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Does Declaring Obesity a Disease Help or Hinder?

By now, you’ve probably heard that the American Medical Association (AMA) has recognized obesity as a disease. It’s an interesting development, one that has sparked a great deal of reflection and vitriol.

Those who agree with the decision argue that it will focus more attention on obesity, bring more research dollars, improve public health initiatives and help improve reimbursement for drugs and surgery.

Those who disagree say that obesity doesn’t meet the generally accepted definition of a disease, that it’s a ruse to put more money in the pockets of big pharma, that it gives overweight individuals an easy out and that, most importantly, it puts the cultural reasons for obesity on the back burner.

No question it’s a complex, nuanced issue. Made even more so by the fact that the AMA House of Delegates overrode the conclusions — that obesity not be classified as a disease  — of the expert panel that they themselves commissioned to study the problem.

Reactions to this in-house dissonance abound, and countless articles out there point to statistics, pore over numbers, cite studies, and on and on and on with regard to obesity, both supporting and attacking the decision.  Normally, I’m all for statistics, but in this case I think it’s easy to get lost in the numbers (especially the BMI measurement, which being overweight is based on and which has been shown to be seriously flawed). In this case I think language and semantics are more important, and my gut reaction to this move by the AMA is that it’s detrimental.

As a country and society, we’ve already collectively moved to a “drug-for-every-condition” solution. This change of designation, coupled with Obamacare’s requirement that most insurance plans help obese patients lose weight — including reimbursement for surgery and drugs —seem to indicate a movement away from the true causes of the issue.

As mentioned previously, this is a deeply rooted problem, and there is no question that in certain instances, drugs and procedures like bariatric surgery are necessary for the health of the individual. But for the larger population, it seems like we need to address the cultural change from which obesity stems.

Just a few generations ago, obesity was uncommon. In an article in the Huffington Post by William Anderson, MA, LMHC, he says the rate of obesity in 1960 in young and middle-aged adults was under 10 percent. For children, it was under 5 percent. Within the last 30 years, the obesity rate of adults has doubled; today 1 out of 3 adults is obese. And in the same time frame, the obesity rate in children has nearly quadrupled. We’re on pace for roughly half of adults in the U.S. to be obese, according to current definitions, by 2040.

So what’s going on? Human physiology hasn’t changed significantly in the last 50 years. What has changed though is our culture:

  • Food is generally mass-produced now by the industrial agricultural complex. It’s highly processed, it’s high calorie, has high sugar and salt content, and low nutritional value.
  • Mass farming techniques, GMOs and pesticides have pillaged the land and have unknown, adverse effects on nutrients and how food reacts in our bodies.
  • Poor areas, especially in urban areas, don’t have access to fresh, healthy and affordable food.
  • Urban planning, specifically toward car use over pedestrian or bike use, makes for non-walkable spaces that are not geared toward fitness.
  • Recess and gym classes have been stripped away in many schools due to budget cuts and the misplaced notion that mental activity is more important than physical activity.
  • With the wave of technology over the last few decades, we have become, by and large, a sedentary population that sits at computers or in front of the TV.
  • Advertising tells us there’s an easy out for everything, whether it be weight loss, back pain, headaches, you name it. It’s much easier to pop a pill than do … well, anything really.

I could go on and on, but you get the point. Like most of the really complex issues we face today, there is no magic bullet.

Perhaps the AMA’s heart was in the right place, but it remains to be seen if that heart will be lighter or heavier because of their decision.

What do you think about the AMA’s decision to classify obesity as a disease?

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