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Obesity

AMA members vote against council: obesity is a disease

Obesity is too difficult to define
Members vote to recognise obesity as a disease

Despite a report from the American Medical Association (AMA) council concluding that obesity is not a disease as it is too difficult to define or diagnose, the Association’s policy-making House of Delegates have voted to “recognize obesity as a disease state with multiple pathophysiology aspects requiring a range of interventions to advance obesity treatment and prevention.”

Although the vote has no legal authority, it is certainly a shot across the bow to policy-makers in Washington, and Members hope the decision will lead to better reimbursement for treating overweight Americans, greater investments, improved health insurance coverage, and ultimately, patient outcomes.

The report, which can be read here, states: “Without a single, clear, authoritative, and widely-accepted definition of disease, it is difficult to determine conclusively whether or not obesity is a medical disease state”.

Published by the AMA's Council on Science and Public Health and released at the Association’s annual meeting, the paper adds that it is unclear that defining obesity as a disease, as opposed to a condition or disorder, would result in improved health outcomes.

“The disease label is likely to improve health outcomes for some individuals, but may worsen outcomes for others,” the report states. 

Despite the lack of support to categorise obesity as a disease, the paper claims that a clearer definition of obesity is needed and hopes that the National Heart, Lung, and Blood Institute’s soon to be published guidelines “may help clarify clinical uncertainties regarding the best means of measuring obesity, at least in reference to cardiovascular risk.”

The report acknowledges that widespread recognition of obesity as a disease could result in greater investments by government and the private sector to develop and reimburse obesity treatments. It also identifies the argument that FDA would be under increasing pressure to to approve medications for obesity, “and would therefore reframe their approval process to focus on the ability of pharmaceuticals to decrease adipose tissue rather than to improve other markers of metabolic health, such as blood pressure and lipid levels.

This in turn could lead to third party payers approving coverage for such medications, allowing far greater access to care to millions of Americans who are currently diagnosed as ‘obese’.

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