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US weighs in: Obesity now a disease (AFP)

WASHINGTON (AFP) - Obesity is a disease, according to the largest US government health care plan, which will pay for some treatments for overweight Americans, now in epidemic numbers.

Secretary of Health and Human Services Tommy Thompson told a Senate committee Thursday that Medicare, which covers retirees and the handicapped, will allow obesity to be treated as a disease in its own right.

A treatment must prove to be medically effective to be reimbursed, however.

"With this new policy, Medicare will be able to review scientific evidence in order to determine which interventions improve health," Thompson said.

"Obesity is a critical public health problem in our country that causes millions of Americans to suffer unnecessary health problems and to die prematurely."

The number of obese Americans has more than doubled since 1980, affecting one out of three persons, or a total of 59 million adults.

Thompson's department figures that direct economic losses from obesity, due to the illnesses that it brings on, such as cardiovascular disease, diabetes and cancer, total some 120 billion dollars annually, and are growing.

According to a study by the Centers for Disease Control and Prevention published in March, obesity and overweight caused by poor eating habits and lack of exercise could become the leading cause of death in the United States by next year.

To allow coverage of the costs of treatment for obesity, Medicare removed a phrase from its regulations that had said specifically it was not a disease.

"The question isn't whether obesity is a disease or a risk factor," said Medicare administrator Mark McClellan.

"What matters is whether there's scientific evidence that an obesity-related medical treatment improves health," he said.

"This change in Medicare's coverage policy puts the focus on public health."

The change will not be immediate, Medicare officials said, because the government will need to examine the scientific evidence to know which treatments may be reimbursed.

"We encourage -- and we're expecting -- requests to review scientific evidence evaluating the benefits of a range of treatments for obesity in the Medicare population," said Sean Tunis, Medicare's chief medical officer.

He said that in coming months, surgical procedures used to fight obesity will be evaluated.

The government's decision to classify obesity as a disease in itself is laden with consequences for public health and private insurance companies. The decision will place a series of treatments on a list of reimbursable procedures and could accelerate the development of new medicines.

Experts compare this stage to the first steps toward including alcoholism among treatable diseases. That could help affected persons to admit that they are in need of help and the public will cease to consider those persons responsible.

The American Obesity Association (AOA) calls the government's decision a new chapter in the fight against obesity.

"The decision by Medicare recognizes that obesity is not simply a cosmetic issue," AOA president Richard Atkinson said.

"It is a disease in its own right. In fact, obesity is the most prevalent, fatal, chronic disease of the 21st century.

"This decision will open the door not only for better insurance coverage but more medical research and increased education on obesity at the nation's medical and other health schools."

The US tax collection agency, IRS, has accepted since 2002 deductions for expenses to fight obesity, alongside other recognized diseases.


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