http://news.yahoo.com/news?tmpl=story&cid=1508&u=/afp/20040716/hl_afp/us_health_obesity&printer=1
US weighs in: Obesity now a disease

WASHINGTON (AFP) - Obesity is a disease, according to the largest US government health care plan, which will pay for some treatments for overweight Americans, now in epidemic numbers.

Secretary of Health and Human Services Tommy Thompson told a Senate committee Thursday that Medicare, which covers retirees and the handicapped, will allow obesity to be treated as a disease in its own right.

A treatment must prove to be medically effective to be reimbursed, however.

"With this new policy, Medicare will be able to review scientific evidence in order to determine which interventions improve health," Thompson said.

"Obesity is a critical public health problem in our country that causes millions of Americans to suffer unnecessary health problems and to die prematurely."

The number of obese Americans has more than doubled since 1980, affecting one out of three persons, or a total of 59 million adults.

Thompson's department figures that direct economic losses from obesity, due to the illnesses that it brings on, such as cardiovascular disease, diabetes and cancer, total some 120 billion dollars annually, and are growing.

According to a study by the Centers for Disease Control and Prevention published in March, obesity and overweight caused by poor eating habits and lack of exercise could become the leading cause of death in the United States by next year.

To allow coverage of the costs of treatment for obesity, Medicare removed a phrase from its regulations that had said specifically it was not a disease.

"The question isn't whether obesity is a disease or a risk factor," said Medicare administrator Mark McClellan.

"What matters is whether there's scientific evidence that an obesity-related medical treatment improves health," he said.

"This change in Medicare's coverage policy puts the focus on public health."

The change will not be immediate, Medicare officials said, because the government will need to examine the scientific evidence to know which treatments may be reimbursed.

"We encourage -- and we're expecting -- requests to review scientific evidence evaluating the benefits of a range of treatments for obesity in the Medicare population," said Sean Tunis, Medicare's chief medical officer.

He said that in coming months, surgical procedures used to fight obesity will be evaluated.

The government's decision to classify obesity as a disease in itself is laden with consequences for public health and private insurance companies. The decision will place a series of treatments on a list of reimbursable procedures and could accelerate the development of new medicines.

Experts compare this stage to the first steps toward including alcoholism among treatable diseases. That could help affected persons to admit that they are in need of help and the public will cease to consider those persons responsible.

The American Obesity Association (AOA) calls the government's decision a new chapter in the fight against obesity.

"The decision by Medicare recognizes that obesity is not simply a cosmetic issue," AOA president Richard Atkinson said.

"It is a disease in its own right. In fact, obesity is the most prevalent, fatal, chronic disease of the 21st century.

"This decision will open the door not only for better insurance coverage but more medical research and increased education on obesity at the nation's medical and other health schools."

The US tax collection agency, IRS, has accepted since 2002 deductions for expenses to fight obesity, alongside other recognized diseases. So, is obesity "a disease in its own right"? Should the U.S. government pay for "medically effective" treatments?

I've always had a hard time calling obesity a disease. Is it callous of me to just say... stop eating so much? If calories eaten > calories burnt, you will get fat. I take my position partially because for a long time I used to be about 50 lbs heavier than I am now, and I just decided that I didn't like it anymore so I disciplined myself and ate a proper amount. Some of my family members are extremely overweight and it's sad to see, but I also see them eat and eat and eat junk food... It's their own fault. To me a disease is something you have little control over, not something that is dictated 100% by your own voluntary actions. It seems that if people would have a little more discipline and personal responsibility then there really wouldn't be much of a problem.

Another thought... what if everyone did slim up and start eating a healthy amount? How would that affect the farm, grocery, and medical economy?

I just heard about this on the news. What a bunch of crap that was. Americans are just getting too lazy and eating more food. I mean like people really don't have to leave the house anymore with the Internet and all that stuff. You can work at home, order your groceries, clothes and basically anything else you want online. So, people take advantage of this. They sit on the computer all day, play videogames, and take advantage of all this high tech stuff we have these days. And, while they are doing all this, they eat, and eat, and eat some more. I mean I'm pretty sure we all are guilty of munching in front of the computer, but Americans are taking it to the extreme.
Or you have the people that just drive around to various fast food places and eat in their car. My uncle is obese and he is a limo driver. He eats while he drives people places, and he eats on his breaks and everything else. My Aunt is also obese but she is just a bizatch I can barely stand talking about her. I mean she thinks that because she is obese she has to feed my couzins to the extreme so they can be as unhappy and unhealthy as she is.

