Obesity Is a Disease – Part 1: A Medical Roadmap to Help

[Alex Brecher 10,515]

Obesity has been officially categorized as a disease for four years now. The categorization of obesity as a disease puts more of the burden on doctors to help you lose weight, but some people are still wary of the title.

Who cares what obesity is?

You might wonder whether it matters whether obesity is a “disease” or not, especially if doctors have not managed to help you lose weight, except, possibly, your bariatric surgeon. But, the name actually does make a difference.

• It gives obesity and obesity treatment more attention.
• It can help remove the stigma surrounding obesity.
• It gives doctors a mandate to treat you.
• It could lead to increased medical insurance coverage for obesity treatment, from diet programs to bariatric surgery.

Here is why obesity is a “disease.”

Obesity meets a definition of disease comprising three criteria:

1. "an impairment of the normal functioning of some aspect of the body;" (changes in organ function, for example)
2. "characteristic signs and symptoms" (excess body weight, for example)
3. "harm or morbidity” (obesity-related complications, such as diabetes and arthritis, for example)

The American Medical Association, the American Heart Association, the American College of Cardiology, and The Obesity Society are among the respected organizations who agree that obesity is a disease.

Obesity is not only a disease but an epidemic based on the number of people it affects. It affects 35% of American adults, not including the other 30% who are overweight and at risk for obesity. Nearly one out of five children are obese.

Healthcare providers can take charge.

One point of calling obesity a disease is to allow and even require, healthcare providers to treat it. No longer should they simply tell you to lose weight, or, worse, ignore the “condition” in the first place. Instead, they should provide care for obesity, including developing treatment plans and following up with you to discuss progress.

Now there is a roadmap.

Now that obesity treatment is in the realm of medical professionals, there needs to be a standard approach to treating it. The American Heart Association, along with the American College of Cardiology and The Obesity Society, have published clear guidelines for treating obesity.

1. Identify at-risk patients and patients with obesity using BMI, and monitor them at each appointment.
2. Enroll patients with BMI of 30 or over in a medically-supervised weight loss program (note: this is not the same as your doctor telling you to eat less and lose weight on your own!)
3. Keep weight loss surgery in mind for patients with extreme obesity and an obesity-related condition).

Weight loss surgery is a recognized treatment for obesity.

The third prong of the roadmap is especially important if you are considering weight loss surgery. The recommendation to consider it when treating high-risk patients has a few effects.

• It reduces stigma, from primary care physicians and your other regular doctors, surrounding WLS.
• It increases the number of patients who may have WLS covered by insurance.
• It encourages patients and professionals alike to learn about WLS.

No longer is weight loss surgery considered to be an extreme or fringe approach. The ASMBS states that experts who agree that bariatric surgery has a role in obesity treatment also include the American Association of Clinical Endocrinologists, the American Diabetes Association, Centers for Medicare & Medicaid Services (CMS), and the National Institutes of Health (NIH).

Further progress is needed.

There is still much to be done in the medical arena. Healthcare professionals aside from bariatric specialists are often still in the dark about recognizing obesity and treating it. Worse, many still have stigma or bias against overweight patients, and still, engage in patient-blaming.

Obesity almost certainly has genetic components along with lifestyle factors. While it may be a disease, it is also a disease that you can work to treat. Now that it has officially been recognized as a disease, let us hope that patients and healthcare professionals can work hand-in-hand, each doing their part to fight obesity.