That is far from a simple question although the American Medical Association answered it in the affirmative at its semi-annual meeting in Orlando last week. Even within that august body there was disagreement; the council who offered the report to the House of Delegates did not recommend approval, but the overall assembly disregarded the council report and voted to list obesity as a disease.
Having served in that assembly, I cannot recall an issue that so quickly became front page news. Many organizations that are advocates for weight control have long since taken the stand that obesity is a disease. The American Association of Clinical Endocrinologists joined with The Obesity Society last year in making the same statement, but that attracted no public outcry since they have much less recognition than the AMA.
If you think back a few decades one might have predicted that there would be major public reaction. After all, the Center for Disease Control and Prevention states that 35% of all Americans are overweight. That’s a lot of people who have a stake in this.
When alcohol and depression made the list some years ago there was a similar, although more muted, response. Many said that those problems were choices made by individuals therefore should not be thought of as an illness. Certainly, there are abundant data now to show that addiction and psychiatric disorders belong in the category of disease. That has led to a lessening of the stigma of those problems, a marked increase in research, and made treatment more accessible.
Already T-shirts are appearing in XXL size stating “I am NOT a Disease.” Many other organizations who work with the problem of obesity have taken the stand that the AMA action stigmatizes their constituents. They would do well to remember the sea change that has taken place in the treatment of addiction and psychiatric illness; the same is possible for the severely overweight.
To say that obesity does not have serious health ramifications is absurd. The incidence of coronary artery disease, Type II diabetes, and hypertension is markedly increased in patients with a Body Mass Index (BMI) of >30. To be sure, there is a substantial population in that group that suffers from none of those ailments and they are among the number who might feel especially singled out for scorn.
Here’s a very unscientific study anyone can do that proves the point. On your next visit to a major sporting event, sitting in the parking lot of an international retail outlet, or in a gate area of an international airport notice how many truly elderly pass by who are obese. There will be virtually none. The reason is obvious: The lifespan of the severely obese is remarkably shorter than the general population. Notice those debarking from an overseas flight who are not American; very few will be obese. There are complex reasons for that but the most obvious that they do not have access to a food supply like ours. Those two facts alone would suggest that our country is in serious trouble with this problem.
The reasons for obesity are complex. They include a genetic predisposition, life style in the home in which we were raised, psychological needs that are satisfied by eating, the availability of cheap, unhealthy food, an aversion to exercise, a sedentary existence, and a host of others. That said there are no simple solutions; a multidisciplinary approach is needed.
For those who believe naming this condition as pathological is an insult to their freedom of choice. That is understandable but the facts are undeniable: Morbid obesity is a killer; lesser degrees carry a smaller, but still important risk. Michele Obama has made childhood obesity a cause in which she is extremely vocal. There has been no organized protest against her totally sensible approach.
After the furor dies down, then perhaps more rational treatment plans will be forthcoming. Fad diets which virtually never produce sustained weight loss will be replaced by a more sensitive medical profession and a public acceptance that, while obesity is a disease, it is not an indictment of lack of will power. We should all have the same compassion for those who literally carry such a heavy burden as we have for those with other illnesses.
– J. Hayden Hollingsworth, MD
Obesity is now declared a disease! If so, it is a disease of affluence and most people afflicted by it, are obsessed about the difficulty of losing weight, whereas I believe the solution is quite simple.
As a kid I grew up in New Zealand during the 2nd world war, when food was scarce and rationed. I remember only 2 kids at primary school who were overweight. One lived on a farm and ate dairy and other foods which were obviously not rationed or at least, were hard to ration by the authorities. The other had no interest in physical activity, but loved eating, particularly fatty fried food. Overweight adults were a rarity, as they are still in poorer societies.
I walk along the streets of Balmain in Sydney after schools are out and most kids are eating ice creams, or consuming sugary drinks, bought for them by their mothers! When I grew up, the standard of living was much lower, but an ice cream or lemonade was a special treat, bought for me rarely.
Today, in the 1st World, the majority of adults are overweight, many grossly and hideously obese. During my frequent business trips to the USA in the nineties, I was taken once to dinner by an obese company representative to Ur Cooks in Houston, Texas, where we selected our own steaks, cooked them and added cooked vegetables. The concept was ideal for feeding yourself a healthy nutritious meal. My host selected an enormous steak about 2 inches thick, covering most of his plate, cooked it and added copious vegetables that almost fell off his plate. I selected the smallest steak available – still large in my view, added vegetables, ate my meal, feeling I probably could have eaten more, but pleasantly satisfied.
The answer to obesity is common sense. If anyone is overweight, they must stop being be so greedy, but select nutritious food of a quantity that doesn’t make them feel (and look like) like a stuffed pig.
Most obese people blame everyone but themselves – they have tried everything, they say – their genes are wrong (if so, they are lucky, they have an efficient metabolism and don’t need much food to remain functioning and healthy – would have been great in the ‘hunter/gatherer’ days) – they love sweet things – fast food is so tasty (lots of salt and fat!). There were no fat people in those horrendous concentration or POW camps during the 2nd world war.
Has old fashioned, self discipline just gone out the window? For goodness sake, can’t humans stop putting food in their mouths! They don’t need a fad diet. In the blog on my site, ‘Lose Weight’, (See http://fitnessforum.us), I specify how to live a life that will banish obesity – to live longer and enjoy the years much more – obese people must simply resolve themselves NOW – only they can do it and it is simple.