There has been significant debate in the American Medical Association on whether to classify obesity as a disease. At the core of the debate is a question of what is the definition of disease. Perhaps surprisingly, there is no consensus on this. There are several definitions, and not all experts agree. Consequently, all official determinations of disease have a sociological and contextual aspect to them.
There has been a significant trend toward the medicalization of deviant behavior in western society. Many behaviors that previously were thought of as an immoral choice or crime have been reclassified as a disease, such as alcoholism, drug addiction, hyperactivity in children, and some mental illnesses. Obesity is similar to these in that it is affected by behavioral choices, yet it is unclear to what extent social and physical factors contribute to it.
Additionally, obesity is not in and of itself a health problem. It can, and often does, correlate with other diseases, such as heart disease, stroke, and diabetes. It also can be caused by diseases, such as Prader-Willi syndrome. However, there are many healthy obese people, and obesity has not been empirically proven to directly cause negative health conditions.
The question at hand is how society can best deal with an obesity problem so widespread that it affects one third of all adults. First, this question presupposes that obesity is indeed a problem for society, and not simply an individual problem. Arguments for this include the structure of health insurance which diffuses risk, and therefore cost, to the general population. Lost productivity has also been considered in the economic impact, so there is more justifying this perspective than pure communal altruism.
If obesity were to be designated a disease, there are many consequences that would come with it. More medical treatments would be available, and providers would receive more reimbursement for treating obesity. The FDA would be pressured to approve more obesity medications. The government could increase funding to obesity-prevention programs, and obese people would receive special considerations from employers.
On the other hand, there may be some negative consequences to labeling a third of the country diseased. As has been seen with other diseases, there may be more pharmacological and surgical treatments for obesity at the expense of healthy eating and physical activity. There could be over treatment, even for aesthetic reasons. Bearing the label of diseased can negatively affect obese people when it comes to health insurance premiums and employment. Above all, if a person has a disease they may lose motivation to personally change their situation. Often people adopt a mentality of, “it isn’t my fault and there is nothing I can do about it.”
What the medicalization of obesity also does is remove the incentive to find the root social causes of increased obesity. We all know that sugary drinks can make people fat. What we do not know is why people are drinking so much more sugary drinks. Is it simply because they are more available? If so, why are they more available? Humans are adaptive creatures. There is a deeper reason why Americans are more frequently becoming obese. We need to find out why if we are ever going to change the behavior.
Podcast – Is Obesity A Disease? – The Adam Goldfein Show – Hour 1
Podcast – Is Obesity A Disease? – The Adam Goldfein Show – Hour 2
Additional Resources
Med Page Today, Obesity Not a Disease, AMA Council Says: http://www.medpagetoday.com/MeetingCoverage/AMA/39918
World Health Organization, Obesity and Overweight: http://www.who.int/mediacentre/factsheets/fs311/en/#
Ronin Pen 