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Obesity as a Disability

By: Hayder Alamar, Contributing Writer

Edited by: Elias Azizi, Editor in Chief


There are a myriad of disabilities that can substantially affect one’s ability to live a functional, daily life. In fact, according to the Centers for Disease Control (CDC), 25% of Americans are currently disabled. A common disability which has been plaguing Americans is caused by obesity, which is the leading risk factor for chronic diseases, also known as non-communicable diseases (NCDs). Obesity, a chronic condition affecting more than 33% of Americans today, serves as a major global health crisis today. Defined as a BMI of over 30.0 kg/m2, obesity is the leading cause of poor health and early death (CDC). High BMI is a major risk marker for diseases pertaining to diet and physical movement. Obese and overweight individuals are at a higher risk for comorbidities such as hypertension, type 2 diabetes (T2D), coronary artery disease (CAD), cancer, osteoarthiritis, and OSD (obstructive sleep apnea). These diseases related to obesity increase one's mortality and disability risk. Morbid obesity, BMI > 40.0 kg/m2, poses the greatest risk for disabling health conditions because increased BMI levels have substantially higher levels of risk for these diseases.


Obesity is not generally viewed as a disability, however most effects of obesity may qualify obese inidividuals as legally disabled. A condition is considered a disability if it displays a recurring physical impairment which may pose adverse effects on an individual’s ability to perform day-to-day activities. The Americans with Disability Act (ADA) defines disability as “a physical or mental impairment that substantially limits one or more of the major life activities of [an] individual”. Under disability discrimination laws, obesity has not been traditionally viewed as a disability until 2008, where The Americans With Disabilities Amendments Act became effective and the Equal Employment Opportunity Commission (EEOC) has stated that obesity may be categorized as a disability in certain cases.

The excessive accumulation of body fat poses a major health concern for not just Americans, but individuals globally who have felt the harsh realities which come with a Western diet. Although obesity in and of itself is not considered a disability, the health conditions associated like CAD and T2D have been considered disabling. Obese individuals with medical impairments should be able to freely apply for Social Security Disability benefits if they’re unable to work efficiently.

Those with extra fat have elevated blood pressures, thus putting them at increased risk for the leading causes of death and disability: cardiovascular disease and stroke. Blood pressure is known as the “silent killer” because there aren’t too many signs which might let someone know something is wrong. Obesity affects your heart’s ability to pump blood to all your cells effectively, while also damaging kidney function. The more weight one carries, the higher their blood pressure will be. Hypertension and left ventricular hypertrophy increase the risk for heart failure, disabling one’s ability to meet the body’s needs for oxygenated blood. They also have elevated blood sugar levels, making them vulnerable to type 2 diabetes. Diabetes qualifies as a disability due to endocrine complications such as the regulation of insulin and blood glucose, which gravely increase one’s risk for functional disabilities. Excess weight also has a wear-and-tear effect on cartilage due to the increased pressure on joints, leading to osteoarthritis. Sleep apnea, a condition characterized by heavy snoring and shortness of breath during sleep, is a common condition with excess body fat as well. Other conditions related to obesity include cancers, dementia, depression, gallbladder disease, fatty liver, gout, and pregnancy-associated conditions. The trend is that the higher the body weight an individual carries, the higher the risk for contracting severe disorders, and these disorders may impair bodily or mental functions, limit common activities, or restrict activities of normal daily life. Obesity can also have a negative economic impact on the families of the obese individual, as well as healthcare spending.

Disabilities negatively affect one's quality of life, due to either stress or rendering them physically unable to work. In fact, obesity accounts for about 30% of disabled adults compared to 20% of adults without any disabilities. Also, children with disabilities have a nearly 40% higher risk to develop obesity than their undisabled counterparts. The annual cost for healthcare of obesity related to disability is $44 billion, with annual costs for obesity and obesity-related diseases estimated at nearly $150 billion.

Healthcare professionals must focus on maximizing quality of life for obese individuals by promoting health and wellness, while emphasizing the prevention and treatment for risk factors pertaining to obesity. If obese individuals are just able to just lose 5-10 pounds, these comorbid conditions associated with obesity may be delayed, or completely prevented, in onset. Excess body fat is correlated with higher blood pressure and cholesterol levels. Thus, losing this fat will be able to stabilize one’s markers for diseases like heart disease. Besides weight loss, physical activity, exercise, avoiding smoking and alcohol, eating healthy, and reducing salt intake may allow one to stabilize their BMI to a more baseline range.



Link to cover image: http://www.hopsonsolicitors.co.uk/wp-content/uploads/2015/03/iStock_000015807869_Medium.jpg


Sources:

  1. Finkelstein E, Trogdon J, Cohen J, Dietz W. Annual medical spending attributable to obesity: Payer- and service-specific estimates. Health Affairs 28, 5(2009):w822-31.

  2. Froehlich-Grobe K, Lollar D. Obesity and disability: time to act. Am J Prev Med. 2011;41(5):541-545. doi:10.1016/j.amepre.2011.07.015

  3. Gil-Rojas Y, Garzón A, Hernández F, Pacheco B, González D, Campos J, Mosos JD, Barahona J, Polania MJ, Restrepo P, Lasalvia P, Castañeda-Cardona C, Rosselli D. Burden of Disease Attributable to Obesity and Overweight in Colombia. Value Health Reg Issues. 2019 Dec;20:66-72. doi: 10.1016/j.vhri.2019.02.001. Epub 2019 Apr 28. PMID: 31035116.

  4. https://www.cdc.gov/ncbddd/disabilityandhealth/obesity.html#ref


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