Answers (10)
3
Hi Joanne,
Thanks for posting this question! Here are my thoughts:
I wouldn't call obesity a disease. For the most part, obesity has been (and continues to be) a result of poor choices in diet and lifestyle. It surprises me that the AMA has declared obesity a disease. I would classify Type 2 diabetes, heart disease and other conditions that result from being obese as diseases, but not obesity itself. You’ve probably heard the term “diabesity” used to describe the cascade of ailments (insulin resistance, elevated blood sugar, blood pressure and cholesterol, pre-diabetes) resulting from poor lifestyle choices, and it’s 100% reversible. Type 1 diabetes has a genetic and autoimmune component, and cannot be cured or prevented (nor is it caused by the patient), so that’s clearly not part of this discussion. The vast majority of heart disease can be directly linked to lifestyle choices, and an even higher percentage of Type 2 diabetes is linked to lifestyle choices. Just because those who have made poor lifestyle choices eventually become obese doesn't mean that it cannot be corrected. The fact that obesity is an epidemic doesn’t make it a disease. Obesity can be reversed and "cured" if better food choices are made and if obese people start being more active and taking responsibility for their actions. This is another example of our current society’s tendency to not accept personal responsibility. Big pharmaceutical companies are now pushing drugs and other invasive methods of treatment, when the vast majority of these cases can actually be fixed with education, improved diet, increased physical activity and personal accountability. Of course the AMA would like to declare obesity a disease because of the vast amount of revenue they and their associates make from treating obese people with pills instead of preventive measures.
In my opinion, the danger in calling obesity a disease removes some of the fault that needs to be placed on the obese individual so he or she can 1) become aware 2) accept responsibility 3) receive education and 4) make necessary changes. If these steps aren’t taken, people aren’t capable of embracing a new lifestyle and making it permanent, which is what must occur in order to rid our society of the obesity epidemic. Calling obesity a disease also opens the door with the ADA (Americans with Disabilities Act 1990), which could make obese people a protected class. That is an entirely different, disturbing conversation! My point is that by going down this road, we aren’t helping obese people get healthier—we’re just giving them a crutch so they can limp along and use more and more valuable healthcare dollars. Obesity could singlehandedly break the PPACA (Patient Protection and Affordable Care Act) because healthcare costs will skyrocket if we focus on treatment rather than prevention of a problem of such epidemic proportions. Let’s not forget that those costs will skyrocket for everyone (including healthy people like us who work hard to stay healthy) once our healthcare is regulated by the government. I’m guessing obesity will now be considered a pre-existing condition for insurance purposes too, so that will further insulate obese people from accepting any blame whatsoever, and will force the costs of their care onto others. What this also means to me as a trainer is that clients may use the “I have a disease/condition” excuse for why they can’t work out or do certain exercises. As a trainer, I’ve dedicated my life to helping people adopt healthier lifestyles. It can be very challenging at times, and I need all the reinforcement available to help some clients push through barriers. I don’t believe labeling people with a medical condition reinforces what I do in any way. I’m guessing my comments might be considered taboo, and that’s okay. I don’t dislike obese people—we all have our struggles, and I work with overweight and obese clients regularly. I just know that not making them face their demons will prevent them from becoming the healthy, happy, vibrant people they’re meant to be, and I don’t want to be part of a movement that fails one-third of Americans. There are consequences for every single action in life, and giving people the freedom to live without consequences is dangerous.
Best,
Harris
Thanks for posting this question! Here are my thoughts:
I wouldn't call obesity a disease. For the most part, obesity has been (and continues to be) a result of poor choices in diet and lifestyle. It surprises me that the AMA has declared obesity a disease. I would classify Type 2 diabetes, heart disease and other conditions that result from being obese as diseases, but not obesity itself. You’ve probably heard the term “diabesity” used to describe the cascade of ailments (insulin resistance, elevated blood sugar, blood pressure and cholesterol, pre-diabetes) resulting from poor lifestyle choices, and it’s 100% reversible. Type 1 diabetes has a genetic and autoimmune component, and cannot be cured or prevented (nor is it caused by the patient), so that’s clearly not part of this discussion. The vast majority of heart disease can be directly linked to lifestyle choices, and an even higher percentage of Type 2 diabetes is linked to lifestyle choices. Just because those who have made poor lifestyle choices eventually become obese doesn't mean that it cannot be corrected. The fact that obesity is an epidemic doesn’t make it a disease. Obesity can be reversed and "cured" if better food choices are made and if obese people start being more active and taking responsibility for their actions. This is another example of our current society’s tendency to not accept personal responsibility. Big pharmaceutical companies are now pushing drugs and other invasive methods of treatment, when the vast majority of these cases can actually be fixed with education, improved diet, increased physical activity and personal accountability. Of course the AMA would like to declare obesity a disease because of the vast amount of revenue they and their associates make from treating obese people with pills instead of preventive measures.
