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If You're Fat, Does It Mean You're Ill? (Yes, Says AMA)

Is being overweight a disease?

One in three American adults is obese, and the American Medical Association (AMA) believes the medical community needs to do more to help fight this problem.

Th AMA's solution is to declare obesity a disease.

The nation's largest physician organization said this week that "recognizing obesity as a disease will help change the way the medical community tackles this complex issue." It could have a greater impact on how insurance companies deal with the problem and what additional treatments they decide to cover.

The obesity epidemic costs the country about  $150 billion a year on treatment for obesity-related conditions like heart disease and type 2 diabetes, according to the Centers for Disease Control and Prevention (CDC). Obesity is generally defined as being 35 pounds or more overweight; the most likely adults to be obese are those over 60, the latest CDC figures show.

Douglas Martin, M.D., chairman of the AMA public health committee, told MedPage Today the group wanted "to send a message," even though members debated whether it would really help patients get more treatment or simply stigmatize them further.

The AMA's own Council on Science and Public Health had recommended against the decision, saying obesity can't be defined as a disease because the only way to measure obesity - calculating body mass i ndex, a ratio of weight to height - is overly simplistic and flawed.

Many AMA members, however, felt differently. Virginia Hall, M.D., an obstetrician from Hershey, Pa., said obesity should be defined as a disease so "insurers can stop ducking their responsibility" in paying for obesity treatments, as  Forbes reported.

Coverage for obesity treatment varies among private insurers, although Medicare covers things like behavioral therapy or bariatric surgery for obese patients if it's part of treatment for a related dangerous health condition - such as obesity that's aggravating diabetes, a Medicare spokesman told CNN.

What the AMA decision essentially does is give doctors a greater obligation to discuss with patients their weight problem and how it's affecting their health - and maybe get reimbursed by the insurance company to do so.

As the Los Angeles Times pointed out, "Studies have found that more than half of obese patients have never been told by a medical professional they need to lose weight - a result not only of some doctors' reluctance to offend but of their unwillingness to open a lengthy consultation for which they might not be reimbursed."

But whether labeling obesity a disease will lead to any substantive changes is unclear. After all, we live in a culture that often seems oblivious to health concerns. How else to explain this bacon-cheddar-fried egg burger between two glazed donuts?

Photo: Ocean/Corbis


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