By Chris Hoenig & Manuel McDonnell-Smith
In June, the nation’s leading organization of medical professionals, the American Medical Association (AMA), made a bold move in recognizing obesity as a disease. The new policy calls for expanded research, treatment options and insurance coverage to treat patients who are already or closely at risk of being classified as Obese.
While the AMA has no official control of treatment guidelines, insurance coverage and research grants directed to the issue, their influence in both industry and government could move those parties to also take more action in taking on the rising costs of the nation’s obesity epidemic. “Recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately one in three Americans,” said AMA board member Patrice Harris, M.D. “The AMA is committed to improving health outcomes and is working to reduce the incidence of cardiovascular disease and type 2 diabetes, which are often linked to obesity.”
Since the announcement, lawmakers on Capitol Hill have introduced bipartisan bills that specifically address obesity. “Many of us believe that this is going to propel a critical mass effect so that we will see a lot of action,” Jeffrey I. Mechanick, M.D., President of the American Association of Clinical Endocrinologists, told AMED News, the newsletter of the AMA. Mechanick was able to speak with authority on the issue not only as a provider, but as a co-author of the resolution designating obesity as a disease with colleagues of his group & others.
First up is consideration of “The Treat and Reduce Obesity Act“, which calls for Medicare to cover prescription drugs and weight loss counseling for patients seeking assistance in managing their weight. The bill was introduced on June 19th by U.S. Senators Tom Carper (D-DE) and Lisa Murkowski (R-AK), and Congressmen Bill Cassidy (R-LA) and Ron Kind (D-WI).
Most at Risk
More than one-third of American adults are classified as obese, which is defined by the Centers for Disease Control as having a Body Mass Index (BMI) above 30. The BMI is a measure of height relative to weight.
According to CDC data, non-Hispanic Blacks have the highest rate of obesity at nearly 50 percent. Coronary heart disease, type 2 diabetes, cancer, hypertension and stroke are just some of the health problems linked to obesity, and these too occur at disproportionate rates in Blacks.
One-half of all Black women will die from a stroke or heart disease, according to the National Stroke Association, a rate twice as high as whites. The American Diabetes Association says nearly 20 percent of all Black people over age 20 are diabetic, a rate that is also nearly twice as high as whites. Black people also make up more than one-third of all kidney failure patients in the U.S., according to the American Kidney Fund. Lowering the obesity rate is seen as a way to bring each of these stats down.
The impact on Business
Outside of the medical office, the AMA’s classification could also have a direct effect on the workplace and employee management. By designating obesity as a disease, the Association believes that employers will consider changes to their approach and strategy on the issuenot just in insurance coverage terms, but also employee policy. Some corporations, like Abercrombie & Fitch, have already been called out publicly by journalists and activists about biased policies regarding obese people. Now, medical professionals are calling for change. “Employers may be required to cover obesity treatments for their employees and may be less able to discriminate on the basis of body weight,” the AMA explained in a statement.
Discrimination by Doctors
Regardless of legislation, the AMA’s resolution could change the way that doctors and their patients communicate about obesity. A 2009 study of 40 Baltimore-area doctors and 238 patients, published in the Journal of General Internal Medicine, found that doctors have “lower respect” for their patients with high BMIs. “When you say obesity is a disease, it has the potential to remove the stigma, because you start seeing it as a place where people need help”, said Dr. Marlene B. Schwartz of the Rudd Center for Food Policy and Obesity at Yale University. In the AMA’s newsletter, she called for doctors to help patients in this classification rather than just telling them “to push away from the table.”
In addition to advocating for changes, Schwartz says that her center will “probably monitor how the classification is affecting doctors’ feelings towards obese patients” over the next few years.
Advice on managing obesity and risk will likely have to start with medical professionals discussing changes in their patients’ lifestyles, a conversation likely to cross racial & cultural divides. DiversityInc will host a conference in September on Culturally Competent Healthcare, where medical professionals from across the industry will discuss the meaning of culturally competent care, strategies they are implementing to reduce disparities, and the educational tools that are most effective in reaching their audiences. Professionals interested in learning more are invited to register for this special event.