Last night I was watching another episode of “My 600-lb Life” (see my review of the first episode here), when my boyfriend asked me an interesting question: “Do you think obesity is a disease?” It reminded me of the many discussions I’ve seen floating around the web about Whitney Houston’s untimely death and whether we should mourn given that she chose to use drugs. I think people have a similar ambivalence about calling obesity a disease- many think it’s a choice that certain (misguided) people make.
Well, first let’s define the terms. I want to be clear that I’m not talking about people who are overweight or want to lose those last ten pounds. ‘Obese’ generally means having a body mass index of greater than or equal to 30. A disease is “a condition of the living animal or plant body or one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms.”
Based on the definitions above, obesity certainly seems to fit into the definition of a disease, doesn’t it? When someone is obese (not just overweight), it often impairs their normal functioning; basic physical functioning (walking, standing, breathing etc.) and even more complex physical functioning (heart disease, high blood pressure, diabetes, etc). And there are certainly signs and symptoms leading up to obesity- obviously weight gain but more specifically increased body fat.
So why do we as a society have such a hard time considering obesity a disease? I think it’s because we have a view that a “disease” is something that happens to someone- it’s completely out of their control. A person is “struck” with a disease, without warning and through no “fault of their own”. Weight gain on the other hand, is widely viewed as completely controllable- it’s a choice, one that an obese person could have (and should have) avoided. Finally, I believe there is a certain disdain that society has for obese people as undisciplined and weak-willed, so that the idea of calling obesity a disease seems to be letting obese people “off the hook”.
But consider the fact that not too long ago we had the same attitudes towards alcohol. It wasn’t until the 1980s that the American Medical Association adopted policies to treat the abuse of alcohol as an actual disease. Alcoholism, as it is currently understood, is a disease with both a mental and physical components: we now understand that one can be genetically pre-disposed to becoming an alcoholic but that you can also become an alcoholic as a result of mental problems (depression, poor impulse control, etc.) And, as my friend pointed out, while you can commit to stop drinking alcohol to guard against alcoholism, you can’t stop eating food to guard against over-eating.
So obesity, in my view, is a disease. To me, it’s a form of ‘food abuse’ much in the same way that alcoholism is a form of drug/substance abuse. I think society is reluctant to call obesity a ‘disease’ because we think doing so would in some way mean that obese people shouldn’t be held responsible for their abuse of food. But to say that obesity is a disease does not diminish any individual’s responsibility to eat healthy; acknowledging that obesity is a disease just properly defines something that we as a society have been reluctant to define for far too long.
I would go even further to say that we must treat obesity as a disease, if only because it forces us to take the issue more seriously and tackle it in an urgent and nuanced way. Much in the same way that we have come to understand that alcoholism requires medical treatment (eg. rehabilitation centers) and ongoing support (eg. Alcoholics Anonymous, support groups, etc.), perhaps understanding obesity as a disease would create a clearer conversation about what methods would be most effective in treating it. As seen on “My 600-lb Life”, simply losing the weight often is not enough; the underlying psychological causes for the abuse of food have to be explored and treated for any real progress to be made. I think that the moment society treats obesity as a disease, and not grounds for shame/ridicule, we move closer to solving the obesity problem and saving people’s lives. What do you think? -CFC
Do you think obesity is a disease? Why or why not?
What do you think the impact would be of the medical community (and larger society) treating obesity as a disease?
Governor Chris Christie has long been scrutinized for being obese. Do you think that obesity is a sign of a lack of discipline? Hear Christie’s comments here and sound off on chicfitchef.com! (http://www.oprah.com/own-oprahs-next-chapter/Governor-Chris-Christies-Weight-Video)