What do you think about obesity now being classified as a disease?

Two words, fat chance.

Like any new government initiative designed for the public good (and yes, private profit)—perhaps especially one involving healthcare—it needs time to be implemented before we have enough data to praise iit or trash it.

It brings attention to a real problem.

@Pachyderm_In_The_Room It’s not a government thing, it is the AMA, all doctors. And they know that obesity results in a lot of other problems. If it helps even one percent of obese patients change their lifestyle, it will be worth it.

I don’t know. I think people just need to learn how to control what they need to eat and how to eat it and when to.

Stop making bad choices. Cigarettes are bad, it’s not a disease before you start smoking but when you are a smoking, it becomes an addiction. Too many humans overindulge in too much stuff and don’t care about what they put into their body let alone what we are doing to the earth.

I think we really have all the anwers we just don’t want to change and old habits die hard.

I think it is too ‘big’ an umbrella to classify it as a disease on its own. I want to see people who get fat treated as sick, absolutely, but their reasons for getting fat will differ. Again, calling the symptom a disease and not identifying the reason for the illness because doctors are lazy.

Cool. I’m calling in sick today.

The causes and treatment of obesity are so little understood still that I think it is a very good thing to look at it as a disease. I have heard talks about how they now perceive insulin resistance as a cause rather than a result of obesity and that may effect some possible cures. We as a society so often blame the victim and our prejudice against obese people is one of the still acceptable prejudices. I am for something that can remove some of the stigma and deal with a huge (hmm) problem that affects all of society with its costs.

@janbb So are you saying you think classifying obesity as a disease will result in more research? Or, are you just saying doctors will look at it differently? Or, society at large?

@JLeslie I think it will result in more research.

@janbb Interesting. There already has been tons of research done. It kind of contradicts what @cazzie was saying. Although, she was particularly commenting on doctors I think, not research. Maybe you are right that even more funds will be thrown at obesity research now. I think we already know the answer. The average American diet has changed.

The whole insulin resitsance thing, it isn’t like our bodies have all changed in the last 40 years as obesity numbers have risen exponentially.

@JLeslie The talk I saw thought it was due to the high fructose content of most of our foods now.

I’d think many people would disagree because fat people “make themselves that way.” If they just stopped eating so much and exercising so little, they wouldn’t be so big, right? However, no one has a problem calling lung cancer a disease when many people do it to themselves by smoking when they know damn well that it’s not good for them.

Personally, I’m way more comfortable saying disease sometimes causes obesity and obesity sometimes causes disease than I would be calling obesity itself a disease. Now, a food addiction can be considered a disease, but food addiction does not necessarily equal obesity. The same with anorexia – it’s the behavior and mental state that defines the disease, not the condition of being underweight.

@janbb I don’t really believe that, but many people do, including medical doctors. They have done research on it. Still, that would be in line with going back to what our diets used to be.

My worry is people will even be more empowered to take less responsibility for their obesity of they can throw theor hands up and say they have a disease. But, if you are right, and we really clarify why people are getting fatter, then it will help people feel more empowered that changes they make will directly impact the scale.

@livelaughlove21 Interesting you brought up addiction, because I think some people take issue with calling addictions diseases.

@JLeslie Well, as a psychology major and someone who has seen addiction more than anyone should, I’d say those people don’t know what they’re talking about.

@livelaughlove21 I can see an argument for both points of view.

Excuse me, @zenvelo.

Like any new government initiative designed for the public good (and yes, private profit)—perhaps especially one involving healthcare—it needs time to be implemented before we have enough data to praise it or trash it.

@JLeslie That’s great for you and so can I, but only one makes any kind of sense to me. It’s easy for people who have never had an addiction to say it’s not a disease. I’ve actually never had an addiction myself, and I’ve been known to place a lot of weight on personal responsibility and free will in these situations. Others saying, “I can’t quit,” makes me want to roll my eyes and tell them that it’s their own fault they have this addiction in the first place and they’re incredibly weak if they can’t stop it. And they are incredibly weak if they are addicted, but whatever the addiction is has a hold on their mind and body and they truly feel as if they cannot stop. Perception is reality. If you have no control over your own behavior or thoughts, calling that a disease/disorder sounds about right. In their addicted little minds, they can’t walk away from the pipe or the pill just like a Type 1 diabetic can’t maintain a healthy blood glucose level without medical intervention.

