Obesity: Choice or Disease

Obesity: Choice or Disease Public health experts agree that overweight and obesity have reached epidemic proportions in this country and around the world. More than a third of U.S. adults are obese. People ages 60 and older are more likely to be obese than younger adults, according to the most recent data from the National Health and Nutrition Examination Survey. And the problem also affects children. One out of five, or 17 percent, of U.S. children ages 6 to 19 are obese. (John Hopkins University )
In many ways, obesity is a puzzling disease. Experts don't know exactly how your body regulates your weight and body fat. What they do know is that a person who eats more calories than he or she uses for energy each day will gain weight. But the risk factors that determine obesity can be complex. They are usually a combination of your genes, socioeconomic factors, metabolism, and lifestyle choices. Some endocrine disorders, diseases, and medications may also affect a person's weight. Proponents stress that obesity is a disease because it is a result of genetics and biological factors, or illnesses that cause weight gain, Cushing's syndrome, and polycystic ovary syndrome. Opponents argue that obesity is not a disease because it is the result of a person's chosen lifestyle, eating habits, and environment (Convenience, money, social circle etc).
Here's the downside of calling obesity a disease. Some worry that this would medicalize obesity and intensify reliance on drugs and surgical treatments rather than relying on diet and exercise to attain a healthy weight. Another concern is that calling obesity a disease could alienate some obese individuals, especially if the emphasis is on achieving ideal weight rather than focusing on healthy eating and increasing physical activity. Some argue that how much and what you eat is a personal choice. Others point out that there is no effective well-established treatment. (Sandra Adamson, Medscape)
Here's the pro side. Calling obesity a disease could mean greater investments by the government and the private sector: more research into causes, triggers, and treatments, including more US Food and Drug Administration (FDA)-approved drugs for treatment. Another benefit of making obesity a disease is that it could make it harder for third-party payers to deny coverage. (Sandra Adamson, Medscape)
Defining obesity as a disease makes little medical sense, since, rather than judging a person’s health based solely on his/her BMI, a physician needs to examine each patient as an individual, take a detailed history, and assess clinical parameters, such as blood insulin, cholesterol, triglycerides, etc. If these are somewhat outside of the desirable bounds, behavior changes may have the desired effect. If the values are more extreme and if behavior changes are less of a realistic option, then drugs can be considered. But the decision needs to be made based on the complete profile of the individual, not on some arbitrary cut-point in a proxy variable.Our capacity to get fat is also part of normal physiology. Obesity begins with the accumulation of body fat, and that in turn begins with the conversion of a surplus of daily calories into an energy reserve. That’s exactly what a healthy body is supposed to do with today’s surplus calories: store them against the advent of a rainy (i.e., hungry) day tomorrow. The problem that leads to obesity is that the surplus of calories extends to every day, and tomorrow never comes. (Geoffrey Kabat, Breakthrough). Obesity has become a public health crisis, not just in the United States but all over the world. Obesity problem can be reduced by educating about healthy nutrition and encouraging to be physically active. There are effective interventions and government policies for prevention and control of obesity. Sustainability of these interventions is a key factor, so that people can adopt these healthy behaviors as a lifelong practice and have a healthy life. This will lead to a nationwide healthy future.