Back to the topic though... obesity is not a disease, it's more like a bad habit or laziness of people. It's not right for our tax dollars to go to some medical research or treatment thingy for lazy people!!!

Did you find that in Time magazine? Or US News & World Report? Because I read some 5 page thing about it- following a few families and yeah- obesity really 'takes over' and the fat almost acts like its own organ and pumps out essential things the body needs, etc.

And in some cases, I think its a disease. But its like cancer- if you notice it and take care of it quick, then you're "cured". But you wait too long and put off the help you need, then it becomes incurable and maybe terminal.

I dont think its cold to tell people not to eat too much, or go on some low-calorie diet- but when they keep eating and become 30 yrs old and weigh 510 lbs and they arent a professional wrestler, its too late- like cancer- its probably terminal.

But as cold as it is, i think its fine to tell overweight people you see carrying a bag of 3 cheeseburgers, large fries, and a supersize soda, to just stop.

And regarding obesity not being a disease:
As stated above, I think it is. The fat starts to work like its own thing and takes over like a disease, controlling what can enter and cant in your body. An organ working against you.

And you're right saying that lazyness, over-indulgence, etc do lead to it. And that sorta goes for everything unhealthy for you. Stop while you're ahead, really.

Obsedity has a lot of factors, but just being lazy is rarely the sole cause of such. Before you jump on every obese person, you should take a look at a few minor details, which usually play a part in someone who has chronic weight issues..


List of some important factors you may not be aware of:
Genetic Make up such as transfigured prohormone convertase 1, pro-opiomelanocortine, an over erratic leptin gene, malformation of the melanocortin receptor 4, can all play a major role in how your body responds to food.
Polygenic hypercholesterolemia; When a given genotype can becomes exacerbated by a disproportionate amount of things such as cholesterol, fatty acids, and of course saturated fat.
Matabolism
Psychological constituents such as particular simulants (a certain smell, or or person, or other such components) that trigger a specific responce such as overeating.
Depression

Yes, there is a variable degree in obesity, from considering it a disease, to believe in someone overeating or not practicing regular excersice or good eating habbits. Personally, I believe in most cases it is a bit of both. But again, it really does depend on exactly how obese the person is, and what other factors in there life could also be involved.

To me a disease is something you have little control over, not something that is dictated 100% by your own voluntary actions. It seems that if people would have a little more discipline and personal responsibility then there really wouldn't be much of a problem.

A person's weight is NOT dictated 100% by voluntary actions. Body chemistry plays a huge role in it.

Back to the topic though... obesity is not a disease, it's more like a bad habit or laziness of people. It's not right for our tax dollars to go to some medical research or treatment thingy for lazy people!!!

I take offense to that. I'm not lazy. I don't go to McDonald's and order three cheeseburgers and supersized fries. I don't eat that much, I drink diet soda, I exercise, I play tennis...yet it is almost physically impossible for me to lose weight. I have tried almost everything. While I'm not grotesquely obese, I'm heavier than I want to be. According to the statements I quoted, I should be just fine, huh? I used to be a smaller size. A spider bit me and the doctor put me on some strong steroids to control the infection. About the same time, my other doctor put me on birth control pills. The combination of those two drugs completely changed my body chemistry and I gained a lot of weight. I didn't ask for it. I don't overeat. If they did their medical research and found something that would effectively jumpstart my metabolism, I would be all for it.

So please don't just write stuff like that off to people being lazy. It isn't always the case.

Thats interesting that you would bring the genetic issue. Some people do have genes that are geared towards eating in excess. In that case, with a faulty gene being the problem, I can see obesity being a disease because the peson had no control over it. Denying them help would be like denying someone with a cold help because he has a weak immune system.

Anyway, as its been stated, lifestyle has everything to do with this. At my job in a restaurant, im around food all day and the smells seem to offset my hunger. I only eat once a day, occaisonally twice, and not trying to lose weight. It just happens because of the way that I function.