I just take issue with people that have no experience in something thinking they know jack squat about how someone else feels and then feels free to say they don’t believe something like this is true. What the hell do they know? If people much smarter than you and I have decided, through tons of research, that something is a disease, then I’m not arrogant enough to say it’s not true when I honestly haven’t a clue about it.

Terrible idea, imo. As @JLeslie pointed out, I’m one of those people who doesn’t view addiction as a disease and that doesn’t make me clueless. I’ve grown up around addiction, my father being a chronic alcoholic & drug addict and brothers following suit. I respect that others have differing opinions regarding this, of course.
I believe that classifying obesity, like any other addiction, as a disease places the individual in a state of helplessness & lack of control, i.e. “Well, I can’t help it, I have a disease”. Labelling something like this as a disease can easily lead to victim-like mentality & I imagine this only perpetuates the vicious cycle of a negative attitude towards food & the self.
There’s more empowering ways for people to stand up and take control of their health and their lives.

@livelaughlove21 I am not saying addiction is not a real and difficult thing to cope with and beat, and I don’t think it is all lack of willpower or weakness. I think some people have brains more set up for addiction either from genetics or environmental influences. I don’t try to guess how difficult it is for an addict, I believe it is very difficult for them. I worked in a chemical addiction center for a while and I know a few people who are addicts, and how they cope with problems and see the world seems to be fairly different than how people who aren’t addicts see the world. It’s interesting. Different addictions seem to have different themes, but then also some common threads. Maybe you were not directing what you wrote at me, but just talking in generalities.

@stardust I don’t understand your point. I agree that calling something a disease may give people an excuse to take on a victim role. However, that being true doesn’t make something less of a disease. I had a cousin with fibromyalgia and she was very overweight, which made her pain so much worse. She had this mindset that she was in too much pain and under too much stress to try to lose weight because of her medical disorder, even though she knew she could alleviate a lot of that pain by shedding some pounds. That doesn’t mean fibromyalgia is not a disease or shouldn’t be called a disease. Many diseases lead to people using their condition as an excuse for not doing one thing or another, and that’s a shame, but it doesn’t mean we shouldn’t call whatever it is a disease.

@JLeslie No, I was not referring to you specifically.

@livelaughlove21 I don’t think obesity is a disease by any means. I think people may use food for a variety of emotional reasons & overeating can become habitual, etc, but that doesn’t make it a disease to me.
I believe it comes down to responsibility for oneself & making healthy choices.
This is just my own personal opinion.

I’d also like to add – there’s this school of belief backed by German psychiatrist Thomas Szasz that states that there is no such thing as mental illness. They say a disease or illness is something you can test for – something concrete. You cannot point at a brain scan and say, “there’s your bipolar disorder,” and therefore it is not really an illness, but a problem of living. These people don’t believe in medication for individuals with so-called mental illnesses because they view that as a way to control people to behave in a way society sees fit when, in reality, there’s nothing truly wrong with the person.

Now, this view truly fascinates me and learning about this really influenced my decision to study psychology. I agree with a lot of it, actually. If a person believes that mental illnesses are not actually illnesses, then I have no argument for that. However, if you believe schizophrenia or bipolar disorder are illnesses, as I do, then there’s no valid reason to think addiction is not an illness. It is a mental illness, according to the DSM, which is really the authority here.

Oh, and @stardust, I thought we were talking about addiction in general, not obesity specifically. I already stated that I’m not convinced obesity is a disease. It seems we’re discussing two different things here.

@livelaughlove21 Ah, okay. I think I may have picked you up incorrectly at points then.

As for the DSM being the authority, that manual is a prime example of how the lunatics are running the asylum. There’s a new disease/disorder conjured up every five minutes, which as we all know keeps the pharmaceutical industries ticking over nicely, but that’s a discussion for another day

I just skipped over a bunch of the conversation about “fat people did this to themselves/no they did not”. REGARDLESS of the cause, obesity is a disease. When you have it, it is the main cause of many other disorders that have a serious effect on your health. There are cardiovascular issues—like blood clots, heart attack and stroke, shortness of breath. Endocrine issues like type 2 diabetes. Even arthritis can be related to obesity.

It’s not some moral thing. It’s a physical thing. No matter how you became obese, you’re very likely to have a number of health problems directly related to it and it makes things easier for a doctor to treat you, the secondary health problems AND the obesity if it’s classified as a disease.

