Doctors say obesity isn't a disability

[kgalas]

Interesting development...

AMA objects to calling obesity a disability
21 hours ago

CHICAGO (AP) — The American Medical Association has taken action to support doctors' ability to discuss obesity with their overweight patients.

Under a new policy adopted Tuesday, the AMA formally opposes efforts by advocacy groups to define obesity as a disability.

Doctors fear using that definition makes them vulnerable under disability laws to lawsuits from obese patients who don't want their doctors to discuss their weight.

Doctors took the action at their annual meeting in Chicago.

In other action Tuesday, the AMA agreed to lobby for legislation to ban selling tobacco in pharmacies.

Health care reform issues are slated to come up later at the meeting, which ends Wednesday


What do you think?

 

[carres1973]

OK, I'll bite! As someone classified as "obese" according to the BMI chart (or am I just overweight now?), I agree with the decision but not the reason. I don't think obesity should be considered a disability. MOST (but by no means all) people who are obese got that way because of poor choices. Most (again, by no means all) people who are truly disabled (i.e. blind, deaf, in a wheelchair, etc.) did not make choices that resulted in their disability. I don't understand why they feel it would open them up to lawsuits to discuss the patients weight. If they do it compassionately, I don't see the problem. Just like most overweight people, I realize I am overweight. I don't feel discriminated against if my physician mentions it. I would probably feel she wasn't doing her job if she DIDN'T mention it!

Carrie

 

[Davidj]

I agree with the AMA and carress1973: obesity is not a disability

I agree with the AMA and carress1973: obesity is not a disability. Obesity is caused by poor lifesyle choices (poor eating and lack of exercise). If society kowtows to obesity "rights" groups, such would hinder efforts -- at the personal and societal levels -- to curb our obesity epidemic.

Maybe have haven't read enought posts on this CatheNation site, but I haven't seen much discussion of the obesity problem out there. At church I, along with my pastor, are councelling a younger man who I would think is bordrline morbidly obese (5'10" 340 lbs at 34 years old). We approach his problem with the intent of changing his lifestyle, to help him out. I will be discussing his difficulties in a later post.
-- David

 

[spyrosmom]

I agree with the AMA on this one, too. Obesity (been there, done that, still working my way out) is not a disability. It can cause one to BECOME disabled by causing a whole laundry list of other problem, but being obese is not a disability. And if it is a disability, it is almost entirely preventable, so why should people be ashamed of or not want a solution to a problem that they caused themselves? If the you get offended bc the Dr calls you obese or overweight - that's being a bit oversensitive, in my opinion. Trust me, when I was 270, I knew I was fat (hell, I was FAT) so not like the Dr telling me that would've upset me. In fact, I wish she would have addressed it with me sooner in life. I knew better, yes, but a kick in the rear wouldn't have hurt, either. I did make an appt w/ her to talk about it several years back, but I was the one who had to bring it up. I didn't really listen to much she said and got off course a month or 2 later, but again that was my issue, I don't think I was ready. But was I disabled? No? Stairs sucked, my knees hurt, my back hurt, and so on and so forth, but that was caused by being obese. The obesity may have eventually been the cause of being disabled, but it wasn't a disability in and of itself.

I know what I was trying to say, not sure it came out it writing correctly. Got it?

Nan

 

[icumom]

Yeah, I agree with the AMA for the most part......but I don't dismiss the pathology - almost a psycho sexual fettish kind of thing that occurs in the supermorbidly obese - they are truly different psychologically (talking over 400lbs-600 plus!) and the neurosis may truly be disabling - I've heard it described as a failure to break with the infantile oral fiixation that infants have w/ hand to mouth immediate gratification..and those I"ve taken care of that extreme range (over 500lbs) seem to manifest this...but watching Brookhaven,where that one doc is trying so earnestly to advocate for them, they are jokingly sending out for pizza's and donuts on the taxpayer bill....alcoholics are tossed out for doing that in rehab...should it be any different?
And yes, as a critical care nurse for decades, folks sheepishly accept my in the face teaching on cigarettes,but are taken aback when I address weight...

