Abramson, just 5 feet tall, was classified as morbidly obese. Debilitating conditions caused by her weight, which she doesn't wish to reveal, forced her to stop working. She could barely walk the 20 feet from her kitchen table to the front door.

Even though Abramson was taking a dozen medications each day to treat the symptoms caused by her obesity - diabetes, chest pains, high blood pressure, high cholesterol and nerve pains - the source of those potentially fatal conditions wasn't recognized as an illness by her health-care provider, Medicare.

As a result, Abramson's two sons bore the $30,000 cost of her year-long treatment at the Rice Diet Program in Durham.

No longer.

Medicare announced on July 15 that, after proclaiming for 40 years that obesity is a personal problem, not a clinical one, it now classifies the No. 2 cause of preventable death in America as an illness.

That's good news for people such as Abramson and thousands of others across the nation. More than 64 percent of Americans are categorized as overweight or obese, and medical conditions resulting from obesity are the source of a $100 billion drain on the health-care industry, according to the American Obesity Association.

Many of those dollars are spent annually in Durham, which is home to some of the nation's top weight-loss programs. It's unclear just what Medicare will pay and how quickly payments can be claimed.

But industry watchers say the designation probably will have a ripple effect on private health insurers, which must consider whether to provide coverage for treatment of obesity. "Medicare is the tail that wags the dog when it comes to insurance coverage," says Dr. Francis Neelon, Rice Diet Program medical director.

The Rice Diet Program is one of several obesity treatment programs located in the Triangle. Others include the Duke Center for Living, Structure House and Rex Weigh.

The average cost for treatment at one of these facilities ranges from $2,000 to $7,000 for a stay of one to six weeks, but each also has programs for long-term patients.

Neelon and his peers say it is unlikely that Medicare will provide full payment for such treatments, which she says average a five-year success rate of 35 percent. She does believe the government's designation of obesity as an illness will lead to an increase in research dollars for the condition.

Gerard Musante, founder of Structure House, questions whether Medicare can even afford to take on the cost of obesity treatment, which totals an estimated $36 million annually in the United States.

"If this thing gets really crazy and people come out of the woodwork for this treatment, then the government is going to have to decide how they're going to pay for this," Musante says.

Abramson, who has lost enough weight that she now needs only cholesterol medication, believes it's time for insurance companies to provide coverage.

"I'm doing the impossible," she says. "It's costly, and there are people like me who can't afford treatment, but they need it."