The American Medical Association has declared that it will treat obesity as a disease, rather than as just a condition. The decision was applaused by the American Society of Bariatric Physicians and the American Association of Clinical Endocrinologists.
According to the AACE, being overweight or obese increases the risk of health conditions and diseases including breast cancer, coronary heart disease, type 2 diabetes, gallbladder disease, osteoarthritis, colon cancer, hypertension and stroke. The medical cost of adult obesity in the United States is estimated to range between US$147 billion to nearly $210 billion per year. Obesity is estimated to cause 111,909 to 365,000 deaths each year. On average, it reduces life expectancy by six to seven years, while severe obesity, characterized as a BMI greater than 40, reduces life expectancy by 10 years.
Past efforts to contain obesity as a social and lifestyle phenomenon have failed. Instead, the US has an epidemic on its hands. Based on accumulating scientific evidence, the AACE concludes that the disease of obesity must be addressed using a robust medical model for treatment and prevention that includes lifestyle modifications, medications, and surgery together with interventions targeted to public education, behavioral change, and the built environment.
The decision is a controversial one. Some critics grumble about the nanny state. “The AMA decision shifts responsibility for weight loss from the individual to society at large, while expanded Medicare and insurance coverage socialize the cost of treating obesity, thereby inviting all manner of government mischief,” says Michael Tanner, of the libertarian Cato Institute.
But even some medical associations were critical. It would medicalise a condition which affects one-third of all Americans. Beside, not all overweight patients are in bad health. Many doctors feel that obesity is a lifestyle choice, not an illness. This attitude is “fervently” opposed by the AACE. “Obesity has the characteristic signs, symptoms and morbidities that qualify it as a disease,” Jeffrey Mechanick, AACE President.