Healthcare professionals advocate for reframing obesity as a disease in Boston panel discussion

Senator Becca Rausch speaks at "The Obesity Epidemic Fight: Split Perspectives" of the Overcoming Obesity 2019 Conference. Boston, Mass., Oct. 4., 2019. Photo by Anna Stjernquist/ BU News Service

By Anna Stjernquist
BU News Service

For Dr. Ethan Lazarus, treating patients with obesity carries frustrations that extends past medical issues.

“The medical systems say it’s a disease. The doctors who’ve spoken up say it’s a disease. The political system says ‘Well, go ahead and fire the person because their butt’s too big’ – that’s offensive,” Lazarus told attendees at Friday’s Overcoming Obesity 2019 conference at the Boston Marriott.

Lazarus, an obesity medicine specialist at Clinical Nutrition Center in Denver, continued to list other indignities faced by obesity doctors and their patients during the panel “The Obesity Epidemic Fight: Split Perspectives.”

“The airline companies let go of their flight attendants because their BMI is too high – that’s offensive,” he said. “The insurance company say it’s a lifestyle choice – that’s offensive.”

The panel was the first as part of a five-day conference, sponsored by the Obesity Medicine Association, that brought in healthcare specialists to discuss advances in the clinical and surgical treatment of obesity, health coverage for and discrimination against patients with obesity.

Obesity has been rising as an epidemic across the United States for the last few decades, but especially in recent years, several panelists argued. Lazarus referred to the Milken Institute’s figures collected in 2016 to showcase the societal burden of obesity:

“Obesity costs our country $1.7 trillion annually and we’re losing over 300,000 Americans a year to the disease of obesity, third only to cancer and heart disease,” he said.

Lazarus said obesity isn’t taken as seriously as other diseases because of the social stigma connected to it.

“Substitute any other disease with obesity and it highlights how offensive our current policies and insurance are,” Lazarus said. “Just because a lot of Americans have high blood pressure doesn’t mean that it’s not a disease worth treating – obesity is a disease as any other, even if it involves a lifestyle component.“

State Sen. Rebecca Rausch said the crux of the problem, from a policymaker perspective, is confusion over how medicalized this topic is, noting shifting complexities faced by lawmakers and public policy officials when protecting obese people’s rights.

She mentioned when U.S. medical institutions adopted the World Health Organization’s tougher standards for Body Mass Index, a formula to determine an individual’s weight category “millions of Americans became fat overnight without gaining a pound.”

A representative of the insurance industry acknowledged existing inequities in obesity treatment, including insurance companies resistance in paying for obesity treatment. 

“One thing we can do, given our current benefit structure, is make it easier for members to navigate benefits and manage obesity as any other disease,” said Kathleen Proctor, managing director of Blue Cross Blue Shield, a federation of 36 health insurance companies.

She said they will do their part by developing a two-year pilot health insurance program, to launch in New York, New Jersey, Washington and Arkansas, by 2020. The pilot will be available for federal BCBS members with a BMI over 30.

“We feel that tackling obesity is key to saving money because it will help with these downstream co-morbidities that go along with obesity,” she said.

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