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About obesity

The great debate: Is obesity a disease?

More and more experts are recognising that obesity is a disease, not a choice. However, this still comes as a surprise to many due to the stigma, shame and misinformation about obesity. So why is obesity considered a disease and not simply a lack of willpower?

6 min. read

Part of the answer to why obesity is considered a disease lies in the fact that there’s more to obesity that you can see. A lot more.

Supporters say:

  • Obesity is a disease because it is influenced by lots of factors, and many of them are out of an individual’s control.
  • Obesity is a disease because it has the classical signs, symptoms, complications, and etiologies of a chronic disease – a long-lasting condition with persistent effects on individuals’ health.

 As a chronic disease, obesity shouldn’t be treated any differently. People with obesity should seek medical care and ask their doctor about treatment options.  On the other side, sceptics believe a whole range of myths about obesity. They argue:

  • Obesity is a lifestyle choice and a result of how much you eat and how little you move.

Saying obesity is a disease allows people to make excuses and not be responsible for their actions. This type of misinformation and stigma impacts the way society thinks about obesity and impairs how it should be treated.

Why is obesity a chronic disease?

In January 2019, the Royal College of Physicians (RCP) recognized obesity as a disease. A chronic yet manageable disease that’s affected not only by our genes but also by the modern environment we live in. According to Dr. Andrew Goddard, “It is not a lifestyle choice caused by individual greed, but a disease caused by health inequalities, genetic influences, and social factors.” Even with this recognition, the debate around why obesity is a disease continued and reactions in the UK media were strong.

The science of why obesity is a disease

Around the world, similar expert working groups have arrived at the same conclusion that often provokes heated debates in the media. Obesity is still widely misunderstood and considered  a lifestyle choice – influenced by how much you eat and how little you move. In truth, most people living with obesity have many reasons for their weight. The science is clear on that obesity is not just a result of poor choices.

In fact, obesity is a disease that:

  • Puts people at a high risk of developing or worsening other serious health conditions such as cardiovascular disease, type 2 diabetes, increased blood pressure, high cholesterol, obstructive sleep apnoea, certain types of cancer, anxiety, and depression.
  • Changes the way the body responds to treatments. What worked before may not work anymore.
  • Is constantly made stronger by our everyday environment.
  • Affects people for life.

Though obesity is a disease with serious health implications, people living with obesity rarely seek professional medical help and believe they should deal with it on their own. 

Thankfully, more and more healthcare providers recognise the complexity of obesity and are learning how to help. Their toolbox of treatment options is also growing and is constantly being updated. Today, obesity is a disease with treatment options that include behavioural therapy, individualized nutrition therapy, weight-loss medication, and bariatric surgery. Modern obesity management looks beyond what you eat and how much you move. It involves understanding individual eating patterns (how, when, and why you eat), as well as patterns of mood, sleep, stress, and physical activity. A personalised treatment plan will probably require a combination of different treatment options to meet your needs.

Infographic displaying the amount of people and health care professionals that recognise obesity as a disease.

                                                

Obesity is a disease with new hope for better health

Excess weight is not the only reason why obesity is a disease. Stigma, shame and low self-esteem are the consequences we don’t see and ones that impact people living with obesity on a daily basis. 

While misinformation and stigma continue to impact society’s understanding of obesity, more healthcare providers are beginning to recognize obesity as a chronic disease – one that demands medical attention and potentially treatment.

The good news is that obesity is a disease that is manageable and even minor modifications can improve your overall health and wellbeing.  Weight loss of only five percent is enough to lower the risk of many weight-related health complications, including diabetes, cardiovascular disease and more.

Currently, there are several treatment options available for managing overweight and obesity. To lose weight and keep it off in a healthy way, it is important to acknowledge that obesity is a chronic disease. Speak with a weight management specialist about the right way to treat it. 

References
  • Royal College of Physicians. Obesity should be recognized as a disease. Council Paper 2018.
  • Royal College of Physicians. RCP calls for obesity to be recognized as a disease. RCP London News 2019. https://www.rcplondon.ac.uk/news/rcp-calls-
    obesity-be-recognised-disease [Accessed June 2019]
  • European Medicines Agency. Draft Guideline on clinical evaluation of medicinal products used in weight control 2014.
  • Food and Drug Administration. Guidance for Industry Developing Products for Weight Management 2007.
  • Heuer CA, McClure KJ & Puhl RM. Obesity Stigma in Online News: A Visual Content Analysis. Journal of Health Communication 2001; 16:976–987.
  • Guh et al. The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis. BMC Public Health 2009; 9:88.
  • Luppino et al. Depression and obesity: A meta-analysis of community-based studies. Arch Gen Psychiatry 2010; 67:220–9.
  • Sumithran P & Proietto J. The defence of body weight: a physiological basis for weight regain after weight loss. Clinical Science 2013; 124:231-241.
  • National Institutes of Health. Clinical Guidelines On The Identification, Evaluation, And Treatment Of Overweight And Obesity In Adults 1988.
  • Rand K et al. It is not the diet; it is the mental part we need help with. A multilevel analysis of psychological, emotional, and social well-being in obesi-ty. International Journal of Qualitative Studies on Health and Well-being 2017; 12:1-14.
  • Yumuk V et al. European Guidelines for Obesity Management in Adults. Obesity Facts 2015; 8:402-424.
  • Warkentin et al. The effect of weight loss on health‐related quality of life: systematic review and meta‐analysis of randomized trials. Obes Rev 2014;
    15:169–82.
  • Berthoud H, Münzberg H, & Morrison, CD. Blaming the brain for obesity. Gastroenterology 2017; 152(7):1728-1738.
  • Astrup A. Dietary treatment of overweight and obesity. In: Thomas A. Wadden & George A. Bray (eds.). Handbook of Obesity Treatment. New York:
    Guilford Press 2018: 309-321.
  • Caterson ID et al. Gaps to bridge: Misalignment between perception, reality and actions in obesity. Diabetes Obes Metab 2019; 21(8): 1914-1924.

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