AMA Says Obesity is a Disease

Bad DoctorA year ago the American Medical Association charged its Council on Science and Public Health with studying whether or not obesity should be considered a disease.  Today they ignored that council’s recommendation and now, per the American Medical Association,  Arnold Schwarzenegger, Tom Cruise, Barry Bonds and I all have the same disease.

To be very clear, there is no shame in having a disease, I think that there is shame in the actions of the AMA.

So does that mean that Tom Cruise needs to start diet pills?  Does Barry Bonds have to sign up for Weight Loss surgery?  After all, they are obese by the clinical definition and obesity is a disease per the AMA  So you can see why the Council on Science and Public Health thought this was a bad idea.  The “disease” is a body size, the “cure” is to change the body size and nobody has to take any health measurements at all. This does not have the feel of sound science.

But really it’s just the Council on Science and Public Health and what do they know about science and public health making  a profit for pharmaceutical companies?

“Companies marketing the products will be able to take this to physicians and point to it and say, ‘Look, the mother ship has now recognized obesity as a disease’” says Morgan Downey, a self-identified advocate for obese people and publisher of the online Downey Obesity Report.  I’ve got to say, with advocates like this, who need detractors.  Morgan gets paid to consult for organizations that represent companies that market these products, so it’s a good day for him.

In a blatant attempt at “if wishing made it so” the AMA resolution stated hypotheses as if they were facts:

Whereas, Weight loss from lifestyle, medical therapies, and bariatric surgery can dramatically reduce early mortality, progression of type 2 diabetes, cardiovascular disease risk, stroke risk, incidence of cancer in women, and constitute effective treatment options for type 2 diabetes and hypertension;

It’s important to note that there is not a single study that proves this.  They forgot the last sentence which is “We guess.”  They also ignore the fact that many obese people never develop these issues and plenty of thin people have them.  Not to mention that one reasons that good research doesn’t exist is that so few people have lost weight long term that there aren’t even enough to study.  That’s because there aren’t any weight loss methods that are shown to work long term for more than a tiny fraction of participants, and studies don’t have a success criteria that included a change in BMI, often the “successful” weight loss amounts to 2-5 pounds.   There’s weight loss surgery but that has a high rate of weight regain and may have a 700% greater chance of dying in the first year alone and no proof that those who underwent the surgery have any better health outcomes than they would have if they had skipped the surgery and practiced healthy habits, so that’s questionable at best.

So against their own recommendations the AMA declared body size – including my body size – to be a disease.  No actual health measurements necessary, just a quick ratio of your weight and your height and they’ve got you diagnosed.  They aren’t the first, the NIH has considered me, Mel Gibson, and most NFL linemen to have a disease for a while now. No matter how many organizations say it, I don’t think it’s medically and scientifically sound.  I do think it’s profit driven.

I’m still going to the doctor’s office as the CEO of my healthcare team.  I’m still going to say the same things at the doctor’s office, I’m still going to insist on appropriate, evidence-based health care.  I will continue to defend my amazing body from any and all attacks. So bring it on AMA, I’m a fat woman, but I will not be your cash cow.

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44 thoughts on “AMA Says Obesity is a Disease

  1. I completely misunderstood what I saw on facebook. I interpreted it as the AMA did NOT say obesity was a disease, but now I see that they were told by the Councel on Science & Public Health that it was not, but decided to listen to those bankrolling them, & call it one anyway. Sorry for my mistake & this is just one more thing for me to add to my list of reasons why I have no respect for or faith in the medical profession & why I avoid doctors as much as possible.

    1. The article I read yesterday said that the AMA said it was NOT a disease. Maybe the press was confused yesterday. Or maybe I was confused.

    1. OMG I can’t believe this guy actually posted this comment after that medpagetoday article

      Brainmaster
      06/19/13
      My favorite topic. As I tell all my “I can not loose the weight no matter what I do” patients: There were no fat people in the concentration camps!! Low nutritional intake and increased energy expenditure will do the job..

      So I suppose we need to have camps for all fat people and we’ll call them “Fat Camps” and does anyone else think some of this ridding the world of obesity crap is smelling of Hitler??

