AMA: Obesity Is a Disease. Do You Agree?

AMA: Obesity Is a Disease. Do You Agree?

The American Medical Association (AMA) has officially labeled obesity as a disease in hopes that it will help change the way the medical community tackles the complex issue. As it stands, insurance companies generally exclude obesity treatment, which can limit how physicians manage obesity-related conditions like diabetes and high blood pressure.  While the AMA’s decision has no legal authority, some hope that medical therapies and procedures such as the lap-band or gastric bypass surgeries will now be included in insurance coverage. Proponents of the decision contend that treatment for clinically obese patients is not as simple as eating less and exercising more. Physical mechanisms and damage to signaling pathways can make it extremely difficult for people to lose weight. Improving reimbursement for obesity drugs, surgery, and counseling may significantly impact patient outcomes. Those opposing the decision, including the AMA’s own Council on Science and Public Health, consider the measure to define obesity, the body mass index (BMI), too simplistic and flawed.  They argue people with a BMI above the level defining obesity may be perfectly healthy, while others may have dangerous levels of body fat and metabolic problems. Others are concerned that the lack of specific symptoms associated with obesity classify it as more of a risk factor for other conditions than a disease in its own right. Physician’s Weekly wants to know…Will the AMA’s decision influence how you view and manage obesity among your patients? Do you think it will impact insurance...

New Guidelines for Assessing Adiposity

The rate of obesity in the United States has reached the epidemic level despite efforts by healthcare providers and patients to improve health-related behaviors and increased efforts to better understand its pathophysiology. “Assessment for excess adiposity is of critical importance,” says Marc-Andre Cornier, MD. To address the issue of assessing adiposity, the American Heart Association (AHA) released a scientific statement to help clinicians. The statement, which was published in the November 1, 2011 issue of Circulation, provides practical guidance for clinical researchers who seek to identify precise measurements for their patients. It also provides recommendations for clinicians who care for patients whose excess weight is a clinical problem. “Before clinicians can recommend treatment options or talk to patients about obesity prevention, they need to know whether a patient is obese,” says Dr. Cornier, who was the lead author of the AHA scientific statement. He adds that there are also new Medicare guidelines for covering obesity treatment that require clinicians to identify whether or not patients are obese. Medicare will cover provider visits for weight loss counseling in patients who screen “positive” for obesity. Reviewing the Methodologies for Assessing Adiposity Healthcare providers and systems are not regularly assessing for excess adiposity with even the simplest, least costly methods, says Dr. Cornier. “Most methods for assessing excess adiposity are not ready for routine clinical use,” he says. “Measuring BMI and waist circumference is currently best to assess adiposity. These are strategies all clinicians should be practicing on a regular basis for patients. Other newer, complex, and more expensive tools are currently available, but physicians need to do a better job utilizing...