June 18, 2013. It's hard to believe that it took this long, but the American Medical Association (AMA) has finally voted to recognize obesity as a real disease. I'd like to spend a few minutes talking about why this recognition took so long and what it may mean in the years ahead for patients in the US who are obese.
Perhaps the biggest reason it's taken the AMA so long to come around on the issue of obesity is (was) the view, held by many physicians, that obesity is simply a lifestyle problem resulting from poor food choices and inactivity. This view has persisted despite truly vast amounts of medical and scientific data showing that nothing could be farther from the truth and that in fact obesity is a very complex biological illness brought-on by genetic, hormonal, neurochemical, environmental factors. It is in fact, today, in the year 2013, crystal clear that obesity is a disease and not the result of some character flaw in its suffers.
So why do many doctors still believe otherwise?
In my honest opinion, the answer is simple prejudice. Doctors are people and like all people they sometimes hold beliefs that are informed not by intellect or evidence but by emotion. Most doctors receive very little formal training in obesity and lacking a basic professional understanding of the illness they tend, like most people, to reflexively view the condition as caused by gluttony and sloth. Over the 23 years that I have practiced bariatric medicine, hardly a week passes when I don't hear yet another story from an obese patient about a doctor or other health care worker who treated them insensitively. Given how common this is, it's not surprising that it the AMA so long to come around.
Regardless of why it's taken so long, the good news is that finally the AMA has acted and from that a number of positive changes are likely to emerge. Probably the most important change will come with health insurance. The AMA's recognition of obesity as a disease is going to put political pressure on insurance companies to finally begin reimbursing doctors for obesity care. At the moment, very few insurance companies do this and most patients who seek care for their weight from doctors such as myself have to pay the full cost for their treatment out of pocket. It may take a while, but, thanks to the AMA announcement, this should start to change.
Also, the recognition as obesity as a disease is just the right thing to do. Today, sixty percent of the US population is overweight or obese and rates of type 2 diabetes are skyrocketing around the nation. We have been in the middle of a full blown obesity epidemic for more than a decade and it's well past time that this public health disaster is given the recognition that it is due. It's also time for attitudes to change. Nobody (I hope) blames a person sick with, say cancer, for being ill and nobody should ever thus blame a person sick from obesity. Obese people need compassion and help just like everyone else and, despite the delays, today's announcement by the AMA is a huge step in the right direction.
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