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Obesity as a disease: has the AMA resolution had an impact on how physicians view obesity?
Luke M Funk1, Sally A Jolles1, Corrine I Voils2
1William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin; Department of Surgery, Wisconsin Surgical Outcomes Research Program (WiSOR), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Background:
In 2013, the American Medical Association (AMA) passed a resolution characterizing obesity as a disease. It is unclear whether primary care physicians (PCPs) agree with this characterization and how their agreement or lack thereof affects their treatment of patients with obesity.
Objectives:
We sought to understand PCP opinions about the AMA obesity resolution and how it has affected management of patients with obesity.
Setting:
Small, medium, and large communities in Wisconsin METHODS: Focus groups were conducted with PCPs in Wisconsin. PCPs were asked whether they considered obesity a disease and what they factored into this consideration, including the AMA decision. A directed approach to content analysis was used to analyze the data. A taxonomy of consensus codes was developed, coding summaries were generated, and representative quotes were identified.
Results:
Three focus groups comprising a total of 16 PCP participants were conducted. Not all PCPs were aware of the AMA resolution. PCPs held divergent opinions on whether obesity represented a disease, primarily focusing their considerations on obesity as a risk factor versus a disease. They also discussed how considering obesity as a disease affects the patient-doctor relationship, insurance coverage, physician reimbursement, and research.
Conclusion:
The AMA resolution did not appear to have made a significant impact on PCP opinions or management practices in our focus groups in Wisconsin. Follow-up surveys that quantify the prevalance of these opinions and practices at the state and national levels would be highly informative.
