The American Medical Association made headlines June 18, 2013 by acknowledging that obesity is, in fact, a true disease. For those struggling with overweight and for those of us engaged in the medical battle against obesity these past 20 years, this was not really news, but an affirmation of sorts. Indeed, both the medical causes and complications of obesity are just as medical in nature as other common diseases. Let me explain…
Obesity has very clear medical factor causes that have been well documented in research. Ever wonder why some people struggle with obesity and others do not? Here is a partial list of reasons why:
Research-Proven Medical Factors Contributing to Obesity:
- Genetics (approximately 70% of the influence on your weight destiny)
- Metabolic Rate (influenced by genetics, stress, sleep, vitamin status, others)
- Hormone Function (thyroid, growth hormone, estrogen, testosterone, others)
- Activity Level (being paid to sit, fatigue, poor climate, social factors, hobby preferences)
- Nutrition Factors (food exposures, environment, food costs)
- Social Factors (family upbringing, friend influences, work factors)
- Medication Factors (many medications cause weight gain!)
- Psychological Factors (stress, depression, “winter blues” affect weight)
- Appetite Factors (influenced by brain signal imbalances, i.e. leptin, ghrelin, CCK, PYY)
Simply ask yourself how many in the above list are easy or possible for an individual to control! How many are attributable to some defect in character or intelligence? I think you will struggle to find any!!! No one, let me repeat, no one chooses obesity! It is the unwanted plague of our generation.
Now consider the formal definition of disease. Human disease is defined as a disorder of structure or function. The “fat-storage” disease of obesity qualifies on both accounts.
Disorder of Structure: Those with the “Obesity” disease have a very measurable structural disorder as the body’s fat cells experience an unwanted explosive growth in both number and size, to the point of compromising normal body composition and structure.
Disorder of Function: The functional limitations from obesity are obvious, with decreased activity levels for pleasure and productivity, and subtle, with abnormal functions of blood chemistry, brain function, heart function, joint function, and other problems that arise.
Every American should know, very clearly, that obesity is an unwanted disease! After assisting over 15,000 patients with this disease, these 5 truths have become crystal clear:
- No one wants to be obese
- No one deserves to be obese
- No one wants the health problems of obesity
- No one wants the daily oppression of obesity
- And… all those who are obese want an exit strategy… and now!
Further, the complications of obesity are painful, expensive, pleasure-limiting, life-limiting and, at times, deadly! No one who looks honestly at the well-documented causes and complications of obesity can deny it qualifies as a disease.
Let’s be clear. Obesity is a disease and a serious disease at that! Name another disease with such severe consequences. Obesity should be addressed thoughtfully, intentionally, and very strategically. The biggest medical error of our time is to underestimate the powerful causes, the devastating consequences, and the tremendous benefits of aggressive medical and nutritional treatment of unwanted weight gain. Now, with the AMA’s support, let’s be a part of the solution, move past the social stigmas, and embrace real answers for this devastating disease…
For Optimum Health,
Rick Tague, M.D., M.P.H.
Additional Helpful Resources:
Read my complete article on Obesity: Causes, Consequences and Current Treatment Benefits
Excellent post. To date my weight loss on program is 38.8#. My blood pressure is down substantially, 148/90 down 113/67.
I am at goal…but my personal goal is to loose just a few more pounds!
As a female, how fun, exciting, and often very surprising when I go shopping and find that I’ve chosen a size too big to try on. For the first time in a long long time, I actually enjoy clothes shopping. And I actually wear a swimsuit out in public…
I have more energy, I feel better about myself, that has to have a positive affect on everything. By the way, I’ll turn 59 in a couple of weeks, and I’m really starting to enjoy retirement!
Thanks to you and your staff!
The next battle is to get insurance companies to recognize this and agree to treat it as any other disease. My biggest frustration is that I cannot afford any of the programs available to treat obesity. It seems as if insurance companies and employers as just hoping the fat people will hurry up and die in order to save them money. If they were to deny coverage for cancer or AIDS the the whole world would have a hissy fit. But it’s ok to discriminate against obese people. They just assume we are all lazy and undisciplined.
Why should insurance companies pay (and by definition, that means that our neighbors who share the insurance pay more) to cover expensive medical treatments for obesity when cheap alternatives exist, such as diet and exercise?
By this logic, insurance companies should cover alcohol and drug rehab and treatment as well.
Thanks for the questions. We wish that dieting and exercise were effective treatments for obesity. Obese self-dieters in the U.S. typically gain 1/2 pound per year. Exercise typically is ineffective at reducing weight significantly. Even though these approaches should logically work, they unfortunately do not work in the real world for most people. Weight Watchers has been forthright at publishing their statistics and average weight loss after one year on their programs is around 4 1/2 pounds. However, their dieters typically are 40 or more pounds overweight. Medical approaches are far more effective with medications that can average 15% weight loss (30 lbs in one year for a 200 lb individual) simply by using proper medications and counseling. The very low calorie diets we use average 39 lbs of weight loss in 12 weeks for women and 48 lbs in 12 weeks for men. Unfortunately, even though these approaches are highly effective and lower disease risks for individuals, insurance companies have chosen to not pay for these treatments, but instead wait until full diabetes, hypertension, heart disease, cancer and osteoarthritis have taken their toll.
Will this result in more obesity treatments, such as doctor-supervised weight management and corresponding tests and treatments being covered by insurance plans?
It now seems inevitable that more medical services for obesity will be covered by insurance plans.
There are two forces at work: 1) The Affordable Care Act (ObamaCare) has mandates for preventive services, including nutritional counseling, built in to it for things like high cholesterol and obesity. 2) WIth the AMA defining Obesity as a disease, it will be difficult for insurance companies to discriminate against covering this disease when all other diseases are covered.
I believe that the next 12-24 months will see dramatic changes in coverage. We have already seen the Federal employee’s Blue Cross insurance plan in Topeka begin to cover Obesity as a diagnosis. Other plans will likely follow… There is a long history of discrimination against those struggling with their weight, so change may be slower than we would hope.
It’s funny, you listed a bunch of factors that contribute to obesity and then asked how many of them are controllable? I thought, “well, most of them” before you said, “none of them.”
Stress, sleep, vitamin status, being paid to sit, fatigue, poor climate, social factors, hobby preferences, food exposures, environment, food costs, friend influences, work factors, are all factors that can be impacted, adjusted, or overcome by US. Yes, it’s more difficult for some of us (I’m fighting obesity and am from a family of morbid obesity) than others, and some of us are placed in situations that require more of a fight than others.
But we can reduce our own stress, we can get more sleep, we can take more vitamins, we can walk around more during our work day and move at our desk, we can control our fatigue, we can work out indoors if the climate is bad, we can impact our social situation, we can choose or pursue active hobbies, we can impact the food that’s in our house, we can impact our environment, we can be intentional about the food we buy, and we can work with our friends to get healthier.
I agree with your strategies! Let’s do what we can to fight negative environmental factors thoughtfully and intentionally. My point was that we do not choose things like stress, poor food environments, challenging genetics, or food cravings. However, I did not mean to indicate that there is no hope for managing these unwanted factors. Thoughtful, strategic plans should be implemented and followed through with each individual struggling with their weight. Health care providers should provide assistance to their patients who struggle and should be reimbursed for delivering thoughtful counsel in a personal and encouraging manner.