The term
"obesity" gets thrown around a lot, and sometimes it may not be clear
what it means. Does it refer to anyone who has excessive weight, or has some
excess weight to lose, Or is it more than that? Well there is a medical
definition for obesity, as well as for the term "excessive weight".
What is excessive
weight? In medical terminology, the word excessive weight has come to be used
as a noun (as in,"obesity and excessive weight") as much as an
adjective. Such usage has the effect of making clear that excessive weight and
obesity are part of a disease process, more on that below. The medical
definition for excessive weight is based on body mass index (BMI). BMI is
measured in units of kg/m2, which means that it requires height and weight for
the calculation. BMI calculators are readily available online, such as the one
offered by the National Heart, Lung and Blood Institute ( NHLBI ). Excessive
weight is defined as a BMI of 25.0 to 29.9 kg/m2. A normal BMI is defined as
falling between 18.5 and 24.9. Having a BMI lower than 18.5 classifies one as
being underweight.
What is Obesity? Just
as for excessive weight, the medical definition for obesity hinge on the BMI
calculation. To be classified as obese, a patient must have a BMI of 30.0 or
greater. A BMI of 40.0 or greater is often referred to as "morbid
obesity" and is recommended by national guide lines as the cut point for
identifying highly muscular, may have a high BMI that is due to their greater
muscle weight rather than to body fat. Thus, the BMI is intended to be part of
a greater clinical assessment.
Why Does it Matter?
Many studies have shown that the likelihood of poorer health out comes (in
teams of such diseases as cancer, cardiovascular disease, obstructive sleep
apnea, diabetes, high blood pressure, and others), as well as overall premature
death, increases as BMI increases. And the clinical definition of obesity (BMI
of 30.0 or greater) is used in many cases to determine appropriate treatment
options. There are also implications for insurance coverage and what therapies
would be considered medically necessary. In 2013, the American Medical
Association (AMA) officially declared obesity to be a disease, acknowledging
the "enormous humanitarian and economic impact of obesity as requiring the
medical care, research and education attention of other major global medical
diseases."
In 2013, the American
Heart Association, American College of Cardiology, and The Obesity Society
released new long awaited obesity guide lines, which were published as the
"2013 ACCF/AHA/TOS Guide line for the Management of excessive weight and
Obesity in adults." The impact of officially acknowledging obesity as a
chronic disease is expected not only to raise awareness of the problem among
the general public, but also to impact policy at all levels. Policymakers may
feel greater need to fund and implement obesity treatment and intervention
programs, while third-party payers may be more likely to reimburse physicians
and other healthcare professionals for treatment and management of obesity as a
recognized disease.
As for the centers
for Medicare and Medicaid Services (CMS) are concerned, obesity has been
categorized as a chronic illness since 2004. Since November 29, 2011, Medicare
has covered the cost of behavioral therapy for patients with a diagnosis of obesity.
This may consist of screening with BMI and midsection circumference, dietary
assessment, and high-intensity behavioral interventions.
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