In case you hadn’t heard, the American Medical Association classified obesity as a disease last week.
As CBS reported, “Medical therapies and procedures like the lap-band or gastric bypass surgeries are courses of treatment that may now be included in insurance coverage, based on the AMA’s decision.”
Does that sound like good news for the obese? Maybe. It sounds like even better news for the pharmaceutical companies who market weight loss drugs and the doctors who perform weight loss surgeries.
Will losing weight actually make people healthier, though?
Yes, there are certain health risks associated with having an elevated BMI, such as Type II diabetes and heart disease. More broadly, a higher BMI is associated with a greater risk of cardiometabolic abnormalities, as measured by blood pressure, triglycerides, cholesterol, glucose, insulin resistance and inflammation. Nonetheless, almost one quarter of “normal weight” people also have metabolic abnormalities, and more than half of “overweight” and almost one third of “obese” people have normal profiles, according to a 2008 study. That’s 16 million normal weight Americans who have metabolic abnormalities and 20 million obese (or 56 million overweight and obese) Americans who have no such abnormalities. (Abigail C. Saguy, read full article here)
I think medical procedures should be available to those who need them, but this decision from the AMA troubles me. It seems like one more way that our society promotes appearance over substance.
We want people to be beautiful more than we want them to be healthy, and we equate thin with health.
Why can’t insurance companies cover treatments based on metabolic abnormalities, instead of BMI? If the doctors believe gastric bypass would be an effective way to treat heart disease, cover it. However, if it isn’t making one sick, why is obesity a disease?
Am I jaded that I think this decision was based on money? There is so much money to be made in the weight loss industry. $61.6 billion in 2012. Most of that money is not spent in doctor’s offices or on pharmaceuticals. Even less of it is spent on surgical solutions. According to Marketdata Enterprises,
The number of bariatric surgeries is significantly less than reported by the ASMBS (bariatric surgeon’s national society). Surgeries peaked at 135,000 in 2008, according to government healthcare agency data (not 209,000 reported by the ASMBS). However, since then, insurers have gotten tougher on coverage and the number has fallen 15% to an estimated 114,000 last year. This reduced the size of the total weight loss market by $2.6 billion and translated into less business for bariatricians and VLCD programs.
Now that obesity is a disease, perhaps those numbers will change.
It seems like we are still moving one step forward two steps back when it comes to body image. We have campaigns to promote the idea that healthy beauty comes in all sizes. Then we declare fat a disease.
Sorry, you’re not beautiful; you’re sick. Poor pitiful you. It’s not your fault; you have a disease. Let me cure you, then you’ll be happy, healthy, and – most of all – thin.