Maybe if gas gets to be over $6.00/gallon then people will start walking places and riding bikes instead of driving. That'd do it.....

Obsedity has a lot of factors......
Yes, there is a variable degree in obesity, from considering it a disease, to believe in someone overeating or not practicing regular excersice or good eating habbits. Personally, I believe in most cases it is a bit of both. But again, it really does depend on exactly how obese the person is, and what other factors in there life could also be involved.
The definition of 'disease' is the impairment of normal function.
I don't think of obesity as a disease but as the result or symptom of a disease.
Depression is a good example. As a result of depression, you can gain weight. It's the same with metabolism malfunctions, medications to deal with other medical complaints etc.

Even then, excluding serious metabolic disorders that gave a direct effect on how the body stores fat, I don't think you can become obese without a direct cause (eg. overeating, sedentary lifestyle). Overweight yes, obese no. Our society is one that seeks to shift blame onto others for our problems, especially in America it seems. In other words, people claim they have become obese because McDonalds doesn't offer a health range, rather than admitting it was their fault that they CHOSE to eat junk food everyday.

I know I'm getting kinda offtopic here as well, but to some extent the whole "I am beautiful as I am" mantra has become a little out of hand. Before I am attacked from all angles I do not mean people who do the right thing and just have a different body shape than normal. I mean the people who hide behind that saying. They eat junk food for breakfast lunch and tea, sit at home watching TV or playing the playstation or xbox. Damn, I didn't put that very well...i think I need a while to fully collect my thoughts on that issue.

The thing is, there are two radically different types of "obesity" being discussed here.

I don't think "eating at McDonald's and not exercising" should qualify as a disease. I detest how people are so incredibly unwilling to take responsibility for their own actions, and it disgusts me that the government would financially support this behavior.

On the other hand, there are people who simply gain weight easier and lose it much more difficultly than others, and I acknowledge that.

What I'm wondering, is it necessary/helpful to classify obesity itself as the "disease"? I mean, if you are genetically prone to obesity due to thyroid problems or other similar medical conditions, then it is those factors that need to be researched and treated, not just some simple weight measurements.

There are just too many factors that may cause obesity to list.

Sure, some overweight people eat a lot of junk food, and that doesn't help at all (and adds to it).

But there are also a lot of people that can't help their weight, as has been mentioned. People may have another disease that may contribute to the weight, or other physical problems.

What about little kids whose parents feed them whatever they want when they're toddlers (and perhaps only offer a not-so-great choice in food), and they are considered obese at a very young age? Are THEY responsible for their own actions?

And I believe that even someone who eats all the time and never excercises, thus leading to obesity, it can still be considered a disease. A LOT of diseases can be caused by one's own actions. Have you forgotten about diabetes, lung cancer and heart disease, just to name a few (no, those are NOT always caused by someone's own actions, just saying that they can be)?

Maybe we should all just take this to a new level, and start asking if people who are alcoholics and eventually need a liver transplant should get it, or smokers developing lung cancer or emphysema should have any treatment at all?

List of some important factors you may not be aware of:

Genetic Make up such as transfigured prohormone convertase 1, pro-opiomelanocortine, an over erratic leptin gene, malformation of the melanocortin receptor 4, can all play a major role in how your body responds to food.
Polygenic hypercholesterolemia; When a given genotype can becomes exacerbated by a disproportionate amount of things such as cholesterol, fatty acids, and of course saturated fat.
Matabolism
Psychological constituents such as particular simulants (a certain smell, or or person, or other such components) that trigger a specific responce such as overeating.
Depression
Lly, is that you? LOL

I would have to say that those folks without the medical reasons as listed by the lovely Angelia for their hugeness have no one to blame but themselves. One third of americans (not sure of the stats for canuckians) are over-weight. Fast food and over-eating are products of our western culture.

You can make a conscious choice to eat to live instead of living to eat. Just say NO to the Super-Size. Chocolate ice cream, potato chips and tira misu should be a treat, not a staple. The health problems and life shortening effects that go along with being obese are not worth that load 'em up visit to the candy aisle at Loblaws or (insert american grocery store name here).

Not to mention the strain it puts on our already over-loaded medical system.

