NCPA - National Center for Policy Analysis

The Fight Over Fat

November 11, 2003

The rising number of seriously overweight Americans has triggered intense debate among scientists, advocacy groups, federal agencies, insurance companies and drug makers about whether obesity should be declared a "disease." This is a move that could open up insurance coverage to millions who need treatment for weight problems and could speed the approval of new diet drugs.

Supporters contend the move would destigmatize the condition, and would immediately remove key economic and regulatory hurdles to prevention and treatment. Opponents argue that such a move would divert scarce resources from diseases which are actual ailments.

  • The Internal Revenue Service has ruled that, for tax purposes, obesity is a disease, allowing Americans for the first time to claim a deduction for some health expenses related to obesity.
  • The federal agency in charge of Medicaid and Medicare is conducting a review to determine whether it should consider obesity a disease; that would mean that for the first time the poor, elderly and infirm would be covered for some weight-control therapies without first having another illness, such as diabetes, diagnosed.
  • The Food and Drug Administration is reviewing how it judges new weight-loss drugs; the agency will consider whether it should evaluate diet drugs more like it assesses treatments for such illnesses as diabetes and cardiovascular disease, making it easier for them to be approved.

Together, these actions could result in a major shift in how the nation deals with what has long been considered a cosmetic or psychological problem, not a major public health crisis.

Source: Rob Stein, "Is Obesity A Disease? Insurance, Drug Access May Hinge on Answer," Washington Post, November 10, 2003.


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