10 Responses to “Is obesity a disease?”

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  1. avatar Louise says:

    Surely the definition of obesity is the most unsatisfying one here?

    As you correctly point out, weight is far from being the best measure of this. Body fat percentage (from a reliable method) would be a better and more accurate way to discern the obese, though I realise it is a harder number to come by.
    I wonder how many seemingly ‘healthy weight’ folks would be classed as overweight or obese if this measure was widely used?
    Before I became interested in health, nutrition and exercise, I was relatively slim (UK size 12), around 11 stone, but had a body fat percentage (as measured with a BodPod machine) of 35%. Now, even though I weigh a little more (11st 5lbs – at 5ft 7 I think I am technically – or very close to – ‘overweight’ by BMI standards) and I am a similar size, but due to turning to exercise and a good, ‘real food’, diet I am now 18% BF.

    Thanks Zoe – very interesting article (the only teeny critique I would have is that you cannot ‘turn body fat to muscle’ without the help of alchemy, but I get where you are going with that…!

  2. avatar Fiona says:

    Great article Zoe and interesting comments from your readers.

    My initial thoughts are that obesity is not a disease, it seems to be a consequence of addiction and bad advice. If the government did a u-turn on smoking, there is still hope for us :)

    Since reading your research, and more background reading myself, there are too many companies that make money out of our obesity to have any non-government help to fix the problem. The ones that manufacture the junk purported to be ‘healthy’, and the ones that produce drugs to make us feel more normal after eating the junk.

    I also agree that high BMI/obesity doesn’t have to impact health. I have bone problems (since I was a ‘normal’ child), but since I was about 20 have had BMI 48. In the last 10 years I’ve been identified with high BP, high cholesterol and more recently hypoglycaemia. Over that time, my BMI didn’t change… I know now what caused it. And like others, my statins are becoming redundant, but my GP isn’t interested in how I’ve done it. BMI still 48, and I’m coming out the other end ditching the conditions and the medications thanks to your work. I might just buy her a copy of your Obesity Epidemic. I’m certain she has no idea what causes high cholesterol, but she’s a wee skelf of a girl anyway… and thinks that keep telling me to eat the balanced plate will help *sigh*

    LIke all things when you are growing up, you can choose to take the advice offered to you – from parents, elders, NHS, government – but at the end of the day it’s YOUR body, and you only get one of them. Who do you listen to for feedback? The advice-givers? Or your body??

  3. avatar Ann says:

    Yes Obesity is a disease, but a very complex and serious one. Just think of the “big” diseases that can affect anyone of us – Arthritis, Asthma, Diabeties, these can be diagnosed and treated by the medical profession. But along comes Obesity. The Obese patient will, unlike other ill people, will have had years of people staring and making comments such as “Just stop eating” and slef confidence will have been replaced by self-loathing. Why do the vast majority of obese people not have full length mirrors in their homes? A question never taken seriously. The Obese patient seeking help will have a multiplex of conditions and will also need specialised counsilling. Obesity is a multi layered disease needing “Case Connference” type treatment crossing from general medicine to mental health to physical therapy and counselling. Not attacking obesity in this fashion is (in my uneducated opinion)part of the reaason that it is proving so difficult to treat.

  4. avatar Mark says:

    Paul energy balance isn’t static. The energy needs of an adolescent is much different when that person becomes an adult, this is well known. For the vast majority, with the exception of genetic outliers and it’s well established that exits, energy balance does matter.

  5. avatar Jessica says:

    But the NHS would argue that they advised people to the best of their belief. They would point to the teaching that they have had and say, “Look, it’s not our fault we were taught the wrong thing.”

    Is there any one person we can point to and say, “You saw these facts, but you chose to ignore them”? The government would say it relied on scientists, the scientists will say, “We gave you the facts”, the government will say, “We relied on you to interpret the facts” – I hope a good precedent has been set for smoking – we’re going to need it! I get most annoyed with the BBC when they put up stuff on “Have your say” and then don’t follow up comments like “Low carbing” works. I guess they believe all the “Fad diets don’t work” and so on. And “Embarrasing bodies” – have you seen the desperate stories on there? They make me so upset, these people begging for help from a programme which doesn’t.

