Obesity is now a Disease...

[I-Jo]

Seriously not sure how I feel about this.

 

Discuss. 

 

http://www.nj.com/news/index.ssf/2013/06/obesity_is_now_a_disease_doctors_say.html#incart_river

 

 

 

 

The American Medical Association Wednesday voted to work with the federal government to try and remove soda and other sugar-sweetened beverages from the Supplemental Nutrition Assistance Program, also known as food stamps.

 

The move comes one day after the AMA voted to classify obesity as a disease, a change that could affect the care, diagnoses and treatment of more than 78 million adults and 12 million children.

 

“Recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately one in three Americans,†AMA board member Patrice Harris said. “The AMA is committed to improving health outcomes and is working to reduce the incidence of cardiovascular disease and Type 2 diabetes, which are often linked to obesity.â€

 

This is more than just semantics, said Kenneth Storch, director of Atlantic Health's metabolic program at Overlook hospital, and an internist specializing in obesity and metabolism.

Storch said doctors were prone to treat symptoms of obesity such as high blood pressure, high cholesterol, diabetes or sleep apnea rather than treating the underlying cause — obesity. This new designation could encourage doctors to take a more proactive role with medications or surgeries, as opposed to only recommending diet and exercise.

 

The other reason this could change the lives of millions of Americans, Storch said, is because the AMA's new classification has the potential to put pressure on insurance companies to cover certain procedures and medications associated with obesity.

 

"The third parties have more of a gun to their head to reimburse these services," he said.

Specifically, drugs like Qsymia and Belviq, which treat obesity, are not covered by all insurance companies, Storch said, "and even the use of those medications will be pushed forward by this."

The AMA's push to remove sugary drinks from the SNAP program comes after numerous studies have shown a link between these types of beverages and obesity.

 

Studies also show sugar-sweetened drinks account for 58 percent of beverages purchased with food stamps, according to the AMA.

 

“The AMA is working to improve the nation’s health care outcomes, particularly cardiovascular disease and diabetes, which are often linked to obesity,†said AMA President Ardis D. Hoven. “Removing sugar-sweetened beverages from the Supplemental Nutrition Assistance Program will help encourage healthier beverage choices.â€

 

The new policy, voted on by the nation's largest group of physicians, also calls on the AMA to encourage state health agencies to include nutrition information in routine materials sent to SNAP recipients.

"I think it is wonderful," Storch said. "This is a giant leap forward and is going to leave more money on the table for healthy foods."

 

Obesity is measured using the Body Mass Index, which calculates a person's height and weight to determine whether a person is underweight, average, overweight or obese -- and there are three levels of obesity. The standards were set by the World Health Organization.

For a 5-foot-9 adult, the system considers 124 pounds or less as underweight; 125 to 168 pounds as healthy; 169 to 202 pounds as overweight; 203 to 236 pounds as Grade 1 obese; 237 to 270 pounds as Grade 2 obese; and above 270 pounds as Grade 3 obese.

 

In New Jersey, about 61 percent of adults are overweight, meaning their BMI is between 25 and 30. About 24 percent of adults are obese, with a BMI of 30 or higher, according to the CDC, and 17 percent of children, ages 2 through 5, were obese.

 

The AMA's yearly meeting produces a series policy recommendations for doctors and government. In addition to its votes on obesity and SNAP, the AMA on Tuesday recommended the Food and Drug Administration remove its lifetime ban on blood donations from men who have sex with men.

 

“The lifetime ban on blood donation for men who have sex with men is discriminatory and not based on sound science,†said AMA Board Member William Kobler. “This new policy urges a federal policy change to ensure blood donation bans or deferrals are applied to donors according to their individual level of risk and are not based on sexual orientation alone.â€

 

 

[XSanguinus]

...at least according to the American Medical Association.

 

http://www.latimes.com/news/science/la-sci-obesity-disease-20130619,0,4422080.story

 

 

How do we feel about this?

[Waldo]

Bunch of talk about this, but I think most misses the point.

Fed law has mandated no insurace discrimination for prexisting conditions, and that everyone has to have health care. Now obesity is a preexisting condition that can't be discriminated against.

Prior to this to me there was abolutely no doubt that within short order there would be skinny people plans and fat people plans (there already are).

(though I don't think that this officially recognizes it for that purpose)

[I-Jo]

Oh- I posted this exact thread in the General Diet Thread.

