Although obesity is the second most widespread cause of preventable death in the United States, many people still disagree over the American Medical Association’s June decision to classify obesity as a disease. Licensed mental health counselor William Anderson agrees that it is, and he carries an unusual personal credential: after “years of obesity and dieting failure,” he lost 140 pounds and then maintained his new weight for 30 years. Anderson asks a question and, in the spirit of full disclosure, makes a statement:
Is classifying obesity as a disease about health, or is it really all about money?
I should also point out that I’m one of the professionals whose mission and livelihood is providing weight loss treatment to overweight people.
Many professionals believe that the disease classification is the only route to receiving fair compensation for their work. Insurance companies are reluctant to pay unless they see that label. But Anderson seems to have doubts when it comes to, for instance, the American Society for Metabolic and Bariatric Surgery. Many professionals in the childhood obesity field view surgical intervention as a desperate last resort, and would prefer that it not be too easy for patients to afford. Anderson writes:
Drugs and surgery are not going to fix what is causing this epidemic…. It’s caused by recent changes in our environment and behavior. We have a different culture than we had — different foods, a different food industry, a different mindset and habits. Those are the things that need to be fixed to end obesity. Drugs and surgery will not do that, but if we’re not careful, that’s where all the attention and money will go. If that happens, the problem will get worse and we’ll go broke to boot.
It is certain that many professionals contribute beyond what they can collect payment for — like Dr. Jamie Jeffrey, who checks in with her young overweight and obese patients through Weigh2Rock. She does this pro bono, but she says it’s worth the effort in terms of its effect on the children, who seem “more likely to stay on track with their nutritional and activity goals,” as well as more conscientious in keeping their appointments.
Weigh2Rock is of course the website founded by Dr. Pretlow, who describes the process:
The children weigh in on their secure individual charts on the site, via the eCare system, and the provider[s] may monitor the weight charts of their patients and post secure supportive and educational messages to the child in each child’s individual ‘e-Room.’
As always, the financial aspect of the obesity epidemic looms large. Even with the modern availability of data, it is difficult to quantify such things. Lisette Hilton, author of the Contemporary Pediatrics article that extensively quoted Dr. Pretlow, found information on what happened throughout the United States in 2005. The figures always take a while to sort out and tabulate, and that year’s numbers suggest that obesity-related health care expenses totaled around $190 billion, which is a staggering amount. When the figures from subsequent years have all been crunched, the big picture is apt to look grim.
The American public is periodically stunned by impossible-sounding numbers coming out of Washington — numbers that have become so huge we can’t even wrap our heads around them. But Hilton makes a much more comprehensible point, one that has perhaps been lost among the many facets of the obesity discussion:
Because of obesity, today’s pediatricians are witness to an onslaught of pediatric patients with adult-like physical and mental health problems. Obesity in children and adolescents is associated with multiple comorbidities, including metabolic, cardiovascular, gastrointestinal, pulmonary, orthopedic, and psychological disorders.
In other words, although all physicians go through the same basic training, they do concentrate on one specialty, and the doctors trained to care for children have been ambushed by an onslaught of problems and conditions they never expected. Forced to play catch-up, they must acquire expert knowledge of conditions they never thought would show up in their waiting rooms.
Your responses and feedback are welcome!
Source: “Calling Obesity a Disease: Is This About Health or Is It About Money?,” HuffingtonPost.com, 07/09/2013
Source: “Overview: childhood overweight and obesity diagnosis and treatment,” ModernMedicine.com, 09/01/13
Image by Wayne Noffsinger