Eating well, regular exercise and maintaining a healthy body weight (BMI between 20 and 30) are important for your health. If you choose not to do so then it is possible that in due course your health will suffer. However making that choice is NOT a disease, it is a choice.
Sometimes it feels like we have entered a parallel universe where nothing makes sense anymore. Other times it makes perfect sense when you realize that the Orwellian concept of changing the meaning of words so as to suit the user is being applied.
The American Medical Association, against the recommendation of its own subcommittee, which investigated this, has declared that obesity is a disease. The dictionary definition of disease is “ a disordered or incorrectly functioning organ, part structure or system of the body resulting from the effect of genetic or developmental errors, infection, toxicity or unfavorable environmental factors”.
There is nothing in this definition, which includes choosing to consume more energy that you expend.
I have pondered whether to write something about this as in some respects the decision makes no difference. The AMA is a representative body not a research one so has no power to declare anything a disease. It can pass resolutions and put out its opinion but that is as far as it goes.
However such pronouncements can make a difference because medical associations tend to be taken seriously (even if they may not deserve to be). In the eyes of many in the public, representative organizations are seen to speak for all doctors and be the authority on all things medical. I can say this from personal experience in having been involved with a variety of medical groups.
In reality the AMA in both the USA and Australia is a political and industrial organization for doctors. Yes they make policy statements but these are not “scientific” releases but positions of opinion.
So if the American AMA labels obesity a disease, governments, insurers and the public may listen. In turn this may impact on decisions made. It is hopefully a coincidence that two new weight loss pharmaceuticals have recently come onto the market. Both are struggling for sales. Neither has been shown to have a major effect. As a group, weight loss drugs are essentially useless. If they “worked” nobody would be overweight!
What better way to market a new pill than as a cure for a “disease”? The facts that tablets are not a cure and obesity is not a disease won’t spoil the narrative.
Let me be crystal clear. Obesity is NOT in any way, shape or form a disease.
It is the end result of an energy imbalance over a period of time and is completely reversible by reversing the energy imbalance. Yes there are a host of individual issues sitting behind this but the final common pathway is the law of physics not biology.
By labeling it a disease we are seeking to give people an out from taking responsibility for their actions.
Words have meanings and also connotations. If we call something a disease it immediately implies that the sufferer is a “victim” (definition – a person who suffers from a destructive or injurious action or agency) and that it has “happened to them”. Earlier this year I wrote about the overweight man suing his doctor for not referring him for gastric surgery. His obesity presumably had nothing to do with his eating habits. The case is again being appealed.
There is one more aspect to this and it is important. The thresholds for overweight and obesity are too low. This is why we hear the hysteria about crises and epidemics. As was shown earlier this year people with a BMI of up to 30 do not have any impact on their life expectancy. Whilst they may want to lose weight for personal or cosmetic reasons they do not have to do so for purely medical reasons.
So it could be that having tried to whip everyone up into hysteria by overstating the problem there is now a perceived need to call the crisis a disease. This is particularly the case as medical interventions such as surgery and tablets look better treating a disease than a lifestyle choice, which has a non-medical inexpensive solution.
And of course if your precious government funding requires things to look bad then we can’t possibly offer any good news can we?