Sunday, June 23, 2013

AMA Decides Obesity is a Disease

The American Medical Association (AMA) decided, and it is their opinion, that obesity is a disease. Like every profession the AMA is an association that can be joined by doctors and medical students, but they have absolutely no authority to officially classify a disease. The World Health Organization and CDC can actually classify a disease, but so far they have not agreed that obesity is a disease. 

So, at the AMA’s annual convention this year, and against their own counsel’s advice, the majority voted to say obesity is a disease. Even after the AMA Council on Science and Public Health, which had examined the subject over the last year, declared that obesity should not be classified as a disease because the measure that is used to categorize obesity is flawed.  However, at their meeting the majority of physicians voted to say obesity was a disease. Therefore, it is now their opinion that 78 million or 1/3 of the US population has a disease.
Is calling a disease less of a stigma than telling a patient they have a serious risk factor they can influence.

Instead of doctors pushing for lifestyle changes does this open the door to more surgery, medications, and insurance reimbursement for obesity treatment?

For many years the CDC has recognized that the two biggest preventable causes of death are using tobacco products and obesity. Obesity is not a disease, but a risk factor for other diseases, like cardiovascular disease, diabetes, hypertension, metabolic syndrome, etc.  

Should we now say smoking is a disease or is it still the cause of a disease? 

I am waiting for my first primary care patient to tell me they have the disease obesity. 
Yes obesity is serious, but instead of running for the knife lets first try:
Dietary changes
Exercise and activity
Behavior change
And if needed prescription weight-loss medications.  

Wednesday, June 12, 2013

Graduation and summer

Graduation week, but that does not mean the work is done. In grad school you can still walk, even though they give you a little extra time to finish some requirements. Like a 30 page paper and clinicals until the end of the month. I will miss my primary care clinical site. However, it is starting to feel strange that this school part of my NP journey is over in 3-4 weeks.  

But come mid-July it will be time for me to mentally and physically clean my house and mind after years of school dictating life.  

So many stacks of papers, references, Power-points and lecture materials that I thought I might need one day, will be placed with love in the recycling bin. I will keep the important books and notes, but literally there are stacks of paper feet deep. Yes, I still prefer taking notes on paper and reading books with pages instead of e-books. So much easier to write in the margins and highlight in a book.  

Then I will need to take care of, boxes that are rarely opened and need to be evaluated and items tossed or donated.

Electronics and cell phones not used for years need to be recycled.     
Clothes still with tags that I will never wear. They were gifts from my Mother, and sometimes her taste is good and at other times it is not my style, but I still love her for sending them and so will the Goodwill.       

After a good mind and house cleaning the rest of the summer will be studying for boards and working on a resume. Although, no hurry in looking for work yet before September. 

Saturday, June 1, 2013


Another reason I was never interested in pediatrics.  

The other day a friend’s 8 years old, rationalized and told us that we are old because we were born in the "nineteen hundreds".

Their reality is so different from mine.