Written on April 14, 2023 by Theresa Vuskovich, DMD. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
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The American Medical Association (AMA) House of Delegates answered the question, "Is obesity a disease?" in 2013.[1] According to the AMA House of Delegates, obesity is a disease. By designating obesity as a disease, the AMA aimed to increase funding for obesity-related public health initiatives and health insurance coverage for obesity-related treatment. Nevertheless, many medical authorities see obesity not as a disease but as a consequence of lifestyle choices.[1]
According to the Centers for Disease Control and Prevention (CDC), approximately 41% of Americans have obesity.[2] Obesity is an epidemic affecting people of all racial backgrounds and socioeconomic statuses. Obesity increases your risk for various chronic diseases, including Type 2 diabetes mellitus (T2DM), heart disease, stroke, and cancers [2,5]
What is the definition of a disease, though? Currently, there is no universal definition of disease.[3] According to one definition, a disease is a set of signs and symptoms or a condition with an underlying cause.[3] Based on this definition, obesity is a disease since it has distinct symptoms and may have underlying causes. This article aims to explain the debate around defining obesity as a disease.
Obesity is characterized by an excessive accumulation of body fat, which can adversely impact health and is diagnosed based on your body mass index (BMI). Your BMI is calculated based on your height and weight. Here is how each BMI is categorized for adults [4]:
Getting diagnosed with obesity requires a healthcare provider's expertise. Aside from BMI, other factors are considered when a healthcare provider is diagnosing obesity, including age, race, waist circumference, and family history. Body composition and muscle mass make it possible for people to have higher BMIs while still being healthy.
How you carry excess weight can also impact the health effects of obesity. Abdominal fat is more likely to cause health problems. [4] Even if you have a normal BMI, a waist size greater than 40 inches for men and 35 inches for women increases the risk of obesity-related diseases.[4]
A healthcare provider needs to consider all of these factors when diagnosing obesity. Providers aim to reduce obesity-related health risks and help people live healthy lives.
While there is no specific set of signs and symptoms associated with obesity, people with obesity commonly experience the following [4,6]:
Obesity often has an underlying cause. Taking certain medicines or having other medical conditions may increase your risk of obesity. The following are some common causes of obesity[4,7]:
Obesity is a genetic condition, and obesity is associated with more than 100 genetic syndromes. [8] Additionally, people with a family history of obesity are more likely to become obese.[8] Genes can play different roles in the development of obesity. Genetic factors causing obesity can be categorized as follows [8]:
Obesity can result from changes in your metabolic hormones. Thyroid hormones contribute to your metabolism, and a deficiency in these hormones can contribute to obesity. Obesity is also linked to metabolic syndrome.[9]
Metabolic syndrome occurs when an individual has multiple factors that lead to heart disease. [9] Individuals with metabolic syndrome typically have insulin resistance and T2DM. Sedentary lifestyles and obesity are risk factors for metabolic syndrome. Although some people with metabolic syndrome have obesity, not everyone with metabolic syndrome is obese.
Metabolic syndrome is characterized by the following symptoms [9]:
Obesity is a complex condition, and some experts disagree about whether it is a disease.[1,10-12] The AMA's Council on Science and Public Health disagreed with the AMA House of Delegates' decision to define obesity as a disease. Other organizations, such as the Obesity Society and the American Association of Clinical Endocrinologists (AACE), released position statements also defining obesity as a disease.[11,12]
Some experts believe obesity is a risk factor rather than a disease.[11] They believe obesity is the consequence of modern living. Additionally, some people, who are diagnosed with obesity based solely on their BMI, are healthy and do not have any medical conditions.[11] As an additional problem, defining obesity as a disease fosters irresponsibility and forgiveness for unhealthy living.
Yet, other experts believe defining obesity as a disease will raise awareness of the problem. The Obesity Society seeks to improve the obesity epidemic by recognizing obesity as a disease. The organization believes this designation will bring greater awareness to the epidemic and shift the perception that obesity is solely based on lifestyle.[12] Additionally, they believe it will reduce some of the stigma people with obesity face. The designation may make getting insurance coverage for weight-management treatment and prevention easier.
Insurance will cover some weight-loss treatments, but coverage varies widely based on your health insurance plan. [13,14] The Centers for Medicare and Medicaid Services (CMS) does not recognize obesity as a disease.[11,15] However, they removed a sentence stating "obesity is not an illness" in their manual.[11,15]
Obesity treatment is covered under the Patient Protection and Affordable Care Act (ACA). [16] However, coverage varies considerably from state to state. As a result, it is important to confirm coverage with your health insurance provider when seeking obesity-related treatment.
The Everlywell Weight Care+ program is a weight management program providing treatment for weight-related conditions. The program offers support throughout the weight loss process with virtual care visits with a healthcare provider. Your healthcare provider will create an individualized plan for you which may include medication. However, medications are prescribed based on clinical judgment and are not guaranteed. Weight Care+ helps you get your weight down to a science.
Obesity-related comorbidities: what comorbidities are related to obesity?
Managing obesity in patients with comorbidities: what to know
References