Thursday, June 20, 2013

Really Not Sure How I Feel About This One...

American Medical Association votes to recognize obesity as a disease
In order to fight what it described as an "obesity epidemic," the American Medical Association voted on Tuesday to recognize obesity as a disease and recommended a number of measures to fight it.

The association voted on the measure at its annual meeting in Chicago. The AMA noted that obesity rates in the United States have "doubled among adults in the last twenty years and tripled among children in a single generation" and that the World Health Organization, the U.S. Food and Drug Administration and Internal Revenue Service already recognize the condition as a disease.
Now, I'm torn here. On the one hand, obesity is - with very few exceptions - 100% curable with no medical intervention. It's tough, certainly; however there is simple nothing stopping folks from changing their dietary habits and losing weight. Been there, done that. Yes, there are cases where there are physiological defects that cause people to become obese even though they are not overeating - but they dwarfed by plain old over-consumption.

Few would dispute that being obese leads to many other diseases - there's a great deal of evidence to that end. Make a dent in the number of obese Americans, there will be a corresponding decrease in these diseases. We're getting fatter as a nation, and reversing this trend is going to take a herculean effort.

But calling obesity a disease is a lot like calling "gun violence" an "epidemic". Obesity is a condition; gun violence is a specific subset of a type of crime. You don't catch obesity. You don't suddenly wake up one morning obese. It's pretty hard to miss the warning signs of weight gain, heart disease, etc. Simply put, it requires conscious effort on the part of the obese person to become obese, unlike someone suffering from cancer or high blood pressure.

There's the rub, though. We all crave the quick fix, and when we can't get it, we demand that someone step in and save us from ourselves. Can't put down the double bacon cheeseburgers? It's not your fault! You suffer from obesity! Obviously we'll need a government funded study to find out why you can't put down the double bacon cheeseburger, and then a government grant to study double bacon cheeseburgers, and finally a comprehensive "double bacon cheeseburger buy back" plan to take those dangerous food items out of overweight hands.

Good luck "warn[ing] of the risks of obesity." Good luck "highlight[ing] the benefits of exercise." Good luck pushing anything that vaguely resembles taking responsibility for your own actions. We don't need to take responsibility for our actions, remember? That's what Big Nanny government is for. Cigarettes are bad? Sue the tobacco companies! Heart disease is bad? Ban trans fats! Ban large sodas! Not "learn how to only have one double bacon cheeseburger. Not "take the stairs up one floor instead of the elevator". Those things are hard and require effort. Not like "Poof! All large sodas are hereby banned".

Just think about how much better it will be when they control *all* your healthcare and start mandating exercise...

That is all.

Another dispatch from...
(image courtesy of Robb Allen)


Armed Texan said...

I absolutely cannot wait for the day (coming real soon) when the IRS calling for its pound of flesh from each and every one of us becomes a literal phrase.

Waffenbesitzer 2.0 said...

Personally, I see an even bigger problem: Even if one agreed that there is such a thing as an obesity epidemic, and following that, knowing that "something needs to be done", the government would find the most stupid solution do so.

Let's keep in mind about official health statements that
* the "food pyramid" that is commonly mentioned as base of healthy nutrition is outdated by about 40 years
* that the BMI as measure for obesity was never intended for that in the first place and produces worse results that even simpler formulas like height-to-waist.
* that the typical official answer regarding sports it "go running", which every trained professional will agree, is one of the worst ways to start.

Rob said...

This 'medical condition' looks to be a byproduct of cheap fast food, large sugary carbonated drinks & Madison Ave.
Don't eat it is the simple cure but with a share of McDonadls (MCD-NYSE)going for $98 & change this morning this is not as simple a cure as might sound.

Obesity is not the disease, rather the symptom maybe?

LCB said...

I think there is a point of no return where diet alone will NOT cure obesity. For me...losing 20lbs was a simple matter of cutting carbs way back in my diet. But for someone that's morbidly obese...say 100lbs overweight...I think the body's control mechinisms are toast from the a high insulin diet (re: carbs).

Gary Taubes "Why We Get Fat..." talks about this point of no's very sad reading.

JD Rush said...

Now the disability rolls will swell up even more. Pun intended. As a disease, does that have Obamacare implications?

Jay G said...

I was > 100 pounds overweight. Close to 300 pounds at my heaviest.

Last month marked the sixth year anniversary of going off blood pressure medication.

How did I do it? Quite simply, I counted calories.

I spent two weeks where I ate like I always did, and I counted up the caloric intake.

I was SHOCKED. North of 4,000 calories a day, for a sedentary lifestyle.

I dialed it back to 2,750. Weight came off slowly at first, but as it started to come off, I dialed my daily intake back to 2,500.

Then 2,000.

Then 1,500.

It took me almost a year and a half - the goal was to lose 1-2 pounds a week - but I lost over 100 pounds.

It SUCKED. And in many ways, some 7 years later, it still sucks.

I pass on the office birthday cake.

I pass on going out to lunch once a week.

I pass on my beloved Dunkin Donuts large regular every Friday.

McDonalds only gets my business when I'm taking my kids out for a treat (and even then, they get it maybe twice a year).

It's hard, and it requires a LOT of willpower, but it most certainly CAN be done.

