A plus or minus for the plus-sized?


The American Medical Association (AMA) today endorsed recognizing obesity as a disease, rather than a mere condition. The hope is that such a designation would maybe lead to better health insurance covereage, which in theory leads to better care, which is of course a good idea in theory.

There is also plenty of opposition. Critics say BMI isn't one size fits all and not everybody with certain BMI measurements needs aggressive treatment. This also makes sense.

There is also concern that this will lead to increased health costs, which is also true when reimbursement becomes available for treating disease or establishing a disability (have you read the latest on CPAP and the VA?). On the flip side, if treating obesity is successful it reduces costs, both to the healthcare system and the workforce, because let's face it, the obese population is a population that is faced with lots of chronic comorbidities. I write enough about them for HME News.

My first thought when I read the announcement was a bit pessimistic. Will the very people this is aimed at helping really get help, or will they just throw up their hands and say, I can't help it, I have a disease? and then reach for the doughnuts? Also, as some naysayers have said, and I kind of agree but try to be sympathetic, it's the result of lifestyle choices. Let me say here, that some people gain or lose weight far easier than others, I get that. Life is unfair. Having Type 1 diabetes is unfair, but I roll with it. I have no choice (see: disease).

And there are other sticking points: This blog I wrote last year focuses on a study about docs not discussing obesity with their obese patients. Will classifying obesity as a disease open up dialogue? Maybe. And what about this recent article on a study which found that overweight (23%) and obese (52%) doctor shop? The study couldn't however, determine why this was so.

At the end of the day, the only way to lose weight is to take in fewer calories than you put out, however you choose to do that. Period. Does that require education and willpower? Absolutely. One of the diabetes slogans that has been one of my mantras, and I have mentioned it here before, is nothing tastes as good as being healthy feels.

But Americans of all sizes like the easy way out, often in the form of an elusive magic pill. I have also been reading a lot of weight loss surgery horror stories lately and I am concerned this trend will grow.

Magic pills are a major reason why our healthcare costs are soaring.

 Maybe the place to start is in childhood.

Theresa Flaherty