 

[farmgirl]

another vote for the AMA

Obesity can have many disabling conditions but I don't believe that's it's a disability in and of itself. It will be interesting to see what comes of this! I see too many people who are "disabled" the way it is (and many who should be classified as disabled but somehow either refuse to request help or slip through the cracks!)

 

[morningstar]

Morbid obesity is indeed a disability. Yes, most often it was negative personal choices and a lack of knowledge (and conflicting information) that got the person to that state. However, absolutely NO ONE wants to be morbidly obese. No one. It is quite clear from watching anyone with this condition that they are indeed disabled, and many of life's regular activities are not even remotely possible for them. Almost all of them have tried desperately to lose weight, many of them all of their adult lives. It's not that they don't want to lose weight, it's that it is really m*******g hard to do, and the self righteousness of those that have never been there telling morbidly obese individuals to just make better choices just isolates these people more and makes them feel worse about themselves- and that makes them gain more weight, not make better choices.

As someone who used to be morbidly obese, I can tell you that I did not want my doctor discussing it, since the doctor would only tell me to lose weight, but would not give me any tools or assistance to do so. Every morbidly obese person knows they need to lose weight; just telling them to do so is not even remotely helpful. Until the medical community comes up with comprehensive strategies for weight loss that actually work, they need to butt out. This is not their area of expertise. This belongs to the therapists, dietitians and fitness coaches, at least those ones that know what the hell they are doing.

I never had a single doctor ever help me with weight loss, other than to tell me I needed to lose weight. Big help. It just made me feel even worse about myself (and as someone with an eating disorder who was morbidly obese, I really didn't need another hit to my self esteem) and I just ate more and threw up more.

 

[cakebaker]

Go, spyrosmom!

I agree with the AMA on this one, too. Obesity (been there, done that, still working my way out) is not a disability. It can cause one to BECOME disabled by causing a whole laundry list of other problem, but being obese is not a disability. And if it is a disability, it is almost entirely preventable, so why should people be ashamed of or not want a solution to a problem that they caused themselves? If the you get offended bc the Dr calls you obese or overweight - that's being a bit oversensitive, in my opinion. Trust me, when I was 270, I knew I was fat (hell, I was FAT) so not like the Dr telling me that would've upset me. In fact, I wish she would have addressed it with me sooner in life. I knew better, yes, but a kick in the rear wouldn't have hurt, either. I did make an appt w/ her to talk about it several years back, but I was the one who had to bring it up. I didn't really listen to much she said and got off course a month or 2 later, but again that was my issue, I don't think I was ready. But was I disabled? No? Stairs sucked, my knees hurt, my back hurt, and so on and so forth, but that was caused by being obese. The obesity may have eventually been the cause of being disabled, but it wasn't a disability in and of itself.

I know what I was trying to say, not sure it came out it writing correctly. Got it?

Nan

I totally agree - obesity is a result of poor choices, just as alcoholism is a result of poor choices & not a disease.

 

[GMonkey]

Wait a second--are doctors at risk of lawsuit for discussing disabilities with their patients? I can see if they breached a confidentiality agreement, but discussing health issues with a patient seems sort of like their job.

I do think that with the truly morbidly obese (super obese) there is something going on beyond just bad choices. I think that there are other physiological and/or serious psychological problems and it's not just a love of Big Macs making them so large that they need 2 seats at a restaurant. Both of my parents are obese (100 lbs overweight) and their problems are lifestyle related, but for someone to be in the 400 lb + range there is something deeper going on. I agree that doctors need to go over health plans for weight loss with their patients besides offering a blanket, "lose weight" recommendation. Patients should be referred to dietitians and given safe exercise plans.

I worry about obesity being considered a disability because then people will be able to get SSI for simply being fat, which is like people getting SSI for having face tattoos. I object to my tax dollars paying for other people's bad choices. Just like I don't agree with having to pay for people's disability because they rode motorcycles without helmets, or skate boarded down the art museums steps. True medical problems? Sure. If someone is super-obese due to leptin imbalances or other problems, they should be classified as disabled. Either way, it's an issue which deserves medical attention with compassion as well as discipline.

