Nav: Home

Should obesity be recognized as a disease?

July 17, 2019

With obesity now affecting almost a third (29%) of the population in England, and expected to rise to 35% by 2030, should we now recognise it as a disease? Experts debate the issue in The BMJ today.

Obesity, in which excess body fat has accumulated to such an extent that health may be adversely affected, meets the dictionary definition of disease, argue Professor John Wilding at the University of Liverpool and Vicky Mooney, representing the European Coalition for People living with Obesity (ECPO).

They point out that more than 200 genes influence weight, and most of these are expressed in the brain or in adipose tissue. "Thus body weight, fat distribution, and risk of complications are strongly influenced by biology - it is not an individual's fault if they develop obesity."

They argue that the recent rapid increase in obesity is not due to genetics but to an altered environment (food availability and cost, physical environment, and social factors).

Yet the widespread view is that obesity is self inflicted and that it is entirely the individual's responsibility to do something about it, while healthcare professionals seem ill informed on the complexity of obesity and what patients with obesity want.

Recognising obesity as a chronic disease with severe complications rather than a lifestyle choice "should help reduce the stigma and discrimination experienced by many people with obesity," they add.

They disagree that labelling a high proportion of the population as having a disease removes personal responsibility or may overwhelm health services, pointing out that other common diseases, such as high blood pressure and diabetes, require people to take action to manage their condition.

They suggest that most people with obesity will eventually develop complications, and those who do not could be considered as not having disease. "But unless we accept that obesity is a disease, we are not going to be able to curb the epidemic," they conclude.

But Dr Richard Pile, a GP with a special interest in cardiology and Clinical Lead for Prevention for Herts Valleys Clinical Commissioning Group, argues that adopting this approach "could actually result in worse outcomes for individuals and society."

He believes that the dictionary definition of disease "is so vague that we can classify almost anything as a disease" and says the question is not whether we can, but whether we should, and to what end.

If labelling obesity as a disease was harmless then it wouldn't really matter, he writes. But labelling obesity as a disease "risks reducing autonomy, disempowering and robbing people of the intrinsic motivation that is such an important enabler of change."

There is an important difference psychologically between having a risk factor that you have some responsibility for and control over and having a disease that someone else is responsible for treating, he says.

What's more, making obesity a disease "may not benefit patients, but it will benefit healthcare providers and the pharmaceutical industry when health insurance and clinical guidelines promote treatment with drugs and surgery," he warns.

While self determination is key in enabling change, "we should acknowledge that the origins of obesity for most people are social, and so too is the solution," he adds. "If people meet, shop, cook, eat, and engage in activities together the end result will be improved wellbeing and reducing obesity will be a consequential beneficial side effect."

Classifying obesity as a disease is neither essential nor beneficial. It's much more complicated than that, he concludes.
-end-
Externally peer-reviewed? Yes
Type of evidence: Opinion
Subject: Obesity

BMJ

Related Obesity Articles:

How much do obesity and addictions overlap?
A large analysis of personality studies has found that people with obesity behave somewhat like people with addictions to alcohol or drugs.
Should obesity be recognized as a disease?
With obesity now affecting almost a third (29%) of the population in England, and expected to rise to 35% by 2030, should we now recognize it as a disease?
Is obesity associated with risk of pediatric MS?
A single-center study of 453 children in Germany with multiple sclerosis (MS) investigated the association of obesity with pediatric MS risk and with the response of first-line therapy in children with MS.
Women with obesity prior to conception are more likely to have children with obesity
A systematic review and meta-analysis identified significantly increased odds of child obesity when mothers have obesity before conception, according to a study published June 11, 2019 in the open-access journal PLOS Medicine by Nicola Heslehurst of Newcastle University in the UK, and colleagues.
Obesity medicine association announces major updates to its adult obesity algorithm
The Obesity Medicine Association (OMA) announced the immediate availability of the 2019 OMA Adult Obesity Algorithm, with new information for clinicians including the relationship between Obesity and Cardiovascular Disease, Diabetes Mellitus, Dyslipidemia, and Cancer; information on investigational Anti-Obesity Pharmacotherapy; treatments for Lipodystrophy; and Pharmacokinetics and Obesity.
Systematic review shows risk of a child developing overweight or obesity is more than trebled by maternal obesity prior to pregnancy
New research presented at this year's European Congress on Obesity (ECO) in Glasgow, Scotland (April 28- May 1) reveals that the risk of a child becoming overweight or obese is more than trebled by maternal obesity prior to getting pregnant.
Eating later in the day may be associated with obesity
Eating later in the day may contribute to weight gain, according to a new study to be presented Saturday at ENDO 2019, the Endocrine Society's annual meeting in New Orleans, La.
How obesity affects vitamin D metabolism
A new Journal of Bone and Mineral Research study confirms that vitamin D supplementation is less effective in the presence of obesity, and it uncovers a biological mechanism to explain this observation.
Wired for obesity
In a multi-center collaboration, scientists at Children's Hospital Los Angeles and University of Cambridge discover a set of genes that help to establish brain connections governing body weight.
Sarcopenic obesity: The ignored phenotype
A new condition, that occurs in the presence of both sarcopenia and obesity and termed as ''sarcopenic obesity'', and that describes under the same phenotype the increase in body fat mass deposition, and the reduction in lean mass and muscle strength.
More Obesity News and Obesity Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

Risk
Why do we revere risk-takers, even when their actions terrify us? Why are some better at taking risks than others? This hour, TED speakers explore the alluring, dangerous, and calculated sides of risk. Guests include professional rock climber Alex Honnold, economist Mariana Mazzucato, psychology researcher Kashfia Rahman, structural engineer and bridge designer Ian Firth, and risk intelligence expert Dylan Evans.
Now Playing: Science for the People

#540 Specialize? Or Generalize?
Ever been called a "jack of all trades, master of none"? The world loves to elevate specialists, people who drill deep into a single topic. Those people are great. But there's a place for generalists too, argues David Epstein. Jacks of all trades are often more successful than specialists. And he's got science to back it up. We talk with Epstein about his latest book, "Range: Why Generalists Triumph in a Specialized World".
Now Playing: Radiolab

Dolly Parton's America: Neon Moss
Today on Radiolab, we're bringing you the fourth episode of Jad's special series, Dolly Parton's America. In this episode, Jad goes back up the mountain to visit Dolly's actual Tennessee mountain home, where she tells stories about her first trips out of the holler. Back on the mountaintop, standing under the rain by the Little Pigeon River, the trip triggers memories of Jad's first visit to his father's childhood home, and opens the gateway to dizzying stories of music and migration. Support Radiolab today at Radiolab.org/donate.