A big congrats to all those who have been able to get a handle on their gluttony, and best of luck to those who need to get help with their health problems that are causing their obesity.

Andy

Maybe we should all just take this to a new level, and start asking if people who are alcoholics and eventually need a liver transplant should get it, or smokers developing lung cancer or emphysema should have any treatment at all? Hmmmmmmmmmm? ;)
20202020202020202020

Ok. Yes, I believe that obeisty is a disease. I am a former obese person. I used to weigh over 300 pounds. I tried everything to try and lose weight. It didn't work. So as a last resort, I opted for Gastric Bypass surgery. It has helped me get down below 175 pounds. I still have to be careful because of my predisposition to eat. I throw up a lot because I may have eaten the wrong things so it makes me sick. Try living with weight you can't control before you say that "fat" people are just lazy.

I dont believe Obesity is a disease, i believe people who are obese should get of there arse and do some exercise... but not all people are obese cause they are lazy, it could be cause of family background. Take me for example, my background shows big people, and i cant help it..

Lly, is that you? LOL I have no idea what you are talking about.. :o ;)

I would have to say that those folks without the medical reasons as listed by the lovely Angelia for their hugeness have no one to blame but themselves. I believe it is a conjunction of both, actually. ;)

Here is the way I see it: people who have problems with obesity will most always have one thing in common between eachother, which is that their body does not know how to properly store or expend the energy they consume. That said, it would be more or less a collaboration of eating more then that specific body can handle. I also believe such hormone defficiencies such as Leptin and Insulin, also play a major roles.

A low metabolism does not necessarily equal laziness or a fast-food junkie. I have a very high metabolism, and I can tell you right now there isn't a meal out there that will add more then a pound to me.

I have a very high metabolism, and I can tell you right now there isn't a meal out there that will add more then a pound to me.

Gosh, I so envy you!

Thanks for sharing some useful info/facts :)

http://news.yahoo.com/news?tmpl=story&cid=1508&u=/afp/20040716/hl_afp/us_health_obesity&printer=1
So, is obesity "a disease in its own right"?
Disease is understood as a harmful condition of the body, so I don't see how obesity would not fit the definition.
Should the U.S. government pay for "medically effective" treatments?
I think people who can afford these treatments should pay for them. Who pays for those who can't is a delicate issue that I will think about. Hopefully I can come back with some solution.

A low metabolism does not necessarily equal laziness or a fast-food junkie. I have a very high metabolism, and I can tell you right now there isn't a meal out there that will add more then a pound to me.
Oh i am right there with you~ I can eat and eat and eat and be lazy. I just have that SUPER metabolism that helps me out. I tried excersing but i am to lazy. If i can ever break 100 i will be a happy camper.

I do not know if i agree with Obese being a disease. I do think once you get passed a certain weight that it is hard to fix. I just do not get when you seen a heavily weighted person cram a plate full of food and then order a diet coke?
If The claim that infact this is a disease... will it be easier to have the surgries that they do. Stapling the stomach and so on. Bc i would be just a little bit pissed off having my tax dollars go to someone who cant control what they are doing with their life???Is that wrong?

Obesity makes me physically ill. Well, I despise the sight of majorly fat people. Am I a sizeist? Whatever, I can't help my taste, how I feel when I see something, so before anyone jumps on my back for saying "such a thing", it's the way I feel. If people are majorly fat because they are "uncontrollably eating", it really annoys me. Oh, and ladies, don't take that the wrong way and get all paranoid about us guys - my last girlfriend wasn't a twig, and I was really attracted to her. She wasn't overweight either, she had just the right amount of flesh.

Onto the topic, obesity is a disease, and people in Britain have to pay for treatment for skin rashes, hair loss, allergys... why should people's obesity be any different? So, no, they shouldn't be funded by anyone, they should have to deal with their problem like everyone else. They can start off by not eating so much, really.

While obesity may be considered a disease in certain populations, one also has to consider that in other cultures and in other races of people it is considered beautiful if not more healthy.

Here in hawaii, there are a lot of Samoan people. Samoans are enormous people, even the women. Their general body shape and size might be considered "obese," or even "ugly" by other people's standards. However, most Samoans would consider bieng skinny, ugly and unhealthy.