      1. Just read all the comments – there are a lot of ignorant people out there. It has always mystified me that a lot of people seem to think that just because they’ve had a certain experience with something, everyone else will have exactly the SAME experience that they did. Everybody has a different genetic make-up, different circumstances, etc., etc. How can any intelligent being even think for a second that we’re all the same? I just cannot get it. Maybe I’m the ignorant one, I just can’t comprehend what is so difficult to understand.

      2. Somebody. Seriously. Tells his patients. That they need to try harder. Like the inmates in Auschwitz. And Birkenau. And Dachau. And Treblinka. And Ravensbrück. And Sobibor. And dozens of other concentration and extermination camps, where guards shot human beings because they were bored, and the skies billowed black and oily with the output of monstrous crematoria. Somebody compared weight loss in the current era with hours upon hours of forced labor, and a bullet to the brain to anyone that fell in the fields, with only a small bowl of watery cabbage soup and a small piece of bread at the end of the day–first come, first served, too bad if they ran out.

        Please, please, please, please, please let this so-called caregiver say that to someone like the love of my life, whose great-grandmother was shot by an SS officer execution-style and buried in a mass grave. I promise you, he’ll never practice again.

          1. I have absolutely no doubt there are some who’d gladly see it happen, and many, many more who’d simply put us all in Biggest Loser camps until we lose our weight, then straight back when we put it on again. Arbeit macht frei, my ass.

      3. I can’t believe this clown actually sounds pleased with him/herself for treating their patients like this. Sure, the prisoners in the death camps may have been enviably slim but I would remind the good doctor that those people were suffering and dying and not in any way, shape or form “healthy “

  2. Of course, while messers Cruise, Gibson, and all those NBA players have the same ‘disease’ I do, my guess is that not one of them will have a doctor sit them down to discuss what can be done to ‘cure’ it.

    After all, they have the ‘disease’ but they don’t have the symptom: they don’t look fat.

    Fuck you, AMA! And the horse you rode in on!

  3. I wonder when “they” are going to start trying to FORCE us to have WLS. I’ve got a couple of doctors trying to steer me in that direction right now. Of course, I told them – NO WAY, NO HOW!!!! Damn, just treat what I came to see you about and leave me alone.

    Marilyn Wann put a petition a change.org if you want to sign it.

    1. That was not what I wanted to post. Dang it.
      I’m a healthcare professional and I’m appalled at what the AMA has done. In fact, I’ve had weight loss surgery that was a failure from the beginning and I would never recommend it to anyone. Most of my weight loss has been regained. And I did this for my “health”! Are you kidding me? I have more problems now than I did before. I have constant digestive issues and when I get a GI bug, I can’t vomit. I just have to live in misery until it passes. The AMA can kiss my large white ass on this one. My body size is not a disease and I’ve tried everything I’ve been asked to do to drop weight. I’ve never been successful. When you start dieting at age 7, well, it screws up your metabolism, and a lot of you know what I mean.

      If obesity is a disease, surely they also have a cure. Is this a disease just like cancer? Then do the research, the unbiased, real, scientific research that supports this and can also provide a “cure”. And start talking to anyone who has a BMI in the obesity range, whether they “look” fat or not. Preach to them about dieting and the need to lose weight for their “health”. Let’s see how the rest of these people feel when they are targeted for their size. And the doctors that are obese need the lectures, too. They need to go on a diet, start an insane exercise schedule, and then maintain that once they are within the “not sick” weight range.

      Can I get disability for being fat? If its an illness, and I can’t be cured, can’t I be disabled? Its intractable. Hmmm…

      I’m done with this crap. Take me as I am or get the fuck out. And I usually ignore my doctor when she starts in on the weight crap. I know what I’ve been through and what I’ve tried. Telling me to eat a low-carb diet one more time lands on deaf ears. Thanks, but my blood pressure, cholesterol and all of that crap is within normal limits. If my size bothers you, look the other way.

      1. I’m with you. I’m a burned out (fat) LPN. I’m sick of working. Since I have a plethora of diseases (bipolar disorder, borderline personality disorder, obsessive-compulsive disorder, fibromyalgia, hypothyroidism, hypertension, and now, according to the AMA, obesity) can I get disability so I can quit working?

