AMA label Obesity a Disease – Benefits & Drawbacks of the decision.

AMA label Obesity a Disease –  Benefits & Drawbacks of the decision.

Recently the American Medical Association labeled Obesity a disease. A disease. That would place this complex lifestyle issue in similar category as Alcoholism and Depression. With a capital O.

This decision has caused all sorts of controversy with many holding differing opinions and positions. The AMA’s position is that the ruling will bring the costs of treating obesity down, make it more likely covered by insurance and would also raise awareness and initiatives for treatment.

This is serious.

No-one needs to be told that obesity is a massive issue worldwide. Trends show that 50% of the adult population in the US will be obese by the end of 2030! Not just overweight. Obese. BMI 30+.

In Australia 14 million are overweight or obese. More than 5 million are obese. If the trend continues nearly 80% of all adults and a third of all children will be overweight or obese by 2025.

We have got to do something about this. Think of the larger impact of 80% of all adult Australians being dissatisfied with their own bodies, the knock-on effect of the decisions that people make while dealing with all the inner conflict and emotional turmoil that is going on below the surface. It’s got to stop.

The AMA are trying to take a stand and move forward to help their population, but many overweight and obese people themselves are criticising the decision:

Ragen Chastain, a ballroom dancer, writer, public speaker and self-described “fat person.” was offended, read her wise comments…

I think the best idea is to remove weight from the conversation and focus completely on health so people aren’t stigmatized for their body size… Because the more you stigmatize somebody, the more they think their body is unworthy of care and the less they care for it. People won’t take care of things they hate.”

– Ragen Chastain, Dances with fat.

 

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Challenges & Drawbacks with this new definition.

  • The wordsDisease” & “obesity” are poorly defined.
  • BMI itself is a poor classification, it is designed for measuring statistical populations not individual people.
  • You can be fat and fit, and relatively healthy. And you can be skinny and very unhealthy. Fat does not necessarily equal diseased and unhealthy.
  • Body weight is not a clear metric of health. Therefore not all obese need to lose weight. If they are genuinely happy and healthy, who cares what your size or weight?
  • It’s very problematic labelling, stigmatizing and discriminating against people based on how they appear. The American “war on obesity” is only fuelling deep held societal beliefs that fat is wrong/ and to be ashamed of.
  • It’s more likely to fuel identification with the problem for the obese. I “have” this disease, and there’s nothing I can do about it. Identifying with it stops your ability to separate from it. You ARE NOT fat. You may HAVE excess fat, but you are much more than that.
  • Obesity is not a disease in the same sense as other diseases, it cannot be treated with surgery or a pill. Most doctors do not have a clue how to treat it and are not trained in nutrition, exercise, psych or coaching.
  • Likely lead to more obese going for the outside-in surgical approach to try and deal with their “disease”. Lap-band is not a lasting solution. It does not deal with the underlying issues, and can cause horrific side-effect problems.
  • Further stigmatizes the overweight, removes responsibility.
  • Takes focus from the real problem, underlying mental and emotional and hormonal issues that are causing the body to store excess fat.
  • Researchers  still can’t tell with any certainty why we gain weight or how to lose it. They are missing the emotional, and energetic pieces of the puzzle.
  • Is obesity really a cause? or is it an effect / symptom of other deeper problems. The Doctor in the TED talk I posted about last week seems to think that Obesity is a reaction to diabetes, not the other way around, and he is doing deeper research into it.

Possible Benefits of the new definition

  • Obesity contributes and is related to 60 other illnesses, this will undoubtedly create even more focus on possible treatments.
  • Political move. More weight loss treatments to be covered under health insurance.
  • May lead some obese people to feeling validated in that it’s a long term chronic problem, not just a lack of willpower.
  • Could reduce shame for some obese.
  • Could lead to more options and long term solutions being supported by the medical establishment and create more lasting change.
  • Could lead to more obese seeking treatment, feeling like they will be taken seriously.

 

Many doctors feel unqualified to treat obesity, and they are. It cannot be fixed with a prescription pill.  Dealing with obesity requires a long term behavioral change that begins with mental and emotional awareness of self, self-love, self-compassion and self-responsibility. Those things can be taught and learnt, but GP’s aren’t the experts to go to. For that kind of long term support to shift lifestyle habits, requires a mindset specialist; CBT style positive psychologist, hypnotherapist or Meta-Coach. Someone trained in getting to the heart of the deeper issues, who can read gestures, words spoken and unspoken. Someone who can help the obese person regain a love for themselves that will allow them to come to peace with their body and create healthful habits out of joy. Not to reach a number on the scale.

As with anything in life, this decision and obesity itself, we have the ability to make it mean whatever we want it to mean. This decision could be great, or terrible or “who cares” based on your position and what you choose to make it mean. I’m interested, what does this mean to you?

Want to read more on this?  Here’s what I read to write this article.

Comments (4)

  1. I know that it is not the simple old approach of in and out of energy and food – it is what we make it mean emotionally too; genetics and environment.

    I feel that many other symptoms are hidden including other health concerns such as PCOS & thyroid and too easily dismissed into the 'too hard' basket for most GPs- please note that this is my experience. However no one has a magic cure – as an individual it is worth our while working through the many different tools of support to assist us in our lives and your healthy is the core of living.

  2. Great article and perspective Kylie and well done for looking from a higher perspective at the pluses and minuses of this decision. I completely agree that a GP or Family doctor is not the best person to help a person with obesity – they often to not have the breadth of skills (nutrition, physical activity, emotional) or the time to support and integrate a long term mental, emotional, physical and behavioral change.

    I am also not a big fan of the whole "War on X". It just does not work. Whether it is terror, cancer, or anything else. It focuses on a 'problem' and not the opposite which is where the light exists. I think we definitely need to bring the spotlight onto 'health' as you said Kylie and drop the whole weight fixation.

    Great stuff. I will definitely be passing on this well considered article. 😉

  3. Thanks Carl! Exactly, we get what we focus on… If only we can switch the focus to health. One step at a time..

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