In Japan, Sumo wrestlers are treated as national icons, and part of their respect is earned by their size. It would be nice to have some statistics, however, to compare obesity in different races but I don't have any. :cool:

One thing that doesn't seem to have been discussed here are the reasons behind classifying obesity as a disease. In the world or insurance companies and governing bodies what is considered a disease has very little with the nature of the disorder and has more to do with disease being a term they throw on anything they cover and refusing to whatever they don't want to. So the question of is obesity a disease is a moot point since pretty much anything can arbitrarily be declared a disease or not to suit the needs of those making the decision.

Should obesity treatment be paid for by government or insurance? Well there are good financial sound reasons for treatments to alleve obesity to be paid for. Obesity increases the chances of developing many other conditions type 2 diabetes, heart disease, high blood pressure, stroke, cancer, gallbladder disease and gallstones, liver disease, osteoarthritis, gout, pulmonary problems and reproductive problems in women. If treating obesity can cause a signifcant enough reduce in the risk of devloping the realed conditions then it makes sense to pay for the treatment rather than paying to treat all of the potential affiliated problems.

I believe the same holds true for any addiciton, if you can save money by treating the main cause of the problems and make people's lives better in the process, why wouldn't you?

As for anyone who said that treatment for obesity should not be covered, what is your opinion on the related health risks should be paid for? If not, should we not refuse coverage related to any self-inflicted condition?

You've got lung cancer, sorry you smoked it's you fault. Liver problems, sorry you drink, not our problem. Your father had a heart attack, sorry he's 20 pounds overweight. You 12 year old emo son OD'd on sleeping pills, sorry again, that's self induced.

At what point do you stop paying for avoidable conditions?

As for anyone who said obese people just need to stop eating so much, you're grossly over simplifying things if you think you can just say "stop it" and people can solve the problem. Any addicition such as eating, drinking, smoking, drugs or cutting requires a more complex solution that just saying quit doing whatever the problem is. And above the other problems obesity become more problematic since there is no way to stop eating and going cold-turkey like you can with other addictions.

While obesity may be considered a disease in certain populations, one also has to consider that in other cultures and in other races of people it is considered beautiful if not more healthy. I agree that different ethnicities are going to view obesity in a very broad manner, but even still, what is healthy for our body has never and will never change. Of course there is some leeway as to what is considered healthy looking by each culture, but that does not mean that a sumo wrestler is medically healthy.

I believe that is what we are talking about here, is extreme obesity. When it becomes a health issue, I no longer look at it as a cultural difference.

I will testify that many problems I was going to have are gone. When I was obese, I had horrbile joint pain, back pain, I coluldn't walk around without getting tired, and I had lost my period thus losing my chance to have children if I kept the weight on. I treated it with surgery (which is a tool not a cure) and my life is better. I don't have the pain. I don't get winded. Now I can have children (some of ya'll know my pregnancy scares) I won't get diabetes like my mom and grandmother who got type 2 as adults. I will be able to enjoy my life better without worrying about getting too tired from carrying extra weight. It is a sickness. It's an addiction if you eat so much you put yourself $300 in debt (did that my freshman year of college), you eat everytime you see something, you eat, eat, eat, eat...ect. Now I eat 6 times a day, small meals, and if I eat too much like one bite over I regret it by getting sick. I am happy to do that. I get to spend money on other things besides food. This is a disease. It needs to helped. If not, then healthcare will be strained to the max.

There's an interesting interview with Paul Campos in the Denver Rocky Mountain News (http://insidedenver.com/drmn/opinion/article/0,1299,DRMN_38_3054218,00.html) today where Campos insists being overweight not always a bad thing.

Most people are obese simply because they don't take care of themselves. I think if someone wants medical treatment for obesity, then they should pay for it themselves. Yes, there are people that are just naturally obese, but then again there's tons of diseases that people are born with that isn't covered in health care. Maybe others' opinions'll be different, but obesity doesn't rank that high on the list of diseases.

Also, if the government pays for these treatments, it will have a negative impact on the people that are obese due to not taking care of themselves; thinking that they can continue with their lifestyle and use medical treatment to stay thin. That's even more unhealthy than being obese.

