Since the AOA was founded just over a year ago, it is an appropriate time to assess the strides that have been made. As I reviewed our progress, I found much of which we can be proud and identified a number of areas where we need to do much more.
The first of our three missions is education. The newsletters we have published have been a major tool for educating members, the business community and government. We received many compliments for this publication, and we look forward to adding more educational features to the newsletter.
We have used the media to good effect. Representing the association, our officers and Scientific Advisory Council have appeared on television, radio and in print. Our vice president, Dr. Judith S. Stern, and I have been quoted frequently as AOA spokespersons on the air, in magazine and newspaper articles, and on Internet news services.
Greatest Success
Our greatest success, and the task that took most of our effort during the first year, was publication of the
Guidance for Treatment of Adult Obesity, a project undertaken jointly with Shape Up America! The committee that developed the guidance was chaired by Dr. Patricia Choban of Ohio State University. After extensive review of the literature, science writer Carol Morton produced a draft that was critiqued by the committee and a number of other individuals and organizations. The revised draft was discussed at a consensus conference in Washington, DC, and the final document was unveiled last October by Dr. C. Everett Koop, the former U.S. Surgeon General. The document has been acclaimed as the most comprehensive set of guidelines for treating obesity that have ever appeared.
To advance our research mission, the AOA created a subsidiary organization: the AOA Research Foundation. The foundation will invite applications from researchers who need modest funding in order to accumulate preliminary data that will enable them to receive grants from the National Institutes of Health (NIH). The research proposals will be reviewed by an AOA committee. Priority will be given to younger researchers and to established scientists in other fields who are moving into obesity research. In the coming year, AOA will begin raising funds to support the Foundation’s work.
AOA officers and advisers have vigorously pursued our community action mission. Dr. Stern and I, along with several members of the Scientific Advisory Council, testified at hearings of the U.S. Food and Drug Administration (FDA) about two anti-obesity drugs: dexfenfluramine and sibutramine. Position papers were approved by the SAC and submitted to the FDA Endocrine and Metabolic Drugs Advisory Committee. AOA’s position was that research data supported approval of both drugs but that long-term safety and efficacy needed to be studied further. The FDA approved dexfenfluramine, and final approval is expected for sibutramine after discussions on package labeling are completed. We were pleased to see that additional research studies were recommended on both agents.
Dr. Stern and I have met with members of the House and Senate to point out the inequities suffered by obese people and to urge greater funding for obesity research. We were pleased that the NIH and National Science Foundation research budgets increased this year, but we still need to fight for adequate funding for biomedical research.
The AOA will launch two major initiatives during 1997-98. The first is an effort to change the U.S. Government’s perception of obesity. Medicare regulations deny that obesity is a disease. The Internal Revenue Service does not allow the cost of obesity treatment to be deducted as a medical expense. And the armed forces remove personnel who cannot meet the prescribed weight or body fat standards. Since the removal is not a medical discharge, all benefits, including medical and retirement, are lost. These regulations are unacceptable, and we will fight to have them changed.
The second initiative is development of a scientifically based Obesity Risk Profile. The profile will assign an appropriately weighted degree of risk to each of the major obesity-related factors that predispose toward disease and death. A composite score will be calculated. Healthful changes in behavior would be expected to lower the score. Similar to a profile widely used in cardiovascular medicine, the Obesity Risk Profile will allow individuals and their physicians to measure their progress in reducing risk.
It is an exciting time to be involved with obesity and the AOA. I hope that next year’s report will be as positive as this one. With your help we can make a real difference.
