Obesity is now a disease: What it means for blacks

OPINION - Obesity is now classified as a disease. This was the final decision at the annual meeting of the American Medical Association (AMA), the organization that represents doctors nationwide...

Luther Vandross was outed as gay after his death.

Obesity is now classified as a disease. This was the final decision at the annual meeting of the American Medical Association (AMA), the organization that represents doctors nationwide.

Despite their own Council on Science and Public Health releasing a report earlier in the meeting which indicated that obesity was not a disease process, the AMA House of Delegates took the bold step to vote in opposition to this report.

Taking away the blame

For persons who struggle with their weight and the physicians that care for them, this designation of obesity as a disease is seen as a victory. Currently, there are very few resources available to those with obesity as this entity has been viewed as self-induced. The current dogma suggests that obesity can be cured with proper diet and nutrition.

Many persons believe that if you are eating the right foods in the proper portion sizes and following a dedicated exercise regimen, you will never become obese. However, science has taught us that while this may be the case for some persons, there is not a “one size fits all” approach to obesity.

Studies have shown that hormones in the body such as leptin and ghrelin play a role in the weight status of an individual. These hormones are just a few of the hormones that regulate energy balance in the human body. Leptin, a hormone that is primarily produced by fat, circulates in the bloodstream and communicates with the brain whether or not the body has had enough to eat.

For persons that have a higher leptin level, they will tend to eat more as their body does not sense that there is enough food or energy on board. The leptin level varies from person to person.

Some studies suggest that blacks are more likely to have a higher leptin level than whites. One such study indicated that leptin levels were much higher in black women, even after controlling for factors such as weight. The authors suggested that further research into leptin is needed to investigate racial differences in obesity-related diseases.

Obesity’s impact

Current data from the CDC indicate that 36 percent of adults in the United States overall are characterized as obese. And ethnic minorities have the highest rates of obesity. Half of African-Americans are considered obese while only 34 percent of Caucasian Americans are considered obese.

While there are differences in access to high quality foods and safe spaces for physical activity, these differences persist even when levels of income and education are equal. African-American men who have a college degree are more likely to be obese than African-American men without a high school education. African-American women, the subgroup with the highest obesity rates, also have higher rates of obesity if they have higher income and education levels. While we have yet to understand all of the reasons that account for the higher obesity rates in the African-American community, it is clear that African-Americans are disproportionately affected by obesity and obesity-related disease processes such as Type 2 diabetes and heart disease.

Opening doors

With the largest organized group of physicians, the AMA, acknowledging obesity as a disease, they have helped to pave the way for policy changes and medical coverage of obesity. In 2012, The Centers for Medicare and Medicaid Services began to reimburse primary care providers for obesity screening and counseling in patients 65 and older.

More dollars need to be allocated towards the treatment of obesity in the 36 percent of adults and 17 percent of children and adolescents who already have this diagnosis. Efforts should also be made towards prevention of obesity by ensuring adequate resources for all populations with particular emphasis on ethnic minority populations due to the higher disease burden.

Conservative estimates of obesity costs demonstrate that this disease process costs approximately $147 billion U.S. dollars annually. While African-Americans are more likely to struggle with their weight, they are less likely to access care to reduce the disease burden of obesity on their quality of life. The AMA should be applauded for their recent strides to improve the health of all Americans.

While the war on obesity is far from over, we have won one recent battle — obesity has been acknowledged as a disease. Now let’s focus our attention on reducing obesity to improve the health of generations to come.

Dr. Fatima Cody Stanford, MD, MPH is an obesity medicine and nutrition fellow at Massachusetts General Hospital and Harvard Medical School. As a physician trained in internal medicine and pediatrics, she works at the intersection of obesity, health policy, and health disparities.