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As of July 15, 2004, obesity has gone from being a personal problem to an officially classified disease in the US. The change of classification was described in the Newsday as follows.
"The federal Medicare program yesterday abandoned a long-standing policy that obesity is not a disease, removing what has been a major roadblock for many people trying to get treatment for the burgeoning health problem.
After years of review, the Centers for Medicare & Medicaid Services, which runs the health program for the elderly and disabled, announced it was dropping language that had led the agency to routinely deny coverage for a host of weight-loss therapies.
While the decision does not automatically mean any specific treatment will be covered, the move opens the door to what is expected to be a flood of applications from individuals, doctors and companies for Medicare to begin paying for a wide variety of therapies, including stomach surgery, diet programs and counseling.
"Obesity is a critical public health problem in our country that causes millions of Americans to suffer unnecessary health problems and die prematurely," Health and Human Services Secretary Tommy Thompson said in announcing the long-awaited decision. "With this new policy, Medicare will be able to review scientific evidence in order to determine which interventions improve health outcomes for seniors and disabled Americans who are obese.
The move, the latest in a series of steps the federal government has taken to fight the nation's rising obesity problem, was hailed as a major step forward by public health experts, anti-obesity advocates, and individual doctors.
"Conceptually, this is a huge change, for the medical profession, for insurers and for employers to treat this just like any other disease," said Morgan Downey, executive director of the American ObesityThe move, the latest in a series of steps the federal government has taken to fight the nation's rising obesity problem, was hailed as a major step forward by public health experts, anti-obesity advocates, and individual doctors. Association, an advocacy group that has been lobbying for the change.
Private insurance companies often pattern their coverage after Medicare, so the decision is expected to put strong pressure on them to expand coverage."
Martin Comments
Overall I suspect this is a good thing and will enable some people to get help that they may not otherwise be able to afford. But we have to be so careful of medicalizing lifestyle related problems. Obesity can be attacked with pills and surgery but without personal commitment and understanding there is no long term fix. There's no fluoride-like substance we can put in the water to keep us thin.
A recent observation I've made after speaking with 3 different people, who were morbidly obese and diagnosed with fibromyalgia, is that they may have been misdiagnosed. All three had lost at least 75 lbs. and with the weight loss the symptoms of 'fibromyalgia' had disappeared. The first step in dealing with fibromyalgia would obviously seem to be weight loss.
With so many fat people in the USA, this new legislation seems like a prescription to bankrupt Medicare and Medicaid Services, but there is a catch. (Isn't there always?) The funded treatments "must prove effective"; but the meaning of 'effective' isn't defined. Does it mean, for example, that 80% of people on a particular program would lose the weight required to put them in a 'normal' classification and keep the weight off for at least 5 years? This would exclude almost every advertised weight loss program. On the other hand does it mean that people will live longer? This type of longitudinal data is almost non-existant. So don't expect Medicare to be paying your Weight Watchers dues, covering the cost of special meals from Jenny Craig or The Zone or refunding money spent on 'Atkins Approved' groceries.
Through my cheerfully biased eyes it would make so much more fiscal and lifestyle sense to underwrite and subsidize exercise programs rather than paying billions of dollars to support people, who in many cases (certainly not all), have made poor lifestyle choices. It's been proved over and over again that exercise prevents, controls or cures most chronic disease and that it is a natural and effective method of weight loss and weight control. Remember the words of Don Ardell, which are featured in the 'Quotes' section of this issue. "We expect far too much of the medical system and far too little of ourselves."
What is a Billion?
Firstly, in the US and Canada, it is one thousand million: 1,000,000,000
A billion seconds ago it was 1972.
A billion minutes ago Jesus had just been crucified.
A billion hours ago, we were in the Stone Age.
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