In my opinion, the danger in calling obesity a disease removes some of the fault that needs to be placed on the obese individual so he or she can 1) become aware 2) accept responsibility 3) receive education and 4) make necessary changes. If these steps aren’t taken, people aren’t capable of embracing a new lifestyle and making it permanent, which is what must occur in order to rid our society of the obesity epidemic. Calling obesity a disease also opens the door with the ADA (Americans with Disabilities Act 1990), which could make obese people a protected class. That is an entirely different, disturbing conversation! My point is that by going down this road, we aren’t helping obese people get healthier—we’re just giving them a crutch so they can limp along and use more and more valuable healthcare dollars. Obesity could singlehandedly break the PPACA (Patient Protection and Affordable Care Act) because healthcare costs will skyrocket if we focus on treatment rather than prevention of a problem of such epidemic proportions. Let’s not forget that those costs will skyrocket for everyone (including healthy people like us who work hard to stay healthy) once our healthcare is regulated by the government. I’m guessing obesity will now be considered a pre-existing condition for insurance purposes too, so that will further insulate obese people from accepting any blame whatsoever, and will force the costs of their care onto others. What this also means to me as a trainer is that clients may use the “I have a disease/condition” excuse for why they can’t work out or do certain exercises. As a trainer, I’ve dedicated my life to helping people adopt healthier lifestyles. It can be very challenging at times, and I need all the reinforcement available to help some clients push through barriers. I don’t believe labeling people with a medical condition reinforces what I do in any way. I’m guessing my comments might be considered taboo, and that’s okay. I don’t dislike obese people—we all have our struggles, and I work with overweight and obese clients regularly. I just know that not making them face their demons will prevent them from becoming the healthy, happy, vibrant people they’re meant to be, and I don’t want to be part of a movement that fails one-third of Americans. There are consequences for every single action in life, and giving people the freedom to live without consequences is dangerous.
Best,
Harris
0
Hi Joanne. Great question! I think that this further opens the door for the 'possibility' that we fitness professionals will become a official part of the medical system. By now recognizing this as a disease, this opens the way for actual prescriptions dealing with this disease, which in turn opens the way for 'professionals' who can affect positive changes in obesity as becoming a part of the cure or prevention. This in turn could open the door for further discussion and action on providing health insurance coverage for such services. Hmmm...
LaRue, CSCS
www.lecfitness.com
LaRue, CSCS
www.lecfitness.com
0
Took them long enough.
I agree with LaRue.
I get the impression that CPT's will slowly get more clients through insurance. Companies are slowly realizing that training is a great way of preventing this and employers are offering help for gym memberships. At a hospital I was at mentioned that their doctors are starting to refer people to trainers- I'd guess that its a matter of time before training is covered by peoples insurance.
I agree with LaRue.
I get the impression that CPT's will slowly get more clients through insurance. Companies are slowly realizing that training is a great way of preventing this and employers are offering help for gym memberships. At a hospital I was at mentioned that their doctors are starting to refer people to trainers- I'd guess that its a matter of time before training is covered by peoples insurance.
0
The word disease may scare people to the gym. I know that they should have likely realized that being obese is of course not healthy, but now with more attention to the matter, there may be a bigger movement of obese people going to the gym.
0
My personal opinion is that obesity is a result of other factors, and then when it (obesity) becomes a "disease", the other factors then become the result...
Obesity is in part, due to our "food system", the overabundance of processed foods, and sugar.
Which comes first the chicken or the egg?
This will be interesting.
0
At this point it is irrelevant whether or not it is a disease, it has been classified as one. What concerns me is if this is going to affect scope of practice for personal trainers. We are not medical providers and working with a "disease" is outside of our scope of practice. This can be bad for us. On the other hand it could lead to standardizing our industry and allowing us to accept insurance payments. It's tough to say where this will lead.
0
Hi Joanne,
you started an interesting discussion.
