Rethinking Obesity: Why Not All Obesity Should Be Considered a Disease

Obesity is often labeled as a disease, a classification that has far-reaching implications for how it is perceived, treated, and managed within the healthcare industry. However, this blanket classification deserves a closer examination. The complexity of obesity, encompassing diverse physiological, psychological, and social dimensions, suggests that not all instances of obesity should be considered a disease. Here’s why this nuanced approach is crucial for the healthcare industry.

Listening to some physicians talk about obesity and its treatment was eye-opening, giving the latest news about how new diet drugs lead to better outcomes in many areas. However, as I soon learned, “When you lose weight, myriad health problems start to improve, with some improving tremendously. So the moderator then asked, “Is it the drugs or the weight loss?”. The answer was, “Weight loss due to using these drugs.”

The session then turned to obesity and its dangers. I would say that the majority of HCPs felt obesity “was not a disease” but, relatively, a health issue caused by eating the wrong foods and not exercising.

Do doctors classify obesity as a disease?

The American Medical Association (AMA)Trusted Source recognizes obesity as a disease that involves geneticmetabolic, and behavioral aspects that require medical support. The decision was initially made in 2013 by Trusted Source and confirmed in 2023.

Despite a lack of consensus on the diagnostic criteria for obesity, the AMA stated it released this new definition to positively affect the healthcare system, public policies, and people living with obesity but the debate rages on.

1. The Spectrum of Obesity

Obesity is an excess accumulation of body fat, typically measured by the Body Mass Index (BMI). However, BMI is an imperfect metric. It does not account for muscle mass, bone density, or fat distribution, leading to potential misclassifications. For instance, athletes with high muscle mass may have a high BMI but low body fat and excellent health. Conversely, some individuals with normal BMI may have high body fat and associated health risks.

Recognizing obesity as a spectrum rather than a monolithic disease allows healthcare providers to focus on individual health metrics and risks rather than a single numerical value.

2. Differentiating Between Cause and Effect

Obesity can be both a cause and a symptom of various health conditions. It is associated with diseases such as type 2 diabetes, hypertension, and cardiovascular diseases. However, obesity can also be a symptom of underlying issues such as endocrine disorders, genetic conditions, or psychological factors like stress and depression.

By categorizing all obesity as a disease, there’s a risk of overlooking these underlying causes. A more differentiated approach encourages healthcare providers to investigate and address root causes rather than focusing solely on weight reduction.

3. Psychological and Social Implications

Labeling obesity as a disease can have significant psychological and social implications. It may lead to stigma and discrimination, affecting individuals’ self-esteem and mental health. This stigma can create barriers to seeking help and discourage individuals from engaging in healthy behaviors.

Moreover, societal attitudes towards body image and weight can influence the development of eating disorders and other mental health conditions. A more holistic view that considers the social and psychological dimensions of obesity can help mitigate these adverse effects.

4. Personalized Medicine and Individual Health

The rise of personalized medicine emphasizes the importance of individualized treatment plans. Not all individuals with obesity face the same health risks or respond similarly to treatments. Genetic, environmental, and lifestyle factors all play significant roles in how obesity affects an individual’s health.

Adopting a more personalized approach aligns with modern medical practices. It focuses on individual health profiles rather than a one-size-fits-all classification, which can lead to more effective and sustainable health outcomes.

5. Prevention and Public Health

Viewing obesity strictly as a disease may inadvertently shift focus away from prevention. Public health strategies should aim to create environments that promote healthy living, including access to nutritious foods, safe spaces for physical activity, and education about healthy lifestyles.

By emphasizing the preventive aspects and recognizing the multifaceted nature of obesity, healthcare providers can better address the root causes and contribute to long-term health improvements.

The classification of obesity as a disease is a complex issue with significant implications for healthcare. While obesity is undoubtedly a primary public health concern associated with various health risks, a nuanced approach that considers individual differences, underlying causes, and broader societal impacts is essential. The healthcare industry must move towards personalized, holistic strategies that address the multifaceted nature of obesity, promoting both physical and mental well-being.

Both psychological and physical issues can cause obesity, but it is my opinion that the majority of cases are simply because people overeat and don’t exercise. The new weight loss drugs are NOT the answer, as they could cost our healthcare system billions. The answer lies in a multitiered approach of behavior modification along with education.