Last week, the American Medical Association (AMA) House of Delegates voted to declare obesity a “disease,” perhaps the only such curable by shutting your pie-hole and taking a hike. We weren’t alone in expressing skepticism of the AMA’s move and motives in the headline-grabbing decision.
First, we must note a possible ulterior motive for the Association’s decision. If — as several Congressmen have already proposed with respect to Medicare — “obesity disease treatment” gets insurance coverage, more people will get prescription referrals and follow-up visits for their “chronic disease.” Those prescriptions and follow-up visits aren’t free, and doctors cash in on a significant portion of that. A Los Angeles Times columnist speculated that the declaration sounded “more like an attempt to suit an agenda than a responsible medical resolution.”
But there are other substantive objections to calling obesity, formerly just a possible risk factor for certain conditions, a “disease” of its own. First, as an Indiana University medicine professor writes in The Atlantic, it’s not clear how dangerous obesity is. The professor notes that despite having numerous unhealthy habits and being fairly fat, famed British Prime Minister Winston Churchill lived to 90. A plump former Indiana University president made 97 despite his weight, too.
The plural of anecdote is not data — both men probably had excellent longevity genetics that covered for their unhealthy choices — but the data also show that a little fatness is not necessarily a death sentence. Analyses by researchers from the National Center for Health Statistics at the CDC have found that moderate overweight may be protective against death.
Another objection to the AMA’s decision is that declaring obesity a “disease” will cause people who need to lose weight and are making efforts to do so to give up. As a writer for TIME notes, the experience of “medicalizing” other conditions triggered by insufficient personal responsibility suggests that declaring those conditions diseases may lead to worse relapses for people trying to reform themselves.
Ultimately, the AMA’s denial of personal responsibility in physical activity and eating behavior is a mistake. We are pleased to see that we aren’t alone in noting that.