AMA Calls Obesity a ‘Disease’, What Do You Think?

Complications from Childhood Obesity

Complications from Childhood Obesity

Last week there was a big stir as the American Medical Association (AMA) made a change in their definition of obesity. While obesity was previously defined as a “major public health problem,” it is now recognized as a disease. The AMA is the largest group of physicians in the U.S. and, while their vote isn’t legally binding, they are a highly influential body that can influence medical standards and insurance policy. In other words, what they have to say matters.

But for most of us, the decision of a group of doctors to reclassify something as a disease doesn’t change whether or not illness/issue/disease impacts us and, if so, how it impacts us. What I find staggering is the insensitivity and hostility displayed in reactions to the announcement … but then again there are many who still don’t believe that alcoholism is a disease despite the AMA declaration more than 55 years ago!

In order for the AMA to make this declaration, they had to determine that obesity met the three standard criteria for being declared a disease. First, it had an identifiable set of symptoms. Second, it followed a predictable and malignant progression if not treated, and third, it did respond to treatment.

I noted this to a smaller extent in my recent Monday Mile regarding weight loss, but even though many debate the specific metrics used, there are some clear signs that we should be concerned:
– More than one-third of adults are classified as ‘obese’, and nearly two-thirds are overweight
– Obesity-related conditions such as heart disease, stroke, and type 2 diabetes are some of the most prevalent causes of preventable death – and have seen tremendous increases in incidences in recent years.
– Childhood obesity is increasing faster than in the adult population.

We have discussed whether the exact numbers and break-points are appropriate, but that misses the point: all of these things have been trending upward at a alarming rate, and we have many correlated trends in nutrition and lifestyle changes to go along with them.

The reason I think this is worth discussing is because we have focused more coverage on health and fitness over the last year, and have looked at eating, food and other nutritional issues as well as exercise and gear (of course). Obesity is a complex issue – we have had great debates in the comments, and Time takes a look at it in a recent article asking why so many ‘obese’ people are healthy.

So what do you think? Is the ‘disease’ designation correct? If so, what should happen now? Let’s get a discussion started in the comments!

Categories: Health and Fitness


6 replies

  1. There’s an interesting study that was published yesterday in the The American Journal of Clinical Nutrition that discussed a study done by Dr. David Ludwig, director, and his team at New Balance Foundation Obesity Prevention Center suggesting that high-glycemic index foods can trigger reward centers in the brain in certain people in much the same way that an addict’s brain gets stimulated, and also stimulate hunger at the same time, thus causing a vicious cycle. IIRC the study found that most obese patients who participated in the study displayed this behavior.

    • Exactly – there is a massive body of work that points back to the HFCS and corn dumping policies out of Nixon as the foundation of so many of our obesity issues. Oh, and food groups basically joining together to blame ‘fat’ for people becoming fat and starting the ‘low fat’ revolution … which means foods full of corn-based fillers that all mess with our reward and fullness centers.

      Which means that by piling on these chem-lab foods to our kids, especially ones labeled ‘low fat’, we are actually poisoning their systems from an early age. Some have said that a diet full of fast processed foods is tantamount to ‘child abuse’.

      • Yes, you are correct about the fat demonization an the early 70s timeline. My wife was reading an interesting book about dietary changes over the last 40 years and how government and industry responded, and a very surprising look at how current research may turn some of our dietary habits on its ear. With regard to HFCS, there is a growing body of research that seems to indicate that the problem with fructose in excess is fructose’s role in inflammatory response, particularly in the circulatory system (e.g., http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518440/).
        See, this is what nerdy (former) lab-coat types like me do for occasional intellectual recreation. 😀

        • Yeah it appears that eating Fat specifically won’t make you fat unless you eat a lot of it.

          The documentary Fathead is very good and points this out. When you eat Fat, you feel fuller.

          It’s because of the transfats and other things we replaced the fat with that we’re getting fat and having higher incidence of increased cholesterol and more.

          So a while back my family switched to real butter and at least 1 percent milk. I don’t like the taste of full fat milk as I drank skim for a long time.

  2. I’m obese according to the metrics that are used to measure this. I paid no attention to my weight until about 12 months ago. I did nothing about it until about 4 months ago. I would not have said that I have a disease but when you explain the condition in term of symptoms, outcome, and effect of treatment I would have to agree it is a disease. I suspect I have a mild version of it, but I also came to the conclusion that is I did not address the issue of my increasing weight I would shorten my life. Like alcoholics I think I will have to see myself as a recovering obese person for the rest of my life and continue to mindful of what I eat. I am not looking for sympathy but I think we need more honesty from the “food industry”, we need more education about the effect of food, and we need way more research in to effective treatment for those of us who don’t want to be obese anymore. And I don’t mean medical intervention in the form of a pill or gastric band surgery, although in some cases that is the solution, I mean support structures that help people cope when they do deicide to change their way of life. I don’t need a doctor to tell me I’m overweight, eat less and do more exercise because when I was exercising regularly I was will in the overweight/ obese side of the charts. I need doctors that will tell me how I can help myself, where I can get support from like minded people, not a commercial organisation selling eating plans and charging me money to weigh me every week, but supporting me through the is process and encouraging me.
    Sorry for the rant. I spent too much of my life not paying attention to this stuff but I have been luckier health wise then most. I believe there is not enough good information being transmitted in an engaging and helpful way because if there was may be I would not be where I am today.

    • Good on you, Philip! There are a lot of issues, both social, dietary, medical and food tech that are at play here. Most tend to overlook the fact that different people respond differently to food types. Before I was married, my BMI was about 17. More than a decade later, my BMI is 22. What’s interesting is my weight barely fluctuates by more than a pound or two, regardless of what I eat whereas my wife’s may fluctuate more (btw, she’s a food scientist that deals with immune products)—even though we tend to eat essentially the same things, though in all honesty I have more fat in mine than she does (she doesn’t like sauces, cheese, cream, salad dressings, and so forth). Clearly there is more at play here than mere diet alone, as our cholesterol levels are quite different as well. I guess what I’m trying to say here is that being thinner ought not to be automatically considered an achieved virtue. There are just too many genetic factors at play here. If we as a society would spend more time paying attention to the content of others’ character and less on frivolous appearances, oh how much better our civilization would be.

      As an aside, I do think one thing that has helped us is that I like to cook from scratch when I can, thus I can choose what sources to begin with. It requires a bit more planning up front, but you’d be surprised what you can come up with in 30 minutes or so. Plus I have found women react very favorably to a man who likes to cook, and I don’t just mean doing bbq on the grill. I’m NOT kidding!