In the News: Obesity Isn’t Just a Problem, It’s Now a Disease

By: Andr??a Stanford

The American Medical Association (AMA), the nation’s longstanding medical society that has the ability to influence public health decisions, officially recognized obesity as a disease. In a vote during the AMA’s annual meeting in Chicago last week, members designated obesity as a disease that deserves medical prevention and treatment. While this decision does not have legal standing, it does elevate obesity to the level of other chronic illnesses, such as diabetes, cancer and heart disease.
We sat down with Esa Davis, M.D., M.P.H., assistant professor and obesity researcher at the University of Pittsburgh School of Medicine, and primary care physician at UPMC Montefiore, to learn more about what this decision means for obesity-related patient care.  
Q: As a primary care physician, what was your reaction to the AMA’s announcement?
A: This is a step in the right direction. One-third of the U.S. population is obese, and obesity contributes to more preventable deaths than smoking. This decision can potentially lead to a definitive pathway for more programs, research, prevention and treatment options for obese patients.
For physicians, we now have a meaningful way to address this issue. Our patients are often unable to access weight-loss treatments because health insurance does not cover patient referrals to dietitians and other weight management resources unless a chronic illness diagnosis is present. The hope is that now more patients will be able to receive these treatment options in both medical and community settings.
Q: Will health costs rise as a result of this decision?
A: That’s a great question. Regardless of the AMA’s decision, health costs attributed to obesity are already on the rise. Obesity is one of the major risk factors for developing diabetes, cardiovascular disease, hypertension and cancer. As a result, many individuals are at risk of developing kidney failure, receiving heart transplants, taking medications to moderate blood pressure and having limb amputations – the direct outcomes of this disease. Ultimately, it isn’t a matter of the increase in cost; it becomes more of a decision on the timing. Will society want to pay upfront for prevention programs to confront obesity, or will the costs be absorbed in the result of not curbing this disease sooner?
Q: In addition to health care professionals, are there other groups and/or organizations that share the responsibility in confronting obesity?
A: Absolutely. Although it is critical for individuals to take responsibility for their health outcomes, there are several stakeholders that influence the trend of this epidemic on the United States population. For example, the food industry should be held accountable for the availability of healthy food options. Additionally, companies need to be explicit in their product packaging, and should remove misleading advertisements and labels that falsify the nutritional value of consumer products.
Community planning also plays a direct role in shaping the health patterns of inhabitants. Bike lanes and walkable neighborhoods promote physical activity and influence positive behavioral changes, while community gardens are beneficial in gathering neighbors together to grow healthy foods. 
With regards to childhood obesity, schools definitely play a role in prevention. Outlets for physical activity including recess, physical education and after-school athletic programs can help kids stay active outside the classroom setting. Additionally, placing healthy snack alternatives in vending machines and removing high caloric foods from cafeteria menus are critical.
Lastly, employershave a vested interest in the health of their workforce. UPMC does a great job of encouraging healthy lifestyles by creating access to nutritional and affordable food choices to employees at work, while also incentivizing individuals to take “healthy steps” (i.e. preventive exams, smoking cessation, etc.) to receive significant reductions in their health insurance deductible.
Q: How can patients become proactive about their weight management?  
A: Individuals struggling with obesity can definitely be proactive about their health:
  • Acknowledge. Understanding that your weight is an issue and confronting it head-on is the first step to managing your health.
  • Seek Information. Do your own research. There is a wealth of literature both online and in print that can help you make lifestyle changes (eating right, exercising, etc.)
  • Make an appointment with your physician. Bring your research with you to your next doctor’s appointment and create an action plan for effective weight loss with your primary care provider. He or she can direct you to available resources to help you achieve your goal.
Want to learn more about how the AMA’s decision will impact obesity treatment? Listen to Dr. Esa Davis discuss this new development on 905. WESA’s Essential Pittsburgh segment.