        1. I’ve got bipolar II and fibro, among other things, and those two were critical in my SSDI approval. If you really feel you’re too sick to work, you’re too sick to work. Keep in mind, my psych and neuro issues are exceedingly touchy. They also include anxiety issues, possible PTSD from my extremely abusive marriage–bastard won’t even grant me a divorce, and he kicked me out four years ago–and Asperger’s syndrome. I’ve got other physical issues that weren’t considered severe enough to be disabling, too.

          If you need to apply, good luck. {{{{{HUGS}}}}} And get a good attorney. That’s the best damn advice I can give you.

        2. I am on disability as I am disabled and can’t work. Not don’t, can’t even though I wish I could. There is a 2000 dollar limit to what you can have. This goes total for all the money you have and any assets. This means I cannot put any money away for a possible emergency nor for the future like they tell normal people it is smart and the obvious thing to do because savings accounts would count against me. Do you own a car? Asset. They can require you to sell anything they say and if you don’t then you’re rejected and that’s the end, luckily I didn’t own anything. I get 7800 a year and that is my only income. I don’t get enough to pay taxes. Not even half the amount needed to pay. If you can work, even the shittiest job will make you more than that in a year and more than I get a month. I just checked and according to 2011 stats, I am 4000 bucks below the poverty line. I am lucky I can live in my parent’s house and pay rent from my payments but someday they will be gone and that amount, may not be enough to pay for my own place to live. I don’t know what will happen to me. Also when you apply, you give up all your privacy. They have access to my bank account, they know everything about me that I was required to tell them and they can access any kind of records about me and for someone who highly values their privacy this was extremely hard. Not only that, I got accepted the second time but the first time they: sent me to their own psychologist as part of the application process then proceeded to discredit and berate her analysis as false even though it matched up with what my own psychiatrists and therapist said. It is a humiliating thing to be unmistakably disabled and get that letter telling you they don’t think so. Not to mention the stigma from all around me that if I just “tried harder” and “worked harder” I could cure myself and work. Oh and in 3 years I get to come back up for review and they could always reject me and make me have to apply all over again which was extremely exacerbating to my illnesses the first two times. yay!

          I don’t think you guys were seriously going to do it, but if you can work, even though this fat as a disease is bullshit, you are much better off doing that. Of course I’m aware being able to work and being able to FIND work are two different things. This is my only option and that’s why I applied. I would not wish this for someone unless that was the case for them too. Too many people see social services as some kind of gold mine people hit when I would trade this for “normal” working life any day. Disability is also already stigmatized in much the same way Welfare is: that most of the people on it are frauds and we’re all stealing the hardworking taxpayers money and they don’t want to pay for those lazy non-workers. Just.. seriously I can’t disrecommend this enough.

          1. I wanted to add I feel it’s more likely that with something like this, they will go along the lines of “oh no the epidemic of fats! We need to discourage them from being fat! Let’s add a weight and/or BMI limit to disability and welfare, maybe that will motivate them” and I, being fat, get told I must lose weight or get kicked off disability and having no ability to lose weight, they do.

          2. I needed to add one more thing. I read that one of the commenters has some other illnesses and I feel when I said “I dont think you’re really going to do it” it was ignorant. If you guys really do meet the requirements to apply, that’s your right no matter what I said. I just wanted to say that I’m sorry for that.

  4. ((((hugs))))

    This AMA decision is…crap. Not that you didn’t know that.

    Until now, I have resisted comparing people’s intrusive, concern-trolling and useless attitudes toward fat with old-fangled DSM “diagnoses” of homosexuality (the situations are too different in too many other ways).

    However, like the other situation, this “pathologizing” ignores much scientific evidence, makes bigots feel even more justified in their discrimination, and sanctions intrusive measures into matters which are no one else’s business. I predict it will have a similar failure rate at “eradicating” a naturally-occurring human variant.

    How very interesting it is, that the NY Times story announcing this decision to ignore science was published, not in the Science or Health section, but in the BUSINESS section. I predict more forcible future pick-pocketing of fat people where your only choice is whose hand grabs your wallet.

    I signed Marilyn’s petition.

    I am so, so sorry we are having to put up with all this crap (((hugs)))

  5. Any indication if they are using BMI as the diagnostic tool? There are screening tools and diagnostic tools. If they use BMI as a screening tool only, it might be slightly less damaging than if they use it as a diagnostic. Slightly.

