麻豆传媒

Could a national task force addressing America's growing epidemic of obesity help turn the tide on maternal mortality and other adverse health outcomes?

Members of the American Medical Association (AMA) debated the benefits and potential harms of establishing such a task force during a virtual discussion at the Special Meeting of the AMA House of Delegates.

Leadership is about "doing the right thing, despite how difficult it might be," said Myriam Mondestin-Sorrentino, MD, author of the proposed policy and an alternate delegate from New Jersey, paraphrasing AMA President Susan Bailey, MD.

Minority women are the demographic most affected by obesity, she noted. Given that fact, "how do we effectively talk about equity without confronting obesity?" she asked.

Michael Knight, MD, an obesity medicine physician and the National Medical Association representative of the AMA's Minority Affairs Section Governing Council, noted that African-American women in particular have the highest rates of obesity in the country.

"We cannot effectively address disparities in health, including maternal mortality, COVID-19 morbidity and mortality, [and] cardiometabolic disease, without confronting obesity as a key contributor that requires comprehensive and effective care," he said.

The AMA has a policy related to reducing obesity, Knight noted, but he argued that a policy resolution specific to the impact of obesity on minoritized communities was needed.

Carrie DeLone, MD, an alternate delegate from Pennsylvania, supported the resolution. She said it worries her that obesity has been normalized in the U.S., simply because of its "excessive prevalence."

According to the CDC, prior to the COVID-19 pandemic, approximately 74% of U.S. citizens over age 20 were overweight and 40% were obese.

The AMA must lead on this problem by raising the public's awareness that being overweight increases the risks of multiple disease states, including cancer and coronary artery disease, DeLone said.

However, not everyone embraced the new policy resolution by Mondestin-Sorrentino.

Cee Ann Davis, MD, an alternate delegate from Virginia speaking on behalf of the American College of Obstetricians and Gynecologists, said that while ACOG appreciates its intent, the proposed policy seems to over-simplify a complex issue. She recommended the resolution be referred back to the AMA's Board of Trustees for further study.

"The drivers of maternal mortality are multifaceted," she added, calling attention to a published in the Morbidity and Mortality Weekly Report.

Joanna Bisgrove, MD, a delegate from Oregon speaking on behalf of the American Academy of Family Physicians, agreed with Davis, noting that addressing obesity without also tackling institutional racism and other social determinants of health would not reduce inequities in health outcomes.

Nicole Plenty, MD, an alternate delegate from Texas for the AMA's Women Physicians Section, said she agreed with "the sentiment" of the resolution and the fact that obesity has greatly contributed to maternal mortality, especially among minority women.

But any task force that's established must also examine the root causes of obesity and seek to address them, she added. "Otherwise, it looks like the resolution is blaming minority women for being obese." While that wasn't the author's intent, it could still be misinterpreted, she noted.

If it isn't possible to "get the language right," Plenty said she would also recommend that the policy be referred.

Despite some estimates that the resolution would cost the AMA close to $600,000, Mondestin-Sorrentino said she is not asking the association to build and implement the task force itself, but rather to use its influence to urge the federal government to create one. In that case, the costs to the AMA "should be negligible," she noted.

The committee on public health will offer its own recommendation in a forthcoming report, and delegates will have the opportunity to discuss the policy resolution further on the virtual "floor" during the House of Delegates meeting.

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