    Anyway, back to the blinkered NHS, curiously, at my last doctor’s appointment, I as told that I had put on weight, and she had my weight a year ago as 92kg. I cannot think why the nurse would have that figure. My clothes are in the process of falling down, so I’ve definitely lost. My specialist told me I had lost weight from the last time he weighed me which was after the 92kg figure. I’m wondering if they have taken a bogus figure in an attempt to make it look as though low carbing doesn’t work. She was going to go through my diet and then checked herself by saying, “Oh, whatever you’re doing, it’s working” and didn’t. Interesting then that she isn’t asking questions like, “HOW are you doing that?” Doesn’t she want to know? Won’t it help her other patients?

  6. avatar Paul says:

    It is an interesting concept. Obesity is a symptom of an underlying issue, generally a hormonal issue to do with the disruption of insulin.

    I think Zoe would agree that the heavy promotion of carbohydrates since 1984 and the demonisation of fat has resulted in permanent damage to many peoples’ insulin receptors (including mine, which can only be kept under control by eating a high fat diet). That the damage is permanent can be observed by looking at a teenager who can eat anything without putting on weight, but suddenly in their twenties, they eat the same foods, but suddenly put on a lot of weight – so clearly not an energy balance question).

    It follows that if a large percentage of the population have done permanent and irreversible damage to themselves through avoiding saturated fat and eating what they were told to eat. There are then two issues:-

    1. A large proportion of the population has a chronic condition which is life-threatening, which I would conclude IS a disease; and

    2. The NHS may actually be responsible for the condition due to its advice

    The problem for the NHS is that, logically, it should treat obesity as a disease on clinical and moral grounds. BUT, an acceptance of obesity as a disease MAY eventually lead to legal action against the government if it accepts that the advice to eat more refined carbohydrates was clinically wrong.

    The problem with this is a measure of cognitive dissonance, where it (the NHS) thinks that obesity is a lifestyle choice, but at the same time, accepting that obesity has underlying chronic hormonal issues. This is explained by the fact that the NHS is not one ‘person’, but an organisation made up of many people, and the official advice on diet conflicts with the observation of those at the coal face dealing with obese people.

    My view is that obesity IS a disease, and within 15 years we will see lawsuits being prepared as it becomes increasingly apparent that the NHS conducted a massive health experiment on the population with no intervention study to back up the experiment.

  7. avatar Jessica says:

    But should we have it labelled a disease to try and get across the idea that at the moment, people can’t help being obese? I mean, I know that they can if they eat the correct diet, but trying to change 20 years of government brain washing is more painful than trying to put my head through a brick wall. In the meantime, people are treating the obese as a sub set of ‘human’. I can see money better spent on investigating obesity being diverted away from people who “just want to be fat” and research on type 2 diabetes being shifted onto more ‘deserving’ causes because type 2 is a ‘self-inflicted’ condition.
    If we could change the mental attitude to show that if you are convinced that low fat/high carb is the way to lose weight, you will be unable to avoid being fat, people out there would be less likely to throw around the “Lazy porkers” label….

  8. avatar Mark says:

    Zoe I enjoyed this piece and your arguments. My personal view with regards to obesity has been that it is primarilly a symptom. That is obesity is caused by chronic postivie energy balance that results in a hypertrophic response in the fat organ/adipocytes, that is or may be patholoigical. This pathological response results in the known disregulations and can lead to multiple diseased states. The single largest contributor to this disregulation is foods that are energy dense with low nutrient content and low in volume. However it’s much more complicated than that for some, that is known, but for those without what appears to be a genetic disorder that predisposes them to serious obesity, other factors are at play and I don’t think it takes rocket science to determine where the starting point is.

  9. avatar Tom Welsh says:

    I think the Merriam-Webster definition you cite includes a single word that might be interpreted as making obesity a “disease”. That word is “malnutrition”. Not in the sense of “inadequate calories”, to be sure. But malnutrition can also mean “inappropriate or unhealthy food”. In that sense, many people who slurp their carbs are malnourished in more ways than one. They may not be getting enough protein and fat; but also, if their metabolism is damaged, even what food they do eat may be going to build up their fat reserves rather than their other vital organs.

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