It’s been almost exactly a year now since the AMA in the United States made the controversial decision to officially classify obesity as a disease, and it seems that experts are still in disagreement about whether it’s a good thing or a bad thing. In fact, many are against the decision simply because there still isn’t any clear-cut, measurable definition of what obesity is precisely.
When I first heard about the decision I must admit I was pretty outraged. Even though a percentage of obese people do have underlying physiological factors behind their condition, the fact of the matter is that the biggest contributor to the obesity epidemic in the Western world is poor lifestyle choices.
How can the outcome of what you choose to do with your body on a daily basis constitute a disease? It just doesn’t make sense!
I was discussing this with a friend just recently who believed that obesity should be classified as a disease, and he raised the example of another unhealthy practice by way of comparison – smoking. Smoking is a voluntary practice, and we know that it can lead to conditions such as emphysema, lung cancer, stroke and coronary heart disease. These are the outcomes of poor lifestyle choices and they are all real diseases.
The big difference with these however is that they can only be corrected or managed by medical treatment. Sure, they’re brought on by poor choices, but once you have them, you can’t just make them go away by quitting smoking.
A disease is by definition a malfunctioning of the body. An obese body, however, isn’t malfunctioning. It’s functioning perfectly in fact, given its environment and usage. For example, if you were sitting comfortably in an air-conditioned room, chances are your body wouldn’t be perspiring much, if at all. If you were jogging outdoors under the hot sun, on the other hand, you’d most likely be perspiring quite heavily.
It’s not a state that your body is normally in, but given the circumstances it’s a normal and expected response. It’s not malfunctioning. Once you take yourself out of that environment (stop running and come back into a cooler location) your body will then return to normal.
This is the more often than not the case with obesity as well. Again, I want to re-emphasize that I’m not saying that there are no cases whatsoever of obesity requiring treatment or medical intervention. Those with underlying physiological, genetic, and in some cases, even psychological causes absolutely require treatment of one type or another.
But in these cases obesity still isn’t a disease but rather a symptom, and it’s the underlying condition or the symptom (obesity) that requires treatment as a result.
I think there are several dangers of labeling obesity as a disease, such as:
- Society runs the risk of developing an attitude that obesity is something that “happens” to people or something that they “contract”, diminishing people’s sense of responsibility in the condition.
- Society runs the risk of developing an attitude that all cases of obesity require some form of medical treatment or intervention. Over time this would potentially lead to a mindset of reliance on drugs, surgical intervention, and so on, as a solution to obesity rather than an emphasis on healthy lifestyle choices.
- People start relying on an already-overburdened healthcare system to “come to their rescue” rather than making a serious effort to take responsibility for their own wellbeing.
There’s no denying that obesity is a serious problem in the Western world and in all likelihood it will continue to get worse, but I just don’t think that labeling obesity as a disease is the answer, or that it sends the right signals to society.
So what is the solution?
Well, the problem is a very complex one and I don’t think that there is an easy solution. The solution will need to focus on prevention however, and not on cure. It will need to involve a drastic change in the mindset and lifestyle of people as a whole, both of which are not easy changes to make.
Education has to play some role. The problem is, even if information is made publicly available by dietary authorities, people have a tendency to do what comes easy or what they enjoy regardless of the consequences when those consequences come sometime in the future. Smoking is a perfect example of this.
The other problem is that when people suffering from obesity ultimately start concerning themselves with a cure, they will be more inclined to look for quick, easy fixes to their problem rather than listening to advice about healthy eating, food groups, portion sizes, and so on.
And so they’ll turn their attention instead to the attractive marketing claims made by promoters of miracle weight loss products and end up on the weight loss roller coaster, becoming more frustrated, more confused, and most likely more obese as time goes on.
Education needs to start at a young age, in schools and through media that specifically targets children, but unless they get consistent messages at home from their parents, even this won’t be very effective.
I believe that the only truly effective way to help alleviate the obesity epidemic is to give people a strong incentive not to engage in the behavior that leads to obesity in the first place. This incentive would need to be something that affects them immediately, at the decision point, rather than in the future.
Here in Australia, the government in 2013 announced that it would introduce staged 12.5% increases in tobacco tax over four years as a strategy aimed at both encouraging people to quit smoking, and to help stop people from commencing smoking in the first place, especially younger people.
This would make a great first step to tackling the obesity problem in my opinion – tax junk food and snack foods so that they become financially unattractive (painful) choices for people. And those foods which have been shown to contribute the most heavily to obesity, such as sugared soft drinks (sodas), could be taxed the most heavily.
The money raised from these taxes could then be directed into educating people about the prevention of obesity.
Obesity is largely a social problem and it therefore needs to be tackled at a social level, through lifestyle changes, rather than at a medical level, which is what I believe categorizing it as a disease will tend to make people focus on doing.
What are your thoughts on obesity being classified as a disease? Do you agree or disagree with this decision by the AMA? What do you think is the best way to tackle the obesity problem?
I’d love to hear your ideas in the comments below!