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Obesity: A Disease?

Will the AMA's new definition of obesity help people shake the extra pounds?

In a landmark decision last week, the American Medical Association chose to officially recognize obesity as a disease, in a vote that marks the first time the AMA has chosen to treat a non-infectious condition as a disease.

The Association, of course, is proud of its decision. Though its own Council on Science and Public Health made recommendations against recognizing obesity as a disease, citing the flaws in the body mass index (BMI) and using it as a metric of health, the A.M.A.’s House of Delegates still voted in acceptance.

We can speculate, all day, as to why they’d do this even against the research of its own inner council. Could it be the money – if the Association is going to throw its weight (no pun intended) behind preparing doctors to advise patients on obesity, doesn’t that mean they’ll have to put their lobbying power behind government requiring insurance providers to cover the cost, guaranteeing additional income for doctors? Could it be power – what does it do for them, politically, to make such a major move? Does it encourage doctors to join an organization that’s constantly looking out for them economically? Could it be something as simple – and altruistic – as “we think this is the best thing for our patients?”

Dr. Patrice Harris, a member of the Association’s board, said the following in a statement on behalf of the org: “Recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately one in three Americans.”

To be clear, the move does not change the way the government views obesity. It does not change the “eat less, move more” edict. It does not change the way insurance carriers treat preventative care in regards to obesity, nor does it change the way they regard reactive measures, such as bariatric surgeries. All this changes, literally, is the way the A.M.A. focuses its attention with regard to obesity.

And, dare I say it, it was a bold move.

In light of major collections of stories regarding the way doctors treat overweight patients, it’s clear to me that many doctors who believe weight loss is simply “eat less, move more” are treating their overweight patients as lazy buffoons when aren’t successful. It’s clear to me that stigma affecting overweight doctors is affecting the way those doctors treat their patients, and the way those patients listen to their overweight doctors. When doctors look at someone who is 30 pounds overweight according to a BMI chart, yet is excessively muscular, and tells them they still need to lose weight, it’s clear to me that doctors don’t have enough information to value the right things. And, lastly, when Johns Hopkins publishes a study that determines that doctors are 35% less likely to have an emotional rapport with patients who are overweight…it’s clear to me that doctors are letting their individual biases affect their ability to provide care.

Research into obesity and its contributing factors means doctors will be flooded with information to guide them, and not their own personal – often privileged – experiences. What happens when research is done on the BMI as an adequate measure of this newly-determined disease, and it comes to light that the BMI is inadequate? Ineffective? It means we abandon the BMI, and find better ways to understand weight management. What happens when, as a result of this decision, insurance companies are now goaded into covering preventative care? It means we start saving money – more money spent on Overeaters Anonymous-esque groups and less money spent on kidney dialysis.

And, what happens when other major organizations start to throw their support behind the A.M.A.’s decision, like the American Heart Association already has? It means that, like an avalanche, more organizations and entities begin to pile on, forcing the government to address obesity’s contributors, like poverty, access to fresh produce, environmental contributors, and general education on how to work with ingredients many families have never heard or cooked before.

Clearly, I am optimistic. I can admit that. I can also admit that this is not without its flaws. What’s most important to me, is advancing the study and research into obesity, because a lot of long-held myths that many physicians parrot are the reason why health care cannot advance in this country. Educating the people who are our first line of support in the quest for long, healthy lives can only benefit us in the end, and – as I always say – our bodies will undoubtedly thank us for it in the end.

Erika Nicole Kendall is the writer behind the award winning blog, A Black Girl’s Guide to Weight Loss, where she blogs her journey of losing over 150lbs. A personal trainer certified in women’s fitness, fitness nutrition and