WASHINGTON - The American Medical Association voted Tuesday to declare obesity a disease, a move that effectively defines 78 million American adults and 12 million children as having a medical condition requiring treatment.
The nation's leading physicians organization took the vote after debating whether the action would do more to help affected patients get useful treatment or would further stigmatize a condition with many causes and few easy fixes.
In the end, members of the AMA's House of Delegates rejected cautionary advice from their own experts and extended the new status to a condition that affects almost 36 percent of adults and 12 percent of children in the United States.
"Recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately 1 in 3 Americans," said Dr. Patrice Harris, an AMA board member.
Tuesday's vote is certain to step up pressure on health insurance companies to reimburse physicians for the time-consuming task of discussing obesity's health risks with patients whose body-mass index exceeds 30. It should also encourage doctors to direct these patients to weight-loss programs and to monitor their often-fitful progress.
The federally funded Medicare program, which insures an estimated 13 million obese Americans who are over 65 or disabled, already covers the costs of "intensive behavioral therapy" for obese patients, as well as bariatric surgery for those with additional health conditions. But coverage for such obesity treatments has been uneven among private insurers.
Insurers who are members of the California Association of Health Plans cover many services to treat medical conditions associated with obesity, including bariatric surgery and diabetes, said President and Chief Executive Patrick Johnston.
The AMA's decision effectively makes diagnosis and treatment of obesity a physician's professional obligation. As such, it should encourage primary-care physicians to get over their discomfort about raising weight concerns with obese patients. Studies have found that more than half of obese patients have never been told by a medical professional they need to lose weight - a result not only of some doctors' reluctance to offend but of their unwillingness to open a lengthy consultation for which they might not be reimbursed.
Past AMA documents have referred to obesity as an "urgent chronic condition," a "major health concern" and a "complex disorder." The vote now lifts obesity above the status of a health condition, disorder, or marker for heightened risk of disease - as high cholesterol is for heart disease, for instance.