Obesity - A Problem Or A Disease?

Earlier this summer, the American Medical Association (AMA) classified obesity as a disease.  I have my doubts about this new approach to obesity.  It is, without any doubt, a problem in America and a growing issue in other countries as well.  Who does this new classification help?  The intention is to help the patient by focusing more attention on obesity and it has the added benefit of allowing more people to qualify for obesity treatment.  This new classification comes with a few problems.  

The External Factors

Let’s start off with the dictionary definition of disease: 

A disorder of structure or function in a human, animal, or plant, esp. one that produces specific signs or symptoms or that affects a specific location and is not simply a direct result of physical injury.

Now that obesity has been classified as a disease, it is all too possible that people will think their bodies are acting strangely.  This notion is false.  The fact is our bodies aren’t acting funny when it comes to obesity.  It’s acting exactly as evolution designed it:  we store excess calories as fat, which we save in case of famine.  A famine in America would be an entirely unprecedented event, and we should not bank on that happening anytime in the near future.  

If we eat a large amount of food and do not expend enough calories during physical activity, we get fat.  It’s not a disorder; the body is functioning perfectly.  Frankly, I would be more concerned if somebody ate a lot of unhealthy food, refused to work out and somehow managed to wither away.  The solution is to address external factors rather than saying the problem is our bodies.  Large portions, unhealthy food options, lack of exercise and, in many cases, lack of access to affordable healthy options are the main causes of obesity.  Classifying obesity as a disease does not address these issues.

The Blame Game

A large concern with this new diagnosis is that it shifts responsibility from the person to the “disease”.  In nearly all cases, obesity is preventable.  Referring to obesity as a disease focuses entirely on the genetic aspect and may make a person feel less responsible for his or her ability to control whether or not they reach the point where they are considered obese.  Instead, they may use this diagnosis as a crutch and feel that there is little to be done.  How many times have you heard a person blame the thyroid for their weight gain and feel that they have no way of mitigating the issue? 

Furthermore, being diagnosed with a disease is often traumatizing, which can also lead to listlessness and a lack of interest in regaining control.  Dr. Peter Morelli is a pediatric cardiologist and co-director of Fit for Life*, a program dedicated to helping overweight and obese children.  He brought up the valid point that referring to obesity as a disease may very well be more stigmatizing than uplifting.  He stated that he prefers to not label his participants as having a disease due to the negative effects.  Adults are not children, but many could react in a similar way and lose interest.

Medication does not solve the cause

There are new medications available for weight loss and insurance companies may very well cover other treatments such as bariatric surgery or nutrition counseling.  Nutrition counseling should be useful step in treating obesity, but again, the largest causes are ignored with this approach.  I cannot help but imagine a vicious cycle where people do not change their nutrition and physical activity, become diagnosed with obesity, take prescription medicines without changing their habits and wait for change…or bariatric surgery.  We should not learn to rely on pharmaceutical companies to fix a problem that we have control over.  “It’s like putting a band-aid on a hemorrhaging artery without acknowledging the cause,” stated Dr. Morelli.  

Some families have more access to fast food chains than supermarkets carrying nutritious and affordable produce.  Medication does not fix this.  Our food portions are larger and more processed; medication does not fix this either.  Saying that obesity is a disease may have the added benefit of insurance companies covering more treatments, but the best treatment is prevention.  Prevention should come from addressing societal issues surrounding the surge in obesity.  The AMA’s intentions may be good, but we will see how effective this new classification is in the long run.  

*Dr. Peter Morelli’s practice is located 57 Southern Blvd., Nesconset - ColumbiaDoctors - Pediatric Cardiology 

Kia Edwards is a certified personal trainer and nutrition specialist who lives in New York City. She studied French and Economics at Colgate University, spent 15 years as a high-level competitive gymnast and 6 years as a gymnastics coach.  Her business, La Fortesse At Home Fitness Training, helps clients get healthy with simple at home exercises and nutrition counseling. www.LaFortesse.com