AMA Says Obesity Is a Disease

This article published with permission from The Burrill Report.

Members of the American Medical Association voted to recognize obesity as a disease, a decision that carries no legal authority, but could have implications for the way insurance companies, employers, policymakers and others address a growing health care issue.

The vote by delegates of the nation’s largest physicians group during its annual meeting in Chicago was one of several on issues that ranged from establishing a policy statement on genetic discrimination to the sale of energy drinks to kids. The declaration on obesity was surprising because it came in the face of a recommendation from an AMA committee that argued the organization should not treat it as such.

“Recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately one in three Americans,” says AMA board member Patrice Harris. “The AMA is committed to improving health outcomes and is working to reduce

the incidence of cardiovascular disease and type 2 diabetes, which are often linked to obesity.”

Some 20 previous policies have called obesity a “complex disorder,” “urgent chronic condition,” “epidemic,” “major health concern” and “major public health problem.” The group has also previously urged coding and payment mechanisms for evaluation and management of obesity,

but has stopped short of declaring it a disease until now.

A report from the AMA’s Council on Science and Public Health recommended against calling obesity a disease. The committee wrote:

“Without a single, clear, authoritative, and widely-accepted definition of disease, it is difficult to determine conclusively whether or not obesity is a medical disease state. Similarly, a sensitive and clinically practical diagnostic indicator of obesity remains elusive. Obesity, measured by BMI, is clearly associated with a number of adverse health outcomes, with greater consistency across populations at the highest BMI levels.

“However, given the existing limitations of BMI to diagnose obesity in clinical practice, it is unclear that recognizing obesity as a disease, as opposed to a ‘condition’ or ‘disorder,’ will result in improved health outcomes.”

Arguments against labeling obesity a disease include beliefs that obesity results from personal choices to overeat or live a sedentary lifestyle. Other arguments have suggested that the “medicalization” of obesity is intended to drive financial gains by certain providers and other interests.

But those in favor of the resolution argued that obesity has the earmarks of a disease with genetic and environmental causes and recognizing it as such would help improve attitudes and financial support for research, prevention, and treatment.

“The suggestion that obesity is not a disease but rather a consequence of a chosen lifestyle exemplified by overeating and/or inactivity is equivalent to suggesting that lung cancer is not a disease because it was brought about by individual choice to smoke cigarettes,” the resolution said.

Other resolutions passed by the AMA at its annual convention supported legislation that would provide robust and comprehensive protections against genetic discrimination and misuse of genetic information beyond existing law; encouragement for companies, laboratories,

researchers, and providers to publicly share data on genetic variants and the clinical significance of those variants through a system that assures patient and provider privacy; and support for a ban of the marketing of high stimulant/caffeine drinks to adolescents under the age of 18.

The delegates voted to oppose the U.S. Food and Drug Administration’s current lifetime ban on

blood donations for gay men. They also voted to call attention to new research and guidelines

that support immediate antiviral treatment for those at risk for HIV infection.

And, the AMA adopted a policy recognizing the potential risks of prolonged sitting and encouraged employers, employees, and others to make available alternatives to sitting, such as standing work stations and isometric balls.

“Prolonged sitting, particularly in work settings, can cause health problems and encouraging workplaces to offer employees alternatives to sitting all day will help to create a healthier workforce,” says Harris.

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