Is Obesity a Disease?

[Fragile Bird]

When you think about it, the articles talk about the issue relating to 1/3 of the US population, but put it into context. Roughly 1/3 of the population is supposed to be of "normal" weight, 1/3 is overweight, and 1/3 is obese. So by elevating obesity to a disease, surely the idea is to help the 1/3 who are obese, and to prevent the 1/3 who are overweight from becoming obese. This seems like a laudable reason for the decision of the members of the AMA.

[Ixodes]

It's as if declaring something a disease immediately releases people from accountability. It can only make people weaker, less able/willing to control themselves.

No. This is completely untrue and only stems from the definitions you have created in your own mind. Calling something a disease does not in any, way, shape. or form absolve someone of the responsibility of taking control of their health. It only means there is a pathophysiologic mechanism that impairs organ function and reduces an individual's quality of life.

Pointing fingers and assigning value judgements is regressive and does nothing to progress returning an individual to health.

[Sci-2]

Though I agree that its status as disease would lead towards more focused research and subsequently, more effective treatment.

This is a good point. This could lead to more funding being offered to study obesity, as well as more researchers looking into the disease.

[Littlefingers In The Air]

If obesity has taught me anything, it's that it's a mental handicap more than a physical one

[Hodor knows]

No. This is completely untrue and only stems from the definitions you have created in your own mind. Calling something a disease does not in any, way, shape. or form absolve someone of the responsibility of taking control of their health. It only means there is a pathophysiologic mechanism that impairs organ function and reduces an individual's quality of life.

Pointing fingers and assigning value judgements is regressive and does nothing to progress returning an individual to health.

I see this now. Thanks to you and Fragile Bird. I was just hung up on how the term was being used. I hope people get the help they truly need.

[straits]

If obesity has taught me anything, it's that it's a mental handicap more than a physical one

Perhaps a mental issue has led to obesity, but obesity itself is very much a physical handicap, to the point that it prevents treatment of other (sometimes unrelated) problems. Surgery on a 400 lb individual is not going to be a simple procedure whichever way you look at it.

[Ixodes]

I see this now. Thanks to you and Fragile Bird. I was just hung up on how the term was being used. I hope people get the help they truly need.

I think a big problem is that society mistakenly views health care providers as being responsible for their patient's health. The more accurate view is that they are a resource to provide information/action that empowers a person with the correct knowledge, skills, and tools to increase their own health. The ways that we in the US have chosen to deliver health care only enforces this mistaken view. But that, my friend, is a long conversation for other more contentious threads!

[jurble]

Not exactly, wiseguy. People make a choice to eat(if they are lucky enough). A person cannot be obese without fuel. The body does not make fat out of thin air. No matter how difficult it can be, no matter how deeply rooted the obsession, obesity is still a choice.

Choice? What's a choice? Is it a friend to fairies? Does it live under a bridge with trolls?

[Littlefingers In The Air]

Perhaps a mental issue has led to obesity, but obesity itself is very much a physical handicap, to the point that it prevents treatment of other (sometimes unrelated) problems. Surgery on a 400 lb individual is not going to be a simple procedure whichever way you look at it.

I am not saying it's not a physical one. I'm saying if you have to weigh the two (no pun intended), it's more of a mental strain. I know from experience.

[Sci-2]

Choice? What's a choice? Is it a friend to fairies? Does it live under a bridge with trolls?

Let's not clutter this thread with philosophical debate that probably is better suited to the consciousness thread.

[Guest]

Here's a question. Are we not doing a lot of research already? That is not to say that more couldn't be useful.

That NuSi site has a graphic from NIH in 2011 which said that it gave funds to 2,355 obesity-related studies.

[Fragile Bird]

I guess, Triskele, that so far the research that's been done hasn't found the answers that are being sought. Otherwise the obesity rates wouldn't have increased over the past 20 years.

[The Anti-Targ]

Obesity is commonly a symptom of a disease process (be it physiological or psychological or both), and of course it is a significant cause of disease. But techincally I don't think it meets the definition of a disease.

To me it's a bit like saying a runny nose is a disease, when in fact it's the common cold, or hay fever, or a foreign body up the nose, or cancer, or a number of other possible disease processes that can cause, among other things, a runny nose.

OTOH, I think there is a fundamental epidemiological difference between being overweight (like me) and obese (like my brother).

Me being overweight is purely because of dietary ill discipline, and I know the fundamental problem: too much carbs in my diet. When I limit the carbs I drop in weight and can maintain my weight over the long term. If I eat a socially "normal" diet I will gain several kilos over a short space of time, and that includes reducing fat intake (like eating a lot less cheese).

My brother is very obese (being more than double my already overweight body weight and only about 3" taller) and his obesity is not just because of dietary ill discipline. He has got some identifiable emotional and psychoilogical issues contributory to his problem. And also, though not diagnosed, he may have some hormonal or metabolic problems as well.