I do not think that it will have much of an impact. Judging from many of the questions placed here on this forum, many personal trainers are already operating outside the scope of their practice. How many trainers truly have 'apparently healthy' clients? On the other hand, if those trainers operated strictly within their scope, many, many people would not have a trainer at all, and, left to their own devices, would probably be worse off. A lot of trainers now are getting physician's approvals for those clients and dealing with them safely. Regrettably, there are some that do not; but I would venture to say that they are not safe for the 'apparently healthy' either.
I hope that the classification of 'obesity' as a disease will prompt ACSM to require a mandatory physician's approval for those prospective clients.
I need to make an additional comment about Harris' statement. For once I do not agree. Obesity is way more complex than simply saying that obese people made poor choices and that this will just provide them with a convenient excuse. I consider compulsive overeating an emotional problem that is probably the most difficult form of addiction to treat. People who have addictions to all the other substances one can get addicted to have one huge advantage: they can stop entirely from using it. People addicted to alcohol do not dare to have even one drink for fear to start the whole process over.
Now look at the situation with food. Not eating is not an option. Not only do people have to navigate their eating behavior, they are at the same time bombarded with messages telling them just the opposite of what they need to do. Yes, there are some that are able to battle those demons. But there are many who are not, and I am not one to cast the first stone.
Karin Singleton
www.meltnc.com
you started an interesting discussion.
I do not think that it will have much of an impact. Judging from many of the questions placed here on this forum, many personal trainers are already operating outside the scope of their practice. How many trainers truly have 'apparently healthy' clients? On the other hand, if those trainers operated strictly within their scope, many, many people would not have a trainer at all, and, left to their own devices, would probably be worse off. A lot of trainers now are getting physician's approvals for those clients and dealing with them safely. Regrettably, there are some that do not; but I would venture to say that they are not safe for the 'apparently healthy' either.
I hope that the classification of 'obesity' as a disease will prompt ACSM to require a mandatory physician's approval for those prospective clients.
I need to make an additional comment about Harris' statement. For once I do not agree. Obesity is way more complex than simply saying that obese people made poor choices and that this will just provide them with a convenient excuse. I consider compulsive overeating an emotional problem that is probably the most difficult form of addiction to treat. People who have addictions to all the other substances one can get addicted to have one huge advantage: they can stop entirely from using it. People addicted to alcohol do not dare to have even one drink for fear to start the whole process over.
Now look at the situation with food. Not eating is not an option. Not only do people have to navigate their eating behavior, they are at the same time bombarded with messages telling them just the opposite of what they need to do. Yes, there are some that are able to battle those demons. But there are many who are not, and I am not one to cast the first stone.
Karin Singleton
www.meltnc.com
0
While I agree with you whole-heartedly on the subject of obesity being more complex and lean towards addiction as well. I have posted on this else where. I cannot agree with you on the acceptance of trainers playing out of their scope of practice all the time. It's not right! It shouldn't happen! It's part of the problem! All it does is confuse EVERYONE, especially the clients! I don't have only apparently healthy individuals as clients but I am an HFS who is qualified to deal with special populations and clients with medically controlled disease... along side doctors. I interact with doctors when it comes to my diseased clients. We send notes back and forth in many cases. I have to say it...if making obesity a disease holds trainers accountable more and helps build relationships between doctors, psychologists, nutritionists and qualified trainers and garners results that stop the rise in obesity rates...then I am happy about it.
0
Interesting topic and opinions :-). Here are some articles from the IDEA Fitness Journal:
http://www.ideafit.com/fitness-library/conquering-the-ldquoobesogenicrdq...
http://www.ideafit.com/fitness-library/overweight-obesity-triples-in-arm...
http://www.ideafit.com/fitness-library/physicians-unqualified-to-treat-o...
http://www.ideafit.com/fitness-library/conquering-the-ldquoobesogenicrdq...
http://www.ideafit.com/fitness-library/overweight-obesity-triples-in-arm...
http://www.ideafit.com/fitness-library/physicians-unqualified-to-treat-o...
0
Hello Joanne Duncan-Carnesciali,
I am glad that I studied ACE Health Coach to have more in depth knowledge when working with the obese and their physicians.
This will force us to be in closer contact with the clients' doctors.
By the way, what degree of obesity draws the line for disease status?
Maybe this will help decrease the amount of comorbidities.
Take care,
Natalie.
I am glad that I studied ACE Health Coach to have more in depth knowledge when working with the obese and their physicians.
This will force us to be in closer contact with the clients' doctors.
By the way, what degree of obesity draws the line for disease status?
Maybe this will help decrease the amount of comorbidities.
Take care,
Natalie.
