a disease which has emotional, mental, and physical consequences. You can't eat yourself happy. To find meetings, search for your state and Overeaters Anonymous. They have the support and training needed to sustain weight loss.

ljh (8/2/2013 at 10:40 AM)
You say "discussions between physician and patient may be the most helpful tool in treating obesity", but I respectfully disagree. If it were that easy, if speaking to your physician about the quantity of adipose tissue in your body actually helped, we wouldn't have the obesity epidemic we do. Even daily discussions with a physician will not prevent the purchase of a chocolate candy bar or an order of fried potatoes, or choosing the parking place closest to the mall doors. The recidivism rate of obesity is mind-boggling -less than 10% manage to keep 5% (!) of their body weight off 5 years after a weight loss program. Obesity is a reflection of evolutionary drive to consume calorie dense foods when available, coupled with the explosion of technology which gave us those foods in a palatable form with an absolute minimum of effort. While I enjoy chatting with my physician, I doubt he has the ability to thwart a million years of mammalian evolution, even if he's compensated by the Feds. As far as I know, bariatric surgery is the only treatment for obesity that has a success rate over single digits 10 years out, correct?

Christie Osuagwu, MPA, MSN, FNP, PhD (8/1/2013 at 11:20 PM)
I applaud the AMA for making this declaration that is long overdue. Physicians and providers at every level should not hesitate to tell any patient that they are obese. Patients should understand what that means for their health, quality of life and eventually their lifespan. Obesity is a disease with too many unfriendly friends, as it predisposes individuals to major preventable health issues including cardiovascular disease, diabetes,and hypertension,just to name a few. Obesity is a plague and must be recognized and treated as such. We need to stop sugar coating it; we need to educate our patients properly, we need to call obesity its name and not be 'nice' to patients by avoiding the truth of their obese status. We are actually cheating them if we don't. Our nation is drowning in fat and it is preventable!!!!




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