So IMO obesity (especially at the extreme end of the scale) is almost invariably associated with a disease of some sort. But that doesn't make it a disease in itself.

At the moment I think our health policy does not really give obesity it's due recognition, and is still treated simplistically as a lifestyle problem in political spheres. As such public funding for surgery and other treatments is quite limited and such funding attracts derision from the general public because of a lack of understanding of the complexities invloved. There are publicly funded obesity clinics which helps to put people on a weight loss plan. But there's no public funding of meal replacers and other foods which form an integral part of many weightloss plans. A lot of commercial weight loss diets are expensive, so are inaccessible to low income people, who are often over-represented in obesity stats.

[Guest]

I guess, Triskele, that so far the research that's been done hasn't found the answers that are being sought. Otherwise the obesity rates wouldn't have increased over the past 20 years.

That doesn't necessarily follow. That pretty much seems to be the point of NuSi, and I'm all for what they're trying to do. I wish I could work for them.

But it also seems conceivable to me that this is something that research alone may not solve or even put a dent in. What if it is simply some combination of lifestyle and diet that people are largely already aware of?

[Sci-2]

But it also seems conceivable to me that this is something that research alone may not solve or even put a dent in. What if it is simply some combination of lifestyle and diet that people are largely already aware of?

This line of reasoning seems fundamentally flawed to me. Would we give up on research for any learning disability or mental illness?

I don't even understand how you can say what is or is not conceivable. How you can speculate on the depths of what we don't know about the mind and body - attempting to quantify ignorance seems like an illogical proposition in this case.

[Fragile Bird]

That doesn't necessarily follow. That pretty much seems to be the point of NuSi, and I'm all for what they're trying to do. I wish I could work for them.

But it also seems conceivable to me that this is something that research alone may not solve or even put a dent in. What if it is simply some combination of lifestyle and diet that people are largely already aware of?

See, this is why I have mixed feelings about the decision to call obesity a disease. What exactly is disease?

From Wikipedia:

A disease is an abnormal condition that affects the body of an organism. It is often construed as a medical condition associated with specific symptoms and signs.^[1] It may be caused by factors originally from an external source, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune diseases. In humans, "disease" is often used more broadly to refer to any condition that causes pain, dysfunction, distress, social problems, or death to the person afflicted, or similar problems for those in contact with the person. In this broader sense, it sometimes includes injuries, disabilities, disorders, syndromes, infections, isolated symptoms, deviant behaviors, and atypical variations of structure and function, while in other contexts and for other purposes these may be considered distinguishable categories. Diseases usually affect people not only physically, but also emotionally, as contracting and living with many diseases can alter one's perspective on life, and their personality.

Death due to disease is called death by natural causes. There are four main types of disease: pathogenic disease, deficiency disease, hereditary disease, and physiological disease. Diseases can also be classified as communicable and non-communicable disease.

The first two sentences comes from a medical dictionary. But reading through that, I can more clearly see the argument for calling obesity a disease. But, if lifestyle and diet are the factors in the majority of cases (as opposed to the situations where there are physical causes), is it a mental illness? We do things that harm us, knowing they are harmful, like eating too much, and we can't, or won't, stop or change our behaviour.

[Guest]

This line of reasoning seems fundamentally flawed to me. Would we give up on research for any learning disability or mental illness?

I don't even understand how you can say what is or is not conceivable. How you can speculate on the depths of what we don't know about the mind and body - attempting to quantify ignorance seems like an illogical proposition in this case.

I don't know why you're suggesting that I'm against research. What I am saying is that while research is great, it may not be enough.

For example, one of the founders of NuSi believes in the carbohydrate hypothesis and wrote a 500 page book about it. Let's say he's proven correct and the obesity crisis is almost entirely about insulin resistant people eating more carbs than they can handle. Let's say that a lot of research backed it up to where it was case closed from a scientific perspective. What would change?

If part of the justification for calling obesity a disease is so that we can do more research, then I think it is fair to talk about what research would even need to be done and then what could even be done with it.

[Sci-2]

Let's say that a lot of research backed it up to where it was case closed from a scientific perspective. What would change?

Seems to me finding out the cause would be part of finding out what drugs might be most effective to assist an obese person in losing excess weight.

In any case, I would expect a good deal of research to be focused on finding effective treatment regimens and therapies with or without drugs and surgeries.

Heck, maybe what's needed is an ibogaine trip.

[Shryke]

What, you think no one is looking for a miracle cure to overweightness right now?

What incentives are there to study how to help people lose weight that don't already exist?

[Commodore]

much easier for doctors to treat obesity as a defect of character (gluttony/sloth) and a simple matter of will, rather than trying to understand biochemistry and hormonal regulation of fat tissue

"Eat less, exercise more, my work here is done"