Am I diseased? I dare you to say it.

The American Medical Association (AMA) voted last Tuesday to categorize obesity as a disease. A statement by Dr. Patrice Harris, a member of the association’s board, said that “recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately 1 in 3 Americans.” This is meant to be the first step to fight against the “obesity epidemic”.

The term disease can be defined as an illness or sickness that disrupts or alters normal functions. The World Health Organization (WHO) doesn’t have a firm definition of the word. Instead, they chose to characterize health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

WHO’s website provides a list of epidemic diseases, including cholera, influenza, SARS, smallpox, and the plague. I’m reminded of that old sesame street song “one of these things is not like the other.” Placing obesity side-by-side to such damaging and frightening illnesses like the plague is misleading, and it doesn’t quite fit. It creates the perception that obesity is something we need to quarantine, institutionalize, and cure.

More than anything, the biggest problem with this label is that it will further stigmatize those who are overweight. A study in the American Journal of Public Health found that discrimination and stigma towards obese people can result in numerous psychological and physical health challenges. It describes disease stigma as occurring “when groups are blamed for their illnesses because they are viewed as immoral, unclean, or lazy.” You only have to look at the public comments beneath articles on the CBC or Globe and Mail to see that this stigma exists. People are concerned that ” the fatties can blame their condition on a disease instead of taking any responsibility for their lack of exercise and poor eating habits”, and the phrase “labeling laziness as a disease” has come up numerous times. These stereotypes only add to the pressure people feel to lose weight and become “average” or skinny. It can lead to mental disorders such as depression, and even cause people to take up eating disorders in an attempt to become an acceptable member of society.

In order to provide full disclosure, I have to admit that I come from a family of big people. In fact, according to my BMI, I am obese. I am a relatively active person, and I eat well enough. As does the rest of my family. Unfortunately, none of that seems to matter to the scale forever counting up beneath my feet.

All of this is a way that there is more to obesity than just poor lifestyle choices. Genetics and medical background can play an integral part in weight gain. As early as the 1960s, medical professionals have made the correlation between genes and obesity. A 2006 article published in Human Molecular Genetics outlines obesity as a hereditary trait and cites 253 quantitative traits identified with weight gain. As of a consequence, some individuals are more predisposed to obesity than others. The study goes even further and follows up with its test participants. They found that even though some were “cured” by bariatric surgery, they could not be considered as truly healthy. To further prove my point, in 2007, another gene called FTO was discovered in Europe to be responsible for weight gain. Sixty-three per cent pf people surveyed had one or two copies of this mutation. The Canadian Association for Neuroscience has linked weight gain with other medical illness such as ADHD, anxiety, or aggressive disorders. This introduces the obvious correlation between emotion and weight gain, a correlation that is exemplified with medications that cause mood swings and erratic behaviour.

By labeling obesity a disease, it creates the perception it is a uni-dimensional medical illness that can be fixed with pills and a strict regiment. But it is a much more complex. Some people are just born bigger than others; some people have genes that make it difficult to metabolize food; and others may gain weight due to surgeries or medications. There are many reasons why a person may be overweight, and this classification puts them all under the same umbrella.

I found this photo on instagram that I think accurately supports my argument.

It seems like the AMA is either ignorant of all these other factors, or they simply don’t care. They have explained that this would mean medications to combat obesity would be covered by insurance, and that it will bring more exposure to the issue. While I agree that more exposure to obesity is a good thing, one can only hope that it will explore all aspects of the “disease” and won’t fall back to societal stigma. It is important that while we work to learn more about the physical aspects of obesity, we do not forget the psychological tole this terminology may create.

My family is beautiful. My mother and sister are gorgeous, generous, kind, and funny. My dad is quite a handsome man and is insanely intelligent.

Would you call them, or me for that matter, diseased or sick? Go on, I dare you.

 

2 thoughts on “Am I diseased? I dare you to say it.

  1. I think calling it a disease is better than calling it moral failure. The result of the various genetic and psychological predispositions does result in poor health – cholesterol/blood pressure/diabetes/heart disease etc. You can argue that overweight people are smart, funny, delightful (as we are!) but it doesn’t take away from the fact that carrying extra weight is not healthy, not optimal and most of us wish we were not overweight. We still call lung cancer a disease, even if it is caused by smoking cigarettes, a habit that can be cited as a moral failure or a genetic pre
    disposition as well. Anyway, interesting post and lots to discuss about this complex issue.

  2. You make an excellent point. There are definitely some positive aspects to this label. The problem is that AMO have yet to discuss this issues. Most comments and discussions—even among professionals—have revolved around it being a moral issue. They argue that it can be “cured” with pills and diets, but haven’t addressed all the factors you mentioned. Maybe it will come with time, and hopefully this will result in more research done on the causes of obesity. However, until they do, I still maintain that the stereotype will do more harm than good.
    p.s. you are the first person to comment on my website and it made me happy 🙂

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