It also makes it easier for insurance companies to cover stuff. Like gastric bypass is dangerous and may be considered “an easy way out”—but for some people with morbid obesity, the state of their obesity is more dangerous to their health than the surgery. It’s not cosmetic—it’s about saving their heart and lungs that are in moderate to severe distress from the weight. It’s the same with weight loss programs or medication.

I seriously don’t get the argument going on here. You want to claim that hepatitis C or AIDS isn’t really a disease because people shot up drugs or had sex to get it and it’s “their fault” they got that way?

@keobooks Your answer is very interesting. You mention AIDS and Hep C as an analogy, but is it? I am just being devils advocate. The health problems related to obesity can be diagnosed and treated, same as being ill from AIDS. I don’t think it matters if something is secondary to a primary problem. I’m not sure that classifying something as a disease has to do with how someone acquires it.

Do you think psychologically it helps people to think they have a “disease.” most people who are obese don’t have endocrine or underlying health problems to explain their obesity.

I don’t care if the disease label helps anyone psychologically or not. It helps doctors and the healthcare industry classify and treat stuff. I am NOT going where the rest of this crazy train thread is headed.

@keobooks So, you think health insurance will now cover treatments when they possibly weren’t before? Is that your point? Or, you think doctors will take the issue more seriously?

I think doctors have always taken the issue seriously. I think insurance is more likely to cover weight loss programs and weight gain prevention programs. I think it’s easier to classify, prevent and treat the secondary health problems related to obesity once you classify the source of the problem—obesity.

The only possible benefit for the patient’s psyche I will concede to is that it may be easier to get someone to seek treatment if they understand that it’s not just a cosmetic or moral issue—it’s a disease that needs to be treated—some more aggressively than others. The doctor isn’t being mean or simply has a subjective opinion about your weight – the doctor is stating facts about BMI and secondary health concerns related to obesity.

I have never been overweight according to the charts, but my endocrinologist and GYN do comment on my weight gain and loss. Especially my weight loss with positive reinforcement. I don’t know how doctors handle obesity from my own first hand experience, but I do assume they already take it seriously. Your point about the psychological aspect for the patient is a good one. I don’t really know the mindset of that person. I think most people are obese either because they are bored, lonely, or grew up in a house where food consumption was screwed up.

If anyone must know I am obese myself. I have been thin or underweight most of my life and in the past few years, I rapidly gained over 100 pounds for “no reason”—very recently discovered that my body is producing too much cortisol. They haven’t discovered the cause of it yet—it could be a tumor in my pituitary gland or adrenal glands, or it could simply be a bad reaction to extremely high stress levels. Right now, I am being tested to see where the cortisol is coming from.

People started treating my weight gain differently when they found out it “wasn’t my fault”. To me, it doesn’t matter. I have several problems related to my weight that I would have regardless of the reason I am fat. If I just stuffed myself on cupcakes nonstop, I’d have the same shortness of breath and the same pounding heart when I went up the stairs. I’d have the same pain in my knees that comes from carrying around all this weight.

And aside from the possible surgery or cortisol blocking drugs I’ll be getting in a few months, the treatment I’ll be getting for weight loss will be IDENTICAL to someone who chowed down on 5000 calorie a day meals. Stopping the cortisol will only stop the rapid weight gain. It WILL NOT cause me to lose weight, as I hoped it would. I have to to the same excersizes and diet plan that a “normal” fat person will get.

The ONLY treat I get is that I get to be smug and tell people that the weight “isn’t my fault” but most people who see me will just assume that I’m some fatty slob who did it to myself. Does it really matter? If there is anyone out there who thinks I am somehow a better moral person because my fatness “isn’t my fault” when just a few months ago, it WAS medically considered “my fault”—well screw you. I’m the same person I always was regardless of how I got fat.

Honestly, I shouldn’t have to answer or give excuses to how I got fat. I have the exact same health problems as a “regular” fat person and both of us would likely see the doctors for the same secondary health reasons (except I have a lower chance of getting diabetes and high cholesterol)

@keobooks I don’t attach morality or anything specifically to people who are obese. My dad has been overweight, mostly obese, my entire life. He is a good, loving, intelligent man. So, I have no judgement, and assume nothing when I see someone who is overweight. My dad can’t “blame” anything physical that we know of for his weight gain. What I do know is it is a struggle for him, and his biggest concern is the health ramifications.

I wasn’t really talking about you. I just think this thread in general has been highlighting the fact that people don’t want obesity to be considered a disease because people “did it to themselves.”