  6. So bring it on AMA, I’m a fat woman, but I will not be your cash cow.- love this!

    Also I’m studying to be a nurse and it makes me sad that the actions of a few narrow minded bigots give people a negative view of all health care workers.

  7. Ugh, this drives me nuts!

    Oh, and ****trigger warning*** Look at the poll I found on my MSN homepage:

    >>Obesity labeled a disease
    >>The American Medical Association has decided to classify obesity >>as a disease that needs medical treatment & prevention.

    >>Do you agree with the AMA?

    >>Do you agree with the AMA?
    >>>>Yes, and it’s becoming an epidemic
    45 %
    >>>>Yes, and it’s becoming an epidemic
    48,357 votesNo, it’s just a matter of self-discipline
    51 %
    >>>>No, it’s just a matter of self-discipline
    53,792 votesI don’t know

    There isn’t something I can answer here!

  8. All told, given the political and social climate, I think this was an inevitable development. There’s always been a desire to scientifically pathologize the Other. Look at the 19th Century, and even the early 20th, when otherwise legitimate doctors and scientists went to great effort to “prove” that people of African descent had less cranial capacity than any other indigenous group on Earth. Look at Piltdown Man, which came about as an effort to prove European (specifically British) superiority when all signs pointed to Africa as the heart of human origin. Look at modern education! We’re still taught that the Fertile Crescent, the same region where the Bible played out, was the cradle of all civilization, while much more ancient discoveries in India and Africa and China (linguistic discoveries! written language!) crumble because so few researchers are drawn to them due to a lack of money.

    Between 50 and 75 years from now, obesity will be quietly and ashamedly removed from the list of pathologies, and people like us will be allowed to go on with their daily lives. Dieting will hopefully have received a much worse rap by that time, as metabolisms swing out of control. No apology will be granted.

    Going to have to talk to my girlfriend about this one this evening. She’s applying to med schools now, and is firmly in the obesity-is-a-normal-variation camp, though she’s also terrified of getting fat due to an understanding of fat stigma. (She’ll be absolutely beautiful no matter what size she is.) Should be an interesting discussion.

    On a personal note, I wonder how long it’ll be until the AMA considers me a “success story?” I’m losing weight right now due to a combination of removing most dairy from my diet (we don’t agree) and taking Adderall to counter the huge quantities of sedatives and anti-seizure meds I take. Regular Adderall whupped my appetite badly enough. Now I’m on XR, which works all day rather than going up like a firework, and I’ve gone from foodie to… well, I finally made myself eat something at bedtime yesterday, and I couldn’t even finish it. Mid-afternoon I managed to have a soda (yuck), and I stopped at my Palestinian market and got a sesame bar and some rose water drink (DELICIOUS!). Other than the occasional snack, I might have a hard cider or a gluten free beer or a scotch. I just don’t care. Hence, my weight is tiptoeing down, and I’m being more active because I’m taking fucking amphetamines. Yeah, that’s a real success story. Right up there with my cousin on meth.

    Come to think, I wonder how long it’ll be before Adderall is classified as a weight loss drug?

    1. I wouldn’t be surprised if doctors already prescribe Adderall off label for weight loss. I know they do for Topamax, an anticonvulsant with some serious side effects, one of which is loss of appetite. But hey, who cares if the patient can’t think, if she can’t drive safely because of the drug dulling her reflexes, if she starts getting nutritional deficiencies because she isn’t eating? She’s losing weight, so she’s getting healthy!

      Yeah, I took Topamax for my seizures several years ago, pre-FA. It didn’t work very well and I kept having seizures triggered by low blood sugar if someone didn’t make me eat, but I liked it because I lost weight.

      1. Oh, Adderall’s already used for some instances of weight loss, but very rarely–as opposed to the ’50s and ’60s, when amphetamines and barbiturates were front-line prescription diet pills. AFAIK, it’s only used in cases of extreme exogenic weight gain, usually caused by prescription medication. That was actually the straw on the camel’s back that let me get it: not because I’m on so many drugs (including Topamax!) that I can’t stay awake, but because I’ve gained 50 pounds since starting Lyrica.

