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Losing Weight: Healthier Wallet

The American Obesity Association (AOA) wants to give new meaning to getting a deduction. The non-profit advocacy organization is trying to change IRS policy to allow taxpayers to deduct the cost of weight loss treatments.

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.

"People with obesity who are trying to control their weight do not get the kind of support for their health care choices like people with other conditions do. Last spring the IRS reversed the policy they had which did not allow the medical deduction for smoking cessation programs," Morgan Downey, the AOA?s executive director.

"We decided when we looked at the IRS? action, that it really didn't make much sense. Nearly as many people die prematurely from obesity in this country as from smoking, the effectiveness of obesity treatments are generally more effective than the smoking cessation treatments, and we think people ought to be treated fairly," Downey says.

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 petition last 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.

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 heart disease, was over $100 billion in 1999 alone.

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 and a 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, that probably 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.


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