In “Is Obesity a Disease? Yes — and the Medical Community Is Finally Recognizing That,” you'll find the story of Michelle, a mother who has struggled with obesity since childhood, highlighting the journey many face with this complex condition. Medical experts, including Dr. Holly F. Lofton, emphasize that obesity is not merely a matter of willpower but a multifaceted disease influenced by hormones, genetics, and the environment. With recent shifts in treatment guidelines, there's a stronger focus on comprehensive approaches combining medication and lifestyle changes. Unfortunately, access to these treatments remains inconsistent due to insurance barriers. This article explores the intricate nature of obesity, the evolving treatment protocols, and the ongoing battle for better healthcare access. Have you ever wondered if obesity is really a disease? It might surprise you to learn that the medical community is increasingly recognizing it as such. Despite widespread chatter about diet and exercise, it's a much more complex issue than previously understood. Join me as we unravel why obesity is now classified as a disease and what this means for treatment options and healthcare policies.
Is Obesity a Disease? Yes — and the Medical Community Is Finally Recognizing That
Michelle’s Story
Take Michelle,* a 42-year-old mother of two, whose struggle with obesity began as early as third grade. Her parents' shift from encouraging her to eat to scrutinizing her meal portions points to a broader cultural misunderstanding of obesity. Michelle's mother, always concerned about her own weight, inadvertently passed on her anxieties, leading Michelle to join Weight Watchers at just 11 years old.
Michelle recalls, “I started learning not to trust my body because I was always being told what to do or what not to do.” Her experience is not unique but part of a larger dialogue the medical community is now keen to address.
Obesity: A Prevalent Medical Condition
Obesity is remarkably common, affecting an estimated 4 out of 10 women in the United States. The statistics are even more alarming for Black women, with nearly 6 out of 10 experiencing obesity. Often measured by a BMI of 30 or more, obesity is a condition influenced by more than just diet and exercise. Factors such as hormones, genetics, psychology, and environment all play significant roles.
Women Are Particularly Prone to Obesity
Women are particularly susceptible due to hormonal changes during puberty, contraceptive use, infertility treatments, and menopause. According to Dr. Holly F. Lofton, director of the Medical Weight Management Program at the NYU Grossman School of Medicine, obesity is linked to over 200 different conditions, many of which disproportionately affect women. Here are some of the key conditions associated with obesity:
| Condition | Description |
|---|---|
| Heart Disease | A range of conditions that affect the heart and blood vessels |
| Endometrial Cancer | Cancer that starts in the lining of the uterus |
| Breast Cancer | Cancer that forms in the cells of the breasts |
| Type 2 Diabetes | A condition that affects the way the body processes blood sugar |
| Polycystic Ovary Syndrome (PCOS) | A hormonal disorder causing enlarged ovaries with small cysts |
| Infertility | The inability to conceive children |
| Depression | A mood disorder characterized by persistent feelings of sadness |
Obesity also contributes to fatty liver disease, digestive problems, osteoarthritis, anxiety, and certain types of cancers. It poses additional risks for pregnant women, those trying to conceive, and babies born to women with obesity.
Changing Treatment Guidelines for Obesity
Traditional guidelines for treating obesity have focused mainly on lifestyle changes such as calorie reduction and increased physical activity. However, Dr. Lofton suggests a more comprehensive approach. Studies indicate that using anti-obesity medications (AOMs) alongside lifestyle changes results in more significant weight loss than lifestyle changes alone.
Updated Medical Recommendations
The American Gastroenterology Association advises that medication should accompany lifestyle changes for adults with a BMI of at least 27, especially if they have other weight-related conditions. For those with a BMI of 30 or more, medication is recommended even in the absence of other health conditions.
“We are moving from treating obesity with appetite suppressants to combination therapies and hormonal treatments that optimize signals from the brain, intestines, and fatty tissue,” Dr. Lofton explains. Surgery remains an option for those with a BMI of 35 and associated medical conditions, or a BMI of 40 and up. However, these guidelines are continually being reassessed to accommodate individuals with lower BMIs.
“This is a complex disease, and there is no one-size-fits-all model for treating obesity,” adds Lofton. Hence, continued research is critical for expanding and refining treatment methods.
Michelle’s Treatment Journey
Michelle's story illustrates the importance of evolving obesity treatment options. She tried numerous diets, balancing her efforts with physical activities like walking, swimming, and strength training. Despite her efforts, she often regained the weight and eventually faced several health issues, including joint problems, high cholesterol, high blood pressure, acid reflux, pre-diabetes, and fatty liver disease.
Recently, after consulting her healthcare provider, Michelle began taking medication to manage her obesity. “I'm more on the cusp of all these terrible things happening, and so I'm trying to get control of it now,” she says. Michelle estimates she has lost 25 pounds over four months without dieting, experiencing fewer cravings and some side effects like nausea and fatigue. However, she notices improvements in her symptoms of irritable bowel syndrome (IBS) and reduction in joint pain.
Access Barriers to Obesity Treatment
Despite proven effectiveness, barriers still exist that prevent many women from accessing appropriate obesity treatments. Insurance coverage varies, with many requiring additional health conditions to justify nutrition counseling. Anti-obesity medications are often excluded as they are not recognized as essential for managing a chronic disease.
Insurance Complications
Insurance policies often require meeting specific criteria for surgery approval, creating another hurdle for many. “As we bring more attention to obesity as a chronic disease, we still have a lot of work to do in the United States with increasing access to care,” says Lofton.
Those in greatest need of obesity treatment often find it hardest to access. Hence, women should collaborate with healthcare providers to explore evolving treatment options. “It is essential to remember that this is a chronic disease, present even when one's weight is considered normal or under control,” Lofton emphasizes.
If you're struggling with obesity and wish to discuss how it might impact your overall health, finding an obesity care provider could be the next best step for you. The Obesity Action Coalition's search tool can help you find specialists who are well-versed in the latest treatments and support options available.
Help Us Increase Access to Obesity Treatment
*Name has been changed for privacy.
This educational resource was created with support from Novo Nordisk, a HealthyWomen Corporate Advisory Council member.
Source: https://www.healthywomen.org/condition/is-obesity-a-disease