 

http://nerdfitnessrebellion.com/index.php?/topic/31745-obesity-should-be-classified-as-disease/

[Tech_Hunter]

They have to do that to cover up their screw up of endorsing the USDA's bad diets for decades.

[bigm141414]

Bunch of talk about this, but I think most misses the point.

Fed law has mandated no insurace discrimination for prexisting conditions, and that everyone has to have health care. Now obesity is a preexisting condition that can't be discriminated against.

Prior to this to me there was abolutely no doubt that within short order there would be skinny people plans and fat people plans (there already are).

(though I don't think that this officially recognizes it for that purpose)

 

True that the ACA law will help obese people get insurance, but by declaring that obesity is a disease obligates doctors to work with and treat their patients. Which means that they should be versed on treatment options and be able to recommend nutritionists and physiotherapists for consults. 

 

I think it is a decent step in the right direction getting doctors and medical staff into more a preventative mind set rather than fix it mind set.  

[pianolady2005]

There is potential for this decision to be both good and bad.

 

I have concerns that the AMA will advocate for weight loss surgeries and pills rather than lifestyle changes.  With many other chronic diseases in the United States, people are often told to take a pill (or several) because it's considered a quick fix and Americans are willing to do this, even though the problem isn't actually fixed.  

 

On the other hand, if this means that medical practitioners are more open and initiate discussion with people regarding unhealthy weight and how to attain a healthy BMI, it could be a very good thing.  I believe that this ruling alone will not do much - societal changes are needed.  People need affordable access to primary care providers to discuss this problem with them.  They need instruction in how to purchase food within their budget and how to prepare it.  How to exercise.  Regular follow ups and monitoring from their medical provider to give feedback and suggestions so that people actually succeed.  Many people who are obese are also working 2-3 jobs and have difficulty finding the energy to cook.  Could some people cut down on work and prioritize health more?  Probably.  Do some people work that much because they have to provide for a family and pay rent?  Yep.  For many, this is a barrier.  Labeling obesity as a disease won't in and of itself fix this problem.

 

I do not believe this will "fix" the obesity epidemic in America, but hopefully it will be a start in at least initiating discussion on what we can do as a society to help ourselves and each other.

[Waldo]

Everyone has to buy health insurance in the next year that doesn't already have it. Law says insurers can't discrimnate against preexisting conditions. Obesity wasn't, but is now on its way to becoming, a preexisting condition. To me more than anything this is done to prevent insurance segregation into skinny people plans and fat people plans.

[stevembk]

I personally think that obesity is worse than smoking. I know people have the right to choose how they live their lives, but they also have the choice to improve them.

 

I dont know about it being a disease, but its close when you think about diabetes and thyroid issues.

[marionette]

On one hand the classification makes it something that needs to be treated, and will push insurance companies to provide preventative care (ie subsidized gym memberships, nutrition counselling) to people "at risk" which is a good thing. On the other hand there will be another push of people saying "oh but I can't help it, I have a disease!" (you know, like the how everyone had a glandular disorder all of a sudden) while downing a bag of doritos with a coke.

 

Overall though I'm feeling it could be a good thing though. It will push doctors to bring up obesity with their patients. It will allow doctors more tools to help their patients that are wanting to lose weight but just don't know how and need help. It can have a ripple effect that works throughout the population encouraging everyone to be healthier, because, let's face it the whole family eats healthier when the person who buys the groceries and makes the meals eats healthier.

 

I do have issue with them measuring obesity with BMI however. BMI neglects body composition, which invalidates it for an individual fitness metric (imho). Then again I'm ALWAYS going to be considered obese for my height, even when I hit my goal weight. 

 

As for the "No soda on SNAP" part of it - about freaking time! Sugar is a luxury item, and always was, always should be! Personally I think sugar (yes, even stuff in the baking aisle) should all be taxed as a luxury good. The sugar lobbies pushing people to think that sweets are a basic human need are ridiculous.

[FalseAesop]

AMA doesn't really have the authority to decide what is and is not a disease. That being said they are a powerful lobbying group and maybe they will be able to put enough pressure on congress, the FDA, and the USDA,to enact some better regulation of the food industry.

[Bolson32]

Bunch of talk about this, but I think most misses the point.

Fed law has mandated no insurace discrimination for prexisting conditions, and that everyone has to have health care. Now obesity is a preexisting condition that can't be discriminated against.

