Recently, the American Medical Association (AMA) reclassified obesity as a disease and this new designation will affect patients, healthcare professionals, insurers and the healthcare infrastructure. In some ways, calling obesity a disease is a move to shift attention and resources to a complex problem. Obesity is a significant public health concern as it is often the underlying cause of serious comorbidities some of which include diabetes, heart disease, hypertension and fatty liver disease. The most recent national data from the Centers for Disease Control and Prevention on obesity prevalence show that more than one-third of adults and almost 17% of children and adolescents are obese.
It is believed that this decision will help begin a discussion between people and their healthcare providers about a subject that is too often ignored and help provide additional resources such as more intensive counseling and lifestyle interventions for those at risk. However, a new name for the problem is not going to solve the obesity epidemic that we have seen mushroom in the last 30 years. It will take focusing on the environment, education, engagement and prevention as well as the enhanced use of treatment programs that have proven to be effective in treating obesity.
Environmental Change – in the past 30 years, while adult and child obesity rates have increased, our genes haven’t changed; however, the food and activity environments have changed dramatically. Processed foods and sugar-sweetened beverages are cheap and readily available and people are spending half of their food budget eating out. Adults and children alike are spending too much time in cars and on their screens rather than being active while at work or school. Policies that increase the supply and access to healthy foods and that encourage activity will help reverse the obesity epidemic by creating a cultural shift towards healthier lifestyles.
Education and Engagement – it is imperative to teach and reteach children, adults and communities about healthy food, good eating habits, the importance of increasing lifestyle activity and exercise and how to put these healthy practices to use on a daily basis. We as a society have collectively outsourced our food and eating habits to the food and fast food industries while simultaneously reducing our activity levels. We must relearn how to shop, prepare and eat real foods and we must demand whole or minimally processed foods from our food and beverage manufacturers. Additionally, we need to intentionally add activity into our days since movement has been engineered out of daily life.
Prevention – the AMA’s recent ‘Obesity as a Disease’ classification can have a real impact on prevention by focusing time, attention and resources to help keep people healthy and move those at risk to a healthier weight. Prevention measures include improving the food and beverage options at schools, worksites and community organizations and encouraging people to take activity breaks at these locations.
Treatment – from the landmark Diabetes Prevention Program Study whose results were detailed in February 2002 in the New England Journal of Medicine we know that lifestyle interventions work better than pharmaceutical treatment for risk reduction in pre-diabetes patients. Since that study was initiated in 1996, we have advanced our knowledge of nutrition, activity practices and behavior change. Intensive Lifestyle Programs that integrate up-to-date information on nutrition, food, eating and activity practices combined with behavior modification that are led by content experts with health coaching experience are effective in moving people towards sustainable lifestyles.
What is needed now is political support to develop national action plans for obesity prevention and treatment for adults and children. The prerequisites for successful prevention activities include involvement of a number of stakeholders in the public and private sectors as well as different levels of healthcare. Furthermore, structures to identify high-risk individuals and ways to manage intervention, follow-up, evaluation and reimbursement have to be established for effective treatment to take hold. We commend the AMA’s decision on classifying obesity as a disease to move the priorities and resources towards prevention and treatment of the root cause of the devastating comorbidities that are impacting so many Americans.
Andrea Bloom, Founder and CEO, ConnectWell
Lori Arden, Director Client Outreach, ConnectWell