CommonHealth

(Photo: Yale Rudd Center for Food Policy and Obesity)

By Melinda J. Watman
Guest contributor

When the American Medical Association declared obesity a disease last year, most of us — advocates who work to help those with obesity — were thrilled.

We saw the new definition’s potential to change how medical professionals regard people with obesity, increase society’s focus on obesity, push insurance companies to cover obesity treatments, reduce social stigma and moderate the anxiety and depression often afflicting those with obesity.

Already, we see some of those hopes being realized. Just last week, the federal government’s Office of Personnel Management issued a ruling that health insurers who cover federal employees may no longer exclude coverage of weight loss drugs on the basis that obesity is a “lifestyle” condition or that obesity treatment is “cosmetic.” This is one more significant step in the recognition and treatment of obesity as a disease.

But nothing is that simple or easy.

The high-fiving was barely over when the first study came out saying “not so fast.” It would seem, according to an article published in the New York Times, no good deed goes unpunished. The article presented a summary of a research paper titled “‘Obesity Is a Disease’: Examining the Self-Regulatory Impact of this Public-Health Message.”

Melinda Joy Watman (Courtesy)

The three authors concluded that labeling obesity a disease led their subjects to want to eat more, eat worse and care less about their weight. They suggested that labeling obesity a disease leads to the belief that it is futile to try to manage one’s weight.

Whether one agrees with the study’s findings and conclusions or not, the underlying question of whether obesity should be accepted as a disease is the critical point. The authors certainly question its validity based on the findings that their subjects suffered an “undermining of beneficial self-regulatory processes.”

What is interesting is that if it were any other chronic illness with comparable results, we would not be questioning whether the illness should be classified as a disease. Rather, we would be trying to find better ways to engage, educate, support and treat those patients as we continued to work on new therapeutics to manage the disease.

As is often the case with obesity, it would appear this line of thinking and research has the potential to further marginalize the problem and those affected by it. This is completely counter to what the AMA policy strives for – the same medically accepted framework to diagnose, treat and support patients as exists with any other chronic illness. Continue reading →

Disease. That word carries so much weight, and as of this week, it also concerns weight: The American Medical Association decided to officially define obesity, a condition that affects over one third of American adults, as a disease.

The decision went against the recommendations of the AMA’s own Public Health Committee to do the opposite, and it means that obesity will now be joining alcoholism and drug addiction as a “condition” whose elevation to “disease” sparks controversy.

So will calling fat people diseased pave the way to a healthier society?  Members of the fat acceptance community — advocates for reducing the stigma of obesity– say that all depends on what you consider “health” to be in the first place.

“The AMA’s decision makes a body size into a health diagnosis,” says writer and fat-acceptance activist Ragen Chastain.  She is upset by the AMA’s decision and thinks that it is an affront to her movement’s mission.

“The goal is to create a world where fat people are treated with respect, free from bullying, oppression and stigma,” she says. “I think this will absolutely lead to greater stigma.”

The AMA argues the opposite: It cites the reduction of stigma as part of its reasoning for labeling obesity as a disease.

Some advocates of the AMA’s decision say that labeling obesity as a disease is the wake-up call that doctors need to start treating their fat patients using more serious weight-loss strategies, such as bariatric surgeries.

Some also speculate that obesity’s new, serious status will put pressure on insurance companies to start covering fat-fighting procedures and treatment as they would, say, smoking cessation.

Lesley Kinzel, a senior editor of Xo Jane and a longtime Boston-based fat-acceptance ativist, says she recognizes that, from a medical standpoint, it is good to address stigma attached to fat patients. Continue reading →