Last week, the American Medical Association officially designated obesity as a disease that requires medical treatment and prevention. More than a third of all adults in the United States are obese. Obesity-related health conditions cost more than $100 billion every year, as well as premature deaths.
Health issues linked with obesity include: high blood pressure, Type 2 diabetes, heart disease, joint problems, cancer, metabolic syndrome and psychosocial effects. We asked internal medicine expert Dr. Sridevi Bellamkonda, a physician with Johns Hopkins Community Physicians, to give us insight into the issues surrounding obesity and how the AMA’s announcement could change health care and the way we live.
Q. How will the AMA’s new classification of obesity as a disease change the way you treat patients?
A. That’s a great question. I try my best to give obesity equal importance along with some of the most common chronic medical problems that we see in primary care like hypertension, diabetes and high cholesterol. So, I would say it does not affect the way I treat my patients.
Q. What do you consider the most prevalent cause of obesity today?
A. Energy intake exceeding energy expenditure leads to obesity. Body weight regulation involves a complex set of functions involving environmental, genetic and endocrine influences that ultimately control the balance between the energy intake and energy expenditure.
Q. If obesity is “medicalized” by calling it a disease, how could that shift the focus away from lifestyle changes to reliance on drugs and surgery?
A. Evidence shows that any single intervention approach like drugs or surgery to treat obesity is very unlikely to be effective over the long term. So, whether we look at it as a cause or a risk factor or a disease, the treatment of obesity should be a multidisciplinary approach.
Q. Are drugs prescribed to treat obesity and if so, are they effective?
A. Yes, multiple medications are being used in treating obesity in addition to the life style changes and behavioral modifications.
Q. What are the dangers of society believing that obesity is an illness with an easy fix—a pill or a procedure—causing them to adopt even worse eating and lifestyle habits?
A. Unfortunately, there is no easy fix for obesity. The success in treating obesity depends on some of the factors like:
- Identifying the underlying cause(s) of obesity in each patient
- Counseling/educating/motivating the patient
- Giving them a structured plan with realistic short-term and long-term goals to reach
- Close monitoring and good support throughout their journey/transition.
Q. Will this reclassification improve reimbursement for obesity drugs, surgery and counseling? (Currently, Medicare Part D, the prescription drug benefit, includes weight loss drugs among those it will NOT pay for, along with drugs for hair growth and erectile dysfunction.)
A. Given the prevalence of obesity and seriousness of associated medical conditions, it should be given a high priority. Reimbursement will encourage more patients to consider treatment. I hope it improves.
Meet the Physician: Dr. Sridevi Bellamkonda, is an internal medicine physician with Johns Hopkins Community Physicians at Germantown. Her office is at 20500 Seneca Meadows Parkway in Germantown. The office phone number is 240-912-2738.