Cormac said...

I'm 6'4" 255 lbs with a 36 in. waist...and I'm obese according to the BMI calculator...

Does this mean I qualify for disability or something?

joethefatman said...

I'm fat not diseased. And saying it's a disease is BS.

Butch Cassidy said...

Jay, I've lost fifty pounds since you met me through hard work and family support. And I spent a couple years toting people about in back of an ambulance. I'll make a couple points:

1. Obesity has very real and negative effects on health like diabetes, decreased mobility, elevated blood pressure in many cases, etc.

2. I'm sure other libertarians will yell at me, but this could be better for welfare. Would you rather see your tax dollars handing out gym vouchers and the government grants to install bike racks for employees or pay a ton into medical care when an obese person has heart problems?

3. Children now grow up thinking that obesity is just a thing. When they need quidance away from sloth and candy, "you are sick and I can help" carries a much better message than, "stup being a lazy bum."

4. Yes, it is usually a choice to get fat. Getting better is hard. dietary education is pathetic, gyms cost money and time that our over-time obsessed society has precious little of, and it still hurts people's health. A kick in the pants to improve there is fine by me.

Chasing Freedom said...

With the addition of obesity as a disease, it looks as though traditional medicine has learned the same lesson as the mental health profession: If you make the categories broad, the checklists vague and the testing measures ambiguous - you can diagnose yourself money. If they keep at it they'll turn a healthy populace into a diseased nation; one that they must save from itself. Doctor knows best.

Anonymous said...

First, obesity has had a medical code since there were medical codes. Doctors have been able to bill for it forever. (Obesity 278.00, Morbid Obesity 278.01).

If obesity isn't a disease, what about alcoholism? I remember these exact same arguments when it was officially categorized a disease, the same with drug addiction and nicotine dependence. If obesity isn't a disease, what about HIV, which is essentially only a disease among those who use drugs illicitly or have sex indiscriminately, both lifestyle issues just like overeating. In fact, you could point out that HIV is even more so, since you have to eat to live, but you don't have to do illicit drugs or have sex to do so!

Yes, its treatable without medical intervention, but so is diabetes, hypertension, and a myriad of others.

My definition of disease would extend only to medical conditions which had NO lifestyle component. That means disease that is caused by a virus or bacteria, or that is a medical condition with nothing but a genetic or unknown cause, like ALS, or Lupus, etc.

Hows that fit?

Its an imperfect world, and medical science is still an art, not truly a science. The tags don't matter. We need to recognize that obesity is a HUGE issue, and costs extend to TRILLIONS of dollars a year. And we need to attack it like we attacked Smallpox and Polio, or we will have to deal with the consequences.

Dave H said...

When they reported this on the radio last night they said one result of the AMA's decision is that health insurance may now be required to cover treatment for obesity. On the one hand, yes, it'll help drive up insurance costs, but on the other hand, porkers like me are going to drive up costs with more expensive problems like heart disease, diabetes, and worn out joints anyway.

lelnet said...

Also, enjoy the follow-on consequences. If obesity is a disease, does it mean that IPAB gets to veto any treatment for it that doesn't fit the current fads, the way they'll be able to with every other treatment beginning next year?

If so, look for eating a low-carb diet to become a felony, whether it works for you or not. No, now we'll all have to stuff ourselves with grains and pasta, and a significant fraction of us will balloon to mammoth proportions in consequence, while the government just screams at us to DO IT AGAIN, BUT HARDER!

Fun fun fun.

Geodkyt said...

Part of the issue, as Anymous @ 1:09 PM alludes to is the simple fact that we have confused the terms "disease" with "disorder".

Of course, as a nationally recognized "disease", the Americans with Disabilities Act kicks in, correct? Think on the implications of that -- as well as the fact that obesity is WAY overrepresented amongst generationally dependant lower socia-economic individuals. . .

Daniel in Brookline said...

Perhaps we should distinguish between "doing X is hard, but worthwhile" and "I can't do X without government assistance".

Or, to put it in a libertarian context, "I can't do X without demanding tax money from everybody in the United frikkin' States of America".

Yes, it is possible to get yourself into trouble from which you need serious help to get back out. And of course, there are varying degrees of this -- how much damage you do to yourself, how easy it is to get in, how hard it is to get out (alcoholism, drug addiction, obesity).

But at what point is it the Federal Government's responsibility to deal with this, using your money? At what point does our elected government have the right to figuratively point a gun at your head and say "you ARE your brother's keeper, and you must do what we think will help him"?

Friends, we lost that battle long ago. First our government told us they could force us, against our will, to buy health insurance. Now they can declare anything they want to be a disease, and therefore require health insurance to pay for treating it (and require you to pay for it with increased premiums and/or increased taxes to keep the insurance companies afloat).

How long need we wait before hair color is considered a medical condition?

Or, more in line with the nature of this blog, how long before the DESIRE to keep and bear arms is declared a mental illness, requiring a cure? We're basically one CDC study away from that right now, folks.

The Law of Unintended Consequences has bitten us, hard, and it's only the beginning. We're in for some grief before common-sense reasserts itself. (I'm confident that it will -- this is America, and we've ridden through waves of hysteria before -- but it won't be pretty.)