Prior to this to me there was abolutely no doubt that within short order there would be skinny people plans and fat people plans (there already are).

(though I don't think that this officially recognizes it for that purpose)

 

I think you hit it right on the head for the most part. I've seen a lot knee jerk reactions on facebook etc. I don't think obesity should be a determining factor for receiving healthcare, as everyone should be able to get affordable healthcare within reason. But for the vast amount of people, to be obese is something you choose to do. Your diet and lifestyle got you there.

 

We talk about the work it takes to be in great physical shape, low body fat etc. But how much effort does it really take to no be Obese? I pose that question semi-rhetorically as I don't know. I've only bordered on the "grade 1 obese" level, and to be honest, I dropped 30lbs and got back to a relatively normal size really easily. I was certainly never 300lbs, but at 225 with almost no muscle, I was toting around a lot of fat.

 

With that said, I do think if you are a liability on the medical and health insurance companies, you should pay for it. Because i watch what I eat and workout, I certainly shouldn't be charged more to cover the 1 in 3 obese Americans. It sounds harsh, but it's my stance.

[Guest Dirty Deads]

I believe the government is intentionally broadening the definition of disease to make the us think we are sick and helpless. We are all victims of Munchausen syndrome via the government. WE now "need" them and anything they want to sell us in order to ease our "pain".  Of course it's all conspiracy theory about why there are so few cures to things. I'm 375 lbs. Am I disabled? Not really. With weight comes a different set of abilities, but not necessarily DISabilities. What I have been able to d0 in the past I will be able to do again and I'll get there because I am ABLE.

[marionette]

But for the vast amount of people, to be obese is something you choose to do. Your diet and lifestyle got you there.

 

With that said, I do think if you are a liability on the medical and health insurance companies, you should pay for it. Because i watch what I eat and workout, I certainly shouldn't be charged more to cover the 1 in 3 obese Americans. It sounds harsh, but it's my stance.

 

I don't think anyone wakes up one morning and says "I want to be fat" sometimes we just get so caught up in everything else we are doing in life - school, kids, family, house, job, etc that people just lose track of what is going on. It isn't a conscious choice, but it is a problem with diet and lifestyle that has an end result of being obese. That is part of why the whole lifestyle change that people go through involves stepping back and prioritizing.

 

The second part is a bit harsh, and I understand where you are coming from, but ignores the class issues that link poverty and obesity. Basically in developed nations poor people are more at risk for obesity and less able to afford health care. When you don't have a lot of money and an irregular income you don't buy perishables, you buy pasta and sauce, you buy cereal, you buy stew in a can. Sadly many people are perilously close to poverty, or in poverty. Until we can really address poverty and hunger, I don't think we can really penalize those people who are stuck in a system that isn't fostering their health.

[chairohkey]

The second part is a bit harsh, and I understand where you are coming from, but ignores the class issues that link poverty and obesity. Basically in developed nations poor people are more at risk for obesity and less able to afford health care. When you don't have a lot of money and an irregular income you don't buy perishables, you buy pasta and sauce, you buy cereal, you buy stew in a can. Sadly many people are perilously close to poverty, or in poverty. Until we can really address poverty and hunger, I don't think we can really penalize those people who are stuck in a system that isn't fostering their health.

 

I'm sorry but IMHO I don't believe poverty and lack of food quality is the issue. Its still a matter of over eating. 

[Thrillho]

A good friend of mine has been refused corrective surgery, and due to spinal problems she can't actually exercise to lose weight.  Spinal problems that can't be properly fixed until she loses the weight.  Weight she can't lose because of medical problems and the inability to exercise. 

 

All in all, I think this might be a very good thing. 

[Gainsdalf the Whey]

I'm sorry but IMHO I don't believe poverty and lack of food quality is the issue. Its still a matter of over eating. 

 

Yeah, but if it's a high carb diet, the lack of satiety can be a result of the over eating.  It's why poeple lose weight switching to paleo, they eat as much as they want, but it's more filling fats, proteins, and fibers for less calories..

 

edit: *The over eating could be a result of the lack of satiety. My bad.

[chairohkey]

Yeah, but if it's a high carb diet, the lack of satiety can be a result of the over eating.  It's why poeple lose weight switching to paleo, they eat as much as they want, but it's more filling fats, proteins, and fibers for less calories.

 

I completely agree.

