Obesity, a symbol of America
Obesity is a new symbol of America. Am I too fat to live a normal life or even have sex with whoever? So much for America, home of the free, the brave, healthy and youthful. We’re now a bunch of sickly, unhappy, immobile, and vastly overweight folks.
Here’s a real doozy: One in three Americans is now considered diseased. On June 18, 2013, the American Medical Association, a large, clout-carrying physicians’ group, went against the recommendations of its own Council on Science and Public Health and forged ahead to officially declare obesity a disease.
The statement read, “Today, the AMA adopted policy that recognizes obesity as a disease requiring a range of medical interventions to advance obesity treatment and prevention.”
The 457 delegates, which represented specialty and state medical societies, overruled the council’s recommendation about 60 percent to 40 percent in a vote, reported The New York Times.
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A disease is defined by Merriam Webster 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: sickness, malady.”
While some physicians agree with the decision, others have been vociferous in their disagreement.
Proponents of the label say that because it impairs body function, obesity is a disease.
Others scratch their heads and ask what the distinguishing signs and symptoms are. They also point out that using body mass index (BMI) alone, to define obesity, (BMIs greater than 30 are considered obese), makes for a faulty diagnostic tool.
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In response, the council whose research-based recommendations were pretty much ignored, has already produced a report slamming the AMA’s move and urging additional research.
Why does it matter? There are no legal implications, but changing the classification will likely affect whether insurers pay for obesity “treatments.”
That’s a big deal because Americans shell out some $190 billion a year on higher medical costs due to obesity.
Oh, wait, did you hear that? Yes, exactly. Cha-ching. Such classifications have little to do with achieving a healthier American population.
That’s because when we are talking about obesity treatment, this refers to counseling, drugs (such as Qsymia or new-to-market Belviq) and surgery. Bariatric surgery can cost anywhere between $15,000 to $30,000. Many insurers do not cover this or the cost of obesity drugs.
I’d like to think that access to more treatment means more people battling obesity seeking long-term counseling to gently and thoughtfully work through harmful, self-sabotaging issues. That would make me happy. But my hunch is that underlying-problem-probing therapy is not the most frequently selected treatment option. This leads me to believe that if and when more “treatments” are covered by insurers, Americans will far too easily come to rely on these quick-fix, side-effect-loaded, body-tampering and costly ways of addressing obesity, otherwise known as excess body fat.
“It’s not about blame. It’s about action,” wrote Keith-Thomas Ayoob, ED.D., R.D., director of the Nutrition Clinic at New York-based Albert Einstein College of Medicine, on a school-sponsored blog. “The sooner we accept this, the sooner we can take control of our health and our lives.”
Oh, but blaming a disease, or other people, or a job is way easier than taking accountability, seeking support and having to undergo the very hard work and commitment required to make a lifelong shift to a healthy lifestyle. And when given the choice, let’s be honest, most of us prefer the path of least resistance.
Supporters of the label also posit that the new classification will prevent society from seeing obesity as only a result of overeating and under-exercising.
Maybe. But probably not. Because here’s the thing: As described on Medline Plus, “obesity occurs over time when you eat more calories than you use…Factors that might affect your weight include your genetic makeup, overeating, eating high-fat foods and not being physically active.”
How is it wrong for the public to view obesity as related to the type of diet one regularly consumes and the amount of exercise one routinely gets? We can’t sugarcoat this. Consumption of sugar is hugely over the top in the U.S.
An article from the Harvard School of Public Health states, “What’s increasingly clear from these early [research] findings is that genetic factors identified so far make only a small contribution to obesity risk—and that our genes are not our destiny.” In other words, we can’t blame the global swell in obesity rates on genetic makeup, either.
It’s not popular and it’s not what many people want to hear. Daily stress reduction, regular exercise (the sweat-producing kind) and healthy, nutritious eating (whether through a support program or self-directed) can, for a great many people, reduce body fat.
To be clear, I do not mean to suggest that losing weight through lifestyle adjustments is easy. It is not. It is actually very hard. And it can be very slow. But the rewards go way beyond actual pounds shed.
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Being obese increases risk of diabetes, heart disease, stroke, arthritis, and some cancers. This is true. It is a risk factor to be taken tremendously seriously.
But what we’re not getting at through these big meetings, and these debates in semantics, is why Americans’ relationship to what they eat is so out-of-whack; and what, as a society, we can do to get it back on track.
If it smells rotten, don’t eat it.