        I disagree fully with the FDA’s decision to bundle Topamax as part of a weight loss cocktail. I take it for migraines, and it’s a beast. My neurologist had to drop my daytime dose by half because my aphasia was getting so severe I couldn’t carry on a conversation, and I was nowhere near maximum allowable dose. All told, I’d rather have a migraine or two per week than live in that kind of hell. (I’m down from one to two PER DAY, though a lot of that is due to eliminating peanuts from my diet. Turns out that if I eat them, I have hemiplegic migraines. It’s damn near a miracle I neither stroked out nor died.)

        I mentioned the weight gain to my pain doc, and she wanted to up my Dopamax (not a typo!) again. Took some hand flailing and rapid speaking to explain how bad of an idea that was!

        1. I took Topamax and couldn’t drive, cried hysterically at the slightest frustration, scared my family with aggressive behavior (that I was not aware of at all) and the last straw, forgot how to walk- I was just standing at the end of my bed and couldn’t talk my body into moving, lying down, anything… NSAIDS work on my migraines* so taking something to stop them that made me completely unable to function seemed really stupid. I figure an hour of being out of commission until advil kicks in is better than never being functional.

          *which may actually be arthritis based, and not actual migraines, though I have the light sensitivity, sound sensitivity, and nausea.

  9. Check this out! This is the “opinion poll” that MSN.com has on their website today:

    WHAT DO YOU THINK?. Obesity labeled a disease…

    The American Medical Association has classified obesity as a disease that needs medical treatment & prevention.

    Do you agree with the AMA?

    __Yes, and it’s becoming an epidemic

    __No, it’s just a matter of self-discipline

    __I don’t know

    The results so far: Yes – 45%; No – 51%; Don’t Know – 4%

    Notice that you can’t just vote NO! If you make that choice, you’re saying all fat people just need to discipline themselves. What the hell?

    1. I tried to copy that above–exactly! I cannot find an answer I can live with on that poll! How can they think such a biased poll is appropriate?

  10. Please let me bang my head against a wall over and over and see if that helps me understand the bullshit behind them saying it is (or isn’t as a couple articles are suggesting)

    It isn’t a disease, a disease by nature is something harmful and can (at times) be passed on through bodily fluids, coughing, or contact with another person, you also have water borne, food borne, air borne and blood borne. So unless you come in contact with me and catch it (which you can’t) or you get it from food, air or water (which you can’t) it ain’t no disease.

    Now weight gain is common in many medications, treatments and can happen if you have a thyroid issue or cancer, etc. Those are diseases, obesity isn’t.

    This has really gotten to the point of sheer and udder stupidity.

  11. My hormones have been imbalanced for a very long time. I started looking for help about 15 years ago when I was tired all the time, getting my period every 2 weeks, and gaining weight like crazy. I’ve been diagnosed as some combination of fat, depressed, and a liar. I’ve been imbalanced for so long that it almost killed me and with near constant nausea, I certainly wanted to die. I finally got a compassionate doctor who believed me, didn’t think I was depressed, and genuinely wanted to help. I did get the diabetes lecture, but he cut that out after seeing my lab work pointed to low risk. He was able to identify the various imbalances and put me on a course to restoration. I’m so grateful he was able to make a diagnosis by my body’s actions rather than its appearance and it pisses me off that the lab sent my results back with MORBIDLY OBESE at the top. Were the lab determining my treatment, I’d probably get thinner from the nausea and then dead from malnutrition, with every pound lost cheered.

  12. The whole reason the AMA classied obesity as a disease has nothing to do with whettjrr or not they think it is a disease. If it is considered a disease, it can be given a code and placed in the Physician’s Desk Referenced as a disease and insurers must then pay for any obesity related treatment. It has everything to do with doctors and other medical providers making sure they can get their cut of the multi-billion dollar weight loss pie, not just get paid for any legitimate health issues their obese patients may have.

  13. Disheartening. Utterly disheartening. I signed that petition that Marilyn Wann started — I don’t have the link to it anymore, though.

  14. I feel so defeated right now. As if it wasn’t hard enough as a fat activist but this is like a punch in the gut. The fact that they (AMA) was told “NOT” to classify obesity as a disease but did it anyway makes me feel like they can just force fat people into submission against our will.

