The number of people suffering from obesity is staggering. In a 2020 article, the World Health Organization (WHO) reported that worldwide obesity has nearly tripled since 1975, and that in 2016, there were over 650 million people who were obese. And while we might have thought that poverty is the greatest killer, most of the world’s population live in countries where overweight and obesity kills more people than suffering from being underweight.
The WHO together with the AMA, World Obesity Federation, Canadian Medical Association, and Obesity Canada all recognize obesity as a disease. According to the CDC, if a health condition lasts for at least a year and either necessitates ongoing medical attention or limits ADL (activities of daily living), or does both of these, it is classified as a disease.
We all know that diabetes is a disease. Same goes for heart disease, cancer, Alzheimer’s disease, and many others. However, when it comes to obesity, there is an ongoing debate about whether obesity is a disease and indeed whether it should be classified as a one.
What stops some medical authorities from classifying obesity as a disease?
First, there is no precise barometer by which to measure obesity. Even the holy grail of the BMI is not a foolproof method. Secondly, obesity doesn’t always reflect poor health. Further, there are no guarantees that an obese person (or someone with an elevated BMI) will actually develop diseases like heart disease and diabetes, even though there is a correlation between obesity and these diseases. Also, not all of the factors influencing obesity can be controlled.
Another issue that concerns doctors is that if obesity is classified as a disease, those suffering won’t make the necessary efforts to fight it. They might think, “Well, it’s a disease. There is nothing I can do about it.” This classification might also backfire and cause increased discrimination against those with obesity.
Dr. David L. Katz, the founder and director of Yale University’s Prevention Research Center and the editor-in-chief of the journal Childhood Obesity, wrote an article entitled “Obesity is not a disease,” in which he says that although those classifying obesity as a disease have good intentions, the unintentional fallout from this classification is highly problematic. This is because as a disease, doctors will now recommend drugs and bariatric surgery as the correct medical course of action. This will cause skyrocketing healthcare costs, these drugs cause side effects, and we still don’t know the lasting consequences of bariatric surgery. In a brutally honest observation, Dr. Katz says that “even if surgery proves sustainably effective, the need to rely on the rearrangement of natural gastrointestinal anatomy as an alternative to better use of feet and forks seems a societal travesty.”
When it comes to obesity, an ounce of prevention is worth a pound of cure. So our focus should lie first and foremost on preventing obesity and making lifestyle changes for those already suffering–and only on medical interventions as a very last resort.
Whether or not obesity is a disease, it takes a tremendous mental, physical, and financial toll on people and society at large. And it doesn’t need the label of “disease” to warrant our urgent attention.
Written by Gila Isaacson