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IRS enters battle against obesity
As it turns out, the oft-maligned Internal Revenue Service was on the cutting edge of the battle against the nation's obesity epidemic. Two years ago, as concern over the growing problem started to catch media attention, the IRS quietly ruled obesity a disease and made physician-prescribed weight control programs tax deductible. The decision came in Revenue Ruling 2002-19. The ruling took up the question of whether fees paid by overweight people for weight-loss programs and diet foods and which were not covered by health insurance can be deducted as medical expenses on the individuals' income taxes. The IRS said yes, providing a physician writes a prescription. In the ruling, the IRS noted that the medical community has come to the conclusion that obesity is a disease. "Obesity is medically accepted to be a disease in its own right," the IRS said. "The National Heart, Lung and Blood Institute, part of the National Institutes of Health, describes obesity as a complex multifactorial chronic disease. Other government and scientific entities have reached similar conclusions. For example, in a preamble to final regulations the Food and Drug Administration states obesity is a disease." The IRS said the revenue code allows a deduction for uncompensated medical expenses to the extent those expenses exceed 7.5 percent of adjusted gross income. Medical care means "amounts paid for the diagnosis, cure mitigation, treatment, or prevention of disease." The IRS said expenses of general fitness programs are not deductible because they are not designed to prevent or alleviate a physical or mental defect or illness. "An expense that is merely beneficial to the general health of an individual is not an expense for medical care," the IRS said. "A taxpayer who participates in a weight reduction program to improve the taxpayer's appearance, general health and sense of well-being, and not to cure a specific ailment or disease, may not deduct the cost as a medical expense." The ruling applies to not only weight-loss programs prescribed by a physician to treat obesity, but also participation in a weight-loss program by individuals who may not be obese, but have been referred to the program by a physician to treat a cardiovascular disease such as hypertension. Diet has been found to be an important factor in controlling high blood pressure. At the same time, the IRS said special food that is a part of a weight-control program is not deductible because it is a substitute for food the people would normally consume. While it is an important move forward in the battle against obesity, the impact of the IRS ruling has yet to be determined. It will depend on how many physicians diagnose their patients as obese and write prescriptions for participation in weight-control programs. Or prescribe weight-control programs for patients suffering from other diseases, like hypertension or coronary artery disease. We can expect some clarifying rulings in the future as to what other diseases and treatments may be deductible. Some people might say that giving people a deduction for these costs is going to hurt the government by reducing revenue. Well, obesity already costs government huge sums now. Consider that taxpayers already foot the bill for more than half of obesity-related medical costs, which reached $75 billion last year, according to an analysis in the journal Obesity Research . Two-thirds of Americans are either overweight or obese, according to the Centers for Disease Control and Prevention. The analysis by the nonprofit group RTI International and CDC said states spend an average of about 5 percent of their medical costs on obesity. The range is from a high of 6.7 percent in Alaska to a low of 4 percent in Arizona. Giving people a federal tax deduction to get their weight under control could help reduce these costs for state governments. Obesity is a very complicated epidemic. Our lifestyles increasingly seek to make us less active. Tax incentives are only a small part of the solution. Improved diets, more exercise and better health education are key elements, too. Obesity is a very difficult health problem, particularly because getting people to change
behaviors is tough to accomplish.
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