The AOA and 10 other organizations (including Weight Watchers, Jenny Craig, several pharmaceutical companies, professional societies, and consumer advocate groups) petitioned the IRS last year to reverse the revenue ruling that includes weight loss among such other non-deductible categories as cosmetic surgery and health clubs, and until recently, smoking cessation programs.



Weight Loss Programs Should Get The Same Break as Smoking Cessation Programs

The AOA would like to see weight loss treatments included in the same category of allowable medical expenses like treatments for heart disease or stroke. According to Downey, the IRS responded to the petitionlast October by saying consideration would be given to reverse the revenue ruling if facts were provided establishing either that obesity itself is a disease,or weight loss by an obese person could prevent the onset of disease.

The AOA responded with an "exhaustive submission covering both of those bases," Downey says. "It almost gets to the point, why did we ask this question in the first place, it's so obvious, but of course, it isn't, there's still a lot of misunderstanding about obesity."

The AOA wants the reversal to allow deductions for the costs of comprehensive obesity treatment, including surgery, pharmacology, behavioral counseling, and programs for the specific purpose of weight maintenance and loss. Downey says he's "optimistic" the IRS will rule in their favor based on the strength of the evidence in their 58-page submission to the agency.

Obesity Is Considered A Chronic Disease

Chris Rosenbloom, PhD, RD says obesity is considered a "chronic disease, it has actually been classified a disease. It's probably the biggest chronic health problem that we have in the United States." Rosenbloom is an associate professor of nutrition at Georgia State University in Atlanta.

Rosenbloom says obesity can lead to high blood pressure, increased risk for cardiovascular disease, type 2 diabetes, and possibly even certain types of cancers. According to the AOA, about 55% of U.S. adults are overweight or obese. The health care costs for treating diseases caused by obesity, such as diabetes and heartdisease, was over $100 billion in 1999 alone.

Medicare And Medicaid Next?

Downey says the AOA is "working with some of the managed care associations and Medicare. We're going to be looking at Medicaid hopefully in the near future. We obviously want to see them provide better coverage." But Downey says the IRS and the insurance industry are two very different issues. The IRS is more cut-and-dry, and the questions associated with it are not as complex.

The IRS has to interpret obesity as a medical problem. Until it does, it is doubtful that tax relief will come. Even though medical deductions qualify after seven anda half percent of your adjusted gross income. If you were making $100,000 a year, you would have to have over $7,500 before you could deduct it. Most people don't.

Downey agrees "it's a very small category, but in our view, particularly for people who need bariatric [obese-specific] surgery, which is going to be $8,000 to $12,000, or so and frequently is not covered by insurance plans, thatprobably is the individual who is going to benefit from this change. Most middle class people would have to go to a lot of Weight Watchers meetings to get up to that level."

There has been a 40% increase in the number of obese people since 1980 and the incidence of obesity in children is rising. This is an issue that needs to be addressed.