Is Obesity A Disease?

This isn't as simple a question as it might appear, because the answer has a cascading effect in terms of implications. For example, if obesity were classified as a disease, it could take much of the stigma away from being severely overweight, make it easier to get treatment, could help provide insurance coverage for people grappling with weight problems, and could even speed up the approval of new diet drugs.

However, for many of these positives there also are negatives. For example, if insurance companies were forced to cover people's efforts to reduce their weight, this could increase insurance premiums and the already skyrocketing cost of health care in the US. Opponents of classifying obesity as a disease say that it is just a risk factor, not a disease, and that such a formal shift in how it is viewed could actually divert resources from legitimate diseases.

Besides these issues, it is interesting to see how people respond to this question on a personal level. We've been gathering opinions about this issue from a number of different sources over the past week or so, and the debate is almost polarizing.

One person told us, "Obesity is not a 'disease.' It is a product of confusion and misinformation."

And another said, "We all control 100% of the calories that we ingest and of the time that we spend exercising. If I carry too many pounds, it's my choice, but not a disease."

And yet another person we spoke with said, "If people think that obesity is really a disease and it should be treated that way, just wait until we get the newest rate increases in health insurance. Among other factors as we already know, people hop from one "answer" or fad to another, and even after losing weight, they gain it back and do something again to bring it down. Usually when one has a disease, there is, hopefully, a cure. Personal responsibility is the only cure for obesity, coupled with common sense. Tie obesity into health issues, which the insurance companies will have to support in trying to combat it, and our health system will break down under the burden."

Those seem like persuasive arguments…but there is another side.

"Isn't Bulimia a 'real' disease?" asked one person. "How about Anorexia? These diseases revolve around bad food choices or lack thereof and distortions of self image. Both of these factors seem to be very involved with obesity. People die from Anorexia, from Bulimia AND Obesity - often helplessly. They are just as "real" as cancer. Ask anyone who's had a relative or friend die from an eating disorder."

Someone else we spoke with suggested that obesity is a disease in the same way that alcoholism is a disease. (And it wasn't that many years ago that alcoholism was considered a matter of choice and/or personal weakness.) This person, who happens to be an alcoholic, said that he could not have gotten the treatment and support he needed if his condition had not been classified and treated as a serious disease.

Also very persuasive arguments.

This is a serious issue, and not one that should be politicized or trivialized. After all, there are millions of lives at stake in how and what decision is made.

It strikes us that at some level, the argument is between fiscal prudence and unrestrained compassion…and we're not sure that either one makes sense in a vacuum. We do believe that by classifying obesity as a disease, it may bring important and necessary attention to this serious American health issue…but that it must be done in such a way that does not bankrupt an already fragile health care system.

by Kevin Coupe