Costs of Weight-Loss Program May Be Deductible

Taxpayer A is diagnosed by a physician as obese. A does not suffer from any other specific disease. Taxpayer B is not obese, but suffers from hypertension and was directed by a physician to lose weight as treatment.

A and B participate in the X weight-loss program. They are required to pay an initial fee to join X and an additional fee to attend periodic meetings. At the meetings, participants develop a diet plan, receive diet menus and literature and discuss problems encountered in dieting. A and B also purchase X brand reduced-calorie diet food. Neither A's nor B's costs are compensated by insurance or otherwise.

Analysis

Under Sec. 213(a), a taxpayer can deduct uncompensated expenses for medical care for himself, his spouse or a dependent, to the extent the expenses exceed 7.5% of adjusted gross income. Under Sec. 213(d)(1), "medical care" means amounts paid for the diagnosis, cure, mitigation, treatment or prevention of disease, or for the purpose of affecting any structure or function of the body.

Under Regs. Sec. 1.213-1(e)(1)(ii), deductions for medical care expenses are confined strictly to expenses the taxpayer incurs primarily for the prevention or alleviation of a physical or mental defect or illness. An expense that is merely beneficial to an individual's general health is not an expense for medical care. Whether an expenditure is primarily for medical care or is merely beneficial to general health is a question of fact.

Rev. Rul. 79-151 held that a taxpayer who participates in a weight-reduction program to improve his appearance, general health and sense of well-being, and not to cure a specific ailment or disease, cannot deduct the cost as a medical expense. Rev. Rul. 55-261 held that medical care includes the cost of special food, if (1) the food alleviates or treats an illness, (2) it is not part of the taxpayer's normal nutritional needs and (3) a physician substantiates the need. However, special food that is a substitute for the food the taxpayer normally consumes and that satisfies the taxpayer's nutritional needs is not medical care.

Amounts paid for the primary purpose of treating a disease are deductible as medical care. Obesity is medically accepted to be a disease in its own right. 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.

Holding

In the present case, a physician has diagnosed A as suffering from a disease—obesity. Therefore, the cost of A's participation in the X weight-loss program as treatment for his obesity is an amount paid for medical care under Sec. 213(d)(1). Although B is not suffering from obesity, B's participation in X is part of treating his hypertension. Therefore, B's cost of participating in the program is also an amount paid for medical care. Under Sec. 213, A and B can deduct (subject to limits) the fees paid to join the program and attend periodic meetings. Their situations are distinguishable from Rev. Rul. 79-151, in which the taxpayer was not suffering from any specific disease or ailment and participated in a weight-loss program merely to improve his general health and appearance. However, A and B cannot deduct any portion of the cost of purchasing reduced-calorie diet foods; the foods are substitutes for the food they normally consume to satisfy their nutritional requirements.

Rev. Rul. 2002-19, IRB 2002-16