Medicare now defines obesity as a disease, nearly
16 Jul 2004
The US Medicare program did not used to define obesity as a disease, now it almost does. It now says that it cannot say it is not a disease - this a huge shift. This could mean that many people will now be able to get treatment for weight loss on Medicare. The Centers for Medicare and Medicaid Services manages health programs for seniors and the disabled. It says it is changing the definition which routinely used to deny cover for most weight loss treatments.
We could see a wave of applications for such treatments as stomach surgery, diet regimes and counseling.
The decision by the agency to redefine obesity does not state specifically that obesity treatment will be covered - but it has left things much more open. It did not just come out and say obesity is a disease, it said "there is no general agreement on the classification of obesity as an illness." - this is quite a shift in semantics.
"Obesity is a critical public health problem in our country that causes millions of Americans to suffer unnecessary health problems and die prematurely. With this new policy, Medicare will be able to review scientific evidence in order to determine which interventions improve health outcomes for seniors and disabled Americans who are obese," said US Health and Human Services Secretary Tommy Thompson.
Many see this as a huge change in the way Medicare views obesity. Health professionals and health care organizations will be closely looking at what Medicare is evaluating and what it decides to cover.
If cover for obesity does materialize, the stigma of obesity could be overcome as people see it as just another condition that there is treatment for. By not defining obesity as a disease that deserves treatment like any other disease, it has been a difficult problem for health professionals and 'patients'.
Some people have said, in response to Medicare's new definition of obesity, that obesity is a self-indulgent phenomenon that can be easily sorted out with a change in lifestyle. They say that it is not a disease that needs treatment with orthodox medicine.
Others say that the best way to deal with obesity is to have preventive programs (stop it from starting in the first place). More exercise in schools and better nutritional labelling would have a better impact than treating overweight people like patients, they say.
How much a change of approach by Medicare would cost is impossible to estimate, because we do not know what would be covered.
However, a Medicare official said that it is planning to have a meeting later on in the year to decide what would be covered. The deciding factor would be proof of success - if a treatment works, it is more likely to be covered.