    So lets ignore science and condone discrimination, injustice, and bullying against fat people in the name of “profit”? My faith in humanity has taken a hard hit right now. It just doesn’t make any sense for this to happen.

    1. I don’t know if this will help but I would suggest that it doesn’t mean the AMA can force fat people into submission, it means that they (and the people who lobby them) can force their Science and Public Health Committee to submission which isn’t good for anyone but doesn’t mean that fat people can’t continue to fight and won’t eventually win. It also made me feel better that a number of groups (including the National Institutes for Health) already classified obesity as a disease and so this is another opinion that doesn’t hold legal weight. The good news about this one is that it was clearly done and publicly done against science.

      ~Ragen

      ________________________________

  15. Three days later and I still can’t fully process this. I told my fiancé about it and got a “meh”- the verbal equivalent of a shrug. Why is it so hard for thin and “normal” sized people to grasp the seriousness of this? Maybe he will finally get it when they ship me and all my fellow fattys off to weight loss concentration camps for some forced “health” intervention.

    I need to find a way to get him to understand WHY things like this infuriate me.

    1. My husband is like that as well, Stacy. The thing is…to him, you are Stacy and he loves Stacy. You aren’t a “size” to him. So, he can’t see the problem very clearly.

      I’ve been married for 23 years now and when I get absolutely furious about this stuff, I get on that soapbox and just go crazy. After all this time, I think it is finally sinking in because of everything that has been on television in the past couple of years. This “war on obesity” issue is going to change our healthcare and will, of course, cause even more ostracizing in society than we have already suffered. Plus, my husband has seen me being mistreated at the hands of fat hating doctors and knows that there is a definately prejudice out there.

      Give your fiance some more time – he will see it eventually. Especially since it’s getting worse for us very, very quickly. Congratulations on your engagement!

      1. Thanks, La! It’s good to hear that your husband might be finally ‘getting it’. That gives me hope for my fiance! And thank you for the congratulations on my engagement! I wanted to call my grandmother right away and tell her off – she always told me: “people like you are usually meant to be alone” -meaning “morbidly obese” people aren’t meant to be with anyone. With the amount of fat phobia and fat hate that runs in my family, it’s a miracle I don’t have the self esteem of a severely abused puppy.

        Just today my mom called me all excited. “Guess what? Great news!” she said. I immediately got happy, expecting some really good news. The next words out of her mouth: “The American Medical Association has declared obesity a disease!”. I didn’t know whether to laugh or cry.

        1. I know! If your family is anything like mine, I am the fattest one. I always have been. Some of the others are chubby, but nothing close to me. It’s been a real struggle throughout my entire life. They can’t understand why I can’t be like the rest of the family. When I was a child, it was really bad. They were determined to get my weight off. Of course, it never happened, but I was treated differently than all the other kids, and regularly humiliated in public. Trying to keep me away from what everone else was eating and shaming me constantly, only succeeded in turning me into a nervous wreck with no self-esteem whatsoever. I snuck food and ate things I wouldn’t have otherwise.

          All that aside, the family is a powerful force in your life. But, with time (and for me, distance was also necessary – for many reasons), it can get better. They may not ever fully accept you just the way you are, but you can still go on with your life and not worry so much about what they think. I won’t lie, it takes a long time to get to the point where you can just let what they say go right over your head.

          Now, at 50 years of age, my family doesn’t mention my weight very often. My mom does share a lot about the “eating programs” she and my step-father are trying, but doesn’t try to push me to do it as well. I do know what they are thinking a lot of times. I had to have my knees replaced and now I have diabetes – those are things that are definately publicized as “fat people diseases.” So, I know they are concerned that my weight is causing all of this. They aren’t saying much about it though.

          It takes repetition. If you have the same response every time one of your friends or relatives tries to bring up your weight, they will finally figure out that you aren’t going to put up with it and they will stop.

          Sorry it’s so rough for you right now. Keep on persevering!

  16. The only (marginally) good thing that I can see coming from this is that, under the affordable healthcare act, insurance companies would be required to cover fat people. Because, if it’s a disease, then it’s a preexisting condition.

    That’s it.

    There’s a whole mass of negatives including the possibility of mandatory WLS as a “cure.”

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