Q&A: 10 years of obesity recognized as a disease

Key takeaways:

• June marks the 10th anniversary of the AMA’s recognition of obesity as a complex disease.
• An obesity medicine physician discussed with Healio what the decision meant and the progress that has been made since.

This month marks 10 years since the AMA recognized obesity as a complex disease.

When the AMA recognized obesity as a “disease state with multiple pathophysiological aspects requiring a range of interventions to advance obesity treatment and prevention” in June 2013, the move was widely regarded as a turning point in obesity medicine.

Healio spoke with Katherine Saunders, MD, an obesity medicine physician, co-founder of Intellihealth, a software and clinical services company, and clinical assistant professor of medicine at Weill Cornell Medicine, to learn more about how the AMA’s recognition affected obesity medicine, what progress has been made since and more.

Healio: Why was it important for the AMA to recognize obesity as a complex, chronic disease? What progress has been made in the 10 years since the recognition?

Saunders: The first step to improve access to effective medical treatment for individuals with obesity and to combat weight bias, stigma and discrimination is to recognize obesity as the complex, chronic disease that it is. In the decade since the recognition, more health care providers are becoming specialty trained in obesity medicine, more payors are covering treatment for obesity, including anti-obesity medications, and fewer patients are blaming themselves for their disease.

Healio: What was the effect of that decision on obesity care in the United States? Is there a measurable impact?

Saunders: Access to care is slowly improving, and more and more effective and tolerable treatment options are coming to market.

Healio: Why did the AMA wait until 2013 to make this decision?

Saunders: There was a long-held belief that obesity was just a lifestyle problem (that people developed obesity simply because they chose to eat too much and exercise too little); however, groundbreaking research over the past few decades proved that this is not the case. The recognition came after the body of evidence was strong enough to support the classification of obesity as a disease. We know that there are distinct pathophysiological changes that occur with excess weight that facilitate more weight gain and prevent weight loss. We also understand more and more about how obesity leads to over 200 other comorbid health conditions.

Healio: Did the decision have any impact on medication for obesity? Many physicians will recommend medication because obesity is a chronic disease and medication helps manage it — does that have anything to do with the AMA’s decision?

Saunders: Yes, clinicians look to medical societies and organizations for guidance. The AMA’s decision prompted many other medical societies and organizations to recognize obesity as a disease and to develop medical guidelines. The standard of care now for obesity management includes a comprehensive medical evaluation and appropriate medical treatments as indicated.

Healio: What needs to come next to make obesity treatment more widely accessible?

Saunders: More clinicians need to be trained to provide quality medical obesity treatment, and medical coverage must be expanded to cover these treatments.

Reference:

• Obesity. https://policysearch.ama-assn.org/policyfinder/detail/obesity?uri=%2FAMADoc%2FHOD.xml-0-3858.xml. Published June 2013. Accessed May 25, 2023.