 

[ldy_solana]

i can totally see morbid obesity being a different story. usually there is a lot more going on there then just bad choices.

but for others is this going to be another excuse? with all the dang stories coming out about exercise not doing all that good etc its just giving ppl more excuses and conflicted information!

and for fear of lawsuits when are ppl in this country going to suck it up and own some personal responsibility!?!?!? srsly you don't want the dr. telling you its good for your health to lose weight? hey isn't that his job to discuss what is good for your health.

i do agree with morningstar though that they need to discuss HOW to go about it other then just getting on their patients about losing weight. no denying that but most ppl know. lay off the dinners out and the fast food drink water not soda, eat fruits and veggies not candy and chips. move move move no matter what you are doing sports,walking, regular exercise. its not overall rocket science! if you don't know then ask, remember no such thing as a stupid question!?!

also i am considered overweight by the charts. sure i could lose about 10-15lb and i know what i have to do. i am not going to sit here and make excuses or get pissed off at somebody else for it. i am just going to get up dust off and keep on keeping on.

kassia

 

[babindy]

I agree with the AMA and carress1973: obesity is not a disability. Obesity is caused by poor lifesyle choices (poor eating and lack of exercise).
-- David

Just wanted to comment on this thought. As one that has worked out for many, many years and eats clean, I still have to struggle to even maintain my weight. I've done tons of research, journal my food (minimal processed foods -mostly raw- vegan) and workout 6 days a week (weights and cardio). Losing weight is not an exact science (at least to lose it the right way) and is not the same for everyone.

I'm still in the obese category. I'm still working on it. I will work on it until the day I die. I know that my lifestyle choices are better than 90%+ of the population. I'm sure people look at me and think - no way can she do what she says. She must be lying or delusional. Yup. That's right. As I have my 15th serving of leafy greens and one arm curl that 25lb dumbbell while doing Low Max. I'm raising my son to be healthier than I can ever be and to not have to struggle every single day.

Is obesity a disability? Not if you use it as excuse. But (as others posted) there are those that do not have choices. I have choices. I will NOT go gently into that good night!!

 

[crazystepr]

My oh-so-very NOT humble opinion:

Alcoholism is a disease.

Obesity is an eating disorder, same as anorexia and bulimia. They are not disabilities--they are psychological disorders.

 

[morningstar]

My oh-so-very NOT humble opinion:

Alcoholism is a disease.

Obesity is an eating disorder, same as anorexia and bulimia. They are not disabilities--they are psychological disorders.

I don't believe alcoholism is a disease; I do believe chronic overeating is an eating disorder, but as you can be obese for many reasons, I do not believe that obesity is in and of itself an eating disorder- but often the result of one.

 

[marnapril]

Yeah, I agree with the AMA for the most part......but I don't dismiss the pathology - almost a psycho sexual fettish kind of thing that occurs in the supermorbidly obese - they are truly different psychologically (talking over 400lbs-600 plus!) and the neurosis may truly be disabling - I've heard it described as a failure to break with the infantile oral fiixation that infants have w/ hand to mouth immediate gratification..and those I"ve taken care of that extreme range (over 500lbs) seem to manifest this...but watching Brookhaven,where that one doc is trying so earnestly to advocate for them, they are jokingly sending out for pizza's and donuts on the taxpayer bill....alcoholics are tossed out for doing that in rehab...should it be any different?
And yes, as a critical care nurse for decades, folks sheepishly accept my in the face teaching on cigarettes,but are taken aback when I address weight...

um.. what?

to quote my buddy Beavs.. "what a bizzare post"

lol.. and yes, alcoholism IS A DISEASE. morningstar, you can certainly choose to not believe it's a disease, but it is.

 

[morningstar]

um.. what?

to quote my buddy Beavs.. "what a bizzare post"

lol.. and yes, alcoholism IS A DISEASE. morningstar, you can certainly choose to not believe it's a disease, but it is.

Addiction is voluntary, author contends in new book
Updated Wed. Jun. 17 2009 10:08 AM ET

CTV.ca News Staff

The idea that addiction is a disease and that addicts do not have control over their disease, has been a pillar of belief of the psychology community for decades. Yet Gene Heyman, a lecturer in psychology at Harvard Medical School, has set off a firestorm by questioning this time-honoured assumption in his new book, Addiction: A Disorder of Choice.

