Is Obesity is a Disease? AMA Says Yes… and So Does AHA

On Tuesday, June 18, 2013, the American Medical Association officially recognized obesity as a disease. 

It was an action that asked doctors and insurance companies to put more emphasis on the health condition in order to minimize its effects. 

Am I just fat or fat and sick?

Am I just fat or fat and sick?

 

The AMA made the decision that obesity is a disease at their annual meeting in Chicago on June 18, 2013. The decision went against a recommendation by a committee that studied the subject.

The council stated, “Obesity should not be classified as a disease because the measure that is used to categorize obesity (body mass index, BMI) is flawed.”

Your BMI is a number based on a calculation of metric height and metric weight. The problem with using BMI to determine an individual’s risk of weight-related conditions is BMI doesn’t measure for overall fat or lean tissue (muscle) content. 

Many men and some women whose BMI is higher than the index marker that is considered obese are healthy. Some people are below it but can have metabolic issues and dangerous body fat levels.

The AMA decided to vote against the council for two reasons:

1) To decrease the stigma of obesity that comes from the widespread thought that it is just the outcome of excessive eating and not enough exercise. Doctors say some people do not have complete control of their weight.

2) The change could improve funding for obesity drugs, surgery, and counseling as well as aid in the fight against diseases such as heart disease and type 2 diabetes.

As expected, the vote and subsequent announcement was met with mixed reviews.

Physicians reacted to the news positively though they disagree whether the new ruling will have much affect on their everyday practices. They also question whether obesity fits the typical disease parameters.

All seem to agree the decision brings the need for resources for a public health disaster that affects one third of Americans to the forefront.

Most also are hopeful that the stigma associated with obesity will be reduced or eliminated by recognizing that obesity isn’t a condition one does to himself, but rather a disease much in the way alcoholism has garnered empathy and understanding for people who physically are unable to “drink responsibly.”

Will Obesity the Disease end the stigma of being fat and reduce or eliminate fat-shaming?

It hasn’t done much to end it so far. From my perspective it might have made it worse. Now that obesity is a disease, people who are visibly obese are criticized and shamed for not addressing and “curing” the disease by losing weight.

As a society we don’t have much compassion for obviously sick people who do not take active measures to get their disease treated and cured. Maybe the increased attention created by the AMA decision spawns first an intensified reaction to people with obesity and then through more education and understanding it slowly becomes empathy. We will have to wait to see on that.

In the meantime, some obese patients claim to be not sick at all, but rather “fat, fit and healthy.” This begs the question, “Can one be fat and fit?”

Huffpost Healthy Living reported June 26, 2014:

When it comes to health reporting about fat people, don’t swallow everything you see.

Major news outlets on TV, radio and online lit up Monday with news about a study claiming there was no such thing as “healthy obesity,” which is the notion that a person can be obese according to the body mass index chart, while at the same time be spared adverse health effects like high blood pressure, insulin resistance and high cholesterol levels.

For example, NBC News’ headline said the study “Disputes Fat But Fit Claim,” while NPR went with the headline “Overweight And Healthy: A Combo That Looks Too Good To Be True.”

The article concludes with this important message:

The takeaway for fat people? Keep on trucking when it comes to increasing your physical activity, and don’t get discouraged by headlines that seem to make weight the single determining factor in living a long, healthy life.

“It’s much easier to get a fat person fit than it is to get a fat person thin,” concluded Gaesser. And that’s a good thing, because fitness may be much more rewarding than thinness alone.

Geoffrey Kabat is an epidemiologist at the Albert Einstein College of Medicine who has studied a wide range of lifestyle and environmental exposures in relation to cancer and other chronic diseases.

He says, “obesity is not a disease,” and makes strong arguments to support his position.

As the general manager of a franchise of what many consider the most respected and effective commercial weight loss program, I embraced my company’s position that even a modest weight loss of 5-10% of starting body weight can bring significant health improvement to the obese patient.

We see the proof almost daily in Weight Watchers meetings during which a member celebrates with the group that losing 10% of starting body weight (that could be 30 pounds for somebody who joined at 300 pounds) has already showed a marked improvement in blood sugar levels, blood cholesterol levels, and blood pressure levels at a recent physical exam.

My personal opinion about obesity being a disease has yet to be solidified with either a “yes” or a “no” because the diagnosis affects people so differently. Some feel relieved and motivated to “work to cure their disease” while others are defeated by the diagnosis.

If I were put on the spot – yes or no – the best I answer I could give is, “yes and no, each case needs to be decided individually.”

Maybe in the meantime we should all do our best to do the things we know are good for our minds, bodies and souls. We should eat good food and stay in motion, doing the work and play we enjoy.

If our weight gets in the way of living our life the way we want to, then maybe then it’s time to reach out for a reliable way to get help.

Jackie Conn

About Jackie Conn

Jackie Conn is the general manager of Weight Watchers of Maine. She is married and has four grown daughters and four grandchildren. Her experience with her own weight management journey and raising girls has given her insight into the struggles families face with weight, healthy body image, food and physical activity. She has been a regular guest on Channel 5 WABI news for more than ten years and appears monthly as a guest on FOX network morning program Good Day Maine.