I'd heard that the AMA had reclassified obesity from "condition" to "disease" but this news stayed in the periphery of my mind until I read this blog post by a college friend, Danielle. (I must note that Danielle is one of my amateur running heroes and she helped me run to my current 5k PR in January.)
After I read her post this morning, my mind was abuzz. As someone who is most definitely not predisposed to thinness, due to genetics, growing up near the poverty line, and other biological, socio-economic, and emotional factors that contribute to weight gain and retention, I'm worried about the implications of this new diagnosis.
When I was living in Lancaster, PA, in 2010-2011, I started having some health problems. It got to the point that I, one night, around 2 a.m., I drove myself to the hospital because I fully believed I was having a heart attack. Turns out, my heart was fine but my anxiety level was through the roof. Prompted by this scare, I found a primary care physician and we began the process of trying to figure out what was wrong.
My symptoms weren't limited to phantom heart attacks either. I was tired all the time, missed my period for months on end, had constant, achy pain near my liver/gall bladder, in my knees, and in lots of other places as well.
Through a series of tests, I was diagnosed with fatty deposits on my liver, PCOS (poly-cystic ovarian syndrome), insulin-resistance, and anxiety/depression. So, I was prescribed birth control, anti-depressants, and Metformin (for the insulin-resistance). I spent the next six weeks barely able to function because the anti-depressants and Metformin made me so nauseous. I was able to stop the Metformin immediately, but there was a weaning off period for the anti-depressants.
Six months later, the birth control hadn't made any impact - I was still missing periods and growing a beard. At one point, I had an ultrasound and there was no evidence of ovarian cysts. I was still having the same aches and pains everywhere. Nothing was better!
When I look back on those months of tests and failed treatments, I remember my first meeting with my doctor. During that appointment, I came out with the big question no one wants to ask: Could all of these symptoms be a result of how overweight I am? Instead of engaging the conversation, perhaps burned out on giving advice that was never taken, my doc dismissed my question and wrote some prescriptions. I was so tired and anxious that I didn't keep asking. If a pill was going to help, I would try.
Two years and a lot of hard, sometimes tedious work later, I've changed my diet, made exercise a regular part of my life, lost over 70 pounds, and all of my symptoms are gone. Every. Single. One. Including the anxiety and depression and the sore knees (some anecdotal evidence that extra weight and a sedentary lifestyle were far worse for my knees than running ever could be).
I don't blame my doctor for being reluctant to start a conversation that probably goes unheeded by many, if not most, people, but I was literally asking her to hit me with reality and she chose to ignore my interest. Let me be clear: She absolutely is not to blame for my continued inaction but she might have made a huge impact by continuing the conversation I was trying to start.
So, maybe it's good that people can be diagnosed with obesity. Maybe it means that people will be able to get the treatment they need and it will be covered by insurance. Maybe it will make it easier for doctors to start the conversation that begins with, "You know all these problems you're having? A lot of them could be solved by getting rid of the extra pounds you've been carrying around."
I'm a little skeptical, though. Being diagnosed as obese will certainly be a wake-up call for some. But I have to wonder what kind of treatment people will expect. Don't we treat diseases with pills and procedures? Will people be satisfied with their new diagnosis when they learn that the best treatment is diet and exercise? Or will they expect a surgery or medication to fix it quick?
I have other concerns and questions, too. How will obesity be measured? If it's BMI, Lord help us all. Will all overweight/obese people be considered ill? Will treatment be required if one's weight is above an acceptable limit? Will this increase fat stigma beyond what it already is? And on and on...
I'd love to hear thoughts from my very small peanut gallery. What was your initial thought when you heard the news that the AMA considers obesity a diagnosable disease?