Is Obesity a Disease?

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THE GIST

- Obesity puts people at risk for Type 2 diabetes, hypertension, heart disease and even some cancers.

- Scientists don't agree on whether obesity is a disease, itself, although research is suggesting it may qualify.

- The verdict could affect what health care providers cover.

With more than one-third of U.S. adults struggling to keep off the pounds, obesity has left its mark on Americans' waistlines and wallets.

Yet when the Institute of Medicine released its recommendations for essential health benefits to include in the Patient Protection and Affordable Care Act recently, the term obesity was nowhere in sight. The report helps Congress dictate what health insurance companies should cover when the act goes into effect.

Obesity didn't make the cut.

Ambiguity surrounding the condition's causes and a lack of evidence-based medical treatments are likely to blame. But given what researchers know -- and the costs associated with the condition -- should obesity be considered a disease? Should it gain some health care coverage from insurers?

A growing number of researchers think so.

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Typical definitions of disease include a change in a person's body that negatively affects its structure and function. Obesity not only causes structural changes in a person's fat tissue, but it also dictates how the body handles lipids, insulin and blood sugar. As a result, fat exists where it's not normally found in muscle, liver, cardiac tissue and the pancreas, interfering with organs' ability to work properly.

Jyme Schafer, director of medical and surgical services at the Office of Clinical Standards and Quality for the Centers for Medicare and Medicaid Services, told Discovery News that when it comes to providing health coverage for the Medicare population, the centers aren't in the position to view obesity as a stand-alone disease. Instead, the focus is on reducing obesity's role in other health problems.

"We recognize that [relieving obesity] improves health outcomes," Schafer said. "And that's the bottom line."

Currently, Medicare may cover weight loss surgery for some patients with obesity diagnosed alongside conditions such as Type 2 diabetes, and the centers plan to introduce a program focusing on ways to target obesity with behavior. The surgery remains one of the few interventions that insurance companies may cover, even for other people not on Medicare, though policies can vary by state.

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