I don't think obesity can be classified as a disease - it comes from lack of the things we should be doing to stay fit. It cannot be treated with medical means - only exercise and a proper diet can do anything substantial. Sure, there are pills to make you feel like you're not hungry, but then you lose energy because you are not consuming the regular amount of food.

To stay fit, you must do a number of strenous and often painful things - things that cannot be done with medication. I run at least 4 times a week for 45 minutes each time. I eat a proper diet, and that is how I stay fit. Maybe some breakthrough can be made, but once the people are off the pills, what is to stop them from gaining all the weight back? Surely they would have to take it for the rest of their lives.

The only effective method is to exercise regularly and eat a healthy diet. The society has such high standards for people in terms of looks, so I can understand why people would want something as simple as medication, but would that not be merely temporary? Wait - let me re-phrase that, it didn't make sense. The effects would only be temporary - it's the same as these low-carb diets...They only last for a little bit.

Sorry to ramble, it's just...Natural courses must be taken. If the government is going to spend its money on obesity medication...Well, I think there are more important and urgent issues at hand...Just my opinion...Sorry to bore you;)

Obestity is a problem not disease, insurance companies may put it as a disease so that people can get gastric bypass surgery. But it is a problem. The gene that causes obesitiy cannot be in ALL the overweight americans. But who makes up the numbers for what is obese and what is not?
Gastric bypass surgery is not a solution, there are cases where people who had the surgery gain the weight back. Even though your stomach size is reduced you can still snack through out the day and gain the weight back, and there lies a psychological problem not a gene.
Also in this modern age of technology where everything can be bought at a click of a button, and you can take a miracle pill that does everything and makes the pounds melt away you have to wonder why there are so many diet pills out there. and most of them are bad in fact lethal....let's not forget that whole fen-phen incident where it KILLED people.

I take offense to that. I'm not lazy. I don't go to McDonald's and order three cheeseburgers and supersized fries. I don't eat that much, I drink diet soda, I exercise, I play tennis...yet it is almost physically impossible for me to lose weight. I have tried almost everything. While I'm not grotesquely obese, I'm heavier than I want to be. According to the statements I quoted, I should be just fine, huh? I used to be a smaller size. A spider bit me and the doctor put me on some strong steroids to control the infection. About the same time, my other doctor put me on birth control pills. The combination of those two drugs completely changed my body chemistry and I gained a lot of weight. I didn't ask for it. I don't overeat. If they did their medical research and found something that would effectively jumpstart my metabolism, I would be all for it.

So please don't just write stuff like that off to people being lazy. It isn't always the case.

I'm very sorry. I really am. I didn't mean for my statement to offend anyone (especially one of the most powerful mods on this board ). I obviously forgot the effects of medicine and of course the metabolism and genetics of people. I just feel very strongly about laziness and people overeating because that's all I am around in my family. Not in my house but the ones that do not live with me (uncles, aunts, cousins). I just see them eat so much and they do nothing. It just made me sort of angry to see that.
I focused on one cause of obesity making me come across very narrow-minded and immature when I typed that out. However I still do not think that obesity should be refered as a disease.
But I truly am sorry if my post has offended you or anyone else on this board.

I'm very sorry. I really am. I didn't mean for my statement to offend anyone (especially one of the most powerful mods on this board ). I obviously forgot the effects of medicine and of course the metabolism and genetics of people. I just feel very strongly about laziness and people overeating because that's all I am around in my family. Not in my house but the ones that do not live with me (uncles, aunts, cousins). I just see them eat so much and they do nothing. It just made me sort of angry to see that.
I focused on one cause of obesity making me come across very narrow-minded and immature when I typed that out. However I still do not think that obesity should be refered as a disease.
But I truly am sorry if my post has offended you or anyone else on this board.

I hear it from my family all the time. They eat all the time. They aren't really overweight, though. But they give the dog snacks all the time, and our 40 pound Sheltie is in horrible health. She's supposed to weigh 15 to 20 pounds. THAT is overeating.

Oddly enough, I've completely lost my appetite for the past few weeks. I'm going on like a piece of bread a day. Occasionally a little bowl of pasta. I've lost 16 pounds since I posted my last post in this thread, but I think most of it is from stress/zero appetite.