I don’t think it matters. The main thing is that when you are obese, you have a certain set of health problems. It’s easier to classify them—edema related to obesity—cardiovascular disease related to obesity etc.. if they have a disease as the underlying cause. It’s easier to get funds to prevent and treat obesity if it’s classified as a disease.

I don’t care why someone is fat. I do care about what sort of secondary health conditions they have because of it.

Oh and if I have a tumor—it’s called Cushing’s Disease. if I don’t have a tumor, it’s just stress related obesity. And probably tons of people (no pun intended) have that and just haven’t been diagnosed. Most people don’t get their cortisol levels tested and the blockers don’t work that well—and not reacting well to stress could be considered “my fault”.

@keobooks But, the secondary health issues have their own health codes anyway. My dad’s obesity is probably partly related to his heart disease, not classifying obesity as a disease didn’t hamper getting his Lipitor or heart bypass surgery. However, drugs specifically to lose weight might need the obesity health code? An endocrine drug I would think can be given as long as there is evidence of an endocrine issue.

I’m not arguing here, I am genuinely curious how it will affect insurance, doctors, researchers and the patients.

I think what is very different about you and my dad, is my dad for sure eats for some psychological reasons, so just treating him for physical problems probably is not his cure. I do wonder if a psych drug might be helpful.

Considering that many psych drugs out there have weight loss as a side effect, it might help him in more ways than one!

I don’t know exactly how it will help—except I think of how many weight loss programs in my own health insurance program have to have a name like “diabetes prevention” or “cardiovascular health”—when they could just be weight loss or obesity prevention.

@keobooks Another interesting point you make, I agree obesity prevention seems like it should be enough.

I have a friend who started taking Prozak 20 years ago and lost 80 pounds in a few months. She said it was the first time in years she felt like her normal self again. She still bounces up and down a little with her weight, but overall she has it under much more control. I also see that the last few years she is enjoying her life more. I think her weight is directly reated to her mood, and I think the psych drugs also might address some sort of compulsive behavior maybe? Or, just reduce her hunger. Not sure what is at work there. I know for me, I eat more if I am bored or lonely. Switching to a more plant based diet has helped control my weight more though. Still, I need to address some issues in my life. I hope doctor’s don’t just jump to prescribing meds with this new classification. I think a lot of people have weight gain for psychological reasons. I hope they spend a little time talking to the patient, rather than just running blood tests.

It seems to me that it would be more accurate to call it a symptom or even a syndrome. It’s not a disease in itself, i.e. it is not the result of a specific and knowable organ or organ system dysfunction.

It can be caused by many variables and their intersections—diet, genetics, depression, alcohol use, insulin resistance and/or various types of diabetes, physical injuries/disabilities that prohibit exercise, etc…

@keobooks is exactly what I was talking about with my first post. Weight gain is a symptom, first and foremost and it should be treated as such and attention needs to be paid for how and when the weight is put on. The other thing is when a young person is obese, has always been chubby, grows up with a weight problem, there is usually a psychological reason behind it. Obesity isn’t a disease. In the majority of cases it is a symptom, but doctors and treatment specialists are lazy and they only want to see things in black and white. People with this problem should NOT be discounted and simply lumped together. Let us not discount the eaters who are trying to put a barrier between themselves and their abusers, because that is another sort of psychological eating disorder. What about the woman who started eating when she got pregnant and just never stopped because of the horrible empty feeling she was left with….. (post-partum depression, perhaps…) Over eating, carrying too much weight… it is much more complex than to simply give it an umbrella diagnosis. It needs to be treated. Obese people can not function as well as they should in their environment. We don’t need more electric mobile chairs just because they are too fat. It is NOT OK that their bodies have gotten to that point and they should not be complacent and give up or give in. They are morbidly ill and they need to be treated.

Obesity has been a diagnosis for years.

I think it’s important to be able to give a diagnosis. A diagnosis of obesity allows practitioners to be aware of potential secondary diagnoses without even looking at the patient.

Posted before reading Responses. I’m pretty much on the same page as @keobooks

Obesity was part of the old ICD-9 published by the WHO in 1978.

http://en.wikipedia.org/wiki/List_of_ICD-9_codes_240-279:_endocrine,_nutritional_and_metabolic_diseases,_and_immunity_disorders#Obesity_and_other_hyperalimentation

It is clearly a disease, like nicotine or alcohol addiction. People need help and support. And we need to find ways to prevent overweight people from getting obese. Overweight people need to take responsibility.