Every time a political problem gains national attention certain segments of the public cry out for politicians to “do something” — even if the prudent thing to do is to sit back and break the problem down into manageable pieces. Today, the AMA decided to use the “do something” approach to obesity, defining it as a “disease” — even though that isn’t true.
The American Medical Assn. voted Tuesday to declare obesity a disease, a move that effectively defines 78 million American adults and 12 million children as having a medical condition requiring treatment.
The nation’s leading physicians organization took the vote after debating whether the action would do more to help affected patients get useful treatment or would further stigmatize a condition with many causes and few easy fixes. …
Got that? Many causes. It could be that person x has a thyroid condition, or it could be that person x sits on the couch all day playing video games while eating potato chips and drinking cans of soda. It could be that person y has natural joint pain that prevents them from exercising, or it could be that person y has joint pain because they were lazy for decades and the excess weight is straining their knees.
I was once getting examined by a military doctor for what ended up being a slightly fractured collar bone and the guy next to me said, “I have knee problems.” The doctor’s response: “You don’t have knee problems — you have a fat problem. Lose some f***king weight and your knees will feel better.” That’s the kind of honesty that the AMA fears.
“As things stand now, primary care physicians tend to look at obesity as a behavior problem,” said Dr. Rexford Ahima of University of Pennsylvania’s Institute for Diabetes, Obesity and Metabolism. “This will force primary care physicians to address it, even if we don’t have a cure for it.” …
Perhaps doctors look at obesity as a “behavioral problem” because in the vast majority of cases it is. It’s called “not paying attention to the things you shove down your throat and not exercising regularly.”
In laying out the case for and against the redefinition of obesity, the AMA’s Council on Science and Public Health argued that more widespread recognition of obesity as a disease “could result in greater investments by government and the private sector to develop and reimburse obesity treatments.”
The Food and Drug Administration, which has approved just two new prescription weight-loss medications since 1999, would probably face increased pressure to approve new obesity drugs, spurring new drug development and more widespread prescribing by physicians, the council noted. …
[The Council also warned that its decision could] shift the nation’s focus too much toward expensive drug and surgical treatments and away from measures to encourage healthy diets and regular exercise, the council wrote in a background memo for AMA members.
Are you ready for more Drugs! Drugs! Drugs!? That’s exactly what’s going to happen because we live in a society that looks for any opportunity to cut corners. It wants to have its cake and eat it, too. And the sad thing is, the AMA knows exactly what’s going to happen.
I talked to a good friend of mine in the medical field today about this issue and feel as though I should share her response:
It’s a complicated issue. I’m pissed that people who are obese now get to eat up another chunk of my monthly insurance premiums, but I am also happy that doctors will have incentive to counsel patients on the very same issue.
Here’s where I’m torn: People in the U.S. are fat. Despite what science has been warning them of for years and years, they keep putting fat in their mouths and keep putting a burden on medical costs.
Heart disease has become a major killer and the number of diabetics is increasing exponentially. Also, each person who has a metabolic disease won’t have just one issue. They have hypertension, coronary artery disease, foot ulcers, breathing problems — you name it. The lifestyle that brought on diabetes and obesity probably involved drinking (liver disease) and smoking (COPD, lung cancer) and generally living it up. The fat lazy patients who live their entire lives doing what they want to then use the lion’s share of healthcare premium costs. It’s ludicrous.
The other half of me, the doctor half, is relieved. It’s about time that primary care doctors got paid for counseling weight loss. Or for those who don’t currently do it because it doesn’t pay, maybe this will be more incentive to start. I know some doctors don’t even touch on the subject with their patients and it’s not necessarily because they don’t want to call them fat. It’s because they don’t want to spend precious time out of the 15 min they have with the patient when the guy has a list of medical problems a mile long and the doctors don’t even get paid to counsel on obesity.
I envision visits purely dedicated to a “weight loss” talk where the physician goes through diet, exercise, and physiologic impact with the patient — one-on-one. Granted, it won’t be a magic pill but it’s bound to help some people and as a first step, it’s not too shabby.
Anyway sorry for the long rant. The AMA and insurance companies each have their own agenda too and that’s a whole other conversation.
Between the AMA deciding that obesity is a disease and the American Psychiatric Association’s new DSM-V essentially seeing to it that we’re all classified as having some sort of mental disorder, is it any wonder that no one takes responsibility for their actions? “Fat? Pssst! I have a disease. It’s not my fault. And my psychiatrist says I eat because I suffer from a new version of PTSD caused by elementary school bullying. Stop giving me a hard time and pass the Cheetos.”
At what point in time will J Crew start selling designer muumuus? I’ll have my Extra Small in lightweight chambray sunset check, please.