Dispelling nutrition myths, ranting, and occasionally, raving


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Licence to eat?: My thoughts on classifying obesity as a disease

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Sometimes I need a little time to percolate on a subject before I weigh in. This was one of those times. A couple of weeks ago the American Medical Association decided to classify obesity as a disease. This, of course, created quite an uproar. On one side, there are the people who are saying that this will lead to a decrease in personal responsibility for the condition as well as those who believe that it will mean those of us who are not obese will be footing the bill for surgeries and new obesity drugs (1). On the other side, there are those who believe that this will lead to increased efforts to curb rising obesity rates and may be beneficial to those who are suffering from obesity (2).

Personally, I’m not sure that calling obesity a disease will lead to any improvements in obesity rates but I certainly don’t see it causing any harm. Considering how well we’ve being doing reducing obesity rates thus far I figure that classifying obesity as a disease is worth a shot. While I agree with the point made in the Globe article that the current use of BMI to measure obesity is highly flawed I would also like to point out that there are other measurements of obesity being developed (e.g. the Edmonton Obesity Staging System) and perhaps the classification of obesity as a disease will lead to wider use of these more accurate tools.

I also take issue with the notion that classifying obesity as a disease will lead to people throwing up their hands and saying “not my fault, I have a disease” and then going for a big mac meal deal. When alcoholism was classified as a disease in 1956 did alcoholics cheer and say “now I have a licence to drink!”. No. The classification raised served to raise awareness that this was a serious medical condition and increased treatment availability and options.

Did anyone else notice the photos of headless obese bodies accompanying the news articles? I hope that this classification will lead to increased sensitivity toward those who are obese.

My concern is not with the classification of obesity as a disease (keep in mind that over weight is not the same thing as obese and that individuals who are over weight may indeed be healthier than their “healthy” weight counterparts but yes, I am concerned that this classification may detract from the notion of health at every size) it’s with our current medical model in North America. Our focus is on treatment when it should be on prevention. This goes for all diseases, not just obesity. In Canada, our system will cover many treatments once you’ve fallen ill but will not cover most preventative measures. We need to start covering (at least some of) the cost of things like dietitians, certified personal trainers, gym memberships, sports equipment, etc. regardless of disease state. In the long-run it would be a lot less costly to keep people healthy in the first place rather than waiting until they become ill to provide medical and professional supports.

Yes, there is much more than our medical system that needs to be involved in preventing and curing obesity. Our food systems, environment, and societal structure are major contributors to our current high levels of obesity. However, as we’re talking about the AMA classification today I wanted to focus on the medical side of the issue.

So, these are some of my thoughts on the subject. I’ve seen many other thoughts out there as well, mostly from medical professionals and the media. What I’d really like to see are thoughts from those who are most likely to be directly affected by the classification of obesity as a disease. If any of my readers, or anyone you know, is currently (or was ever) obese and would like to share your thoughts on the recent classification of obesity as a disease by the AMA I would love to hear your thoughts on this subject. Please email me at dmc555 [at] gmail [dot] com to let me know what your thoughts are. With your permission, I will share your thoughts in a future blog post.