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Four years after declaring obesity a disease, the national doctor's group is urging new terminology for physicians to use in exam rooms.
In 2013, the American Medical Association (AMA) House of Delegates determined, based upon the scientific evidence, that obesity should be considered a disease. For physicians and their patients with obesity, the effect of this statement would provide the first steps toward destigmatizing a disease that can affect every organ system in profound ways. Over the last four years, clinical practice guidelines have been written by multiple specialty societies describing the correct approach to patients with obesity in terms of diagnosis and treatment.
There remains a great deal of frustration among clinicians who treat patients because of the lack of availability of reimbursement for evaluation and management codes, obesity-related medications on the formulary of payers, and medical school curriculum that includes the scientific and clinical aspects of obesity. Finally, despite the AMA's declaration, there is ongoing stigma among many physicians, and the public in our conversation surrounding obesity.
To address the negativity associated with obesity, one simple way to make a difference would be to use patient-first language. Many clinicians refer to an "obese patient" or a "diabetic patient" rather than using the favorable terminology of a patient with obesity or a patient with diabetes. In studies, patients with obesity have reported over half of doctors making inappropriate comments about their weight. In addition, patients with a body mass index greater than 55 report delays in seeking care because of disrespectful treatment and inadequate healthcare facility accommodations.
In the next few weeks, the AMA will again debate an issue related to obesity while considering a resolution to formally destigmatize obesity by requiring patient-first language in all formal communications. Terms such as "obese," "morbidly obese," and "fat" would be replaced by "weight" and "unhealthy weight," and facilities would be encouraged to provide a comfortable environment with proper sized furniture, equipment and gowns. Obesity and its complications affect 30 percent of adults in the US.
All of our patients deserve the respect of patient first language, adopting the AMA resolution is a first step to tackling the epidemic of obesity in our country.