Phil Brennan, NewsMax.com
Tuesday, Jan. 22, 2002

The nation's leading obesity organizations are pushing for such a step, claiming that obesity is a disease that requires medical attention and should be covered by insurance, HMOs, Medicare and Medicaid, USA Today reported Monday.

More overweight people would seek medical assistance if obesity were covered, the groups insist, and losing as little as 5 percent of one's weight reduces blood pressure, blood sugar and cholesterol levels. This, they claim, might well save health care costs in the long run.

Medicare officials are "expected to announce within the next couple of weeks whether to classify obesity as a disease for the program," the newspaper revealed. Current regulations state that "obesity itself cannot be considered an illness," and as a result, Medicare usually doesn't cover treatments for it.

Adding obesity to the list of covered disorders would not automatically mean that Medicare will start paying for treatments, but it does leave an opening for more discussions at national and state levels, experts say.

Being overweight is a health risk that can cause heart disease and a host of other disorders and should be regarded as a disease requiring medical treatment, advocates of the new classification say.

If obesity isn't covered, "people will continue to get bigger and sicker," Charles Billington, associate director of the Minnesota Obesity Center in Minneapolis, told USA Today.

But classifying obesity as a disease would mean that the cost of medical care and insurance – and the taxes that pay for such federal programs as Medicare – would also get bigger and bigger, experts say.

About 26 percent, or about 54 million adults, are obese: at least 30 pounds over what is considered healthy. About 300,000 deaths a year are attributed to obesity.

The Voluntary 'Disease'

But some experts wonder if those facts justify ballooning medical, insurance and tax costs. They argue that being overweight is a matter of choice due to poor exercise and eating habits that can't be blamed on a disease. And, they add, treating obesity as a disease would be incredibly expensive and boost insurance premiums and other health costs for companies and individuals.

Moreover, even if people do lose weight under costly medical supervision, experience shows there is no guarantee they'll keep it off.

"Historically, insurance companies have looked at obesity as a condition that an individual should be able to manage through modifying their own eating habits and increased exercise," Frank Apgar, senior medical director of care management for Blue Shield of California, told USA Today.

"Does one really need a doctor to accomplish these goals?" If so, "should the individual pay for this, or is it something your insurance company should pay for, i.e., all of us?" he told USA Today's Nanci Hellmich.

According to advocates of the new classification, the answer is clearly "yes."

"Obesity is the engine that is driving a lot of diseases - heart disease, diabetes, hypertension, arthritis," said Morgan Downey, executive director of the American Obesity Association. "We're paying for those diseases, but not contributing nearly enough to deal with the underlying cause, and that just doesn't make sense."

How much would adding obesity to the list of covered diseases cost? USA Today estimated part of the price tag:

Diagnosis: Overeating, Underexercising