CHICAGO – The American Medical Association’s chief policy-making body has decided that obesity should be considered not just a disease risk factor, but an actual disease state that warrants insurance coverage for all aspects of prevention and treatment.
At the annual meeting of the AMA House of Delegates, it voted 276-181 on June 18 to support a resolution that was brought forward by several specialty organizations that called on the AMA to “recognize obesity as a disease state with multiple pathophysiological aspects requiring a range of interventions to advance obesity treatment and prevention.”
The vote ensures that the resolution becomes official AMA policy.
The resolution was sponsored by the American Association of Clinical Endocrinologists, the American College of Cardiology, the Endocrine Society, the American Society for Reproductive Medicine, the Society for Cardiovascular Angiography and Interventions, the American Urological Association, and the American College of Surgeons.
Preliminary testimony on the resolution a few days before the floor vote was “mixed,” according to the committee report presented to the delegates. The committee recommended adopting the resolution, but the AMA’s Council on Science and Public Health had urged against it in its report to the delegates.
Speaking to the House of Delegates, Dr. Robert Gilchick, a member of the council, said, “We did not think the evidence rose to the level where obesity could be recognized as its own distinct medical disease state.”
He noted that, although obesity is a risk factor, it may not in and of itself indicate illness. Some people who are considered obese by virtue of their body mass index might actually be healthy and fit, said Dr. Gilchick. “Why should a third of Americans be diagnosed with having a disease if they aren’t necessarily sick?” he asked.
Calling it a disease risks promoting medical interventions over other potential solutions, like lifestyle changes and advocating policies to improve nutrition and the exercise environment, Dr. Gilchick added.
Dr. Jonathan D. Leffert, a delegate from the AACE, said that the resolution should pass because obesity, like other diseases, has multifactorial causes and can be addressed through behavioral, medical, and surgical treatments. “The scientific evidence is overwhelming,” he said.
“We know that it is a disease,” Dr. Jeffrey Cain, president of the American Academy of Family Physicians, said in an interview after the vote. By calling obesity a disease, physicians will get more resources to help their patients. Hopefully, the AMA’s call to action will move insurers to improve coverage sooner rather than later, he said.
Immediately after the vote, the AACE issued a statement lauding the AMA delegates’ action. “The action by the AMA House of Delegates represents a major step in addressing obesity head-on and helping patients to get appropriate interventions and treatment they need,” AACE President Jeffrey Mechanick said in the statement.
Being overweight or obese increases the risk of breast cancer, coronary heart disease, type 2 diabetes, gallbladder disease, osteoarthritis, colon cancer, hypertension, and stroke and contributes as much as $210 billion a year to the nation’s health costs, according to the AACE.