In this week’s blog post, I am going to attempt to tackle an extremely difficult question related to weight management. The question pertains to labeling obesity a “disease”. Fortunately, I do have a straightforward opinion on the subject (fairly straightforward anyway). This is a question we get all the time in our Cincinnati and Northern Kentucky weight loss offices.
The first thing that we need to do is define what “disease” actually means. As it relates to weight management/obesity, what we are actually trying to define is how much responsibility the individual has for the process. If we think of traditional diseases like cancer, arthritis, or diabetes, these are processes that happen to the individual and almost always require medical management (i.e., they require outside intervention). Certainly, the individual can minimize the likelihood of these by healthy living (more on this later), but once they exist, they do REQUIRE medical management. The responsibility is not solely on the individual.
Obesity does not fit this definition as nicely. Even if we use diseases that are more difficult to define, like depression, obesity still doesn’t fit that well. The argument could be made, however, that like depression, PTSD, etc., obesity is a mental health disorder. This is also not true. Obesity is clinically defined as a BMI over 30. It has strict physical diagnostic parameters. The argument could be made that physical diagnostic parameters are required in order to diagnose any disease, but they are not possible with current technology in many cases (this is a topic that could be expanded on separately).
Obesity doesn’t really fit the definition of a physical disease and it certainly doesn’t fit the definition of a mental health disorder. So, if we are going to define obesity from a healthcare standpoint, what is it? In my opinion, obesity is either the result of overeating as a way to cope with a mental health problem (depression, anxiety, PTSD, etc.), it is the root cause for many preventable diseases (high blood pressure, diabetes, arthritis, etc.), or both. So, it is not a disease itself but can certainly be the result of a disease and can certainly then lead to a number of diseases.
For the most part, however, obesity is just a product of living in a world that directs human beings to gain weight (easy to access junk food and little activity). It really doesn’t need to be overly complicated. It is one of the negative results of living in a modern society with all of its conveniences. Defining obesity as a disease process, however, removes at least a degree of responsibility from the individual. Again, diseases happen TO the individual. This is extremely dangerous because in the overwhelming majority of cases this just isn’t true. The individual can control their weight. It may not be easy, but it is possible. If they are convinced that there is some outside force causing it, however (a disease) then it strips them of this power. Unfortunately, this labeling can also be a sort of self-narcotization for the individual.
Labeling obesity as a disease, in my opinion, is dangerous and irresponsible. If an individual has a true mental health condition causing overeating, then this should be labeled as the disease and treated appropriately. Outside of this, obesity is the cause of disease, not the disease itself. If you are struggling with weight help may be needed. Again, weight loss is difficult in modern society. There is nothing wrong with asking for help. Never allow the control of your body (including your weight) to be taken away from you however.