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ICYMI: 60 Minutes – Recognizing and treating obesity as a disease

KEY POINTS:

  • Almost half of American adults have obesity, a condition that was a fraction of that just 40 years ago and scientists don’t agree on what’s caused the dramatic increase. What everyone does agree on is that it’s a major health crisis, because obesity can cause type 2 diabetes, hypertension, stroke and more than a dozen cancers.”
  • The American Medical Association has recognized obesity as a disease since 2013. “The number one cause of obesity is genetics. That means if you were born to parents that have obesity, you have a 50-85% likelihood of having the disease yourself even with optimal diet, exercise, sleep management, stress management”
  • Yet many do not understand obesity as a complex disease primarily driven by genetics, exacerbating the epidemic. “Most medical schools don’t teach that obesity is a disease and in fact don’t even offer courses on it, even though it’s the second leading cause of preventable death in the country after smoking” and “79-90% of physicians in the United States have significant bias towards individuals that are heavier.”
  • While FDA approved medication has been proven to treat the disease, it is out of reach for millions of Americans due to outdated policies — making medication only available to those with means and highlighting our health equity crisis. “Nicole was also denied coverage. On its website, her health plan, through the state of Rhode Island, puts anti-obesity medications in the same category as drugs for erectile dysfunction and cosmetic purposes.” In addition,  “University of Chicago health care economist Tomas Philipson points out that there’s actually a law that prevents Medicare from covering weight loss drugs.”
  • “I receive emails about [insurance] denials — that state that we’re denying this because “the doctor has not counseled the patient on behavior change as part of this.” That’s where the stigma of obesity comes in, the idea that the patient can do it with diet and exercise. You would never do that to a patient with hypertension or heart disease or Type 2 diabetes, tell them that you “Just don’t eat sugar, you’ll be fine.””

CBS, 60 Minutes: Recognizing and treating obesity as a disease

By: Lesley Stahl

The following is a video transcript, found here on CBS

Almost half of American adults have obesity, a condition that was a fraction of that just 40 years ago and scientists don’t agree on what’s caused the dramatic increase. What everyone does agree on is that it’s a major health crisis, because obesity can cause type 2 diabetes, hypertension, stroke and more than a dozen cancers.

Now there’s a medication that leads to dramatic weight loss. But it’s wildly expensive. Hollywood celebrities take it to flatten their tummies, but few can afford the thousands of dollars it costs a year.  

And very few insurance companies will cover it, even though in 2013 the American Medical Association, some would say, finally recognized obesity as a disease.

Dr. Fatima Cody Stanford: It’s a brain disease. 

Lesley Stahl: It is?

Dr. Fatima Cody Stanford: It’s a brain disease. And the brain tells us how much to eat and how much to store.

Dr. Fatima Cody Stanford, an obesity doctor at Mass General Hospital and associate professor at Harvard Medical School, says common beliefs about obesity are all wrong 

And diet shows like “The Biggest Loser” are snookering people.

Lesley Stahl: If you diet, you lose weight, right? 

Dr. Fatima Cody Stanford: For many of us, we can go on a diet. Something like “The Biggest Loser,” right?  You go and you restrict people.  You make them work out for 10 hours a day and then you feed them 500 calories.  For most people, they will acutely lose weight. But 96% of those participants in “The Biggest Loser” regained their weight because their brain worked well. It was supposed to bring them back to store what they needed or what the brain thinks it needs.

Lesley Stahl: So willpower?  

Dr. Fatima Cody Stanford: Throw that out the window.

Lesley Stahl, 60 Minutes

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