Heyman argues that addiction is very much governed by personal choice and is not an involuntary illness. He says the long-held belief that addicts cannot control their addiction may be well-meaning but is ultimately wrong.

The proof, Heyman says, lies in the number of people who are able to beat their addiction and the reasons they do.

"When people say that addiction is a disease they mean that drug users have become involuntary, that they simply can't say no," Heyman told Canada AM Wednesday.

"I asked the question: What factors influence drug use to halt in addicts? Things like values and laws, being worried about being arrested, financial matters and respect from family -- these are the things that influence decisions.

"And so I looked to see if those factors influenced drug use in addicts. And it turns out when you look at the literature broadly, that's exactly what happens. So I take a different conceptual framework."

The problem with the field of addiction is that people have restricted their analysis, says Heyman. They contend when you consider the terrible toll that addiction takes on the lives of addicts, "no one would choose to be an addict."


Heyman agrees that yes, addicts are self-destructive, but this does not mean they will not change their behaviour once the costs of continuing their addiction become too great.
"I began looking at biographies, at the epidemiological literature, at studies where anthropologists lived with addicts, and what we see again and again is the pattern of behaviour where the factors such as the desire for the respect of children or parents or worries about finances lead addicts to stop using drugs. So that's the real test," he explains.

He says when addiction experts tell addicts their addiction disease is "involuntary," it doesn't help them. If anything, it may give them a crutch to enable them to continue.

"What the data show is that most addicts actually quit. And this is encouraging. To be told that you have a chronic relapsing disease that has no cure cannot be helpful -- but especially if it's not the truth," says Heyman.

"But the truth, when we look at the data, is that most addicts quit, and they can be encouraged to quit much sooner. I think what is required to help someone quit is the knowledge that it is possible and that there's a better life once you do quit.

"Smoking is an addiction. And since the 1964 publishing of the U.S. Surgeon General's report, about 80 per cent of smokers have quit, and they typically quit on their own. So we know that people can quit an addiction."

 

[marnapril]

^^ well that's cool, thanks for posting one doctor's opinion. i appreciate it!

funny how he says smoking is an addiction.

 

[morningstar]

^^ well that's cool, thanks for posting one doctor's opinion. i appreciate it!

funny how he says smoking is an addiction.

I posted it because it reflects my opinion, held for many years, even before I worked with a women's treatment centre for addiction.

 

[LauraMax]

Oh, the smoking is an addiction thing is not news. Nicotine is the second most addicting drug next to heroin. I know b/c I'm a recovering nicotine addict. Personally, I think addiction is a disease. Studies have shown addictive tendencies are hereditary. And let me tell you, I stopped smoking 6 years ago & I still think about it every day. Probably every hour. There are stressful days I have tremendous internal fights w/myself when I pass the CVS to not drop in & purchase a delicious pack of nicotine sticks.

I'm not a doc so I don't know the definition of a disease. But I know some forms of obesity are caused by chemical imbalances, meds for other illnesses, or thyroid problems. Seems to me that qualifies.

But I agree that obesity due to poor lifestyle should not be considered a disease.

 

[GMonkey]

Well, I think that drug/alcohol addictions are diseases because the body has severe physical reactions when the chemical substance is taken away. Just because a disease can be either alleviated or cured doesn't mean that it isn't a disease. Many people are cured of cancer and survive. Some people have even gotten cancer because of things which they could control, sun exposure, etc.

 

[marnapril]

I worked with a women's treatment centre for addiction.

how about that! i was a data analyst at a women's treatment facility and a research analyst at a NIDA-funded research institute. my MA thesis was focused on drug addicts' access to health care in SF.. so i am basing my opinions strictly on years of research conducted not just by me but by many in the field.

just because you can quit or stop something doesn't mean it can't be considered a disease, which is defined as "an impairment of health or a condition of abnormal functioning" (like saying someone who is in remissin from cancer doesn't really have a disease).. and i think the belief that this definition somehow lets addicts "off the hook" or gives them some excuse is a reflection of our society's contempt and hatred for those struggling with addiction.

but.... just my opinions!