Despite what some say, obesity isn’t a disease. Here’s why
A year ago, millions of North Americans contracted a brand new disease they already had—obesity.
You may be a bit confused, so let me explain.
In June 2013, the American Medical Association officially declared obesity a disease. Seeing as how my last blog drew attention to the bias and prejudice that over-weight individuals face on a daily basis, you can imagine that my initial reaction to the news was one of total elation. Finally, a well-respected medical organization was labelling obesity exactly what it is. At least that was how I felt back then.
A year later, I’m revising my original position and asking myself whether obesity really should be considered a disease?
On the one hand there is no denying the American Medical Association’s declaration has helped create awareness and made advocacy easier. I’m hopeful this will translate into increased research, as well as funding for the development of innovative approaches for the treatment of obesity. A University of Minnesota study has already confirmed that the obesity-as-disease message has helped remove some of the shame associated with being overweight. On the other hand, the same study cemented the perception that an individual’s weight is a fixed state—any attempt at weight-loss is futile—with the consequences being continued poor food choices, weight gain and declining health.
I believe that if we’re ever going to win the war against obesity, we must re-align the internal compass of the dieter to focus it on self-determinism. That means helping them navigate from a vicious cycle of negativity to a self-fulfilling state of limitless development.
The challenge for the physician is that there are almost unlimited ways the body can say ‘ouch.’ Traditionally, doctors have organized and grouped signs and symptoms, then given names to the common diseases. In medical school we were taught how to match the treatment (usually medications) to the disease. This approach is only somewhat satisfying, at best. Our diagnoses (since we defined the disease) have almost 100% sensitivity—in other words, when you’re looking for illness, you always find it—however when it comes to what’s really troubling our patients, those diagnoses generally lack specificity or validity customized to that specific individual.
Herein lies part of the problem with the obesity-as-disease model. The usual treatment regimen is: eat less and move around a little more! This approach, as we know all too well, isn’t working. Medications for weight-loss have proven to be ineffective and often dangerous. I believe that when the body says ‘ouch,’ it’s simply saying that something is wrong.
With that in mind, I’m asserting that obesity isn’t a disease. It’s just another way the body has to tell us that something’s wrong. I believe as physicians we must first identify the individual metabolic processes that have caused the weight gain, and then correct them. The American Medical Association states—and I agree—that “obesity is a multi-metabolic and hormonal state.” The Centre for Disease Control and Prevention has declared obesity “public enemy number one!” We must continue to pursue forward-thinking remedies for obesity and its significant medical, psychological and socio-economic consequences.
The obesity-as-disease message might be a little like a Trojan horse. On the surface it’s an unexpected gift. But to those of us treating obesity on a daily basis, it seems to be pulling up lame.
In my next blog I’ll tackle the question of whether food should be considered an addiction. Until then, stay well and keep enjoying your body evolution.
Dr. Jeffrey Brown, Medical Director
Your Body Evolution
Weight Loss Through Wellness