Dr Miriam Stoppard: If obesity was a ‘disease’ would it help weight loss?

By | January 13, 2020

Should we think of obesity as a disease?

Even though many people say it’s self-inflicted, the World Health Organisation has considered it a disease since 1936. And the outcomes of obesity, such as type 2 diabetes, liver disease, cancer, ­arthritis, joint pain, obstetric risk and sleep apnoea definitely are diseases.

The thing is, studies in twins show about two thirds of your weight is down to inheritance. More than 200 gene variations influence weight and those that increase weight are more common in people with severe obesity and less likely to be found in people who are thin.

Most of these genes in the brain affect a person’s appetite control. Fat distribution, on the other hand, is influenced by genes mostly found in fat. Thus it would appear it’s not a person’s fault if they develop obesity.

However, the recent rapid increase in obesity isn’t due to genetics but to an environment that encourages weight gain (food availability, cost of food and social deprivation).

Despite these facts, the usual view is that obesity is entirely a person’s responsibility.

Should obesity be considered a disease? (stock photo)

So does considering obesity a disease remove personal responsibility? Many other chronic diseases (for example, type 1 diabetes) require people to take personal action to manage their condition and people who do so have better outcomes.

The same should apply to obesity. But the stigmatisation of obesity makes people unwilling to discuss their weight.

Consequently they turn to fad diets or over-the-counter medication as they assume their obesity is solely their responsibility and patients often delay discussing their obesity with their GP by an average of six years.

Some argue that obesity is a risk factor rather than a disease and that labelling a high proportion of the population as having a disease could cripple the NHS – but this doesn’t mean they don’t require intervention.

Another problem is that a definition of obesity based on body mass index could lead to some healthy people being ­considered to have the ‘disease’. However, most people with obesity will eventually develop serious complications. Some say unless we accept obesity is a disease, the fallacy that people with obesity just have to try harder will persist.

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Is it really right to label over one quarter of our adult population as having a disease? Probably not, but we should acknowledge the origins of obesity for most people are social and so too is the solution.

As a society we should be spending money to provide education and support. Action should be ­delivered through community ­champions in places offering ­healthcare, education and work.


Mirror – Health