Obesity is currently one of the most serious health issues in the United States. According to the American Heart Association, in 2013, 78.4 million U.S. adults were obese, along with nearly 12.7 million U.S. children and adolescents. Those numbers are more than double what they were in the 1970s.
Obesity is also one of the top causes of preventable death and exposes people to the risk of other health issues like high blood pressure, stroke, diabetes, and heart disease.
Is obesity a disease or lifestyle issue?
While the medical community agrees that obesity is a pressing matter, there is an ongoing debate as to whether or not obesity should be classified as a disease. On one side, proponents argue that classifying obesity as a disease could cause obese people to seek more medical help, whether from a specialist or from regular check-ins with a local family doctor. Opponents say that obesity is a lifestyle issue that can be changed through healthy habits and does not require medical treatment.
This discussion intensified in June 2013 when the American Medical Association (AMA) chose to classify it as a disease. The AMA’s Council on Science and Public Health, which had conducted a yearlong study of the issue at the request of the AMA board, reached the conclusion that obesity is not a disease. The AMA elected to give obesity disease classification despite the Council’s report. The decision has been a major source of controversy, even within the AMA.
The Council’s conclusion was based primarily on the unreliability of the body mass index (BMI), which is commonly used to determine if a person is obese. The BMI’s flaw is that it fails to recognize the difference between fat and lean muscle mass, measuring only the height-to-weight ratio.
Opposition to calling obesity a disease
Opposition to the AMA’s decision comes from sources as diverse as columnists and commentators with no formal medical training who see obesity as a political issue, to well respected, credentialed medical doctors who understand the intricacies and the implications of calling obesity a disease.
Many physicians who oppose the decision point out that obesity can be prevented through a healthier diet and more exercise. One opponent of calling obesity a disease is David Katz, MD, director of the Yale Prevention Research Center. He writes: “If calling obesity a disease makes us treat the condition with more respect, and those who have it with more compassion, and if it directs more resources to the provision of skill-power to adults and kids alike, it’s all for the good. But if, as I predict, it causes us to think more about pharmacotherapy and less about opportunities to make better use of our feet and our forks, it will do net harm. If we look more to clinics and less to culture for definitive remedies, it will do net harm.”
Support of AMA decision may reduce the social stigma of obesity
Dr. Katz, along with many other respected experts, understands companies will capitalize on the AMA’s decision. This could result in new pharmaceuticals prescriptions, possibly very costly ones. While this is not harmful in and of itself, it can take the focus away from natural remedies and lifestyle changes that are necessary in reversing and preventing obesity.
In his comment, Dr. Katz also mentions some of the reasons proponents give for their support of the AMA’s decision. Obesity, they say, is more complicated than diet and exercise, and recognizing that fact might help reduce the social stigma attached to it. The likelihood of more public attention in the fight against obesity and better insurance coverage for obesity-related medical treatment are other reasons why proponents are applauding the AMA’s decision.
This debate will continue for years to come. Regardless of the consensus the medical community reaches, obesity is a health issue that should not be ignored or shunned. Lifestyle changes are often necessary along with a commitment to healthier habits.
Obesity can run in families, making a family medicine provider an important guide and health resource. You and your family deserve the highest quality, personalized care available. Request an appointment with a WWMG family medicine provider today.