Health

Should obesity be considered a disease?

In the last few decades, a debate has emerged on whether labeling obesity a disease was actually helping or hindering people with larger bodies

Rise of the Issue

Since 1960, the U.S. Center for Disease Control (CDC) has been tracking obesity based on the Body Mass Index (BMI). As obesity rates continued to climb year over year, obesity started to be viewed from a different angle. In 1998, the National Institute of Health was the first body in the U.S. to declare obesity as a disease, with The Obesity Society and the American Medical Association following suit in 2008 and 2013, respectively. The federal and state governments began exploring ways to address the issue of obesity, with most legislators leaning towards taking preventative measures by addressing nutritional education in schools.

At the same time, critics of the BMI system and proponents of body positivity began to fight back against the narrative, calling the labeling of obesity as a disease too harsh towards people suffering from it, and saying that BMI is an inadequate and inaccurate measure of health. Meanwhile, people in support of considering obesity to be a disease say that a health issue as serious as obesity needs to be addressed at its core, which can only be done by labeling it for what it is.

Issue Timeline

1998

National Institutes of Health (NIH) Declares Obesity a Disease

The NIH brings its body mass index (BMI) guidelines into line with the World Health Organization’s (WHO) guidelines, and declares that obesity is a disease.

2008

The Obesity Society (TOS) Publishes a White Paper

TOS publishes an expert-backed white paper on obesity, discussing its history, causes, and prevalence in the U.S., and declares that obesity is a disease.

2010

Healthy, Hunger-Free Kids Act Passes

Congress passes the Healthy, Hunger-Free Kids Act in an effort to reduce childhood obesity by ensuring that school meals are healthy, and high in nutritional value. The Act also reauthorizes federal funding for child nutrition programs.

2013

American Medical Association (AMA) Recognizes Obesity as a Disease

The AMA votes to recognize that obesity is a disease that requires both treatment and prevention. Several other health associations, including the American College of Cardiology and the American Heart Association, also supported the AMA in these findings.

Micro Issues

A.

Labeling’s Effects

While opponents say that emphasizing obesity as a disease reinforces shame and negatively impacts obese people, supporters say that raising awareness is crucial because obesity is an illness which poses a serious risk.

B.

Body Mass Index (BMI)

Supporters say that while BMI is not a perfect indicator of health, BMI when used in combination with other metrics and tests can give a relatively accurate picture of one’s health. Opponents say that BMI is an outdated and inaccurate measure of health, and it discriminates against people with larger bodies.

C.

Seeking Help

Supporters say that obesity being labeled a disease helps people take obesity and its negative consequences seriously and care for their health, while opponents say that it further discourages larger people to think that there is something they can do about it.

Pro Arguments

1.

The disease label helps in getting affordable treatment for obesity.

If obesity is labeled as a disease, it makes it easier and more likely for treatment to be covered by insurance companies or Medicare.

2.

Labeling obesity as a disease can help encourage people to seek help.

Without the disease label, obese people may feel like it isn’t that important of an issue. With the label, it will increase the likelihood of obese people seeking help from a doctor or nutritionist.

3.

Obesity is a serious health problem and should be treated as such.

The numbers over time have shown that obesity is an increasingly serious health problem in the U.S., and not labeling obesity as a disease would be doing a disservice to all those who have suffered from it.

4.

Labeling obesity as a disease emphasizes that it is not simply a matter of choice.

If obesity is not labeled as a disease, people may get the impression that obese people are that way by choice, rather than it being a health issue. The label helps to mitigate that stigma by reducing the association between obesity and negative traits such as laziness.

5.

Obesity can increase other physical ailments and illnesses.

Beyond the label, obesity can be both the cause and the result of other types of illnesses. While a correlation between obesity and other issues like diabetes, heart disease or strokes cannot systematically be made, studies have shown that obese people tend to be more prone to them.

Con Arguments

1.

BMI is not necessarily an accurate measure of health.

Obesity is a label that applies to any person above a certain weight, when weight has been shown to not be an accurate measure of one’s health. Instead, body fat, especially visceral fat, has been shown to be directly related to health issues such as cardiovascular diseases.

2.

Labeling obesity as a disease can potentially lead to discrimination.

People with obesity may be associated with having a disease, which may lead to discrimination against them. Without the label, there is less of a negative feeling attached to their condition.

3.

With a disease label, obesity may be viewed as a pre-existing condition by insurance.

If obesity is labeled as a disease, insurance companies may be more reluctant in offering coverage to obese people due to pre-existing conditions. Without the label, it may not be legal to do so.

4.

Labeling may reinforce the obesity shame cycle.

Studies have linked obesity with shame and depression, and obese people being labeled as such could trigger further feelings of shame which in turn can lead them to emotional eating as a coping mechanism, thereby doing more harm than good.

5.

Obesity could be related to trauma.

Some studies have shown that obesity isn’t always a genetic health issue, but can also be triggered by traumatic experiences. Labeling obesity a disease for these cases could then imply trying to treat a psychological issue by medical means.