The Merriam-Webster Dictionary defines the word disease as "a condition of the living animal or plant body or of one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms."
According to the American Medical Association (AMA), obesity is considered a disease. In this case, obesity also needs distinguishing. The term overweight means too much body weight from muscles, bone, fat or water, while obesity is simply defined as excess body fat.
By now you've probably heard the statistics that 78.4 million Americans over the age of 20 are obese. And 12.7 million of children ages 2 to 19 are obese. You've also likely heard that obesity is linked to a wide range of health problems including, but not limited to, heart disease, type 2 diabetes, high blood pressure, stroke, some cancers, and sleeping and breathing problems. Furthermore, you may also know that obesity, and all of its issues that accompany it, makes up a large chunk of our nation's medical costs.
Because obesity has become such a public health problem, the AMA is hoping that by declaring it a disease, obesity will be handled differently by the medical community, possibly leading to reimbursement for treatments and policy change. However, questions surround this controversial decision regarding exactly how diagnosis, treatment, and prevention will be handled.
Currently, the diagnosis for obesity is based off of the Body Mass Index (BMI) tool. The BMI is calculated based on an individual's height and weight. A BMI at or above 30 indicates obesity.
The BMI is easy to determine, inexpensive, and noninvasive. Studies have shown that BMI levels relate to body fat and future health risks. However, the BMI does not directly measure body fat and does not account for excess muscle or bone. For children and adolescents, other factors such as height and sexual maturation can affect the accuracy of BMI.
Other methods, such as skinfold thickness, bioelectrical impedance, underwater weighing, and dual energy x-ray absorption may be more accurate in measuring body fat, but these can be more expensive, intrusive, and more difficult to standardize. Moreover, few reference standards exist for obesity based on these techniques.
The Centers for Disease Control and Prevention state that BMI may be helpful as an initial screening tool, but health care providers should also take other things into consideration such as genetics, fitness level, and fat distribution.
The responsibility of treating obese individuals may lie solely on the shoulders of doctors since they could be the only health professionals to receive reimbursement. Many doctors have stated that they are not equipped with the time or training to provide this type of counseling.
Additionally, some people may feel that a quick trip to see their doctor for a pill or a surgery appointment will cure their obesity. However, few weight loss pills are approved and available for prescription and do not typically provide significant results or long-term lifestyle changes. Weight loss surgery, while useful for some, is not appropriate for everyone.
Many hospitals find significant outcomes using what is known as an interdisciplinary teams to treat certain diseases. This team usually consists of several health care providers who can assist a patient with specific services or information. For obesity, a team might consist of a doctor, nurse, registered dietitian, exercise physiologist, and psychologist. With this combination, treatment is likely to be more individualized and successful. However, reimbursement will determine if these teams may or may not be used for treatment.
In addition to diagnosis and treatment, prevention must also be part of the obesity solution. Tackling the various factors related to obesity may prove the most challenging; sedentary behavior, unsafe or un-walkable communities, low socio-economic status, genetics, pregnancy, stress, media and advertising, smoking, lifestyle, and medications are just a few.
Regardless of the AMA's decision, obesity is an epidemic of great proportions that requires immediate attention. If trends continue, an estimated 42 percent of Americans will be obese by 2030. The solution for this multifactorial problem needs to be carefully analyzed and implemented in order to make efforts successful for patients and health care providers alike.
BEING OVERWEIGHT MAY COST YOU UP TO $4,800 PER YEAR!
Mandy Seay is a bilingual registered and licensed dietitian who holds both a bachelor's degree in nutrition and in journalism. After gaining 30 pounds while living abroad, Mandy worked to lose the weight and regain her health. It was here that she discovered her passion for nutrition and went on to pursue a career as a dietitian. Mandy currently works as a nutrition consultant and freelance writer in Austin, Texas, where she specializes in diabetes, weight management and general and preventive nutrition. She recently published her first book, Your Best Health, a personalized program to losing weight and gaining a healthy lifestyle. Please visit Mandy's website at Nutritionistics.com.