[XSanguinus]

Speaking as a person who used to be obese, I'm of the opinion that obesity is NOT a disease.  However, public awareness of the epidemic has failed to alleviate the problem.  If the AMA is categorizing it as a disease simply so they can more aggressively combat it, I'm alright with that.  I just hope they choose to combat it with something other that pills and surgery. 

[Waldo]

 

I think you hit it right on the head for the most part. I've seen a lot knee jerk reactions on facebook etc. I don't think obesity should be a determining factor for receiving healthcare, as everyone should be able to get affordable healthcare within reason. But for the vast amount of people, to be obese is something you choose to do. Your diet and lifestyle got you there.

 

We talk about the work it takes to be in great physical shape, low body fat etc. But how much effort does it really take to no be Obese? I pose that question semi-rhetorically as I don't know. I've only bordered on the "grade 1 obese" level, and to be honest, I dropped 30lbs and got back to a relatively normal size really easily. I was certainly never 300lbs, but at 225 with almost no muscle, I was toting around a lot of fat.

 

With that said, I do think if you are a liability on the medical and health insurance companies, you should pay for it. Because i watch what I eat and workout, I certainly shouldn't be charged more to cover the 1 in 3 obese Americans. It sounds harsh, but it's my stance.

That's great and all, but for insurance purposes BMI is still used. I'm not a big believer in the whole fat acceptance movement, but there is absolutely no doubt there are a lot of really in shape healthy overweight people and a lot of normal/underweight people that are not.

If we are talking a major structural issue in society (a basic mandated living expense), using BMI to scale costs is totally unacceptable IMHO.

I would be fine if there was a way to scale costs on fitness related risk, but the fact is any reasonable measurement would be outrageously expensive especially given that any reasonable measurement includes multiple measurements over time.

[bigm141414]

Merged two topics. Why? Because I have frickin' shiny ass buttons that let me do stuff like that.

 

Now back to discussion....  

[Thrillho]

 

That's great and all, but for insurance purposes BMI is still used. I'm not a big believer in the whole fat acceptance movement, but there is absolutely no doubt there are a lot of really in shape healthy overweight people and a lot of normal/underweight people that are not.

 

 

I was refused life insurance for five years because I was over 300 lbs (for a while it was only over by two pounds), IN SPITE of a complete medical workup by my doctor.  Blood tests, urine tests, all of that said I was totally healthy, but the 400lb insurance agent could not approve me. They would approve my wife, who had a considerably higher BMI, but was below 300. 

 

...

 

It irked me. 

[Gainsdalf the Whey]

 

That's great and all, but for insurance purposes BMI is still used. I'm not a big believer in the whole fat acceptance movement, but there is absolutely no doubt there are a lot of really in shape healthy overweight people and a lot of normal/underweight people that are not.

If we are talking a major structural issue in society (a basic mandated living expense), using BMI to scale costs is totally unacceptable IMHO.

I would be fine if there was a way to scale costs on fitness related risk, but the fact is any reasonable measurement would be outrageously expensive especially given that any reasonable measurement includes multiple measurements over time.

 

 

I was refused life insurance for five years because I was over 300 lbs (for a while it was only over by two pounds), IN SPITE of a complete medical workup by my doctor.  Blood tests, urine tests, all of that said I was totally healthy, but the 400lb insurance agent could not approve me. They would approve my wife, who had a considerably higher BMI, but was below 300. 

 

...

 

It irked me. 

It's rediculous.  I'll never be in a "healthy" BMI (I'm currently 6 points over the obese cutoff. My lean bodymass alone would give me a BMI of 24. I may be a bit overweight, but I'm not obese.) and if my company ever switches to an insurane company that uses that statistic, I'll fight for it tooth and nail.

 

My favorite example is Ray Lewis, who at 6'1" and 240 lb has a BMI of about 32 (2 points into obese).

[chairohkey]

I was refused life insurance for five years because I was over 300 lbs (for a while it was only over by two pounds), IN SPITE of a complete medical workup by my doctor.  Blood tests, urine tests, all of that said I was totally healthy, but the 400lb insurance agent could not approve me. They would approve my wife, who had a considerably higher BMI, but was below 300. 

 

...

 

It irked me. 

 

So why didn't you just drop the two pounds?

[Guest Dirty Deads]

 

5'9" 286lbs. contest weight alleged 3% BF

42.2 BMI

Cutler is Obese!!