Response: A.M.A. recognizes obesity as a disease

I have seen a lot of responses to the recent declaration: Obesity is a disease. The responses are mixed. I am somewhat surprised that the ACSM supports it – but the announcement likely means more money in their pockets (with the Exercise is Medicine campaign). Who wouldn’t support an idea that puts more money in their pocket?

Me!! — I would rather see individuals succeed. A diagnosis of obesity does not set the platform for success – in fact it is counterproductive.

My reaction

I was initially outraged by this announcement. Obesity is NOT a disease. Suddenly, we are assigning another label to individuals. Supporters of the movement will argue that by defining obesity as a disease, those suffering with obesity will receive better medical assistance and insurance coverage for treatment. The problem? Sure, this could increase coverage for gastric bypass, lap band, etc – but is this really helping individuals? Is this a solution to the overwhelming problem?

Let me break this down to logical pieces and terms.

Obesity

Obesity is an abnormal accumulation of body fat, usually 20% or more over an individual’s ideal body weight. The most common measure used for obesity is BMI.

Disease

A disease is a condition of the living animal or plant body or of one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms.

At first read, you might think that obesity does fit this definition. The above definition is quite vague and as stated could fit the equally vague definition of a disease. But one word jumps out at me: symptoms. Overweight/obesity is a symptom.

It is a symptom of overconsumption of calories (it is NOT the symptom of underactivity as a standalone).

It is the symptom of a metabolic condition.

It is the symptom of hormone imbalances.

With that said. Can a symptom of symptoms of it own? Or is obesity a symptom that correlates with other symptoms of a true disease or condition?

Symptom

Another vague definition. A symptom is: subjective evidence of disease or physical disturbance or something that indicates the existence of something else.

It is unclear to me as to whether a symptom and disease can be synonymous terms. I could get technical – since disease is used in the definition for a symptom and you cannot define a word by using the word itself in the definition, then symptom and disease cannot be one in the same.

Like my logic?

A Real Life Story

Let me put this into perspective. Medical professionals can now assign an individual with the disease of obesity (another wonderful label, by the way, for individuals already struggling with self-esteem, body-image, and stigma). How do doctors quantify obesity? Body Mass Index, or BMI. I have written about BMI and why it is not a good measure, please read the previous post by clicking the link.

I fluctuate between being overweight and obesity on the BMI scale – depending on the season and what I may be training for. However, my appearance and my body fat percentage clearly indicate otherwise. Does this mean that the doctor would approve liposuction for me as a non-elective alternative? In the past, I have had a doctor tell me that I needed to lose weight – because she did not bother to actually look at me and only looked at my BMI. Today, that same doctor would have labeled me obese, and that would have gone in my medical history and I would be dealing with the long-term effects of that being on my medical record (and there are implications! I have learned this, having arthritis in my medical record from age 16 – it creates huge battles with the insurance companies).

The bottomline

I have given a lot of thought to whether obesity is a disease – long before this announcement. It is not. And sadly, this new definition will not solve the nation’s obesity epidemic. We have added stigma to an already debilitating label.

What about self-esteem?

What about self-worth and empowerment? A disease implies there is not much one can do about it – when the number one method of prevention and treatment of overweight obesity is empowerment. Seems to me that we may be going in the wrong direction with this diagnosis —

But some people will be making a lot of money.

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