In case you've been on vacation the last month and incommunicado, the New York Times on June 18 reported that the AMA has officially declared that obesity is a disease, not just a physical condition. Since then, the media, the Internet and the medical community have erupted in a frenzy of stories and opinions. Is it or is it not a disease? What is the right way to define obesity? Those are two of the issues. But the really big issue is money. Is classifying obesity as a disease about health, or is it really all about money?
"I'm okay with it," said Timothy Church, director of preventive medicine research at Pennington Biomedical Research Center in Baton Rouge, La. "If that's what it's going to take to get reimbursement for treatments." Source: Boston Globe.
"If calling obesity a disease will coax insurance companies into providing proper coverage, then I'm all for it," said Dr. David Ludwig, director of the Optimal Weight for Life Clinic at Boston Children's Hospital. "Until insurance companies move towards reimbursement, I don't think we'll make much headway." Source Boston Globe.
In a press release that looked like a news story on online.wsj.com, the Wall Street Journal's online edition, I read "The decision has been roundly applauded by The American Society for Metabolic and Bariatric Surgery (ASMBS), the leading authority on weight loss surgery. Michael Feiz, MD, FACS, is one of the nation's finest specialists in the field of weight loss, and he sees the declaration as extremely welcome news." I'll bet.
Despite visions of the pharmaceutical companies and medical-industrial complex looking like the big bad wolf, licking their chops, I don't want to be too harshly critical of these fellows. Their medical treatments are absolutely necessary and life saving in some cases. They commit no offenses by promoting their work and wanting it available to their patients through insurance, the only way most could afford them. I should also point out that I'm one of the professionals whose mission and livelihood is providing weight loss treatment to overweight people.
However, my point here is that physical medicine, either drugs or surgery, is not going to fix what's wrong. We have an obesity epidemic that is out of control because of something that has changed in the last 50 years of our eons of evolution -- recent changes in our culture and behavior. Drugs and surgery won't change that.
Fifty years ago, obesity was relatively rare. In 1960, the rate of obesity in young and middle aged adults was under 10 percent. In children, it was under 5 percent (Robert Wood Johnson Foundation). Today, the obesity rate in adults has doubled in the last 30 years so one out of three adults is obese. In the last 30 years, the obesity rate in children has nearly quadrupled. New York Times health and science columnist Jane Brody reports that "Experts predict that half of adults in America will be obese by 2040."
Drugs and surgery are not going to fix what is causing this epidemic. Obesity and the epidemic are not caused by some virus or instantly evolved biological characteristic that has just appeared in the last 30 years. It's caused by recent changes in our environment and behavior. We have a different culture than we had -- different foods, a different food industry, a different mindset and habits. Those are the things that need to be fixed to end obesity. Drugs and surgery will not do that, but if we're not careful, that's where all the attention and money will go. If that happens, the problem will get worse and we'll go broke to boot.
Obesity causes early death and ruins the quality of life while you are alive. It triggers all sorts of other diseases. It's the number two cause of preventable death in the country, and it's breaking the healthcare system and our national budget with all the medical care required because of it. We can't produce or pay for enough healthcare to keep up with the sickness we are creating.
No one has to convince me that obesity is a disease. Obesity is a disease I suffered with for 25 years until I found my solution and reversed it. Left unresolved, it's a terrible disorder that causes a great deal of damage, physically, emotionally and financially. However, we can solve the problem. We can change, and we know what to change and how to change it. I teach people how everyday.
To solve the problem, we change things -- at home, at school, at work, at church, at the market, in the marketplace, in the food businesses, in advertising, industry, in congress. We need to put health above personal profit and self-gratification as our priority, each of us. As long as quick fixes and return on investment are our highest values, then we, stockholders, executives, lobbyists, and politicians will be doing what's good for the pharmaceutical industry, the food industry and the medical-industrial complex. Even good people, good doctors, can be seduced by the allure of the money, and they forget what their patients really need, what our country needs.
Yes, obesity is a disease. But the good thing about the AMA recognizing it as such is not that insurance will pay for drugs and surgery. The good thing is that it may help our people and our culture to change. It will be harder to defend what makes us overweight as OK. Manufacturing a disease is not healthy or smart and it should not be legal. Having a disease or an epidemic without trying to fix it is pathological in itself. People will no longer be able to defend it as an acceptable condition without trying to change it. The medicine to cure obesity is at hand. We need to change. We can. Learning what needs to change and learning how to change is the answer.
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William Anderson is a Licensed Mental Health Counselor who specializes in weight loss, eating disorders and addictions. He is the creator of "Therapeutic Psychogenics", which helped him lose 140 pounds permanently thirty years ago after years of obesity and dieting failure. He has written a book about it, The Anderson Method, and he is teaching these techniques to individuals and therapists all over the country.
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