Recently the American Medical Association (AMA) House of Delegates declared that obesity is a disease and should be viewed like all other medical diseases, but this decision has not met with 100 percent agreement. The rationale behind the AMA’s decision was that recognizing obesity as a disease would make it easier for people to receive medical care and treatment, whether that is medication, referral to a Registered Dietitian or bariatric surgery. While treatment for obesity is important and certainly growing in terms of need -- about one third of Americans are now obese -- there are some physicians and health care providers who are concerned about this decision.
The parameter to judge obesity currently is BMI, or body mass index, a measure that is determined by way of a formula that looks at height and weight but does not assess if weight is muscle mass or body fat. You can calculate your BMI here: http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm. Given that the real risk of excess weight to disease incidence is excess body fat, failure to know if someone is over-fat or just overweight could result in a diagnosis that is incorrect. Evidence indicates that excess body fat increases the risk of heart disease, diabetes and several forms of cancer. But is weight the only factor associated with this increased risk?
Disease risk is multi-factorial with some of the risks including genetics, diet, activity and overall lifestyle. Some individuals can carry extra body weight - even fall into the obese category – and still be healthy; a classic example is athletes who have a high BMI due to increased muscle mass. However, if someone has a BMI over 30 – the number that is considered obese – and they do little activity or fail to make healthful food choices, the potential is high that their BMI represents more body fat than muscle.
So how should you view this new decision by the AMA? If you are overweight or obese, you should worry more about changing that fact and start to assess how to engage in more physical activity and make wiser food choices. It is helpful to keep a food and activity log. This helps to learn what you eat and how much you eat while noting how often and what type of activity is a part of your daily routine. Once you know your base you can either visit choosemyplate.gov to develop a personal plan or you can visit eatright.org to "Find a Dietitian" in your area who can help you develop a plan for change. Achieving a healthy body weight is the single most important point of this recent AMA discussion; so if your weight is higher than it should be, now is the time to make some changes to improve your health.
- Remember before you begin any physical activity to talk with your physician to learn what activity is safe for you.
Connie Diekman, M.Ed, RD, LD, FADA, is a registered dietitian and director of university nutrition at Washington University in St. Louis. She also provides expert counsel to the Aspartame Resource Center.