The nation’s top doctors’ group has voted to classify obesity as a disease.
An overdue bow to science or a clever dodge of the real problem? The American Medical Association’s decision Tuesday to classify obesity as a disease left the weight of expert opinion, so to speak, unsettled.
“Long time coming—I have been fighting for this for over 20 years,” says Caroline Apovian, a School of Medicine professor of medicine and pediatrics, and director of the Nutrition and Weight Management Center at Boston Medical Center.
Obesity researcher Daniel Miller is more circumspect. The School of Social Work assistant professor fears that the decision “will prompt people to further identify obesity as a purely medical problem, and one that is best treated by pharmaceuticals or surgery,” leaving what he calls the root causes—social and environmental influences—in the dust.
Miller agrees, however, that if the decision “means access to treatment for some who otherwise might not be able to get it, that is obviously a good thing.”
Then there’s the wait-and-see school. Whether the AMA made the right call depends on whether it “will reduce the number of obese Americans and the gravity of their obesity,” says Alan Sager, a School of Public Health professor of health policy and management. And take-two-pills-and-call-me-in-the-morning hasn’t worked to date to stem the wave of weight, he says: “Doctors have never been the most powerful actors in combating obesity,” which has mushroomed because of such issues as the cost and distribution of good food, and changes in exercise patterns.
Apovian says the disease designation is justified by research showing that weight gain in animals correlates to damage in the gut-to-brain signaling system. “The body does not recognize how much fat is being stored,” she says. “Therefore, you do not feel full, and keep eating.”
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